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結核の発症を予測する

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以前から結核の関係者を悩ませていた事。それは結核の感染はQFやPPD skin testで判断できても、そのうちの極めて一部しか発症しないという事でした。ツ反陽性と結核の発症との距離は非常に大きいのです。

もっと結核の発症を予測するToolが求められて居ました。
以前から、その候補となっていたのが「blood RNA signature」でした。

速報としてメイルが来たので、以下にお知らせします。

Daniel E Zak, PhDら
A blood RNA signature for tuberculosis disease risk: a prospective cohort study
Published Online: 23 March 2016
Lancet DOI: http://dx.doi.org/10.1016/S0140-6736(15)01316-1

Findings
Between July 6, 2005, and April 23, 2007, we enrolled 6363 participants from the ACS study and 4466 from independent South African and Gambian cohorts. 46 progressors and 107 matched controls were identified in the ACS cohort. A 16 gene signature of risk was identified. The signature predicted tuberculosis progression with a sensitivity of 66·1% (95% CI 63·2–68·9) and a specificity of 80·6% (79·2–82·0) in the 12 months preceding tuberculosis diagnosis. The risk signature was validated in an untouched group of adolescents (p=0·018 for RNA sequencing and p=0·0095 for qRT-PCR) and in the independent South African and Gambian cohorts (p values <0·0001 by qRT-PCR) with a sensitivity of 53·7% (42·6–64·3) and a specificity of 82·8% (76·7–86) in the 12 months preceding tuberculosis.

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Interpretation

The whole blood tuberculosis risk signature prospectively identified people at risk of developing active tuberculosis, opening the possibility for targeted intervention to prevent the disease.

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