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Diagnostic Accuracy of Interferon Gamma-Induced Protein 10 mRNA Release Assay for Tuberculosis

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  • Thomas Blauenfeldt
  • Raquel Villar-Hernandez
  • Esther García-García
  • Irene Latorre
  • Line Lindebo Holm
  • Beatriz Muriel-Moreno
  • Maria Luiza De Souza-Galvão
  • Joan Pau Millet
  • Fina Sabriá
  • Adrián Sánchez-Montalva
  • Juan Ruiz-Manzano
  • Jose Pilarte
  • María A Jiménez
  • Carmen Centeno
  • Carmen Torres
  • Israel Molina-Pinargote
  • Yoel D González-Díaz
  • Javier Santiago
  • Adela Cantos
  • Cristina Prat
  • Peter Andersen
  • Jose Dominguez
  • Morten Ruhwald
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Interferon gamma (IFN-γ) release assays (IGRAs) are increasingly used to test for latent tuberculosis (TB) infection. Although highly specific, IGRAs have a relatively high false-negative rate in active TB patients. A more sensitive assay is needed. IFN-γ-induced protein 10 (IP-10) is an alternative biomarker with a 100-fold-higher expression level than IFN-γ, allowing for different analysis platforms, including molecular detection. The PCR technique is already an integrated tool in most TB laboratories and, thus, an obvious platform to turn to. In this case-control study, we investigated the diagnostic sensitivity and specificity of a molecular assay detecting IP-10 mRNA expression following antigen stimulation of a blood sample. We included 89 TB patients and 99 healthy controls. Blood was drawn in QuantiFeron-TB gold in-tube (QFT) assay tubes. Eight hours poststimulation, IP-10 mRNA expression was analyzed, and 20 h poststimulation, IP-10 and IFN-γ protein plasma levels were analyzed using an in-house IP-10 enzyme-linked immunosorbent assay (ELISA) and the official QFT ELISA, respectively. The IP-10 mRNA assay provided high specificity (98%), sensitivity (80%), and area under the concentration-time curve (AUC) (0.97); however, the QFT assay provided a higher overall diagnostic potential, with specificity of 100%, sensitivity of 90%, and AUC of 0.99. The IP-10 protein assay performed on par with the QFT assay, with specificity of 98%, sensitivity of 87%, and AUC of 0.98. We have provided proof of high technical performance of a molecular assay detecting IP-10 mRNA expression. As a diagnostic tool, this assay would gain from further optimization, especially on the kinetics of IP-10 mRNA expression.

Original languageEnglish
JournalJournal of Clinical Microbiology
Volume58
Issue number10
ISSN0095-1137
DOIs
Publication statusPublished - 22 Sep 2020

    Research areas

  • IP-10, diagnosis, mRNA, qPCR, tuberculosis

ID: 60588456