title: Detection of active tuberculosis infection by T cell responses to early-secreted antigenic target 6-kDa protein and culture filtrate protein 10.
abstract: The purified protein derivative (PPD) skin test has no predictive value for tuberculosis (TB) in Mycobacterium bovis bacillus Calmette-Guérin (BCG)-vaccinated individuals because of cross-reactive responses to nonspecific constituents of PPD. T cell responses to early-secreted antigenic target 6-kDa protein (ESAT-6) and the newly identified culture filtrate protein 10 (CFP-10), 2 proteins specifically expressed by M. tuberculosis (MTB) but not by BCG strains, were evaluated. Most TB patients responded to ESAT-6 (92%) or CFP-10 (89%). A minority of BCG-vaccinated individuals responded to both ESAT-6 and CFP-10, their history being consistent with latent infection with MTB in the presence of protective immunity. No responses were found in PPD-negative controls. The sensitivity and specificity of the assay were 84% and 100%, respectively, at a cutoff of 300 pg of interferon-gamma/mL. These data indicate that ESAT-6 and CFP-10 are promising antigens for highly specific immunodiagnosis of TB, even in BCG-vaccinated individuals.
authors.affiliation: Dept. of Infectious Diseases, C5P, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. smarend@lumc.nl.
authors.forename: S M
authors.initials: SM
authors.lastname: Arend
authors.forename: P
authors.initials: P
authors.lastname: Andersen
authors.forename: K E
authors.initials: KE
authors.lastname: van Meijgaarden
authors.forename: R L
authors.initials: RL
authors.lastname: Skjot
authors.forename: Y W
authors.initials: YW
authors.lastname: Subronto
authors.forename: J T
authors.initials: JT
authors.lastname: van Dissel
authors.forename: T H
authors.initials: TH
authors.lastname: Ottenhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000917:Antibody Formation; D000942:Antigens, Bacterial / Q000276:immunology*; D001500:BCG Vaccine; D001426:Bacterial Proteins / Q000276:immunology*; D002648:Child; D006801:Humans; D008213:Lymphocyte Activation; D008875:Middle Aged; D012372:ROC Curve; D013601:T-Lymphocytes / Q000276:immunology*; D014374:Tuberculin Test; D014376:Tuberculosis / Q000276:immunology* / Q000517:prevention & control
chemical_list: D000942:Antigens, Bacterial; D001500:BCG Vaccine; D001426:Bacterial Proteins; C117940:CFP-10 protein, Mycobacterium tuberculosis; C093276:ESAT-6 protein, Mycobacterium tuberculosis