TY - JOUR T1 - Multiple cytokine response to <em>mycobacterium tuberculosis</em> with a whole blood assay is useful to distinguish active from latent tuberculosis infection in a highly tuberculosis endemic country JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2678 AU - Kentaro Sakashita AU - Michio Yasunami AU - Motoi Suzuki AU - Takaharu Shimazaki AU - Naomi Saludar AU - Edith Tria AU - Jose Villarama AU - Winston Go AU - Koya Ariyoshi Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2678.abstract N2 - Background Inclusion of additional cytokine response may improve the diagnostic accuracy of Interferon-gamma releasing assay (IGRA) in highly tuberculosis (TB) endemic area.Objectives We aimed to compare cytokine profiles between pulmonary tuberculosis (PTB) patients and the healthy control and to improve IGRA by evaluating multiple cytokine response.Materials and Methods A hospital based cross sectional study was conducted in the Philippines. From December 2012 to February 2013, we recruited sputum smear-positive PTB patients (n=29), household contacts (n=8), health care workers (HCW) in TB department (n=21), and HCW in non-TB department (n=22). The level of eight cytokines (IFN-γ, IL-2, TNF-α, IL-4, IL-5, IL-10, IL-17A and IL-6) in their plasma were measured by LuminexTM assay after culture with ESAT-6, CFP-10 and TB7.7 in QuantiFERONTM-TB Gold In-Tube.Results IFN-γ/IL-2 ratio was significantly higher in PTB patients (median 2.06, interquartile range [1.30-4.20]) than household contact (0.94 [0.53-1.19], p=0.01), HCW in TB department (0.90 [0.56-1.21], p=0.0004) and HCW in non-TB department (0.56 [0.10-1.47], p=0.0094). In addition, IFN-γ/IL-2 ratio [AUC (area under curve) =0.79] could distinguish PTB patients from household contacts more accurately than a IFN-γ response (AUC=0.50) based on receiver operating characteristic analysis (p=0.0009).Conclusions We found that IFN-γ/IL-2 ratio could distinguish PTB from healthy control more accurately than single cytokine detection. IGRA with additional cytokine detection provides useful information in a highly tuberculosis endemic country. ER -