Abstract | BACKGROUND: MATERIAL AND METHODS: A phase II trial was performed in 158 patients with pulmonary TB (145 initially-treated and 13 re-treated) and 133 healthy subjects. Skin testing was carried out by injecting purified protein derivative ( PPD) (on left forearm) or recombinant ESAT-6 protein at a dosage of 2, 5, or 10 μg/mL (on the right forearm) in each subject. Reaction activity and adverse events were monitored at 24, 48, and 72 h following the injection. Receiver operating characteristic curves were plotted to determine the areas under the curves (AUCs) and the cut-off induration diameters for the optimal diagnostic performance. RESULTS: The reaction activity was significantly increased upon recombinant ESAT-6 injection in pulmonary TB patients compared with healthy subjects. In pulmonary TB patients, the reaction was dose-dependent, and at 48 h, 10 μg/mL recombinant ESAT-6 produced a reaction similar to that produced by PPD. The AUCs for a 10 μg/mL dosage were 0.9823, 0.9552, and 0.9266 for 24 h, 48 h, and 72 h, respectively, and the induration diameters of 4.5-5.5 mm were the optimal trade-off values between true positive rates and false positive rates. No serious adverse events occurred in any subjects. CONCLUSIONS: Recombinant ESAT-6 protein is efficacious and safe for diagnosing pulmonary TB. Based on the reaction, performance, safety, and practicability, we recommend that 10 μg/mL at 48 h with an induration cut-off value of 5.0 mm be used.
|
Authors | Qing-Feng Sun, Miao Xu, Jin-Guo Wu, Bao-Wen Chen, Wei-Xin Du, Ji-Guang Ding, Xiao-Bing Shen, Cheng Su, Jin-Sheng Wen, Guo-Zhi Wang |
Journal | Medical science monitor : international medical journal of experimental and clinical research
(Med Sci Monit)
Vol. 19
Pg. 969-77
(Nov 12 2013)
ISSN: 1643-3750 [Electronic] United States |
PMID | 24217560
(Publication Type: Clinical Trial, Phase II, Journal Article)
|
Chemical References |
- Antigens, Bacterial
- Bacterial Proteins
- ESAT-6 protein, Mycobacterium tuberculosis
- Recombinant Proteins
|
Topics |
- Adult
- Analysis of Variance
- Antigens, Bacterial
(adverse effects, genetics)
- Area Under Curve
- Bacterial Proteins
(adverse effects, genetics)
- China
- Dose-Response Relationship, Drug
- Female
- Humans
- Male
- Middle Aged
- ROC Curve
- Recombinant Proteins
(adverse effects, genetics)
- Skin Tests
- Tuberculosis, Pulmonary
(diagnosis)
|