DIAGNOSIS OF TUBERCULOSIS. TUBERCULIN OR DIASKINTEST - WHAT TO CHOOSE?

Since 1952, mass tuberculin diagnosis has been made in our country for the early prevention of tuberculosis. The standardized intradermal tuberculin test with tuberculosis allergen at a concentration of 2TU of purified tuberculin in standard dilution (Mantoux test) is a major method for examining the population for tuberculosis infection. Tuberculin purified protein derivative (PPD) is a mixture of heat-killed human and bovine Mycobacterium tuberculosis culture filtrates. Its technology is to isolate the Mycobacterium proteins secreted in a concentrated synthetic culture medium after completely removing the grown biological mass of two Mycobacterium species from the latter. The fact that tuberculin contains a broad range of proteins, including low-specific ones, provides an explanation for the wide diagnostic spectrum of the agent that does not miss patients infected with other Mycobacterium species. Since 2008, Diaskintest, a chimeric genetically engineered hybrid Escherichia coli protein with a molecular weight of 27.0 kDa, has come into wide use in Russian to screen the population for tuberculosis infection. It contains the protein portions of M. tuberculosis-secreted glycoprotein ESAT6 (6.0 kDa) and CFP10 (10.0 kDa) in an amino acid sequence. Numerous studies have shown its high specificity, but inadequate sensitivity. Diaskintest and tuberculin have their niches in the diagnosis of tuberculosis and must, in a number of cases, supplement (not replace) each other. The authors consider that the standard Mantoux test should be carried out using the current agent tuberculin having a higher sensitivity than recombinant diaskintest that is easy-to-use and effective for the further confirmation for its specificity in detecting tuberculosis.

human tuberculosis, tuberculin diagnosis, tuberculin, diaskintest, delayed hypersensitivity reaction