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TUBERCULOSIS {TB}
I M M U N O LO G I C A L T E C H N I Q U E S
Genitourinary
Lymph nodes
Skin
Tuberculosi
s
Diagnosis
Latent TB
Active TB
Infection
Disease
TST &
IGRAs
Indirect
tests
Microscopy
& culture
Conventional
Direct
tests
Molecular
Advanced
Interpretation of TST
Skin test interpretations depends on 2
factors:
1. Measurement of induration in mm
2. Persons risk of being infected with TB
Drawbacks of TST
ADVANTAGES OF IGRA
Requires a single patient visit to conduct the test
Results can be available within 24 hours
Dose not boost responses measured by
subsequent tests
Prior BCG vaccination dose not cause a false
positive IGRA test results
DISADVANTAGES OF IGRA
Blood samples must be processed within 8-30 hr
after collection while blood cell still viable
Errors in collecting or transporting blood
specimens or in running and interpretation the
assay can decrease accuracy of the test
Limited data on the use of the IGRA to predict
who will progress to TB disease in the future
Tests may be expensive
Comparison
Immunological responses
to MTB
HIV/TB COINFECTION
Rare lethal combination
Urgent issue in global health
Leading cause of mortality among HIV patients.
HIV weakens immune system leading to false
negative results
HIV virus can weaken the immune system, LTBI
can be activated resulting in pulmonary or
extrapulmonary TB.
ALS ASSAY
ALS ASSAY
Antibodies from Lymphocyte
Secretion or Antibody in Lymphocyte
Supernatant or ALS Assay is an
immunological assay to detect active
diseases like tuberculosis, cholera,
typhoid etc.
ALS ASSAY
Procedure:
PBMCs (peripheral blood mononuclear cell) were
separated from blood by differential
centrifugation
PBMCs were suspended in 24-well tissue culture
plates culture medium.
Different dilutions of PBMCs were incubated at
37C with 5% CO2.
Culture supernatants were collected at 24, 48, 72,
and 96 h after incubation and the supernatants
were test against PPD by ELISA.
The ELISA titer indicates the positive or negative
result.
ALS ASSAY
Advantages:
High Sensitivity >93 %.
Early detection of active TB.
This method does not require a specimen taken
from the site of disease; it also may be useful in
diagnosis of childhood TB.
Secreted antibody may be preserved for long
time for further analysis