title: Peripheral T cell cytokine responses for diagnosis of active tuberculosis.
abstract: BACKGROUND
  A test for diagnosis of active Tuberculosis (TB) from peripheral blood could tremendously improve clinical management of patients.
  
  
  METHODS
  Of 178 prospectively enrolled patients with possible TB, 60 patients were diagnosed with pulmonary and 27 patients with extrapulmonary TB. The frequencies of Mycobacterium tuberculosis (MTB) specific CD4(+) T cells and CD8(+) T cells producing cytokines were assessed using overnight stimulation with purified protein derivate (PPD) or early secretory antigenic target (ESAT)-6, respectively.
  
  
  RESULTS
  Among patients with active TB, an increased type 1 cytokine profile consisting of mainly CD4(+) T cell derived interferon (IFN)-γ was detectable. Despite contributing to the cytokine profile as a whole, the independent diagnostic performance of one cytokine producing T cells as well as polyfunctional T cells was poor. IFN-γ/Interleukin(IL)-2 cytokine ratios discriminated best between active TB and other diseases.
  
  
  CONCLUSIONS
  T cells producing one cytokine and polyfunctional T cells have a limited role in diagnosis of active TB. The significant shift from a "memory type" to an "effector type" cytokine profile may be useful for further development of a rapid immune-diagnostic tool for active TB.
authors.affiliation: Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Nemeth
authors.forename: Heide-Maria
authors.initials: HM
authors.lastname: Winkler
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Zwick
authors.forename: Catharina
authors.initials: C
authors.lastname: Müller
authors.forename: Rudolf
authors.initials: R
authors.lastname: Rumetshofer
authors.forename: Lucas
authors.initials: L
authors.lastname: Boeck
authors.forename: Otto C
authors.initials: OC
authors.lastname: Burghuber
authors.forename: Stefan
authors.initials: S
authors.lastname: Winkler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016207:Cytokines / Q000276:immunology; D005260:Female; D006801:Humans; D007371:Interferon-gamma; D007376:Interleukin-2; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis*
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D016207:Cytokines; C093276:ESAT-6 protein, Mycobacterium tuberculosis; D007376:Interleukin-2; D007371:Interferon-gamma