Unregistered User If this is not your name, click here.
		Contact Us | Order Now | Journals | Bookstore | Register a colleague
	Select a ChannelAcneAIDS and HIVAllergy OtherAlzheimer'sAnaesthesiology OtherAngina Pectoris/MIAnxietyArthritis OtherAsthmaBack PainBacterial InfectionsBladder CancerBone Marrow TransplantationBreast CancerCardiology OtherCataractCell TransplantationCervical CancerCholesterol/Lipid disordersCirrhosisClinical PharmacologyColorectal CancerCongestive Heart FailureContact DermatitisContraceptionCOPDCystic FibrosisDental and Oral DisordersDepressionDermatology OtherDiabetesDialysisEating DisordersElbowEmergency MedicineEndocrinology OtherEpilepsyErectile DysfunctionFibromyalgiaGastro OtherGeneticsGenitourinary OtherGeriatricsGERD/GastritisGlaucomaH. Pylori/UlcerHaematology OtherHair LossHeadachesHepa/Biliary OtherHepatitisHipHRTHypertensionIBDImmunologyInfectious OtherInfertilityIntensive CareIrritable Bowel SyndromeKneeLeukemiasLiver CancerLung CancerLupusLymphomasMelanomaMenopauseMultiple Sclerosis Nephrology OtherNeurologic OtherNutritional / Metabolic OtherOb/Gyn OtherObesityOncology OtherOphth. OtherOphthalmic SurgeryOrgan TransplantationOrthopaedics OtherOsteoarthritisOsteoporosisOtitisOtorhino. OtherOvarian CancerPaediatricsPainPancreatic CancerParkinson'sPregnancyProstate CancerPsychiatry OtherPulmonary OtherRadiologyRenal CancerRenal FailureRespiratory InfectionsRheumatoid arthritisRheumatology OtherRhinitisSchizophreniaShoulderSleep ApnoeaSleep DisordersSpineStrokeSTDsSurgeryThyroid DisordersTransfusionTransplant Surgery OtherTraumaUrinary IncontinenceUrinary tract infectionsVaccinologyVascular DisordersViral Infections

SEARCH   News Bookstore Medline The Web Meetings & Congresses Complete Doctor's Guide    EXPLORE :    All News   All Webcasts   All Cases   All Meetings & Congresses   All Medical Resources New drugs / indications English Dictionary Medical Dictionary Thesaurus Warning | Privacy | Awards  Favourite Journals  Click here to choose your favourite journals  Favourite Sites  Click here to choose your favourite sites  Languages  Select languageEnglishFrançais

New Test Quickly IDs Active Tuberculosis in Smear-Negative Patients NEW YORK -- September 23, 2009 -- Active tuberculosis (TB) can be rapidly identified in patients with negative sputum tests by a new method, according to a study published in the October 1 issue of the American Journal of Respiratory and Critical Care Medicine. “In this study, we showed that a differentiation between active pulmonary tuberculosis and LTBI is possible by the ELISpot (enzyme-linked immunospot assay) test,” said principal investigator of the Tuberculosis Network European Trialsgroup (TBNET) study, Christoph Lange, MD, Research Centre Borstel, Borstel, Germany. The researchers found that immune cells specific to the TB bacilli are concentrated in the airways of patients with active tuberculosis. These cells could be readily identified with an enzyme-linked immunospot assay and the results of the test are available in 1 day. The ELISpot test is then able to distinguish between LTBI and active TB by comparing the frequencies of TB-specific T-lymphocytes in the blood versus in the lung. The identification of tuberculosis bacilli by culture, considered the gold standard takes several weeks. “Because bronchoalveolar lavage is routinely performed in this situation for other diagnostic purposes, the ELISpot does not result in an extra procedure for the patient,” explained Dr. Lange To determine the sensitivity and specificity of the ELISpot test, Dr. Lange and colleagues recruited 347 patients suspected of having TB, but who were either unable to produce sputum, or who had had 3 consecutive negative acid-fast bacilli sputum culture results. Their blood was drawn and bronchoaveolar lavage (BAL) was performed for use in ELISpot testing. Of the 347 patients, 71 were diagnosed with active pulmonary TB. In patients with active TB, ELISpot results were positive in 65 cases (91.5%). “These findings show us that positive result in the BAL ELISpot was highly indicative of and actual case of active TB,” said Dr. Lange. “And a negative BAL ELISpot result almost excludes active tuberculosis.” “Given the number of smear-negative cases of active TB that BAL ELISpot was subsequently able to correctly identify, about 2 in every 2 patients with smear negative pulmonary TB will benefit from BAL ELISpot testing,” said Dr. Lange. “Our results indicate that ELISpot is an important advancement to rapidly distinguish acid-fast bacilli sputum smear-negative active TB from LTBI in routine clinical practice.” “Future research about the immunodiagnosis of tuberculosis will need to identify indicators of treatment success that will allow safe discontinuation of antituberculosis therapy without an increased risk of the reactivation. This will be of great clinical importance to guide the treatment of individuals with LTBI and active tuberculosis, especially in cases of drug-resistant strains of M. tuberculosis,” said Dr. Lange. SOURCE: American Thoracic Society E-mail this page to a friend or colleague! To print, use this version