Diagnostic accuracy of interferon (IFN)-γ inducible protein 10 (IP-10) as a biomarker for the discrimination of active and latent tuberculosis.

ABSTRACT

To assess the potency of Interferon (IFN)-γ inducible protein 10 (IP-10) stimulated by recombinant PE35 and PPE68 as a biomarker in differentiating between active and latent tuberculosis. Patients with active pulmonary TB (PTB) (n = 30), latent TB infection (LTBI) (n = 29), and BCG-vaccinated healthy controls (HCs) (n = 30) were enrolled and blood samples were taken from them. The diagnostic performance of IP-10 was evaluated by the Receiver operator characteristic (ROC) curve and the area under the curve (AUC) and their 95% confidence intervals (CI) were calculated. The median IP-10 concentrations following stimulation with recombinant PE35 and PPE68 were significantly higher in TB-infected group (both PTB and LTBI) compared with HCs (P < 0.05). It was also significantly higher in PTB patients compared with individuals with LTBI (P < 0.05). The discriminatory performance of IP-10 following stimulation with recombinant PE35 and PPE68 (assessed by AUC) between TB patients and HCs were similar (AUC 0.79 [95% CI 0.68-0.89] and 0.79 [95% CI 0.69-0.89], respectively). AUCs of IP-10 following stimulation with recombinant PE35 and PPE68 for distinguishing between PTB and LTBI groups were 0.63 (95% CI 0.47-0.79) and 0.61 (0.45-0.77), respectively. Under the selected cut-off values, the sensitivity and specificity of IP-10 for distinguishing of TB-infected and HCs after stimulation with recombinant PE35 was 74.5% and 73%, respectively and after stimulation with recombinant PPE68 were 76.5% and 63%, respectively. Moreover, the sensitivity and specificity of IP-10 for differentiating of PTB and LTBI following stimulation with recombinant PE35 and PPE68 were 770 pg/ml (sensitivity 63%; specificity 62%) and 502 pg/ml (sensitivity 80%; specificity 52%), respectively. IP-10 stimulated by recombinant PE35 and PPE68 is a promising biomarker for TB diagnosis. However, it doesn't have desirable sensitivity and specificity in distinguishing between PTB and LTBI.