HBHA-IGRA and cytotoxic mediators release assays for the diagnosis of cervical tuberculous lymphadenitis

• DOI: 10.1128/spectrum.01638-23
• Publication Date: 2023-11-01T13:34:28Z
• Authors: Soumaya Bchiri; Asma Bouzekri; Rym Ouni; Rim Lahiani; Emna Romdhane; Neira Dekhil; Sonia Ben Hamouda; Helmi Mardassi; Asma Ferjani; Emanuelle Petit; Véronique Corbière; Soumaya Rammeh; Françoise Mascart; Camille Locht; Mamia Ben Salah; Mohamed Ridha Bar...; Chaouki Benabdess...
• Keywords: Tuberculous lymphadenitis

ABSTRACT Cervical tuberculous lymphadenitis (CTL), the most frequent extrapulmonary form of tuberculosis, is a serious health problem in Tunisia. CTL diagnosis challenging mainly due to paucibacillary nature disease and potential misdiagnosis as cervical non-tuberculous (CNTL). Here, we evaluated performance heparin-binding hemagglutinin (HBHA) interferon-gamma (IFN-γ) release assay (IGRA) for CTL. In addition, granzyme B, granulysin, perforin assays biomarkers assessed their contribution improve HBHA-IGRA performance. Peripheral blood mononuclear cells from CTL-suspected patients were stimulated with HBHA, early secreted antigenic target 6 (ESAT-6), or purified protein derivative (PPD) 24 h presence IL-7. Cytotoxic mediators IFN-γ by enzyme-linked immunosorbent assay. Receiver operating characteristic curves used evaluate capacity ESAT-6, PPD discriminate between ( n = 27) CNTL 21). After applying bivariate multivariate analyses, responses HBHA appeared offer best distinction CNTL, an area under curve 0.9947, associated 95.24% 100% sensitivity specificity, respectively. A principal component analysis showed clear clustering versus groups. This was attributed HBHA-induced IFN-γ, PPD-induced IFN-γ. These results thus suggest that provides high diagnostic accuracy specificity. Combining B improves identify IMPORTANCE currently major Tunisia several regions around world. lymphadenitis. study demonstrates added value hemagglutinin-interferon-gamma immunoassay context