UNLABELLED: Accurate and early diagnosis of active tuberculosis (TB) is problematic as current diagnostic methods show low sensitivity (acid-fast bacilli smears), are time-consuming (culture of biological samples) or show variable results [Mycobacterium tuberculosis (MTB)-specific PCR]. OBJECTIVES: In the course of infection, MTB-specific T cells clonally expand at the site of infection and may thus be used as diagnostic marker for active disease. DESIGN: In this cohort study, the frequency of MTB-specific, interferon (IFN)-gamma expressing CD4(+) T cells obtained from peripheral blood and the site of disease in 25 patients with suspected TB was assessed (n = 11, bronchoalveolar lavage; n = 7, pleural fluid; n = 1, ascites; n = 1, joint fluid; n = 5, cerebrospinal fluid). RESULTS: Amongst 15 patients who showed proven active TB infection, a striking increase of MTB-specific T cells was detected at the site of infection compared with peripheral blood (median increase: 28.5-fold, range: 7.25-531 fold; median of IFN-gamma-producing CD4(+) T cells from blood: 0.02%, range: 0-0.52%; median of IFN-gamma-producing CD4(+) T cells from the site of infection: 1.81%, range: 0.29-6.55%, P < 0.001). MAIN OUTCOME MEASURE: Recruitment of MTB-specific T cells to the site of infection yielded a sensitivity of 100% and specificity of 90%, irrespective of the compartment affected. CONCLUSIONS: The accumulation of MTB-specific T cells at the site of infection may prove as useful diagnostic marker for an accurate and rapid diagnosis of active TB.
UNLABELLED: Accurate and early diagnosis of active tuberculosis (TB) is problematic as current diagnostic methods show low sensitivity (acid-fast bacilli smears), are time-consuming (culture of biological samples) or show variable results [Mycobacterium tuberculosis (MTB)-specific PCR]. OBJECTIVES: In the course of infection, MTB-specific T cells clonally expand at the site of infection and may thus be used as diagnostic marker for active disease. DESIGN: In this cohort study, the frequency of MTB-specific, interferon (IFN)-gamma expressing CD4(+) T cells obtained from peripheral blood and the site of disease in 25 patients with suspected TB was assessed (n = 11, bronchoalveolar lavage; n = 7, pleural fluid; n = 1, ascites; n = 1, joint fluid; n = 5, cerebrospinal fluid). RESULTS: Amongst 15 patients who showed proven active TB infection, a striking increase of MTB-specific T cells was detected at the site of infection compared with peripheral blood (median increase: 28.5-fold, range: 7.25-531 fold; median of IFN-gamma-producing CD4(+) T cells from blood: 0.02%, range: 0-0.52%; median of IFN-gamma-producing CD4(+) T cells from the site of infection: 1.81%, range: 0.29-6.55%, P < 0.001). MAIN OUTCOME MEASURE: Recruitment of MTB-specific T cells to the site of infection yielded a sensitivity of 100% and specificity of 90%, irrespective of the compartment affected. CONCLUSIONS: The accumulation of MTB-specific T cells at the site of infection may prove as useful diagnostic marker for an accurate and rapid diagnosis of active TB.
Authors: Sayma Rahman; Isabelle Magalhaes; Jubayer Rahman; Raija K Ahmed; Donata R Sizemore; Charles A Scanga; Frank Weichold; Frank Verreck; Ivanela Kondova; Jerry Sadoff; Rigmor Thorstensson; Mats Spångberg; Mattias Svensson; Jan Andersson; Markus Maeurer; Susanna Brighenti Journal: Mol Med Date: 2012-05-09 Impact factor: 6.354
Authors: Jacqueline M Achkar; Stephen D Lawn; Mahomed-Yunus S Moosa; Colleen A Wright; Victoria O Kasprowicz Journal: J Infect Dis Date: 2011-11-15 Impact factor: 5.226
Authors: Claudia Jafari; Steven Thijsen; Giovanni Sotgiu; Delia Goletti; José Antonio Domínguez Benítez; Monica Losi; Ralf Eberhardt; Detlef Kirsten; Barbara Kalsdorf; Aik Bossink; Irene Latorre; Giovanni B Migliori; Alan Strassburg; Susanne Winteroll; Ulf Greinert; Luca Richeldi; Martin Ernst; Christoph Lange Journal: Am J Respir Crit Care Med Date: 2009-07-09 Impact factor: 21.405
Authors: Johannes Nemeth; Heide-Maria Winkler; Ralph H Zwick; Catharina Müller; Rudolf Rumetshofer; Lucas Boeck; Otto C Burghuber; Stefan Winkler Journal: PLoS One Date: 2012-04-16 Impact factor: 3.240
Authors: Franz Ratzinger; Harald Bruckschwaiger; Martin Wischenbart; Bernhard Parschalk; Delmiro Fernandez-Reyes; Heimo Lagler; Alexandra Indra; Wolfgang Graninger; Stefan Winkler; Sanjeev Krishna; Michael Ramharter Journal: PLoS One Date: 2012-11-21 Impact factor: 3.240