medigraphic.com
ISSN 2007-2783 (Impreso)
Órgano Oficial del Instituto Científico Pfizer

2009, Número 3

<< Anterior Siguiente >>

Residente 2009; 4 (3)


La prueba cutánea de hipersensibilidad aplicada en un parche. Nueva herramienta en el diagnóstico de la tuberculosis

Trujillo-Roldán MA, Espitia C

Idioma: Español
Referencias bibliográficas: 47
Paginas: 111-116
Archivo PDF: 139.53 Kb.


RESUMEN

Un tercio de la población mundial está infectada de manera latente con tuberculosis (TB) y se estima que una de cada diez personas infectadas desarrollarán la enfermedad activa en algún momento de su vida, con una ocurrencia de muerte aproximada al 7%. Estos números plantean un reto para el diagnóstico y control de la enfermedad. La complejidad de esta tarea aumenta cuando se debe diferenciar entre los pacientes con TB activa de aquellos que están infectados. Entre los métodos de diagnóstico más utilizados actualmente, están la prueba cutánea de la tuberculina (PPD), baciloscopia directa, PCR de fluidos corporales y secreciones y cultivo, pruebas que tienen limitaciones. Para un diagnóstico certero, estas pruebas deberán realizarse en conjunto, con los costos y tiempo que esto requiere. En esta revisión, se presenta la evolución del diagnóstico, basado en la capacidad de respuesta celular de los individuos, que se inicia con la utilización de mezclas complejas de antígenos micobacterianos (propuesta por Robert Koch), hasta la introducción de proteínas específicas utilizadas para la medición de la respuesta celular in vitro, o directamente en el paciente, aplicada en un parche cutáneo. Tal es el caso de la proteína MPT-64, cuyo potencial diagnóstico en la diferenciación de personas infectadas con TB latente y TB activa ha permitido que actualmente esté en fase III de evaluación con la posibilidad de que su uso sea aprobado por la FDA en este mismo año.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. World Health Organization. Global tuberculosis control-epidemiology, strategy, financing, WHO Report 2009. 2009. Report No.: WHO/HTM/TB/2009.411.

  2. Department of Health / Health Education Authority. BCG Vaccine Factsheet. London: Health Education Authority 1998.

  3. Kim JY, Shakow A, Castro A, Vande C, Farmer P. Tuberculosis control. Global Public Goods for Health - A reading companion. World Health Organization 2009.

  4. Geisbrecht BV, Nikonenko B, Samala R, Nakamura R, Nacy CA, Sacksteder KA. Design and optimization of a recombinant system for large-scale production of the MPT64 antigen from Mycobacterium tuberculosis. Protein Expr Purif 2006; 46(1): 64-72.

  5. Zellweger JP. Latent tuberculosis: which test in which situation? Swiss Med Wkly 2008; 138(3-4): 31-37.

  6. Riska PF, Carleton S. Latent tuberculosis: models, mechanisms, and novel prospects for eradication. Semin Pediatr Infect Dis 2002; 13(4): 263-272.

  7. Restrepo BI. New tools for detection of latent tuberculosis. Biomedica 2004; 24(Supp 1): 202-211.

  8. El KA, Henry M, Raoult D, Drancourt M. Detection of Mycobacterium tuberculosis complex organisms in the stools of patients with pulmonary tuberculosis. Microbiol. 2009. doi:10.1099/mic.0.026484-0.

  9. Watanabe A. Diagnosis of infections with difficulty in isolation and identification of the causative organisms. 3) Acid-fast bacterial infections (caused by Mycobacterium tuberculosis or atypical acid-fast organisms). Nippon Naika Gakkai Zasshi 1998; 87(11): 2203-2210.

  10. Lipsky BA, Gates J, Tenover FC, Plorde JJ. Factors affecting the clinical value of microscopy for acid-fast bacilli. Rev Infect Dis 1984; 6(2): 214-222.

  11. Gao DZ, Fan RL. Smear-positive and culture-negative results in detecting acid-fast bacilli in the sputum and their clinical significance. Zhonghua Jie He He Hu Xi Xi Ji Bing Za Zhi 1986; 9(6): 374-376.

  12. Mathew P, Kuo YH, Vazirani B, Eng RH, Weinstein MP. Are three sputum acid-fast bacillus smears necessary for discontinuing tuberculosis isolation? J Clin Microbiol 2002; 40(9): 3482-3484.

  13. Wyplosz B, Truffot-Pernot C, Robert J, Jarlier V, Grosset J. The bacteriology of tuberculosis and non-tuberculosis mycobacterial infections. Rev Mal Respir 1997; 14(Suppl 5): S33-48.

  14. Witebsky FG, Kruczak-Filipov P. Identification of mycobacteria by conventional methods. Clin Lab Med 1996; 16(3): 569-601.

  15. Mallet L, Strozyk WR. Tuberculosis in the elderly: incidence, manifestations, PPD skin tests, and preventive therapy. DICP 1991; 25(6): 650-655.

  16. Ciesielski SD. BCG vaccination and the PPD test: what the clinician needs to know. J Fam Pract 1995; 40(1): 76-80.

  17. Dinnes J, Deeks J, Kunst H et al. A systematic review of rapid diagnostic tests for the detection of tuberculosis infection. Health Technol Assess 2007; 11(3): 1-196.

  18. Cole ST, Brosch R, Parkhill J et al. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature 1998; 393(6685): 537-544.

  19. Stanford JL. Improving on BCG. APMIS 1991; 99(2): 103-113.

  20. Andersen P, Doherty TM. The success and failure of BCG - implications for a novel tuberculosis vaccine. Nat Rev Microbiol 2005; 3(8): 656-662.

  21. Gupta UD, Katoch VM, McMurray DN. Current status of TB vaccines. Vaccine 2007; 25(19): 3742-3751.

  22. van Pinxteren LA, Ravn P, Agger EM, Pollock J, Andersen P. Diagnosis of tuberculosis based on the two specific antigens ESAT-6 and CFP10. Clin Diagn Lab Immunol 2000; 7(2): 155-160.

  23. Arend SM, Ottenhoff TH, Andersen P, van Dissel JT. Uncommon presentations of tuberculosis: the potential value of a novel diagnostic assay based on the Mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10. Int J Tuberc Lung Dis 2001; 5(7): 680-686.

  24. Van-Lume DS, Souza JR, Melo WG, Melo VL, Cabral MM, Rego JC, Schindler HC, Abath FG, Montenegro SM. Preliminary results in the immunodiagnosis of tuberculosis in children based on T cell responses to ESAT-6 and PPD antigens. Mem Inst Oswaldo Cruz 2008; 103(4): 401-404.

  25. Ulrichs T, Munk ME, Mollenkopf H, Behr-Perst S, Colangeli R, Gennaro ML, Kaufmann SH. Differential T cell responses to Mycobacterium tuberculosis ESAT6 in tuberculosis patients and healthy donors. Eur J Immunol 1998; 28(12): 3949-3958.

  26. Ulrichs T, Anding R, Kaufmann SH, Munk ME. Numbers of IFN-gamma-producing cells against ESAT-6 increase in tuberculosis patients during chemotherapy. Int J Tuberc Lung Dis 2000; 4(12): 1181-1183.

  27. Vordermeier HM, Chambers MA, Cockle PJ, Whelan AO, Simmons J, Hewinson RG. Correlation of ESAT-6-specific gamma interferon production with pathology in cattle following Mycobacterium bovis BCG vaccination against experimental bovine tuberculosis. Infect Immun 2002; 70(6): 3026-3032.

  28. Ulrichs T, Anding P, Porcelli S, Kaufmann SH, Munk ME. Increased numbers of ESAT-6- and purified protein derivative-specific gamma interferon-producing cells in subclinical and active tuberculosis infection. Infect Immun 2000; 68(10): 6073-6076.

  29. Tavares RC, Salgado J, Moreira VB, Ferreira MA, Mello FC, Leung JW, Fonseca Lde S, Spallek R, Singh M, Saad MH. Interferon gamma response to combinations 38 kDa/CFP-10, 38 kDa/MPT-64, ESAT-6/MPT-64 and ESAT-6/CFP-10, each related to a single recombinant protein of

  30. Mycobacterium tuberculosis in individuals from tuberculosis endemic areas. Microbiol Immunol 2007; 51(3): 289-296.

  31. Taggart EW, Hill HR, Ruegner RG, Litwin CM. Evaluation of an in vitro assay for interferon gamma production in response to the Mycobacterium tuberculosis-synthesized peptide antigens ESAT-6 and CFP-10 and the PPD skin test. Am J Clin Pathol 2006; 125(3): 467-473.

  32. Porsa E, Cheng L, Seale MM, Delclos GL, Ma X, Reich R, Musser JM, Graviss EA. Comparison of a new ESAT-6/CFP-10 peptide-based gamma interferon assay and a tuberculin skin test for tuberculosis screening in a moderate-risk population. Clin Vaccine Immunol 2006; 13(1): 53-58.

  33. Food and Drug Administration, Center for Devices and Radiological Health. QuantiFERON®-TB - P010033 [Letter]. 2002.

  34. Centers for Disease Control and Prevention. National Center for HIV/AIDS VHSaTP. QuantiFERON®-TB Gold Test. 2007.

  35. Nakamura RM, Einck L, Velmonte MA, et al. Detection of active tuberculosis by an MPB-64 transdermal patch: a field study. Scand J Infect Dis 2001; 33(6): 405-407.

  36. Nakamura RM, Velmonte MA, Kawajiri K, Ang CF, Frias RA, Mendoza MT, Montoya JC, Honda I, Haga S, Toida I. MPB64 mycobacterial antigen: a new skin-test reagent through patch method for rapid diagnosis of active tuberculosis. Int J Tuberc Lung Dis 1998; 2(7): 541-546.

  37. Tiwari RP, Hattikudur NS, Bharmal RN, Kartikeyan S, Deshmukh NM, Bisen PS. Modern approaches to a rapid diagnosis of tuberculosis: promises and challenges ahead. Tuberculosis (Edinb) 2007; 87(3): 193-201.

  38. Sequella Inc. Sequella Licensing Opportunity, Biologic, Diagnostic: Pivotal Trials, Therapeutic Focus: Tuberculosis (TB). http://www.sequella.com/docs/Sequella_1sheet09 v1_TBPatch pdf. 2009. May 5

  39. Schneider I. Sequella takes on pernicious enemies, firm seeks to improve diagnosis and treatment of tuberculosis and bacterial pneumonia. GEN Gen Eng Biotechnol News 29[1]: 1-1-2009.

  40. Oettinger T, Holm A, Mtoni IM, Andersen AB, Hasloov K. Mapping of the delayed-type hypersensitivity-inducing epitope of secreted protein MPT64 from Mycobacterium tuberculosis. Infect Immun 1995; 63(12): 4613-4618.

  41. Harboe M, Nagai S, Patarroyo ME, Torres ML, Ramírez C, Cruz N. Properties of proteins MPB64, MPB70, and MPB80 of Mycobacterium bovis BCG. Infect Immun 1986; 52(1): 293-302.

  42. Betts JC, Lukey PT, Robb LC, McAdam RA, Duncan K. Evaluation of a nutrient starvation model of Mycobacterium tuberculosis persistence by gene and protein expression profiling. Mol Microbiol 2002; 43(3): 717-731.

  43. Li H, Ulstrup JC, Jonassen TO, Melby K, Nagai S, Harboe M. Evidence for absence of the MPB64 gene in some substrains of Mycobacterium bovis BCG. Infect Immun 1993; 61(5): 1730-1734.

  44. Haga S, Kawajiri K, Niinuma S, Honda I, Yamamoto S, Toida I, Nakamura RM, Nagai S. Effective isolation of MPB64 from a large volume of culture filtrate of Mycobacterium bovis BCG Tokyo. Jpn J Med Sci Biol 1996; 49(1): 15-27.

  45. Haga S, Yamaguchi R, Nagai S, Matsuo K, Yamazaki A, Nakamura RM. Delayed-type hypersensitivity to a recombinant mycobacterial antigen, MPB64, in guinea pigs sensitized to Mycobacterium tuberculosis or Mycobacterium bovis BCG. J Leukoc Biol 1995; 57(2): 221-225.

  46. Tasaka H, Shigeto E, Matsuo K, Yamaguchi R, Haga S, Yamazaki A, Yamazaki T, Nagai S, Nakamura RM. Secretion of MPB64 antigen by a recombinant clone of M. smegmatis: Characterization and application for the diagnosis of tuberculosis. Scand J Immunol 1995; 42(4): 487-492.

  47. Roche PW, Winter N, Triccas JA, Feng CG, Britton WJ. Expression of Mycobacterium tuberculosis MPT64 in recombinant M. smegmatis: purification, immunogenicity and application to skin tests for tuberculosis. Clin Exp Immunol 1996; 103(2): 226-232.




2020     |     www.medigraphic.com