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Evaluation of immunological markers for the diagnosis of active and latent tuberculosis.

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  • Additional Information
    • Author(s):
    • Address:
      Welandersalen, B2, plan 0. Karolinska University Hospital, Solna, Sweden.
    • Publication Information:
      Sweden
    • Abstract:
      The objective of the article was to identify novel biomarkers to distinguish the different stages of infection, from latency to active disease and thereby identify individuals in need of treatment. FASCIA analysis with PPD and Mtb antigens was proved to be a robust assay with similar sensitivity and specificity as compared with IGRAs. The overall sensitivity for verified active TB was 86% and for latent TB 61%. FASCIA results were concordant with IGRA results in 90% of active TB cases and in 80% of individuals with LTBI. Stronger and more frequent proliferative CD4+ responses were induced in patients with extra-pulmonary TB compared to pulmonary TB. FASCIA performed well in patients with moderate immunosuppression. It was demonstrated that cytokine levels were significantly higher after stimulation with CFP-10 and ESAT-6 in individuals with verified TB, compared to healthy controls. The chemokine IP-10 levels after stimulation with antigens CFP-10/ESAT-6 showed a significantly higher sensitivity compared to IFN-gamma responses in individuals with active TB. A mathematical model was also developed using clinical and epidemiological data to estimate the probabilities of recent and remote latent TB. A prediction model was developed where the most specific markers for prediction of recent infection were early (<1 month) high proliferative CD4+ responses to CFP-10 and PPD and low responses to ESAT-6 in contacts to verified pulmonary TB. The findings from the studies indicate that positive predictive values for incipient TB in Mtb assays can be improved and aid clinicians in targeting those in need of treatment to prevent disease and further transmission of active TB, as well as avoid unnecessary costs and adverse events.
    • Subject Terms:
      Public Health
    • Subject Terms:
    • Accession Number:
      latency, positive predictive value, predictive value, immunochemical markers, adverse reactions, antigenicity, immunogens, biomarkers, CD4, antivirals
    • CABICODES:
      Prion, Viral, Bacterial and Fungal Pathogens of Humans (VV210) (New March 2000)
      Human Immunology and Allergology (VV055) (New March 2000)
    • Publication Information:
      Thesis; URL:https://openarchive.ki.se/xmlui/handle/10616/46564
    • Accession Number:
      20203185697
    • Copyright:
      ©2019 CAB International
  • Citations
    • ABNT:
      BORGSTRÖM, W. E. Evaluation of immunological markers for the diagnosis of active and latent tuberculosis. 2019. Karolinska Institutet, Stockholm; Sweden, 2019. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697. Acesso em: 23 set. 2020.
    • AMA:
      Borgström WE. Evaluation of immunological markers for the diagnosis of active and latent tuberculosis. Evaluation of immunological markers for the diagnosis of active and latent tuberculosis. 2019:74. Accessed September 23, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697
    • APA:
      Borgström, W. E. (2019). Evaluation of immunological markers for the diagnosis of active and latent tuberculosis [Karolinska Institutet]. In Evaluation of immunological markers for the diagnosis of active and latent tuberculosis (p. 74).
    • Chicago/Turabian: Author-Date:
      Borgström, W. E. 2019. “Evaluation of Immunological Markers for the Diagnosis of Active and Latent Tuberculosis.” Evaluation of Immunological Markers for the Diagnosis of Active and Latent Tuberculosis. Stockholm; Sweden: Karolinska Institutet. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697.
    • Harvard:
      Borgström, W. E. (2019) Evaluation of immunological markers for the diagnosis of active and latent tuberculosis, Evaluation of immunological markers for the diagnosis of active and latent tuberculosis. Karolinska Institutet. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697 (Accessed: 23 September 2020).
    • Harvard: Australian:
      Borgström, WE 2019, ‘Evaluation of immunological markers for the diagnosis of active and latent tuberculosis’, Karolinska Institutet, Stockholm; Sweden, Evaluation of immunological markers for the diagnosis of active and latent tuberculosis, p. 74, viewed 23 September 2020, .
    • MLA:
      Borgström, W. E. “Evaluation of Immunological Markers for the Diagnosis of Active and Latent Tuberculosis.” Evaluation of Immunological Markers for the Diagnosis of Active and Latent Tuberculosis, Karolinska Institutet, 2019, p. 74. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697.
    • Chicago/Turabian: Humanities:
      Borgström, W. E. “Evaluation of Immunological Markers for the Diagnosis of Active and Latent Tuberculosis.” Evaluation of Immunological Markers for the Diagnosis of Active and Latent Tuberculosis. Karolinska Institutet, 2019. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697.
    • Vancouver/ICMJE:
      Borgström WE. Evaluation of immunological markers for the diagnosis of active and latent tuberculosis [Internet]. Evaluation of immunological markers for the diagnosis of active and latent tuberculosis. [Stockholm; Sweden]: Karolinska Institutet; 2019 [cited 2020 Sep 23]. p. 74. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20203185697