Evaluation of QFT-Plus supernatant as a diagnostic tool for tuberculosis and identification of a novel biomarker in tuberculosis

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K08461
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 54030:Infectious disease medicine-related
• Research Institution: Tokyo National Hospital (Clinical research)
• Principal Investigator: Nagai Hideaki 独立行政法人国立病院機構東京病院(臨床研究部), 感染症科, 感染症科部長 (30510391)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: QFT-Plus / cytokines / QFT-GIT / IFN-γ / IP-10

Outline of Final Research Achievements

QuantiFERON (QFT)-Plus contains Mycobacterium tuberculosis-specific antigens that differ from those in conventional QFT-GIT, and thus, it is expected to be more efficient in diagnosing active tuberculosis (TB) in immunocompromised or elderly patients. In this study, we compared the efficacy of QFT-GIT, QFT-Plus, and T-SPOT.TB in diagnosing active TB, and quantified the levels of multiple cytokines in the supernatant of QFTs. QFT-Plus, QFT-GIT, and T-SPOT.TB exhibited similar levels of sensitivity and specificity in diagnosing active TB. Moreover, the results indicated that the QFT-plus antigen is equivalent or slightly inferior to the QFT-3G antigen in eliciting cytokine production. The ROC for diagnosing active TB exhibited the highest AUC when the level of IP-10 in the QFT supernatant was used. Significantly higher levels of IFN-γ, IP-10, IL-1RA, MCP-1, IL-2, and MIP-1β were observed in the QFT supernatant of samples from patients with active TB than in that from healthy subjects.

Free Research Field

感染症内科

Academic Significance and Societal Importance of the Research Achievements

新世代の結核診断法QFT-Plusの有用性が示唆されたことは結核診療に有用である。また、活動性結核で有意に高いQFT残血漿中サイトカインを見出したことは、これらのサイトカインが活動性結核の病態形成に寄与している可能性を示唆しており、新規病態解明につながる。これらサイトカインのバイオマーカーとしての臨床応用も含め更なる検討が必要である。