Infect Chemother.  2011 Jun;43(3):245-250. 10.3947/ic.2011.43.3.245.

Serial Testing of T-SPOT.TB Assays with Anti-Tuberculosis Therapy in Patients with Extrapulmonay Tuberculosis

• Park KH
• Cho OH
• Ko GB
• Lee Y
• Park HJ
• Park SY
• Moon SM
• Chong YP
• Lee SO
• Choi SH
• Kim YS
• Woo JH
• Kim SH

• KMID: 2170345
• DOI: http://doi.org/10.3947/ic.2011.43.3.245

Abstract

BACKGROUND
Limited data are available for the clinical utility of serial interferon-gamma producing T-cell response after initiation of treatment in patients with extrapulmonary tuberculosis (TB). We studied the serial TB-specific antigen T-cell responses measured using the T-SPOT.TB assay during the course of therapy.
MATERIALS AND METHODS
We prospectively enrolled adult patients who were newly diagnosed with active extrapulmonary TB over a 24-month period. All patients were given standard anti-TB treatment. Blood samples were obtained for T-SPOT.TB at diagnosis, as well as 1-, 3-, 6-, and 12-months after initiating anti-TB therapy.
RESULTS
A total of 52 patients with extrapulmonary TB (38 confirmed and 14 probable TB) were included in the final analysis. All patients had clinical and radiologic improvement after treatment and cured. T-SPOT.TB was positive for 90% at diagnosis, 100% at 1-, 3-, and 6-months, and 93% at 12-months after initiation of anti-TB therapy. There was no significant difference in median T-cell response between early secreting antigenic target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10) at all time points. Median T-cell response steadily increased up to 6 months and then decreased.
CONCLUSIONS
T-SPOT.TB assay remained positive after successful anti-TB treatment in most patients with extrapulmonary TB. Our data suggests that serial T-SPOT.TB has limited clinical utility as a surrogate marker of treatment response in patients with extrapulmonary TB.

Keyword

Tuberculosis; Enzyme-linked immunosorbent assay

MeSH Terms

Adult
Biomarkers
Enzyme-Linked Immunosorbent Assay
Humans
Interferon-gamma
Prospective Studies
T-Lymphocytes
Tuberculosis
Interferon-gamma

Figure

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  Figure 1 Serial change of IFN-gamma producing T cell response in all patients with extrapulmonary tuberculosis (n=52) (A) and in the subgroup with confirmed extrapulmonary TB (n=28) (B) ESAT-6, early secreting antigenic target-6; IFN, interferon; TB, tuberculosis; PBMC, peripheral blood mononuclear cell; CFP-10, culture filtrate protein-10.

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