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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

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...

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Published in:Clinical infectious diseases 2005-05, Vol.40 (9), p.1301-1308
Main Authors: Nicol, M. P., Pienaar, D., Wood, K., Eley, B., Wilkinson, R. J., Henderson, H., Smith, L., Beatty, D.
Format: Article
Language:English
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Summary: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.
ISSN:1058-4838
1537-6591
DOI:10.1086/429245