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Using ELISpot technology to improve the diagnosis of tuberculosis infection: from the bench to the T-SPOT.TB assay

Using ELISpot technology to improve the diagnosis of tuberculosis infection: from the bench to the T-SPOT.TB assay
Using ELISpot technology to improve the diagnosis of tuberculosis infection: from the bench to the T-SPOT.TB assay
Accurate detection and adequate treatment of latent tuberculosis infection represent a fundamental cornerstone to reduce the incidence of tuberculosis, in particular in low-incidence countries and among high-risk (i.e., immunosuppressed) individuals. Until recently, however, only the century-old tuberculin skin test was available as a diagnostic tool; its poor specificity and low sensitivity among immunosuppressed individuals has been a major limit to the implementation of effective tuberculosis control strategies. In the last years, the achievements of basic research on the genetics and immunology of Mycobacterium tuberculosis infection rapidly translated into clinical practice two elements of the vast amounts of knowledge acquired. First, the identification and use of specific antigens, which are absent in the tuberculosis vaccine and in most nontuberculous mycobacteria; and second, the identification of IFN-gamma as the main fundamental cytokine implicated in the effective immune response against M. tuberculosis. In an incredibly powerful combination, this new knowledge has been applied to enzyme-linked immunospot (ELISpot) technology, the most sensitive technique to quantify an in vitro antigen-specific cellular immune response. In only a few years, a new commercial, regulatory-approved, diagnostic assay has entered clinical practice as a substitute to the tuberculin skin test. The T-SPOT.TB test has already been applied to several hundreds of patients in the context of controlled clinical trials in different countries and prevalence areas, showing improved specificity and sensitivity in the diagnosis of latent tuberculosis infection over the skin test, in particular in those settings where the diagnosis is most needed.
1747-6348
253-260
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Cerri, Stefania
7ea9bc28-eaf2-46ce-8433-b9e732484b5f
Casali, Lucio
cfa1b4a2-79c5-4051-af45-fa0ddc9d8e9f
Fabbri, Leonardo M.
0f4844a3-b97f-4c2d-9414-bd8d5bd383b7
Ferrara, Giovanni
6c18a55d-3d70-42c9-b342-c5628de2780b
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Cerri, Stefania
7ea9bc28-eaf2-46ce-8433-b9e732484b5f
Casali, Lucio
cfa1b4a2-79c5-4051-af45-fa0ddc9d8e9f
Fabbri, Leonardo M.
0f4844a3-b97f-4c2d-9414-bd8d5bd383b7
Ferrara, Giovanni
6c18a55d-3d70-42c9-b342-c5628de2780b

Richeldi, Luca, Losi, Monica, Cerri, Stefania, Casali, Lucio, Fabbri, Leonardo M. and Ferrara, Giovanni (2008) Using ELISpot technology to improve the diagnosis of tuberculosis infection: from the bench to the T-SPOT.TB assay. Expert Review of Respiratory Medicine, 2 (2), 253-260. (doi:10.1586/17476348.2.2.253). (PMID:20477253)

Record type: Article

Abstract

Accurate detection and adequate treatment of latent tuberculosis infection represent a fundamental cornerstone to reduce the incidence of tuberculosis, in particular in low-incidence countries and among high-risk (i.e., immunosuppressed) individuals. Until recently, however, only the century-old tuberculin skin test was available as a diagnostic tool; its poor specificity and low sensitivity among immunosuppressed individuals has been a major limit to the implementation of effective tuberculosis control strategies. In the last years, the achievements of basic research on the genetics and immunology of Mycobacterium tuberculosis infection rapidly translated into clinical practice two elements of the vast amounts of knowledge acquired. First, the identification and use of specific antigens, which are absent in the tuberculosis vaccine and in most nontuberculous mycobacteria; and second, the identification of IFN-gamma as the main fundamental cytokine implicated in the effective immune response against M. tuberculosis. In an incredibly powerful combination, this new knowledge has been applied to enzyme-linked immunospot (ELISpot) technology, the most sensitive technique to quantify an in vitro antigen-specific cellular immune response. In only a few years, a new commercial, regulatory-approved, diagnostic assay has entered clinical practice as a substitute to the tuberculin skin test. The T-SPOT.TB test has already been applied to several hundreds of patients in the context of controlled clinical trials in different countries and prevalence areas, showing improved specificity and sensitivity in the diagnosis of latent tuberculosis infection over the skin test, in particular in those settings where the diagnosis is most needed.

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More information

Published date: April 2008
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 369068
URI: http://eprints.soton.ac.uk/id/eprint/369068
ISSN: 1747-6348
PURE UUID: 857b7e37-77fe-4474-80c1-29bada00d76e

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Date deposited: 24 Sep 2014 11:32
Last modified: 14 Mar 2024 17:57

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Contributors

Author: Luca Richeldi
Author: Monica Losi
Author: Stefania Cerri
Author: Lucio Casali
Author: Leonardo M. Fabbri
Author: Giovanni Ferrara

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