title: Gamma interferon immunospot assay of pleural effusion mononuclear cells for diagnosis of tuberculous pleurisy.
abstract: Diagnosis of tuberculous pleurisy remains a challenge in the clinic. In this study, we evaluated the usefulness of a previously developed Mycobacterium tuberculosis antigen-specific gamma interferon enzyme-linked immunospot (ELISPOT) assay in the diagnosis of tuberculous pleurisy by testing a cohort of 352 patients with pleural effusion. We found that M. tuberculosis antigen-specific gamma interferon-producing cells were enriched four to five times in pleural fluid compared with their levels in peripheral blood from patients with tuberuclous pleurisy assayed in parallel. The sensitivity, specificity, positive predictive value, and negative predictive value of the pleural fluid mononuclear cell ELISPOT assay for the diagnosis of tuberculous pleurisy were 95.7%, 100%, 100%, and 81.0%, respectively. In comparison, the sensitivity and specificity of the ELISPOT assay using peripheral blood mononuclear cells were 78.3% and 86.3%, respectively. The sensitivity and specificity of the pleural fluid adenosine deaminase activity test were 55.5% and 86.3%, respectively. These results demonstrate that the M. tuberculosis antigen-specific ELISPOT assay performed on pleural fluid mononuclear cells provides an accurate, rapid diagnosis of tuberculous pleurisy.
authors.affiliation: Shenzhen Key Lab of Infection and Immunity, Shenzhen Third People's Hospital, Guangdong Medical College, Shenzhen, China.
authors.forename: Mingfeng
authors.initials: M
authors.lastname: Liao
authors.forename: Qianting
authors.initials: Q
authors.lastname: Yang
authors.forename: Jieyun
authors.initials: J
authors.lastname: Zhang
authors.forename: Mingxia
authors.initials: M
authors.lastname: Zhang
authors.forename: Qunyi
authors.initials: Q
authors.lastname: Deng
authors.forename: Haiying
authors.initials: H
authors.lastname: Liu
authors.forename: Michael W
authors.initials: MW
authors.lastname: Graner
authors.forename: Hardy
authors.initials: H
authors.lastname: Kornfeld
authors.forename: Boping
authors.initials: B
authors.lastname: Zhou
authors.forename: Xinchun
authors.initials: X
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D010996:Pleural Effusion / Q000276:immunology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014396:Tuberculosis, Pleural / Q000175:diagnosis*; D055815:Young Adult