Method of diagnosis of tuberculosis related immune restoration syndrome (IRS)

A syndrome and tuberculosis technology, applied in the fields of instruments, biomaterial analysis, measurement devices, etc., can solve the problems of undetected Th2 cytokines and difficult diagnosis.

Inactive Publication Date: 2009-04-29
INST NAT DE LA SANTE & DE LA RECHERCHE MEDICALE (INSERM)
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

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Problems solved by technology

[0004] However, IRS raises three clinically relevant problems: first, the diagnostic difficulty in distinguishing IRS from treatment failure or resistance or other opportunistic diseases; second, in some life-threatening cases, IRS treatment remains experimental with steroids. HAART, which is not easily introduced in such immunocompromised patients; third, the determination of the IRS risk factor helps clinicians to determine the treatment strategy, that is, to delay or not introduce HAART[4]
These findings correlated with peaks in PPD-specific Th1 cytokines such as IFN-γ, IL-2, IL-12, IP10, MIG, but we did not detect Th2 cytokines; other inflammatory chemokines or cytokines such as TNF-α, IL-6, IL-1β, IL-10, RANTES, MCP-1

Method used

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  • Method of diagnosis of tuberculosis related immune restoration syndrome (IRS)
  • Method of diagnosis of tuberculosis related immune restoration syndrome (IRS)
  • Method of diagnosis of tuberculosis related immune restoration syndrome (IRS)

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0044] Example 1: Mycobacterium-specific Th1 cells induce IRS in HIV tuberculosis superinfected patients.

[0045] 1-Patients and methods

[0046] 1.1.1 Patients

[0047] Twenty-nine consecutive TB-HIV superinfected treatment-naïve patients were prospectively enrolled at the time of initiation of anti-TB therapy. Inclusion criteria were: HIV-1 infection, no previous HAART, CD4 count below 200 cells / mm 3 , the initiation time of anti-TB treatment was at most within one week before enrollment and there were indications for further initiation of HAART.

[0048] Enrollment was confirmed again when M. tuberculosis infection was confirmed (positive culture or histological findings). When initiating antimycobacterial therapy (T BK ) and HAART (M 0 ) and 1, 3, 6, and 12 months after initiation of HAART (M 1、3、6、12 ) to evaluate the patient. In addition, patients with IRS (IRS+) were at IRS (T IRS ) and evaluation after 20 days. IRS is defined as follows [3]: recurrence of inf...

Embodiment 2

[0077] Example 2: IRS is associated with explosive Thl responses specifically to tuberculin (PPD) and a 16 kDa protein.

[0078] Materials and methods

[0079] subjects and patients

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Abstract

The present invention relates to a method and kit of diagnosis of Immune Restoration Syndrome associated with tuberculosis (TB-IRS) in patients infected with tuberculosis (TB) as well as in HIV co-infected patients comprising detecting an acute increase in Th1 response following exposure to mycobacterial extract, referred as tuberculin or PPD (Purified Protein Derivative) as well as to the 16kDa protein, but not to ESAT-6 or CFP-10, two antigens from mycobacterium tuberculosis.

Description

[0001] The present invention relates to a diagnosis method and a diagnostic kit for tuberculosis (TB) infection patients and HIV (human immunodeficiency virus) superinfection patients tuberculosis-associated immune recovery syndrome (Immune Restoration Syndrome associated with tuberculosis, TB-IRS), which comprises Detection of acute Th1 responses after exposure to mycobacterial extracts and / or 16 kDa protein known as tuberculin or PPD (purified protein derivative), but not to ESAT-6 or CFP- Detection was performed after 10 antigens. Background technique [0002] Immune recovery syndrome (IRS) was first described in HIV-infected patients infected with the Mycobacterium avium complex receiving zidovudine monotherapy [1], in highly active antiretroviral therapy (HAART ) era, it occurs with extremely high frequency (29%-36%) in tuberculosis patients [2]. IRS also occurs after initiation of TB treatment in HIV-negative patients, although less frequently. [0003] Classically, IR...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): G01N33/50
CPCG01N2333/35G01N2333/52G01N2333/57G01N33/5091
Inventor B·奥特朗A·布盖瑞特G·卡索兰V·马丁内斯B·吉盖勒D·塞雷尼
Owner INST NAT DE LA SANTE & DE LA RECHERCHE MEDICALE (INSERM)
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