tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2019-97-11-46-58tiblj-1354Research ArticleОБЗОРЫREVIEWSВозможности иммунологических тестов в диагностике латентной туберкулезной инфекции и туберкулезаPotentialities of immunological tests in the diagnosis of latent tuberculosis infection and tuberculosishttps://orcid.org/0000-0001-9956-2385СлогоцкаяЛ. В.SlogotskayaL. V.

Слогоцкая Людмила Владимировна - доктор медицинских наук, заведующая научно-клиническим отделом

107076, Москва, ул. Стромынка, д. 10

Ludmila V. Slogotskaya - Doctor of Medical Sciences, Head of Research Clinical Department

10, Stromynka St., Moscow, 107076

lyu186@yandex.ruhttps://orcid.org/0000-0001-8951-5219СиницынМ. В.SinitsynM. V.

Синицын Михаил Валерьевич - кандидат медицинских наук, исполняющий обязанности директора

107076, Москва, ул. Стромынка, д. 10

Mikhail V. Sinitsyn - Candidate of Medical Sciences, Acting Director

10, Stromynka St., Moscow, 107076

SinitsynMV@zdrav.mos.ruhttps://orcid.org/0000-0003-1878-4467КудлайД. А.KudlayD. A.

Кудлай Дмитрий Анатольевич

115478, Москва, Каширское шоссе, д. 24

Dmitry A. Kudlay

24, Kashirskoye Highway, Moscow, 115478

D624254@gmail.comГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом ДЗМ»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФРоссияMoscow Municipal Scientific Practical Center of Tuberculosis Control, Health Department of Moscow; Russian Medical Academy of On-going Professional EducationRussian FederationФГБУ «Государственный научный центр «Институт иммунологии» Федерального медико-биологического агентства»РоссияImmunology Research Institute by the Federal Medical Biological AgencyRussian Federation20191112201997114658Copyright © Слогоцкая Л.В., Синицын М.В., Кудлай Д.А., 20192019Слогоцкая Л.В., Синицын М.В., Кудлай Д.А.Slogotskaya L.V., Sinitsyn M.V., Kudlay D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1354

Дана оценка существующих иммунологических тестов для выявления туберкулезной инфекции (ТКП, лабораторных тестов IGRA, кожного теста с аллергеном туберкулезным рекомбинантным). Проведен анализ последних разработок по созданию иммунологических тестов, способных дифференцировать латентную туберкулезную инфекцию и активный туберкулез. Показаны трудности создания такого теста и проведения клинических испытаний. Приведен опыт Московской противотуберкулезной службы по использованию кожного теста с аллергеном туберкулезным рекомбинантным в качестве скринингового метода выявления туберкулезной инфекции, его способности выявлять инфекцию в стадии ее развития, когда превентивная терапия оказывается наиболее эффективной, поскольку противотуберкулезные препараты действуют на микобактерии, находящиеся в стадии репликации, а не в дормантном (спящем) состоянии. Такая тактика способствовала снижению заболеваемости как в группах повышенного риска заболевания, так и в целом среди населения.

The article assesses existing immunological tests aimed to detect tuberculosis infection (tuberculin skin test, IGRA, skin test with a recombinant tuberculosis allergen). The latest inventions in the development of immunological tests that can differentiate latent tuberculosis infection and active tuberculosis have been analyzed. The difficulties encountered when developing such a test and conducting clinical trials have been demonstrated. The article presents the experience of the Moscow TB service in using the skin test with recombinant tuberculosis allergen as a screening method for tuberculosis infection, its ability to detect the infection at the stage of its development when preventive therapy is most effective since anti-tuberculosis drugs kill mycobacteria that are replicating but not dormant. Such tactics contributed to the incidence rate decrease both in high-risk groups and among the general population.

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The authors declare that there are no conflicts of interest present.