Abstract

Immunological and molecular advances have modernized diagnostic testing for many diseases. Although interferon gamma-release and polymerase chain reaction assays have been developed to detect Mycobacterium tuberculosis (Mtb) infection, purified protein derivative (PPD)–based tuberculin skin testing (TST) remains the most widely used method. Indeed, the TST is a simple and cost-effective tool that can be easily applied for widespread screening for Mtb infection. However, the lack of specificity has been a limitation of these tests, and, more recently, supply issues have arisen. Building upon the skin tests that historically have been used within TB and leprosy control programs, we discuss recent developments using modern technologies for improving mycobacterial skin testing as well as practical advantages inherent to the technique. Furthermore, we outline how this knowledge could be applied to develop similar tests that could benefit diagnostic strategies for other infections.

Key points

• Skin testing provides a significantly cheaper alternative to most modern technologies.

• Skin tests provide a lab-independent diagnostic strategy that can be widely administered.

• Diseases for which T cell responses are more robust or durable than antibody responses are accessible for skin testing.

中文翻译：

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用于检测分枝杆菌感染的皮肤测试：成就、当前观点和对其他疾病的影响

摘要

免疫学和分子学的进步使许多疾病的诊断测试现代化。尽管已经开发了干扰素 γ 释放和聚合酶链反应测定来检测结核分枝杆菌(Mtb) 感染，基于纯化蛋白衍生物 (PPD) 的结核菌素皮肤试验 (TST) 仍然是最广泛使用的方法。事实上，TST 是一种简单且具有成本效益的工具，可轻松应用于 Mtb 感染的广泛筛查。然而，缺乏特异性一直是这些测试的限制，而且最近出现了供应问题。在历史上已在结核病和麻风病控制计划中使用的皮肤测试的基础上，我们讨论了使用现代技术改进分枝杆菌皮肤测试的最新发展以及该技术固有的实际优势。此外，我们概述了如何应用这些知识来开发类似的测试，这些测试可能有利于其他感染的诊断策略。

关键点

•皮肤测试提供了一种比大多数现代技术便宜得多的替代方法。

•皮肤测试提供了一种独立于实验室的诊断策略，可广泛应用。

• T 细胞反应比抗体反应更强烈或更持久的疾病可用于皮肤测试。