结核特异性抗原刺激对干扰素-γ诱导蛋白-10区分活动性和潜伏性结核感染诊断准确性的影响:荟萃分析。

IF 2.6 4区 医学 Q3 IMMUNOLOGY Microbes and Infection Pub Date : 2024-07-18 DOI:10.1016/j.micinf.2024.105396
Muhammad Iqhrammullah, Rika Yusnaini, Shakira Amirah, Intan Chaharunia Mulya, Ghina Tsurayya, Muhammad Alif Naufal, Sukmawan Fajar Santosa, Harapan Harapan, Baidillah Zulkifli
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引用次数: 0

摘要

背景:将活动性肺结核(ATB)与潜伏性肺结核感染(LTBI)相鉴别一直是个难题,干扰素-γ诱导蛋白-10(IP-10)已被用作解决方案。为了进一步提高其诊断性能,样本可以用结核特异性抗原(TBAg)刺激。目的:对未刺激和TBAg刺激的IP-10在区分ATB和LTBI方面的诊断准确性进行荟萃分析:方法:截至 2023 年 11 月 29 日,在五个主要科学数据库中进行了系统检索。方法:截至 2023 年 11 月 29 日,在五个主要科学数据库中进行了系统检索,纳入了报告非刺激或 TBAg 刺激的 IP-10 在鉴别 ATB 和 LTBI 方面诊断价值的观察性研究。采用两级混合效应逻辑回归模型进行了 Meta 分析:定量分析共纳入了 25 项研究,招募了 2301 名患者(1137 名 ATB 与 1164 名 LTBI)。IP-10的集合敏感性和特异性分别为72%(95%CI:0.59-0.82)和78%(95%CI:0.63-0.88)。至于 TBAg 刺激的 IP-10,其敏感性和特异性分别为 82% (95%CI: 0.76-0.87) 和 85% (95%CI: 0.73-0.92)。敏感性明显降低(pCI):用 TBAg 刺激 IP-10 可提高鉴别 ATB 和 LTBI 的诊断准确性。
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Effect of tuberculosis-specific antigen stimulation on the diagnostic accuracy of interferon-γ inducible protein-10 in distinguishing active and latent tuberculosis infection: a meta-analysis.

Background: Identifying active tuberculosis (ATB) from latent tuberculosis infection (LTBI) persists as a challenge, and interferon-γ inducible protein-10 (IP-10) has been employed as the solution. To further improve its diagnostic performance, the sample can be stimulated with TB specific antigen (TBAg).

Aim: To perform meta-analysis on diagnostic accuracy of unstimulated and TBAg-stimulated IP-10 in differentiating ATB from LTBI.

Methods: Systematic search was performed on five major scientific databases as of 29 November 2023. Observational studies reporting diagnostic values of unstimulated or TBAg-stimulated IP-10 in identifying ATB from LTBI were included. Meta-analysis was carried out using two-level mixed-effect logistic regression model.

Results: Twenty-five studies recruiting 2301 patients (1137 ATB versus 1164 LTBI) were included in the quantitative analysis. The pooled sensitivity and specifity of IP-10 were 72% (95%CI: 0.59-0.82) and 78% (95%CI: 0.63-0.88), respectively. As for TBAg-stimulated IP-10, the sensitivity and specifity were 82% (95%CI: 0.76-0.87) and 85% (95%CI: 0.73-0.92), respectively. The senstivity was reduced signiticantly (p < 0.01) when the patients with human immunodeficiency virus infection were included, except after the TBAg stimulation.

Conclusion: Stimulating IP-10 with TBAg could improve the diagnostic accuracy in differentiating ATB from LTBI.

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来源期刊
Microbes and Infection
Microbes and Infection 医学-病毒学
CiteScore
12.60
自引率
1.70%
发文量
90
审稿时长
40 days
期刊介绍: Microbes and Infection publishes 10 peer-reviewed issues per year in all fields of infection and immunity, covering the different levels of host-microbe interactions, and in particular: the molecular biology and cell biology of the crosstalk between hosts (human and model organisms) and microbes (viruses, bacteria, parasites and fungi), including molecular virulence and evasion mechanisms. the immune response to infection, including pathogenesis and host susceptibility. emerging human infectious diseases. systems immunology. molecular epidemiology/genetics of host pathogen interactions. microbiota and host "interactions". vaccine development, including novel strategies and adjuvants. Clinical studies, accounts of clinical trials and biomarker studies in infectious diseases are within the scope of the journal. Microbes and Infection publishes articles on human pathogens or pathogens of model systems. However, articles on other microbes can be published if they contribute to our understanding of basic mechanisms of host-pathogen interactions. Purely descriptive and preliminary studies are discouraged.
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