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T细胞斑点实验在诊断菌阴肺结核中的应用.docx

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T细胞斑点实验在诊断菌阴肺结核中的应用 Title:ApplicationofT-CellSpotAssayintheDiagnosisofSmear-NegativePulmonaryTuberculosis Abstract: Smear-negativepulmonarytuberculosis(TB)posesasignificantchallengeforaccurateandtimelydiagnosis.T-cellspotassay,alsoknownasinterferon-gammareleaseassays(IGRAs),hasemergedasavaluablediagnostictoolfordetectinglatentTBinfectionandactiveTBdisease.ThispaperdiscussestheapplicationofT-cellspotassayinthediagnosisofsmear-negativepulmonaryTB,emphasizingitsadvantages,limitations,andpotentialforimprovingdiagnosticaccuracyandpatientoutcomes. 1.Introduction: Smear-negativepulmonaryTB,characterizedbytheabsenceofacid-fastbacilliinsputummicroscopy,accountsforasignificantproportionofTBcasesworldwide.Thedelayeddiagnosisofsmear-negativeTBposesariskofdiseasetransmission,morbidity,andmortality.Therefore,thereisaneedformoresensitiveandspecificdiagnosticteststoidentifyindividualswithsmear-negativeTB. 2.TraditionalDiagnosticMethodsforSmear-NegativeTB: Conventionally,thediagnosisofsmear-negativeTBreliedonchestradiography,clinicalsymptoms,andmicrobiologicalculture.However,thesemethodsoftenlacksensitivity,requirealongerturnaroundtime,andmaynotdetectcaseswithlowbacterialburden.Thisnecessitatestheexplorationofalternativediagnosticapproachestoaddressthelimitationsoftraditionalmethods. 3.PrinciplesofT-CellSpotAssay: T-cellspotassaydetectsthereleaseofinterferon-gamma(IFN-γ)fromT-cellsfollowingtheirstimulationbyspecificMycobacteriumtuberculosisantigens.ThisassayreliesontheprinciplethatindividualsinfectedwithM.tuberculosiswillhaveamemoryT-cellresponse,whichcanbeelicitedbystimulationwithspecificantigens.ThereleasedIFN-γisthenquantifiedusinganenzyme-linkedimmunospotassay(ELISpot). 4.AdvantagesofT-CellSpotAssayinSmear-NegativeTBDiagnosis: 4.1IncreasedSensitivity:T-cellspotassayhasdemonstratedhighersensitivitycomparedtoconventionalmethods,particularlyinindividualswithsmear-negativeTB. 4.2EarlyDetection:T-cellspotassayallowsforthedetectionofM.tuberculosisinfectionatanearlierstagebeforethedise