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Oxford Immunotec - A more contemporary test for TB

About Oxford Immunotec

Though it tends to be thought of as a quintessentially Victorian disease, all dusty garrets and penniless writers, tuberculosis (TB) has remained a threat through to our own time. A full 25% of the world's population has latent tuberculosis infection (LTBI), and 5-10% of these cases will become active, endangering millions of lives.

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ABOUT Oxford Immunotec

SECTOR: Patient Care

SUB SECTOR: Critical Care     

SPECIALITY: Respiratory Care and Anaesthesiology

Though it tends to be thought of as a quintessentially Victorian disease, all dusty garrets and penniless writers, tuberculosis (TB) has remained a threat through to our own time. A full 25% of the world’s population has latent tuberculosis infection (LTBI), and 5-10% of these cases will become active, endangering millions of lives.

In developed nations, where active TB is more or less eradicated, doctors focus on hunting down cases of LTBI. This focus makes sense, says Dr Martin Dedicoat, a consultant in infectious diseases at the Heart of England NHS Trust. “If you can find these people, and treat them for their LTBI, they will not progress to active TB,” he explains. “That means no one else can catch it, and TB will ultimately disappear.”

On target

In practice, though, things are not so simple. Because testing entire countries for LTBI is too time-consuming and expensive, doctors hone in on particularly vulnerable groups. At its most basic, this includes people who have come into contact with confirmed TB cases. More broadly, Dedicoat and his colleagues encourage the testing of HIV patients, people with kidney disease and those about to start taking biologic drugs. These patients can be up to 40 times more likely to develop fully fledged TB than the general population. Individuals with “social risk factors” are another target, adds Dedicoat, pointing to “heavy drinkers, homeless people and drug users.”

Within limits

For over 100 years, doctors have tracked the aforementioned cases by using a tuberculin skin test. If the person has been previously exposed to TB, a lump will form. But as Dedicoat emphasises, this method has serious limitations. “It has operator variability,” he explains. “You might inject it wrong or people’s skin is different.” This can create false positive results in some cases. Given treatment for TB can cause side effects of its own – notably liver disease – old-fashioned epidemiological tests risk cutting the life expectancy of patients who have never had TB.

Spot the difference

One solution is the so-called interferon-gamma release assay (IGRA) method. Rather than messing around with patients’ skin, IGRA testing is done in vitro. “What the IGRA test involves is that you take a patient’s blood, isolate their T-cells and stimulate them with TB proteins,” Dedicoat explains. “If the patient’s lymphocytes have been exposed to TB before, it’ll react and release interferon gamma, which can be detected with a colour change or by looking at spots on the bottom of a 96 well plate. You can count the spots and quantify how much interferon gamma is released.”

Two IGRA tests are currently available. One is called T-SPOT.TB, developed by Oxford Immunotec. IGRA has improved TB diagnostics, for example by preventing cross-reactivity to the BCG vaccination.

A quarter of the world’s population has latent tuberculosis infection (LTBI), and 5-10% of these cases will become active, endangering millions of lives.

Although IGRA can accurately inform doctors if someone has TB infection, alone it cannot distinguish active from latent disease, nor predict the risk that latent TB will develop into the more dangerous form of the disease. However, Oxford Immunotec is working assiduously to improve the T-SPOT.TB test, and Dedicoat notes that tests predicting risk have already been done “experimentally”.

Raring to go

Given its successes already – the T-SPOT.TB test was licensed by FDA in 2008 – there is every reason to hope that Oxford Immuntec can offer a risk-prediction test soon. For his part, Dedicoat is enthusiastic about what the future might bring. “A test with inbuilt risk prediction would help us prioritise who we treat,” he says. Combine these timesaving advantages with the cost-effectiveness of better testing and it appears there is every reason to share his excitement.

Oxford Immunotec Global PLC
143 Park Drive Milton Park Abingdon Oxfordshire OX14 4SE
United Kingdom
Tel: +44 (0) 1235 442 780 Fax: +44 (0) 1235 442 781
United Kingdom
Contact: Oxford Immunotec
URL: www.oxfordimmunotec.com

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A more contemporary test for TB

Doctors have made huge strides in fighting tuberculosis, but challenges remain when it comes to testing methods. Practical Patient Care talks to Dr Martin Dedicoat, an expert on the disease, about how research by companies like Oxford Immunotec might help stamp out the disease for good.

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Detect latent TB infection

Latent tuberculosis infection is present in over a quarter of the world’s population. Measures to detect it, therefore, could improve the quality of life for millions of people. Dr Pranab Haldar, a senior clinical lecturer at the University of Leicester, talks about how an ambitious new study has revealed the benefits of using Oxford Immunotec’s T-SPOT.TB test over more traditional methods of detecting this infection.

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The Maldives – an end to TB within five years

To achieve the goal of making the Maldives TB-free by 2025, detecting cases of latent TB infection (LTBI) is crucial. From the Maldives, Dr Mohamed Ismail discusses the roll-out of Oxford Immunotec’s T-SPOT.TB test as part of a nationwide screening programme to find and treat every case of LTBI.

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T-cell response to Covid-19

While Covid-19 testing has been critical to controlling disease spread and directing treatment during the pandemic, conventional tests suffer from several limitations. With growing evidence for a robust and long-lasting response of T-cells to infection with SARS-CoV-2, Dr Tony Allen of Oxford Immunotec explains how T-cell tests can give clinicians a complete picture of an individual’s immune response, and represent an important addition to the Covid-19 test panel.

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Oxford Immunotec - A more contemporary test for TB

Though it tends to be thought of as a quintessentially...