Journal Article

Enzyme-Linked Immunospot Assay Responses to Early Secretory Antigenic Target 6, Culture Filtrate Protein 10, and Purified Protein Derivative among Children with Tuberculosis: Implications for Diagnosis and Monitoring of Therapy

M. P. Nicol, D. Pienaar, K. Wood, B. Eley, R. J. Wilkinson, H. Henderson, L. Smith and D. Beatty

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 9, pages 1301-1308
Published in print May 2005 | ISSN: 1058-4838
Published online May 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/429245
Enzyme-Linked Immunospot Assay Responses to Early Secretory Antigenic Target 6, Culture Filtrate Protein 10, and Purified Protein Derivative among Children with Tuberculosis: Implications for Diagnosis and Monitoring of Therapy

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Background. The ability to detect tuberculosis-specific lymphocytes by enzyme-linked immunospot (ELISPOT) assay may have important implications for the diagnosis and monitoring of tuberculosis in children, for which routine methods lack sensitivity. We conducted a study to determine the presence and time course of ELISPOT responses in children with tuberculosis.

Methods. Blood samples were obtained from children with a clinical diagnosis of tuberculosis, and interferon-γ ELISPOT assays were performed using purified protein derivative (PPD), early secretory antigenic target 6 (ESAT-6), and culture filtrate protein 10 (CFP10) as stimulants. A subset of children were retested after 1, 3, and 6 months of therapy.

Results. Detectable responses to ESAT-6 or CFP10 were found in 49 of 70 children with clinical tuberculosis but were more frequently found in those with culture-proven disease (P = .05). The number of subjects with responses to PPD increased after 1 month of therapy (P = .0004) and decreased at 3 and 6 months.

Conclusion. Tuberculosis-specific ELISPOT testing is a promising tool that should be evaluated as a potential diagnostic test for childhood tuberculosis. We caution against the use of an early decrease in response as a marker of successful antituberculous chemotherapy.

Journal Article.  4335 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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