title: Potential role of immunodiagnosis for pulmonary tuberculosis using induced sputum cells.
abstract: OBJECTIVE
  To evaluate the diagnostic utility and predictors for determinate results of an enzyme-linked immunospot assay using induced sputum cells (IS ELISPOT) for a rapid diagnosis of pulmonary tuberculosis (TB).
  
  
  METHODS
  Subjects suspected of pulmonary TB who had either sputum acid fast bacilli smear-negative or not producing sputum spontaneously were prospectively enrolled. ELISPOT assay was performed using cells from induced sputum.
  
  
  RESULTS
  A total of 43 subjects, including 25 with TB (TB group) and 18 with non-TB disease (non-TB group) were enrolled. Results of IS ELISPOT were determinate in only 17/43 (39%) subjects, but all of determinate results were consistent with the final diagnosis. Of the 43 sputum samples, 11 (26%) were inadequate to perform IS ELISPOT. Of 32 adequate sputum samples, the proportion of determinate results was significantly higher in the TB group (75%, 15/20) than in the non-TB group (17%, 2/12) (p=0.002). The status of active TB was a unique predictor but smear positivity was not a significant predictor for determinate results. In addition, sensitivity of IS ELISPOT (75%, 9/12) in smear negative TB was higher than that of TB-polymerase chain reaction (25%, 3/12).
  
  
  CONCLUSIONS
  IS ELISPOT showed relatively high diagnostic value and accuracy in the TB group, independent of smear positivity. IS ELISPOT may provide additional diagnostic yield for microbiological tools in the rapid diagnosis of smear-negative TB.
authors: Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
authors: Doosoo
authors: D
authors: Jeon
authors: Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
authors: Seung Eun
authors: SE
authors: Lee
authors: Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
authors: Woo Hyun
authors: WH
authors: Cho
authors: Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
authors: Byung Hee
authors: BH
authors: Lee
authors: Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
authors: Yun Seong
authors: YS
authors: Kim
authors: International Tuberculosis Research Center, Changwon, Korea.
authors: Ji-Eun
authors: JE
authors: Lee
authors: International Tuberculosis Research Center, Changwon, Korea.
authors: Eun-Soon
authors: ES
authors: Son
authors: International Tuberculosis Research Center, Changwon, Korea.
authors: Ye-Jin
authors: YJ
authors: Lee
authors: International Tuberculosis Research Center, Changwon, Korea.
authors: Min-Sun
authors: MS
authors: Hong
authors: International Tuberculosis Research Center, Changwon, Korea. sooli10kr@yahoo.co.kr.
authors: Seok-Yong
authors: SY
authors: Eum
mesh_terms: D000328:Adult; D000368:Aged; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology
keywords: Tuberculosis; enzyme-linked immunospot assays; immunodiagnosis; induced sputum