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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The tuberculin skin test (TST) is affected by recent BCG vaccination but not by exposure to non-tuberculosis mycobacteria (NTM) during early life
PLoS ONE, Volume 5, No. 8, Article e12287, Year 2010
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Description
The tuberculin skin test (TST) is widely used in TB clinics to aid Mycobacterium tuberculosis (M.tb) diagnosis, but the definition and the significance of a positive test in very young children is still unclear. This study compared the TST in Gambian children at 4 1/2 months of age who either received BCG vaccination at birth (Group 1) or were BCG naïve (Group 2) in order to examine the role of BCG vaccination and/or exposure to environmental mycobacteria in TST reactivity at this age. Nearly half of the BCG vaccinated children had a positive TST (≥5 mm) whereas all the BCG naïve children were nonreactive, confirming that recent BCG vaccination affects TST reactivity. The BCG naïve children demonstrated in vitro PPD responses in peripheral blood in the absence of TST reactivity, supporting exposure to and priming by environmental mycobacterial antigens. Group 2 were then vaccinated at 4 1/2 months of age and a repeat TST was performed at 20-28 months of age. Positive reactivity (≥5 mm) was evident in 11.1% and 12.5% infants from Group 1 and Group 2 respectively suggesting that the timing of BCG vaccination had little effect by this age. We further assessed for immune correlates in peripheral blood at 4 1/2 months of age. Mycobacterial specific IFNγ responses were greater in TST responders than in nonresponders, although the size of induration did not correlate with IFNγ. However the IFNγ: IL-10 ratio positively correlated with TST induration suggesting that the relationship between PPD induced IFNγ and IL-10 in the peripheral blood may be important in controlling TST reactivity. Collectively these data provide further insights into how the TST is regulated in early life, and how a positive response might be interpreted. © 2010 Burl et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2924396/bin/pone.0012287.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2924396/bin/pone.0012287.s002.tif
Authors & Co-Authors
Burl, Sarah
Gambia
Medical Research Council uk the Gambia
Adetifa, Uche Jane
Gambia
Medical Research Council uk the Gambia
Cox, Momodou
Gambia
Medical Research Council uk the Gambia
Touray, Ebrima S.
Gambia
Medical Research Council uk the Gambia
Whittle, Hilton C.
Gambia
Medical Research Council uk the Gambia
McShane, Helen
United Kingdom, Oxford
Nuffield Department of Medicine
Rowland-Jones, Sarah Louise
United Kingdom, Oxford
Mrc Weatherall Institute of Molecular Medicine
Flanagan, Katie L.
Gambia
Medical Research Council uk the Gambia
Statistics
Citations: 44
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0012287
e-ISSN:
19326203
Research Areas
Infectious Diseases
Maternal And Child Health