Lu C Z, Qiao J, Shen T, Link H
Institute of Neurology, Shanghai Medical University, China.
Lancet. 1990 Jul 7;336(8706):10-3. doi: 10.1016/0140-6736(90)91519-g.
A nitrocellulose immunospot assay to enumerate cells secreting anti-BCG antibodies was evaluated in the diagnosis of tuberculous meningitis. Among 25 Chinese patients with this disease diagnosed on clinical and cerebrospinal fluid (CSF) criteria, 24 had anti-BCG IgG antibody secreting cells in CSF, at a median value of 56 per 10(4) CSF cells. Among 6 patients examined within one week, 5 had antibody secreting cells in CSF, and all 19 patients examined 2-8 weeks after onset had such cells in CSF. Blood examined from 5 patients contained anti-BCG IgG or IgM antibody secreting cells, but usually at much lower numbers than in corresponding CSF, indicating that the specific antibody response is largely confined to CSF. Anti-BCG antibodies measured in parallel by ELISA were slightly raised in CSF in only 1 of the 6 patients examined within a week, whereas a good correspondence was seen between numbers of antibody secreting cells and antibody concentrations from the second week onwards. Detection of anti-BCG IgG antibody secreting cells has higher sensitivity and specificity than ELISA measurement of anti-BCG IgG antibodies, and represents a new, useful method for the early diagnosis of tuberculous meningitis.
一种用于计数分泌抗卡介苗抗体细胞的硝酸纤维素免疫斑点试验在结核性脑膜炎的诊断中进行了评估。在25例根据临床和脑脊液（CSF）标准诊断为此病的中国患者中，24例脑脊液中有分泌抗卡介苗IgG抗体的细胞，每10⁴个脑脊液细胞中值为56个。在发病一周内检查的6例患者中，5例脑脊液中有抗体分泌细胞，发病后2 - 8周检查的所有19例患者脑脊液中均有此类细胞。5例患者血液中含有分泌抗卡介苗IgG或IgM抗体的细胞，但数量通常远低于相应的脑脊液，表明特异性抗体反应主要局限于脑脊液。通过ELISA平行检测的抗卡介苗抗体在发病一周内检查的6例患者中仅1例脑脊液中略有升高，而从第二周起抗体分泌细胞数量与抗体浓度之间呈现良好的对应关系。检测分泌抗卡介苗IgG抗体的细胞比ELISA检测抗卡介苗IgG抗体具有更高的敏感性和特异性，是结核性脑膜炎早期诊断的一种新的有用方法。
