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Published online before print August 6, 2008, 10.1183/09031936.00055508
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Eur Respir J 2008; 32:1607-1615
Copyright ©ERS Journals Ltd 2008

Evaluating the potential of IP-10 and MCP-2 as biomarkers for the diagnosis of tuberculosis

M. Ruhwald1,2, T. Bodmer3, C. Maier3, M. Jepsen1, M. B. Haaland2, J. Eugen-Olsen2, P. Ravn2,4 on behalf of TBNET

1 Dept of Infectious Diseases, 2 Clinical Research Centre, Copenhagen University, Hvidovre Hospital, Hvidovre, 4 Dept of Medicine, Unit for Infectious Diseases, Copenhagen University, Herlev Hospital, Herlev, Denmark, 3 Institute for Infectious Diseases, University of Berne, Berne, Switzerland.

CORRESPONDENCE: M. Ruhwald, Dept of Infectious Diseases 144, Copenhagen University, Hvidovre Hospital, 2650 Hvidovre, Denmark. Fax: 45 36323405. E-mail: mruhwald{at}mail.dk

Keywords: Diagnosis, interferon-{gamma}, interferon-{gamma} release assay, tuberculosis, whole blood

Received: April 12, 2008
Accepted July 24, 2008

The aim of the present study was to evaluate the potential of diagnostic tests based on interferon-{gamma} inducible protein (IP)-10 and monocyte chemotactic protein (MCP)-2, and compare the performance with the QuantiFERON TB® Gold In-Tube (QFT-IT; Cellestis, Carnagie, Australia) test.

IP-10 and MCP-2 were determined in supernatants from whole blood stimulated with Mycobacterium tuberculosis-specific antigens. Samples were obtained from 80 patients with culture- and/or PCR-proven tuberculosis (TB), and 124 unexposed healthy controls: 86 high school students and 38 high school staff. IP-10 and MCP-2 test cut-offs were established based on receiver operating characteristic curve analysis.

TB patients produced significantly higher levels (median) of IP-10 (2158 pg·mL–1) and MCP-2 (379 pg·mL–1) compared with interferon (IFN)-{gamma} (215 pg·mL–1). The QFT-IT, IP-10 and MCP-2 tests detected 81, 83 and 71% of the TB patients; 0, 3 and 0% of the high school students and 0, 16 and 3% of the staff, respectively. Agreement between tests was high (>89%). By combining IP-10 and IFN-{gamma} tests, the detection rate increased among TB patients to 90% without a significant increase in positive responders among the students.

In conclusion, interferon-{gamma} inducible protein-10 and monocyte chemotactic protein-2 responses to Mycobacterium tuberculosis-specific antigens could be used to diagnose infection. Combining interferon-{gamma} inducible protein-10 and interferon-{gamma} may be a simple approach to increase the detection rate of the Mycobacterium tuberculosis-specific in vitro tests.







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Copyright © 2008 by the European Respiratory Society.