Author/Editor     Berce, Vojko; Homšak, Matjaž; Brunčko, Aleksander; Koren, Brigita; Tomazin, Maja
Title     Tuberkulinski test in imunski odziv pri tuberkulozi
Translated title     Tuberculin test and the immune response in tuberculosis
Type     članek
Source     In: Tuberkuloza otrok - čas za nove smernice? Samopoškodovalno vedenje in depresija pri otrocih in mladostnikih Novosti v pediatrični gastroenterologiji : zbornik predavanj Maribor : Univerzitetni klinični center
Publication year     2012
Volume     str. 25-31
Language     slv
Abstract     Tuberkulinski test je že več kot 100 let temeljna diagnostična metoda, s katero dokazujemo okužbo z bacilom tuberkuloze. V našem odzivu na bacil tuberkuloze sodelujejo elementi naravne odpornosti, ki lahko okužbo tudi preprečijo. Če pride do okužbe, se v nekaj tednih razvije specifična celična imunost na bacil tuberkuloze, ki pa okužbe ne odstrani, ampak jo praviloma trajno zameji. Pri majhnih otrocih in imunsko oslabelih osebah pa je imunski odziv na okužbo z bacilom tuberkuloze manj učinkovit, zato pogosto pride do aktivne bolezni. Pojav celične imunosti na bacil tuberkuloze se kaže kot reakcija pozne preobčutljivosti na tuberkulin. V Sloveniji in v večini držav po svetu izvajamo tuberkulinski test intradermalno po tehniki, ki jo je uvedel francoski zdravnik Charles Mantoux. Testiramo otroke, ki so bili v tesnem stiku s kužnim tuberkuloznim bolnikom, imunsko oslabele otroke in otroke pred uvedbo imunosupresivnega zdravljenja. Na rezultat tuberkulinskega testa lahko vplivata tudi predhodno besežiranje in okužba z netuberkuloznimi mikobakterijami. V zadnjih letih lahko okužbo z bacilom tuberkuloze dokažemo tudi s testi sproščanja interferona gama, ki imajo podobno občutljivost kot tuberkulinski test, a nekoliko večjo specifičnost. V nekaterih primerih se oba testa dobro dopolnjujeta. Zaradi dobre občutljivosti, enostavnosti in dostopnosti pa tuberkulinski test v velikem delu sveta še naprej uporabljajo pri ugotavljanju okužbe z bacilom tuberkuloze in tudi kot pomembno sredstvo, ki pomaga pri omejevanju širjenja tuberkuloze.The tuberculin test has been the main diagnostic tool for detecting tuberculosis infection for more than a century. Our immune response to the tuberculosis bacillus involves elements of natural immunity, which can also prevent the infection. If infection occurs, the specific cellular immune response develops in a few weeks. This response does not eliminate the infection, but as a rule permanently limits it. However, the immune response is less effective in small children and immunocompromised persons; therefore active disease is more common in these populations. The occurrence of specific cellular immunity to the tuberculosis bacillus is established as a delayed hypersensitivity reaction to tuberculin. In Slovenia and in most countries worldwide the tuberculin test is performed according to the technique established by the French physician Charles Mantoux. We test children who have been in close contact with patients with infectious tuberculosis, immunocompromised children and children before the initiation of immunosuppressive therapy. Previous BCG vaccination or infection with non-tuberculosis mycobacteria can affect the results of the tuberculin test. In recent years tuberculosis infection can also be detected with Interferon Gamma Release Assay tests, which have a similar sensitivity and a somewhat higher specificity compared to the tuberculin test. Both tests are complementary in some circumstances. Because of its good sensitivity, simplicity and accessibility, the tuberculin test will remain in use for detecting tuberculosis infection and limiting the spreading of the disease in most parts of the world.
Descriptors     Tuberculosis
Tuberkuloza
Latent Tuberculosis
Latentna tuberkuloza
Keywords     tuberkulinski testi
imunski odziv
testi IGRA