PT  - JOURNAL ARTICLE
AU  - Lee, Jaehee
AU  - Kim, Eun Jin
AU  - Yoo, Seung Soo
AU  - Lee, Shin Yup
AU  - Cha, Seung Ick
AU  - Park, Jae Yong
AU  - Kim, Chang Ho
TI  - Application of intracellular cytokine flow cytometry in the diagnosis of active tuberculosis
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P428
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P428.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P428.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Background: Intracellular cytokine flow cytometry (ICCFC) has been introduced to detect the T cell response to M. tuberculosis antigen (MTB Ag) to overcome the limits shown by whole-blood interferon-gamma (IFN-γ) release assays (IGRA). Given the important role of CD4+T cells as well as IFN-γ and TNF-α in pathogenesis of TB, we compared the diagnostic accuracy between ICCFC measuring frequencies of MTB-specific Ag stimulated IFN-γ+TNF-α+CD4+T cells and IGRA to confirm the usefulness of application of ICCFC for TB diagnosis in clinical practice.Methods: Both QuantiFERON® TB Gold In-Tube (QFT-IT) test and ICCFC analysis were performed in 80 patients who were suspected of having pulmonary TB or TB pleurisy and 10 controls with no known exposure to TB.Results: (1) Sixty one and 19 out of total 80 patients were diagnosed with active TB and non-TB, respectively. (2) Double IFN-γ+TNF-α+CD4+T cells among all T cell subsets analyzed by ICCFC showed the highest sensitivity (90%) for diagnosis of TB. (3) Sensitivity of QFT-IT test and ICCFC assay were 77% and 90%, respectively (p = 0.021). (4) Specificity of QFT-IT and ICCFC assay were 73.7% and 89.5%, respectively. (5) There was a good correlation between the quantitiy of IFN-γ, as detected by the QFT-IT test, and the freqeunceis of IFN-γ+TNF-α+CD4+T cell measured by the ICCFC assay in TB patients (p=0.012). (6) The frequencies of IFN-γ+TNF-α+CD4+T cells were significantly decreased after 6 months of treatment compared with pretreatment (p=0.026).Conclusions: The ICCFC assay with T cells stimulation by MTB-specific Ag may be a useful additional tool for the diagnosis of active TB, although further study is needed for more convincing data.