Emine KOCABAŞ, Ümit ÇELİK

Tüberküloz tanısında yeni bir yöntem: İnterferon-gama araştırmasına dayanan testler

Halen önlenebilir infeksiyon hastalıkları içinde birinci ölüm nedeni olan tüberküloz (Tbc)’un tanısında 2000’li yıllarda yeni gelişmeler kaydedilmiştir. Tbc’nin bilinen ilk immünolojik tanı aracı tüberkülin deri testi (TDT), latent Tbc infeksiyonunun tanısında günümüzde altın standart olma özelliğini korurken, bu testin yanlış negatif ve yanlış pozitif sonuçlara yol açma özelliği nedeniyle, daha duyarlı ve özgül tanı araçları geliştirme zorunluluğu doğmuştur. Son yıllarda TDT’ye alternatif olarak ortaya çıkan, in vitro T-hücrelerinden salınan, interferon-gama (IFN-γ)’nın araştırmasına dayanan bu testlerin çalışma ilkesi, Tbc antijenleri ile duyarlanmış kişilerin T-hücrelerinin, mikobakteriyel antijenlerle karşılaştıklarında IFN-γ üretimlerine dayanmaktadır. Bu yazıda IFN-γ araştırmasına dayanan yeni tanı testleri gözden geçirilmiş ve günlük yaşamda uygulanabilirlikleri tartışılmıştır.

New diagnostic tool of tuberculosis: Interferon-gamma assays

New developments have been performed in diagnosis of the tuberculosis (Tbc) which is still the most common and the most mortal preventable infectious disease. Tuberculosis skin test (TST) an immunologic diagnostic method has been used in the diagnosis of Tbc ever since, and is still considered as a gold standart for diagnosis of latent Tbc infection but so far has lost its credibility as a diagnostic test due to its false positivity and negativity characteristics and due to this reason a more sophisticated diagnostic method search is underway. An alternative to the TST has emerged in the form of a new type of in-vitro T-cell-based assay: The interferon-gamma (IFN-γ) assay. IFN-γ assays are based on the principle that T-cells of individuals sensitised with Tbc antigens produce IFN-γ when they reencounter mycobacterial antigens. In this article the principles leading to the production of IFN-γ has been reviewed and its usage in real practise has been discussed.

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