基于γ-干扰素释放试验的麻风分枝杆菌感染筛查诊断

Screening and diagnosis of Mycobacterial leprae infection based on interferon-gamma release assay

目的:探讨γ-干扰素释放试验(IGRA)在麻风分枝杆菌感染诊断中的应用价值。方法:在麻风患者、健康人群的PBMCs中进行IGRA检测。麻风患者进一步按多菌型(MB)和少菌型(PB)展开研究,使用I-SPOT-TB试剂盒(酶联免疫斑点法)检测释放IFN-γ的效应T细胞频数。比较分析MB和PB患者IGRA检测的阳性率,结合qPCR结果对PB患者进行讨论分析。结果:以患者的病理诊断为确诊依据,纳入29例麻风患者,20名健康人群作为对照。用rESAT6-CFP10刺激后,MB和PB患者IFN-γ的激活程度和IGRA阳性率均无统计学差异。37.5%的PB患者qPCR阴性,IGRA阳性;12.5%的PB患者IGRA阴性,qPCR阳性;IGRA阳性或qPCR阳性的PB患者达75%。结论:IGRA阳性提示分枝杆菌感染的可能,IGRA联合qPCR可作为早期筛查麻风的辅助检测方法。

Objective:To investigate the value of interferon-γrelease assay(IGRA)in the diagnosis of Mycobacterium leprae infection.Methods:IGRA was detected in PBMCs of leprosy patients and healthy people.The frequency of IFN-γreleasing effector T cells was detected by I-SPOT-TB kit(enzyme-linked immunospot assay)in the multibacillary(MB)and paucibacillary(PB)leprosy patients.Comparative analysis of IGRA test positive rate between MB and PB patients,and the IGRA test combined with qPCR was discussed and analyzed in PB patients.Results:Based on the pathological diagnosis of patients,29 leprosy patients and 20 healthy people were enrolled as controls.There was no significant difference of IFN-γactivation and IGRA positivity rate between MB and PB patients.37.5%of PB patients were qPCR negative but IGRA positive.12.5%of PB patients were IGRA negative but qPCR positive.The percentage of IGRA positive or qPCR positive PB patients was 75%.Conclusion:Positive result of IGRA suggests the possibility of Mycobacterium leprae infection.IGRA combined with qPCR may be an auxiliary detection method for early screening of leprosy.