Kinetics of T-cell-based assays on cerebrospinal fluid and peripheral blood mononuclear cells in patients with tuberculous meningitis.
10.3904/kjim.2014.29.6.793
- Author:
Ki Ho PARK
1
;
Mi Suk LEE
;
Sang Oh LEE
;
Sang Ho CHOI
;
Yang Soo KIM
;
Jun Hee WOO
;
Joong Koo KANG
;
Sang Ahm LEE
;
Sung Han KIM
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Tuberculosis;
Meningitis;
Enzyme-linked immunosorbent assay;
Cerebrospinal fluid
- MeSH:
Adult;
Antitubercular Agents/therapeutic use;
Biological Markers/blood/cerebrospinal fluid;
*Enzyme-Linked Immunospot Assay;
Female;
Humans;
Interferon-gamma/blood/cerebrospinal fluid;
*Interferon-gamma Release Tests;
Kinetics;
Male;
Middle Aged;
Predictive Value of Tests;
Prospective Studies;
Republic of Korea;
T-Lymphocytes/drug effects/*immunology/metabolism/microbiology;
Treatment Outcome;
Tuberculosis, Meningeal/blood/cerebrospinal fluid/*diagnosis/drug therapy/immunology/microbiology
- From:The Korean Journal of Internal Medicine
2014;29(6):793-799
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The goal of this study was to monitor tuberculosis (TB)-specific T-cell responses in cerebrospinal fluid-mononuclear cells (CSF-MCs) and peripheral blood mononuclear cells (PBMCs) in patients with tuberculous meningitis (TBM) over the course of anti-TB therapy. METHODS: Adult patients (> or = 16 years) with TBM admitted to Asan Medical Center, Seoul, South Korea, were prospectively enrolled between April 2008 and April 2011. Serial blood or CSF samples were collected over the course of the anti-TB therapy, and analyzed using an enzyme-linked immunosorbent spot (ELISPOT) assay. RESULTS: Serial ELISPOT assays were performed on PBMCs from 17 patients (seven definite, four probable, and six possible TBM) and CSF-MC from nine patients (all definite TBM). The median number of interferon-gamma (IFN-gamma)-producing T-cells steadily increased during the first 6 months after commencement of anti-TB therapy in PBMCs. Serial CSF-MC ELISPOT assays revealed significant variability in immune responses during the first 6 weeks of anti-TB therapy, though early increases in CSF-MC ELISPOT results were associated with treatment failure or paradoxical response. CONCLUSIONS: Serial analysis of PBMCs by ELISPOT during the course of treatment was ineffective for predicting clinical response. However, increases in TB-specific IFN-gamma-producing T-cells in CSF-MC during the early phase of anti-TB therapy may be predictive of clinical failure.
