title: Rapid diagnosis of Mycobacterium tuberculosis meningitis by enumeration of cerebrospinal fluid antigen-specific T-cells.
abstract: METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  This pilot study demonstrates proof-of-principle for a new T-cell-based diagnostic test for TBM which is rapid, sensitive and specific.
authors.affiliation: Department of Neurology, Christian Medical College, Vellore, India.
authors.forename: M M
authors.initials: MM
authors.lastname: Thomas
authors.forename: T S C
authors.initials: TS
authors.lastname: Hinks
authors.forename: S
authors.initials: S
authors.lastname: Raghuraman
authors.forename: N
authors.initials: N
authors.lastname: Ramalingam
authors.forename: M
authors.initials: M
authors.lastname: Ernst
authors.forename: R
authors.initials: R
authors.lastname: Nau
authors.forename: C
authors.initials: C
authors.lastname: Lange
authors.forename: K
authors.initials: K
authors.lastname: Kösters
authors.forename: C
authors.initials: C
authors.lastname: Gnanamuthu
authors.forename: G T
authors.initials: GT
authors.lastname: John
authors.forename: B
authors.initials: B
authors.lastname: Marshall
authors.forename: A
authors.initials: A
authors.lastname: Lalvani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D037182:T-Cell Antigen Receptor Specificity; D014390:Tuberculosis, Meningeal / Q000175:diagnosis*
chemical_list: D000942:Antigens, Bacterial; D007371:Interferon-gamma