Diagnosis of Mycobacterium tuberculosis Infection using Ex-vivo interferon-gamma Assay

체외 Interferon-gamma 검사를 이용한 결핵감염의 진단

  • Lee, Jung Yeon (Division of Pulmonary Medicine, Department of Internal Medicine, Konkuk University Medical Center) ;
  • Shim, Tae Sun (Division of Pulmonary & Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • 이정연 (건국대학교 의료원 충주병원 호흡기내과) ;
  • 심태선 (울산대학교 의과대학 서울아산병원 호흡기내과)
  • Published : 2006.05.30

Abstract

Until recently, the tuberculin skin test (TST) has been the only tool available for diagnosing a latent TB infection. However, the development of new diagnostic tools, using the Mycobacterium tuberculosis (MTB)-specific early secreted antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) antigens, should improve the control of tuberculosis (TB) by allowing a more accurate identification of a latent TB infection (LTBI). Antigen-specific interferon-gamma ($IFN-{\gamma}$) assays have greater specificity in BCG-vaccinated individuals, and as less biased by nontuberculous mycobacterial infections. Many comparative studies have suggested that those assays have a higher specificity than the TST, and the sensitivity of these assays are expected to remarkably improved if more MTB-specific antigens can become available. Nevertheless, the major obstacle to the widespread use of these tests is the limited financial resources. Similar to other diagnostic tests, the predictive value of $IFN-{\gamma}$ assays depends on the prevalence of a MTB infection in the population being tested. Therefore, prospective studies will be meeded to establish the applicability of these new assays at multiple geographic locations among patients of different ethnicities, and to determine if the $IFN-{\gamma}$ responses can indicate those with a high risk of progressing to active TB.

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