Is secretion of IFN‐gamma in response to Mycobacterium tuberculosis antigens in youngest children sufficient to play a role in TB diagnostics?. Issue 2 (14th November 2017)

• Record Type: Journal Article
• Authors: Bielecka, Teresa; Komorowska‐Piotrowska, Anna; Krenke, Katarzyna; Feleszko, Wojciech; Kulus, Marek
• Is Part Of: Pediatric pulmonology. Volume 53:Issue 2(2018)
• Page Start: 181
• Page End: 188
• Publication Date: 2017-11-14
• Subjects: IFN‐gamma response -- M. tuberculosis antigens -- M. tuberculosis infection -- TB diagnostics -- youngest children; Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.23910
• Languages: English
• ISSNs: 8755-6863

Abstract

Abstract: Objectives: To assess whether children ≤5 years of age, produce sufficient amounts of interferon gamma (IFN‐ɣ) in response to phytohaemagglutinin (mitogen), and Mycobacterium tuberculosis antigens (TB antigens) in the QuantiFERON‐TB Gold in‐Tube test (QFT‐GIT), (Cellestis Ltd., Australia). Working hypothesis: Is TB‐antigen‐induced IFN‐ɣ response in children ≤5 years sufficient to consider QFT‐GIT a possible tool for TB diagnostics? Study design, patient‐subject selection, and methods: We recruited children 0‐17 years old suspected of TB infection to this cross‐sectional study, in whom QFT–GIT and TST were performed. We analyzed the median IFN‐ɣ levels in mitogen and TB antigen tubes in children ≤5 years and >5 years, and the correlation between IFN‐ɣ level in both tubes and age. Results: A total of 153 children were enrolled, age median was 7.8 (IQR:8), 45 (29.4%) aged ≤5 years (median 3.4, IQR:1.7), 108 > 5 years (median 10.55, IQR:5.93). In the mitogen tubes, the median IFN‐ɣ level was higher in children >5 years (median 17.87, IQR:2.1 vs 16.77, IQR:7.6), but surprisingly in the TB antigen tubes it was higher in the younger group (median 0.12, IQR:0.21vs 0.06, IQR:0.09, P = 0.04). We proved a positive correlation between IFN‐ɣ level and age in mitogen tubes ( r = 0.18, P = 0.03) and a negative correlation in TB antigen tubes ( r = −0.17, P = 0.04). In latent tuberculosis infection patients, the latter correlation was found to be even stronger ( r = −0.39, P = 0.01). Conclusions: The youngest children release sufficient amount of IFN‐ɣ in response to TB antigens thus QFT‐GIT might be a useful tool for TB diagnostics in this age group.