Interleukin-6 and Mycobacterium tuberculosis dormancy antigens improve diagnosis of tuberculosis.

Ernest Adankwah, Norman Nausch, Difery Minadzi, Mohammed K Abass, Kees L M C Franken, Tom H M Ottenhoff, Ertan Mayatepek, Richard O Phillips, Marc Jacobsen

The Journal of infection 2021 Feb

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IFNγ-release assays (IGRAs) used for diagnosis of Mycobacterium (M.) tuberculosis infection have limited sensitivity. Alternative cytokines and M. tuberculosis latency-associated antigens may improve immune-based tests. Multiplex cytokine analyses was done in culture supernatants after 6-day in vitro restimulation with M. tuberculosis IGRA and latency-associated antigens (i.e. Rv2628, Rv1733) in tuberculosis patients (n = 22) and asymptomatic contacts (AC)s (n = 20) from Ghana. Four cytokines (i.e. IFNγ, IP-10, IL-22 and IL-6) were significantly increased after IGRA-antigen specific restimulation. IFNγ, IP-10, and IL-22 correlated positively and showed no differences between the study groups whereas IGRA-antigen induced IL-6 was significantly higher in tuberculosis patients. Using adjusted IGRA criteria, IL-6 showed the highest sensitivity for detection of tuberculosis patients (91%) and ACs (85%) as compared to IFNγ, IP-10, and IL-22. Rv2628 and Rv1733 restimulation induced significantly higher IFNγ, IP-10, and IL-22 concentrations in ACs. Combined antigen/cytokine analyses identified study group specific patterns and a combination of Rv2628/Rv1733 induced IFNγ with IGRA-antigen induced IL-6 was optimal for classification of tuberculosis patients and ACs (AUC: 0.92, p<0.0001). We demonstrate the potency of alternative cytokines, especially IL-6, and latency-associated antigens Rv1733/Rv2628 to improve detection of M. tuberculosis infection and to classify tuberculosis patients and healthy contacts. Copyright © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Citation

Ernest Adankwah, Norman Nausch, Difery Minadzi, Mohammed K Abass, Kees L M C Franken, Tom H M Ottenhoff, Ertan Mayatepek, Richard O Phillips, Marc Jacobsen. Interleukin-6 and Mycobacterium tuberculosis dormancy antigens improve diagnosis of tuberculosis. The Journal of infection. 2021 Feb;82(2):245-252