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Clinical and Diagnostic Laboratory Immunology, July 1999, p. 606-609, Vol. 6, No. 4
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Cellular Immune Responses to ESAT-6 Discriminate between Patients with Pulmonary Disease Due to Mycobacterium avium Complex and Those with Pulmonary Disease Due to Mycobacterium tuberculosis

A. David Lein,1,* C. Fordham von Reyn,1 Pernille Ravn,2 C. Robert Horsburgh Jr.,3 Lorraine N. Alexander,3 and Peter Andersen2

Department of Medicine, Infectious Disease Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire,1 Department for Tuberculosis Immunology, Statens Serum Institute, Copenhagen, Denmark,2 and Department of Medicine, Emory University School of Medicine and Grady Memorial Hospital, Atlanta, Georgia3

Received 30 July 1998/Returned for modification 30 November 1998/Accepted 3 May 1999

ESAT-6 (for 6-kDa early secreted antigenic target) is a secreted antigen found almost exclusively in organisms of the Mycobacterium tuberculosis complex. We compared in vitro gamma interferon (IFN-gamma ) responses by peripheral blood mononuclear cells to this antigen in patients with pulmonary disease due to either Mycobacterium avium complex (MAC) or Mycobacterium tuberculosis with those in healthy, skin test-negative, control subjects. Significant IFN-gamma responses to ESAT-6 were detected in 16 (59%) of 27 M. tuberculosis pulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0 (0%) of 8 controls. Significant IFN-gamma responses to M. tuberculosis purified protein derivative were detected in 23 (85%) of 27 M. tuberculosis disease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls. M. avium sensitin was recognized in 24 (89%) of 27 M. tuberculosis disease patients, 4 (50%) of 8 MAC disease patients, and 1 (13%) of 8 controls. IFN-gamma responses to ESAT-6 are specific for disease due to M. tuberculosis and are not observed in patients with MAC disease or in healthy controls.

* Corresponding author. Mailing address: Section of Infectious Diseases, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756. Phone: (603) 650-8840. Fax: (603) 650-6199. E-mail: dlein{at}hitchcock.org.

Clinical and Diagnostic Laboratory Immunology, July 1999, p. 606-609, Vol. 6, No. 4
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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