通过脑脊液抗原特异性T细胞计数快速诊断结核性脑膜炎
Rapid diagnosis of Mycobacterium tuberculosis meningitis by enumeration of cerebrospinal fluid antigen-specific T-cells.
作者信息
Thomas M M, Hinks T S C, Raghuraman S, Ramalingam N, Ernst M, Nau R, Lange C, Kösters K, Gnanamuthu C, John G T, Marshall B, Lalvani A
机构信息
Department of Neurology, Christian Medical College, Vellore, India.
出版信息
Int J Tuberc Lung Dis. 2008 Jun;12(6):651-7.
Abstract
SETTING
Hospital in-patients with suspected tuberculous meningitis (TBM), predominantly in India.
OBJECTIVE
To determine whether interferon-gamma (IFN-gamma) 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-gamma 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.
摘要
研究背景
主要来自印度的疑似结核性脑膜炎（TBM）住院患者。
研究目的
确定结核性脑膜炎患者的脑脊液（CSF）中是否存在分泌γ干扰素（IFN-γ）的结核分枝杆菌抗原特异性T细胞，并评估脑脊液酶联免疫斑点法（ELISpot）诊断活动性结核性脑膜炎的可行性。
研究设计
基于医院的前瞻性盲法研究。
研究结果
过夜ELISpot检测在10例前瞻性招募的结核性脑膜炎患者中的9例脑脊液中检测到结核分枝杆菌抗原特异性IFN-γ分泌T细胞，而7例其他病因脑膜炎对照患者中未检测到。这对应诊断敏感性为90%（95%CI 56-100），特异性为100%（95%CI 59-100）。
研究结论
这项初步研究证明了一种基于T细胞的新型结核性脑膜炎诊断试验的原理，该试验快速、灵敏且特异。
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