Evaluation of the diagnostic performance of Mycobacterium tuberculosis latency-associated antigen Rv1737c in active pulmonary tuberculosis
Objective To evaluate the diagnostic performance of Mycobacterium tuberculosis(MTB)latency associated antigen Rv1737c in distinguishing between active tuberculosis(ATB)and latent tuberculosis bercu-losis infection(LTBI).Methods From January 2022 to August 2023,294 ATB and 299 LTBI cases from the Infection Department of the First Affiliated Hospital of Xi'an Jiaotong University were included in the study.FluoroSpot method was used to detect the content of interferon γ(IFN-γ)and interleukin 2(IL-2)in T cells stimulated by MTB virulence factor ESAT-6,CFP-10 and MTB latent antigen Rv1737c.The receiver operat-ing characteristic(ROC)curve was used to define the best cutoff value for latency associated antigens in dis-tinguishing ATB from LTBI.Results After stimulation with MTB-specific ESAT-6 and CFP-10 peptides,the percentage of T cells secreting only IFN-γ(IFN-γ+T cells)in ATB group was significantly higher than that in LTBI group(P<0.001).In contrast,the percentage of T cells secreting only IL-2(IL-2+T cells)was significantly lower than that in the LTBI group(P<0.001).After stimulation with MTB latency associated antigen Rv1737c,the percentage of IL-2+T cells in LTBI group was higher than ATB group(P<0.001).Using ROC curve analysis,the AUC derived from the percentage of IL-2+T cells stimulated by Rv1737c was 0.812(95%CI:[0.775,0.850]),and the sensitivity and specificity to distinguish ATB and LTBI were 81.9%and 84.4%,re-spectively.Considering only the percentage of IFN-γ+T cells stimulated by ESAT-6 or CFP-10,the sensitivity and specificity of ESAT-6 and CFP-10 FluoroSpot for the differential diagnosis of ATB and LTBI were 77.6%and 75.3%,respectively,and the AUC value was 0.739(95%CI:[0.695,0.782]).ESAT-6 and CFP-10-Fluo-roSpot combined with Rv1737c increased the specificity to 92.3%(95%CI:[0.872,0.994])and AUC to 0.881(95%CI:[0.853,0.910]).Conclusion Rv1737c,in combination with ESAT-6 and CFP-10,can be used as a candidate antigen for T cell-based TB diagnostic tests to distinguish between ATB and LTBI.
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