This study evaluates the diagnostic and prognostic utility of combined serum IFN-γ and neutrophil CD64 detection for active pulmonary tuberculosis in immunocompromised elderly patients.
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Research Article
This study evaluates the diagnostic and prognostic utility of combined serum IFN-γ and neutrophil CD64 detection for active pulmonary tuberculosis in immunocompromised elderly patients.
This study assessed the risk of active pulmonary tuberculosis (ATB) in elderly patients with weakened immunity by jointly detecting serum interferon-γ (IFN-γ) and neutrophil CD64, and analyzed the impact of this diagnostic protocol on the course of ATB. A total of 50 patients with ATB and 50 age- and sex-matched healthy controls were recruited. Subsequently, the patient's neutrophil CD64 (quantified as the percentage of CD64-positive neutrophils [CD64%]), IFN-γ (by enzyme-linked immunosorbent assay [ELISA]), C-reactive protein (CRP; by immunoturbidimetry), and erythrocyte sedimentation rate (ESR; by Westergren method). Sputum samples from patients were cultured on Löwenstein-Jensen (L-J) medium and in the MGIT 960 automated system. The diagnostic efficacy of individual and combined biomarkers was assessed with receiver operating characteristic (ROC) curve analysis, and a logistic regression model was developed for combined detection. Significantly elevated levels of both IFN-γ and CD64 were observed in ATB patients versus healthy controls (P<0.05). A diagnostic model incorporating both biomarkers had an area under the curve (AUC) of 0.838, with a sensitivity of 84.00% and a specificity of 76.00%. Both markers decreased following therapeutic intervention (P<0.05), showing the lowest values in culture-negative patients (P<0.05). Furthermore, the combined model showed predictive utility for culture conversion, attaining an AUC of 0.756 (65.71% sensitivity, 80.00% specificity; P<0.001). The combined detection of IFN-γ and CD64 can effectively diagnose the occurrence of ATB in immunocompromised elderly people, providing a reference for clinical practice.
Pulmonary tuberculosis (TB), a chronic infectious disease caused by Mycobacterium tuberculosis (MTB), causes more than 10 million new cases globally each year and is the leading cause of death from a single infectious pathogen1. Clinically, populations at high risk of ATB include immunocompromised individuals, patients with diabetes, long-term smokers, close contacts of TB cases, and elderly adults2. Among these groups, elderly adults with impaired immunity have a markedly elevated risk of ATB3. The accurate and early diagnosis of active TB (ATB) is crucial for prognosis, g....
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The study protocol received approval from the Institutional Review Board of Ganzhou Fifth People's Hospital, Ganzhou, Jiangxi, China. Written informed consent was obtained from all individuals who participated in the study. All procedures involving viable Mycobacterium tuberculosis (MTB) were performed in a biosafety level 3 (BSL-3) containment facility, in full compliance with national biosafety guidelines for handling infectious pathogens. For NaOH-mediated sputum liquefaction, operators wore full personal protective equipment (N95 respirators, nitrile gloves, fluid-resistant gowns, and face shields) to prevent chemical and aerosol exposure. The reagent....
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The diagnostic efficacy of the combined detection of IFN-γ and CD64 in ATB
Compared with the control group, the mean serum IFN-γ level in the ATB group increased by 22.57% (21.84 ± 4.23 vs. 16.91 ± 4.41 pg/mL, P<0.05), and the mean CD64% increased by 24.97% (14.90 ± 4.04 vs. 11.18 ± 3.56, P<0.05). ROC curve analysis indicated that IFN-γ possessed a diagnostic sensitivity of 64.00% and specificity of 86.00% for ATB (AUC=0.803, P<0.001), whereas CD64 exhibited a sensitivity of 84.00% and speci.......
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This study proposes an integrated dual-biomarker diagnostic and prognostic framework combining serum IFN-γ (a marker of adaptive T-cell immunity) and neutrophil CD64 (a marker of innate immune activation) for ATB in immunocompromised elderly patients, a high-risk population with unmet clinical needs for accurate, non-invasive TB testing. The management of ATB is complicated by its infectious nature and potential for severe disease, underscoring the need for early, precise diagnosis and monitoring12.......
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The authors declare no conflicts of interest.
| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| AU5800 automatic biochemical analyzer | Beckman Coulter | B04077 | An instrument used to detect and analyze the chemicals of life. |
| CD14-APC | Agilent | 8730057 | A fluorescently labeled antibody for flow cytometry that specifically recognizes the CD14 antigen. |
| CD16-FITC | Agilent | 8920064 | A fluorescently labeled antibody for flow cytometry that specifically recognizes the CD16 antigen. |
| CD64-PE | Agilent | 8730119 | A fluorescently labeled antibody for flow cytometry that specifically recognizes the CD64 antigen. |
| CytoFLEX LX flow cytometry | Beckman Coulter | C00445 | A cell analyzer that measures the fluorescence intensity of stained cell markers. |
| IFN-γ ELISA kit | Wuhan Jilid Biotechnology Co., LTD | J20272 | A tool based on the double antibody sandwich assay for the detection of IFN-γ concentrations. |
| L-J medium | Shandong Topu Biological Engineering Co., LTD | M1607 | A medium used for the isolation and culture of mycobacteria such as Mycobacterium tuberculosis. |
| PASS | NCSS | v.15.0 | A software to support power analyses and sample-size calculations. |
| SPSS | IBM | v.30.0 | A software for data processing, data analysis, and data visualization. |
| XS-1000i erythrocyte sedimentation analyzer | Sysmex | V147451 | A medical device used for clinical blood testing. |