Rapid diagnosis of Mycobacterium tuberculosis meningitis by enumeration of cerebrospinal fluid antigen-specific T-cells
OBJECTIVE: To determine whether interferon-gamma (IFN-) secreting Mycobacterium tuberculosis antigen-specific T-cells are present in the cerebrospinal fluid (CSF) of patients with TBM and to evaluate the feasibility of CSF enzyme-linked immunospot (ELISpot) for the diagnosis of active TBM.
DESIGN: Prospective blinded hospital-based study.
RESULTS: The overnight ELISpot assay detected M. tuberculosis antigen-specific IFN- secreting T-cells in CSF from nine of 10 prospectively recruited patients with TBM, and zero of seven control patients with meningitis of other aetiology. This corresponds to a diagnostic sensitivity of 90% (95%CI 56–100) and specificity of 100% (95%CI 59–100).
CONCLUSION: This pilot study demonstrates proof-of-principle for a new T-cell-based diagnostic test for TBM which is rapid, sensitive and specific.
Document Type: Regular Paper
Affiliations: 1: Department of Neurology, Christian Medical College, Vellore, India 2: Tuberculosis Immunology Group, Centre for Respiratory Infection, National Heart and Lung Institute, Imperial College, London, UK 3: Department of Nephrology, Christian Medical College, Vellore, India 4: Department of Geriatrics, Evangelisches Krankenhaus, Göttingen-Weende, Germany 5: Medical Clinic, Research Centre, Borstel, Germany 6: Institut für Hygiene, Klinikum Krefeld, Krefeld, Germany 7: Department of Respiratory Medicine, Southampton General Hospital, Southampton, UK
Publication date: 2008-06-01
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