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首页 » 组学 » Lancet Infect Dis:开发出针对儿童的新型高特异性的肺结核血液检测技术

Lancet Infect Dis:开发出针对儿童的新型高特异性的肺结核血液检测技术

来源:生物谷 2014-09-03 08:54

2014年9月3日 讯 /生物谷BIOON/ --9月1日,一项发表在国际杂志Lancet Infectious Diseases上的研究报告中,来自瑞士的科学家通过研究开发了一种新型可靠的、针对儿童的高特异性的肺结核血液检测技术;这种新型的名为TAM-TB实验的检测技术是第一个可以用于检测阳性肺结核儿童的可靠免疫诊断法,其具有较高的特异性,可以对儿童是否患肺结核进行快测检测。

儿童患肺结核是全球一项比较严重的健康问题,尤其是在资源较为缺乏的国家里,全球每年大约有100万儿童会患上肺结核,但不幸的是,针对儿童的肺结核诊断手段却未能及时开发出来。

这种新型的TAM-TB实验检测技术是一种不依赖于痰液的血液检测手段,其主要利用免疫学原理来进行检测和判断,当患者处于活性感染期间,在分枝杆菌特定的CD4+ T细胞上表达的标志物CD27往往会缺失,利用标准的细胞内细胞因子染色步骤及多色流式细胞仪检测技术,这种新型检测技术就可以在对血液样本分析24小时后给出可靠的结果。

研究者表示,目前这种新型检测技术可以用于评估坦桑尼亚等肺结核高度流行地区,这种新型检测技术的快速及可靠性使其可以潜在地改善活动性结核儿童患者的诊断结果,为下一步制定这种类型患儿的治疗策略会带来极大的帮助。

后期,研究者们将会对这种检测技术进行优化,研究者希望其也可以应用于HIV感染的儿童身上,从而帮助减少这些患儿的家庭负担;研究者的最终目标是开发一种可靠、快速、非侵入型的诊断技术来对活跃期肺结核患儿进行诊断,这将会对一些肺结核高度流行的国家带来实质性的帮助。(生物谷Bioon.com)

Assessment of the novel T-cell activation marker—tuberculosis assay for diagnosis of active tuberculosis in children: a prospective proof-of-concept study

Damien Portevin PhD a b, Felicien Moukambi MSc c d, Petra Clowes MD c d, Asli Bauer PhD c d, Mkunde Chachage PhD c, Nyanda E Ntinginya MD c, Elirehema Mfinanga MD f, Khadija Said MD f, Frederick Haraka MD f, Andrea Rachow MD d e, Elmar Saathoff PhD d e, Maximilian Mpina MSc f, Levan Jugheli PhD a b f, Fred Lwilla PhD f, Prof Ben J Marais FCPaed g, Prof Michael Hoelscher FRCP d e, Prof Claudia Daubenberger DVM a b, Dr Klaus Reither MD a b f †, Dr Christof Geldmacher PhD d e †

Background The diagnosis of paediatric tuberculosis is complicated by non-specific symptoms, difficult specimen collection, and the paucibacillary nature of the disease. We assessed the accuracy of a novel immunodiagnostic T-cell activation marker—tuberculosis (TAM-TB) assay in a proof-of-concept study to identify children with active tuberculosis. Methods Children with symptoms that suggested tuberculosis were prospectively recruited at the NIMR-Mbeya Medical Research Center in Mbeya, and the Ifakara Health Institute in Bagamoyo, Tanzania, between May 10, 2011, and Sept 4, 2012. Sputum and peripheral blood mononuclear cells were obtained for Mycobacterium tuberculosis culture and performance assessment of the TAM-TB assay. The children were assigned to standardised clinical case classifications based on microbiological and clinical findings. Findings Among 290 children screened, we selected a subgroup of 130 to ensure testing of at least 20 with culture-confirmed tuberculosis. 17 of 130 children were excluded because of inconclusive TAM-TB assay results. The TAM-TB assay enabled detection of 15 of 18 culture-confirmed cases (sensitivity 83·3%, 95% CI 58·6—96·4). Specificity was 96·8% (95% CI 89·0—99·6) in the cases that were classified as not tuberculosis (n=63), with little effect from latent tuberculosis infection. The TAM-TB assay identified five additional patients with highly probable or probable tuberculosis, in whom M tuberculosis was not isolated. The median time to diagnosis was 19·5 days (IQR 14-45) for culture. Interpretation The sputum-independent TAM-TB assay is a rapid and accurate blood test that has the potential to improve the diagnosis of active tuberculosis in children. Funding European and Developing Countries Clinical Trials Partnership, German Federal Ministry of Education and Research, and Swiss National Science Foundation.

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