USEFULNESS OF MYCOBACTERIUM TUBERCULOSIS-SPECIFIC ENZYMELINKED IMMUNOSPOT ASSAY FOR THE DIAGNOSIS OF TUBERCULOUS PLEURISY

概要

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The diagnosis of tuberculous pleurisy by the analysis of pleural fluid (PF) is difficult using standard diagnostic methods. The present study examined the usefulness of mycobacterium tuberculosis (MTB)-specific enzyme-linked immunospot (ELISpot) assay for the diagnosis of tuberculous pleurisy in Japanese patients. Both peripheral blood mononuclear cells (PBMCs) and pleural fluid mononuclear cells (PFMCs) were obtained from 6 patients with tuberculous pleurisy and 10 patirnts with non-tuberculous pleurisy. We analyzed 2×10^5 cells /well of MTB-specific ELISpot assay stimulated by early secretory antigenic target-6 (ESAT-6) antigen and phytogemagglutinin (PHA). Numbers of Spot-forming cells (SFCs) treated by ESAT-6 in PBMCs did not differ significantly between tuberculous and non -tuberculous pleurisy patients. In contrast, numbers of SFCs treated by ESAT-6 were significantly higher in PFMCs in tuberculous pleurisy patients than in non-tuberculous pleurisy patients (p<0.01). Furthermore, the ratio of ESAT-6 SFCs to PHA SFCs (E/P ratio) among PFMCs was significantly higher for tuberculous pleurisy than for non-tuberculous pleurisy. These results indicate that MTB-specific ELISpot assay is useful for rapid diagnosis of tuberculous pleurisy.
名古屋市立大学の論文
2009-10-01