title: Use of lateral flow assays to determine IP-10 and CCL4 levels in pleural effusions and whole blood for TB diagnosis.
abstract: One of the key problems in combating TB is the lack of fast and accurate diagnostic tests that are affordable and easy to use in resource-limited settings. We have used a field-friendly up-converting phosphor (UCP) reporter technology in a lateral flow (LF) based test for the diagnosis of respiratory infections. In this study we analysed samples obtained from patients presenting with symptoms suggestive of TB but prior to confirmation by microbiology in The Gambia. Following clinical and microbiological evaluation they were classified as either having TB or other respiratory disorder (ORD). Analysis of blood was performed for those with pulmonary TB and pleural fluid for those with pleural TB. UCP-LF test for detection and quantitation of IP-10 and CCL4 were used being the two chemokine markers that have been shown to increase in active TB disease. UCP-LF test accurately determined concentrations of both markers as compared to ELISA and multiplex cytokine array. However, only IP-10 could discriminate between TB and ORD, and this was significantly enhanced by analysing the site of infection (pleural fluid), which showed 92% correct classification. Future work will assess the use of multiple markers to increase diagnostic accuracy.
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia. Electronic address: jsutherland@mrc.gm.
authors.forename: Jayne S
authors.initials: JS
authors.lastname: Sutherland
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mendy
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia.
authors.forename: Awa
authors.initials: A
authors.lastname: Gindeh
authors.affiliation: DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Dept of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Walzl
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia.
authors.forename: Toyin
authors.initials: T
authors.lastname: Togun
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia.
authors.forename: Olumuyiwa
authors.initials: O
authors.lastname: Owolabi
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia.
authors.forename: Simon
authors.initials: S
authors.lastname: Donkor
authors.affiliation: Vaccines & Immunity, Medical Research Council Unit, Gambia.
authors.forename: Martin O
authors.initials: MO
authors.lastname: Ota
authors.affiliation: Leiden University Medical Center, Dept. Infectious Diseases, The Netherlands.
authors.forename: Elisa Tjon
authors.initials: ET
authors.lastname: Kon Fat
authors.affiliation: Leiden University Medical Center, Dept. Infectious Diseases, The Netherlands.
authors.forename: Tom H M
authors.initials: TH
authors.lastname: Ottenhoff
authors.affiliation: Leiden University Medical Center, Dept. Infectious Diseases, The Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Geluk
authors.affiliation: Leiden University Medical Center, Dept. Molecular Cell Biology, The Netherlands.
authors.forename: Paul L A M
authors.initials: PL
authors.lastname: Corstjens
mesh_terms: D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D054407:Chemokine CCL4 / Q000097:blood*; D054357:Chemokine CXCL10 / Q000097:blood*; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007159:Immunologic Tests; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D010996:Pleural Effusion / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D012372:ROC Curve; D014396:Tuberculosis, Pleural / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology
chemical_list: D015415:Biomarkers; C066507:CCL4 protein, human; C114753:CXCL10 protein, human; D054407:Chemokine CCL4; D054357:Chemokine CXCL10
keywords: CCL4; IP10; Pleural TB; Pulmonary TB; Tuberculosis; UCP-LF