Local immunodiagnosis of pulmonary TB: ELISPOT or flow cytometry, PPD or ESAT-6?

To the Editors: Immunodiagnosis is a significant addition to the diagnostic armamentarium in tuberculosis (TB) infection and disease. For some time it has been known that cells secreting type-1 cytokines, such as interferon (IFN)-γ and tumour necrosis factor-α, selectively accumulate in the lung in higher frequencies than in the blood 1, as would be expected in a disease dominated by pulmonary pathology. In a recent issue of the European Respiratory Journal , Jafari et al . 2 detailed the TB-specific response in bronchoalveolar lavage (BAL) and blood from 12 patients with culture-positive but smear negative disease. Jafari et al . 2 used a …

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