Maya Mary, Mathew (2007) A T cell based assay using specific Mycobacterium tuberculosis antigens, ESAT-6 and CFP 10, for the diagnosis of Tuberculous Meningitis. Masters thesis, Christian Medical College, Vellore.
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Abstract
Objectives: To evaluate usefulness of the enzyme linked immunospot assay (ELISPOT), a T cell based assay using specific Mycobacterium tuberculosis antigens, ESAT-6 and CFP 10, for the diagnosis of tuberculous meningitis. Methods: This was a prospective study carried out in the department of Neurology, Christian Medical College & Hospital, Vellore, India, from March 2004 to May 2006. Cases were adult patients with clinical features highly suggestive of tuberculous meningitis; controls were age-matched patients with meningitis of non-tuberculous etiology. ELISPOT assay was performed on CSF and heparinised peripheral venous blood. The results were analysed for specificity and sensitivity of the test. Results: A total of 14 cases and 10 controls were recruited. Out of the 14 cases of tuberculous meningitis, 8 were diagnosed as ‘highly probable’ and 6 as ‘probable’. CSF for AFB smear and culture were negative in all cases. TB PCR on CSF was positive only in one patient. ELISPOT assay in 2 of the cases and one control failed. In the rest 12 cases, it was positive in CSF and blood in 6 and only in CSF in 1. Three cases that were positive in blood and negative in CSF had low cell count. Only 8 cases were ideal for both CSF and blood analysis for the ELISPOT assay and of this 7 were positive. CSF was negative in the 9 controls. The sensitivity of the test was 87.5% and specificity 100% with positive predictive value of 100% and negative predictive value 90%. Conclusions: The enzyme-linked immunospot assay for detection of Mycobacterium tuberculosisantigen- specific interferon-γ-secreting T cells in cerebrospinal fluid from patients with tuberculous meningitis had a diagnostic sensitivity of 87.5% and specificity 100%. This pilot study demonstrates that this new T cell-based assay is a promising diagnostic test for tuberculous meningitis that is rapid and sensitive.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | T cell based assay ; Mycobacterium tuberculosis antigens ; ESAT-6 and CFP 10 ; Tuberculous Meningitis. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 30 Jun 2017 03:16 |
| Last Modified: | 30 Jun 2017 06:32 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/687 |
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