title: Clinical application of an in-house ELISPOT assay in patients with suspicious tuberculous uveitis and no signs of active tuberculosis.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the rate of Mycobacterium tuberculosis infection in uveitis patients using an ELISPOT-IFN-gamma (ELISPOT-MTP) assay and a tuberculin skin test (TST).
  
  
  METHODS
  Fifty-three patients with suspicious tuberculous uveitis, seen at the Ocular Immunology and Uveitis Service, Scientific Institute San Raffaele, Milan, Italy, were compared with 233 healthy control subjects. All uveitis patients, together with healthy control subjects, underwent in-house ELISPOT-MTP assay and then the TST.
  
  
  RESULTS
  None of the patients had signs of active tuberculosis. A total of 75.5% of uveitis patients showed positive TST reaction while 58.5% responded positively to ELISPOT-MTP. In healthy individuals, these responses were 30.5% and 25.3%, respectively (p<0.0001). In a different diagnosis subset, TST and ELISPOT positivity were, respectively, 80% and 50% in anterior uveitis; 75% and 50% in intermediate uveitis; 100% and 87.5% in serpiginous-like choroiditis; 90% and 80% in posterior uveitis; and 57.1% and 42.9% in panuveitis. Serpiginous-like choroiditis and posterior uveitis patients had a higher number of ELISPOT-MTP positive results and a higher grade of intensity of ELISPOT-MTP responses compared to healthy control subjects (p=0.0098).
  
  
  CONCLUSIONS
  Our uveitis patients had higher M tuberculosis infection rate and grade of intensity response than healthy control subjects detected by ELISPOT-MTP. This response is statistically significant and higher in patients with serpiginous-like choroiditis and posterior uveitis.
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Modorati
authors.forename: Luigi
authors.initials: L
authors.lastname: Berchicci
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Miserocchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Scarpellini
authors.forename: Paola
authors.initials: P
authors.lastname: Mantegani
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
authors.forename: Claudio
authors.initials: C
authors.lastname: Ortis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D002648:Child; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D010446:Peptide Fragments / Q000276:immunology; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000276:immunology; D014605:Uveitis / Q000175:diagnosis* / Q000276:immunology; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D010446:Peptide Fragments