Quantitative lung T cell responses aid the rapid diagnosis of pulmonary tuberculosis

Background:The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear.Methods:Antigen-specific interferon γ (IFNγ) responses to t...

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Vydáno v:	Thorax Ročník 64; číslo 10; s. 847 - 853
Hlavní autoři:	Dheda, K, van Zyl-Smit, R N, Meldau, R, Meldau, S, Symons, G, Khalfey, H, Govender, N, Rosu, V, Sechi, L A, Maredza, A, Semple, P, Whitelaw, A, Wainwright, H, Badri, M, Dawson, R, Bateman, E D, Zumla, A
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London BMJ Publishing Group Ltd and British Thoracic Society 01.10.2009 BMJ Publishing Group BMJ Publishing Group LTD
Témata:	Adult Antigens Antigens, Bacterial - metabolism Bacterial diseases Bacterial diseases of the respiratory system Bacteriological Techniques - methods Biological and medical sciences Biopsy Bronchoalveolar Lavage Fluid - immunology Cardiology. Vascular system Drug resistance Enzyme-Linked Immunosorbent Assay Female Histology HIV Human bacterial diseases Human immunodeficiency virus Humans Infections Infectious diseases Interferon-gamma - metabolism Lavage Lymphocytes Male Medical sciences Microscopy Mycobacterium tuberculosis - immunology Patients Pneumology T-Lymphocytes - immunology Tuberculosis Tuberculosis and atypical mycobacterial infections Tuberculosis, Pulmonary - diagnosis Tuberculosis, Pulmonary - immunology South Africa Cape Town South Africa Lung disease Respiratory disease Lung Pulmonary tuberculosis Cellular immunity Mycobacterial infection Infection Bacteriosis Anesthesia Circulatory system Diagnosis Cardiology Quantitative analysis
ISSN:	0040-6376, 1468-3296, 1468-3296
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Abstract	Background:The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear.Methods:Antigen-specific interferon γ (IFNγ) responses to the RD-1 antigens ESAT-6 and CFP-10 (T-SPOT.TB and QuantiFERON-TB-Gold-In-Tube), heparin-binding haemagglutinin and purified protein derivative were evaluated, using alveolar lavage cells, in 91 consecutively recruited South African patients suspected of having TB.Results:Of 85 evaluable patients (29% HIV+), 24, 11, 48 and 2 had definite TB, probable TB, non-TB and an uncertain diagnosis, respectively. Between 34% (T-SPOT.TB) and 41% (QuantiFERON-TB-Gold-In-Tube) of all test results were inconclusive. Failure of the positive control was significantly higher with the QuantiFERON-TB-Gold-In-Tube than with T-SPOT.TB (85% vs 46% of inconclusive results; p = 0.001). Using staphylococcal enterotoxin B, compared with phytohaemagglutinin, substantially reduced failure of the positive control (25% to 3%; p = 0.02). In evaluable samples, when the definite and non-TB groups were used for outcome analysis, the percentage sensitivity, specificity, positive predictive value and negative predictive value for T-SPOT.TB (⩾20 spots/million alveolar mononuclear cells) and QuantiFERON-TB-Gold-In-Tube (0.35 IU/ml) were 89, 94, 89 and 94% (n = 55) and 55, 86, 77 and 69% (n = 46), respectively. Rapid diagnosis of TB was achieved more frequently with T-SPOT.TB than with smear microscopy (14/24 (58%) vs. 7/24 (29%) of definite TB cases; p = 0.02). Heparin-binding haemagluttinin and purified protein derivative alveolar lymphocyte IFNγ responses had poor performance outcomes.Conclusion:Provided evaluable results are obtained, the RD-1, but not the heparin-binding haemagglutinin or purified protein derivative, alveolar lymphocyte IFNγ ELISPOT response is a useful rapid immunodiagnostic test for TB. However, test utility in high-burden settings may be limited by the high proportion of inconclusive results.
AbstractList	The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear. Antigen-specific interferon gamma (IFNgamma) responses to the RD-1 antigens ESAT-6 and CFP-10 (T-SPOT.TB and QuantiFERON-TB-Gold-In-Tube), heparin-binding haemagglutinin and purified protein derivative were evaluated, using alveolar lavage cells, in 91 consecutively recruited South African patients suspected of having TB. Of 85 evaluable patients (29% HIV+), 24, 11, 48 and 2 had definite TB, probable TB, non-TB and an uncertain diagnosis, respectively. Between 34% (T-SPOT.TB) and 41% (QuantiFERON-TB-Gold-In-Tube) of all test results were inconclusive. Failure of the positive control was significantly higher with the QuantiFERON-TB-Gold-In-Tube than with T-SPOT.TB (85% vs 46% of inconclusive results; p = 0.001). Using staphylococcal enterotoxin B, compared with phytohaemagglutinin, substantially reduced failure of the positive control (25% to 3%; p = 0.02). In evaluable samples, when the definite and non-TB groups were used for outcome analysis, the percentage sensitivity, specificity, positive predictive value and negative predictive value for T-SPOT.TB (> or = 20 spots/million alveolar mononuclear cells) and QuantiFERON-TB-Gold-In-Tube (0.35 IU/ml) were 89, 94, 89 and 94% (n = 55) and 55, 86, 77 and 69% (n = 46), respectively. Rapid diagnosis of TB was achieved more frequently with T-SPOT.TB than with smear microscopy (14/24 (58%) vs. 7/24 (29%) of definite TB cases; p = 0.02). Heparin-binding haemagluttinin and purified protein derivative alveolar lymphocyte IFNgamma responses had poor performance outcomes. Provided evaluable results are obtained, the RD-1, but not the heparin-binding haemagglutinin or purified protein derivative, alveolar lymphocyte IFNgamma ELISPOT response is a useful rapid immunodiagnostic test for TB. However, test utility in high-burden settings may be limited by the high proportion of inconclusive results. Background: The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear. Methods: Antigen-specific interferon [GAMMA] (IFN[GAMMA]) responses to the RD-1 antigens ESAT-6 and CFP-10 (T-SPOT.TB and QuantiFERON-TB-Gold-In-Tube), heparin-binding haemagglutinin and purified protein derivative were evaluated, using alveolar lavage cells, in 91 consecutively recruited South African patients suspected of having TB. Results: Of 85 evaluable patients (29% HIV+), 24, 11, 48 and 2 had definite TB, probable TB, non-TB and an uncertain diagnosis, respectively. Between 34% (T-SPOT.TB) and 41% (QuantiFERON-TB-Gold-In-Tube) of all test results were inconclusive. Failure of the positive control was significantly higher with the QuantiFERON-TB-Gold-In-Tube than with T-SPOT.TB (85% vs 46% of inconclusive results; pâ[euro]S=â[euro]S0.001). Using staphylococcal enterotoxin B, compared with phytohaemagglutinin, substantially reduced failure of the positive control (25% to 3%; pâ[euro]S=â[euro]S0.02). In evaluable samples, when the definite and non-TB groups were used for outcome analysis, the percentage sensitivity, specificity, positive predictive value and negative predictive value for T-SPOT.TB (â©¾20 spots/million alveolar mononuclear cells) and QuantiFERON-TB-Gold-In-Tube (0.35 IU/ml) were 89, 94, 89 and 94% (nâ[euro]S=â[euro]S55) and 55, 86, 77 and 69% (nâ[euro]S=â[euro]S46), respectively. Rapid diagnosis of TB was achieved more frequently with T-SPOT.TB than with smear microscopy (14/24 (58%) vs. 7/24 (29%) of definite TB cases; pâ[euro]S=â[euro]S0.02). Heparin-binding haemagluttinin and purified protein derivative alveolar lymphocyte IFN[GAMMA] responses had poor performance outcomes. Conclusion: Provided evaluable results are obtained, the RD-1, but not the heparin-binding haemagglutinin or purified protein derivative, alveolar lymphocyte IFN[GAMMA] ELISPOT response is a useful rapid immunodiagnostic test for TB. However, test utility in high-burden settings may be limited by the high proportion of inconclusive results. Background:The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear.Methods:Antigen-specific interferon γ (IFNγ) responses to the RD-1 antigens ESAT-6 and CFP-10 (T-SPOT.TB and QuantiFERON-TB-Gold-In-Tube), heparin-binding haemagglutinin and purified protein derivative were evaluated, using alveolar lavage cells, in 91 consecutively recruited South African patients suspected of having TB.Results:Of 85 evaluable patients (29% HIV+), 24, 11, 48 and 2 had definite TB, probable TB, non-TB and an uncertain diagnosis, respectively. Between 34% (T-SPOT.TB) and 41% (QuantiFERON-TB-Gold-In-Tube) of all test results were inconclusive. Failure of the positive control was significantly higher with the QuantiFERON-TB-Gold-In-Tube than with T-SPOT.TB (85% vs 46% of inconclusive results; p = 0.001). Using staphylococcal enterotoxin B, compared with phytohaemagglutinin, substantially reduced failure of the positive control (25% to 3%; p = 0.02). In evaluable samples, when the definite and non-TB groups were used for outcome analysis, the percentage sensitivity, specificity, positive predictive value and negative predictive value for T-SPOT.TB (⩾20 spots/million alveolar mononuclear cells) and QuantiFERON-TB-Gold-In-Tube (0.35 IU/ml) were 89, 94, 89 and 94% (n = 55) and 55, 86, 77 and 69% (n = 46), respectively. Rapid diagnosis of TB was achieved more frequently with T-SPOT.TB than with smear microscopy (14/24 (58%) vs. 7/24 (29%) of definite TB cases; p = 0.02). Heparin-binding haemagluttinin and purified protein derivative alveolar lymphocyte IFNγ responses had poor performance outcomes.Conclusion:Provided evaluable results are obtained, the RD-1, but not the heparin-binding haemagglutinin or purified protein derivative, alveolar lymphocyte IFNγ ELISPOT response is a useful rapid immunodiagnostic test for TB. However, test utility in high-burden settings may be limited by the high proportion of inconclusive results. The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear.BACKGROUNDThe diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and their utility for the rapid immunodiagnosis of pulmonary TB is unclear.Antigen-specific interferon gamma (IFNgamma) responses to the RD-1 antigens ESAT-6 and CFP-10 (T-SPOT.TB and QuantiFERON-TB-Gold-In-Tube), heparin-binding haemagglutinin and purified protein derivative were evaluated, using alveolar lavage cells, in 91 consecutively recruited South African patients suspected of having TB.METHODSAntigen-specific interferon gamma (IFNgamma) responses to the RD-1 antigens ESAT-6 and CFP-10 (T-SPOT.TB and QuantiFERON-TB-Gold-In-Tube), heparin-binding haemagglutinin and purified protein derivative were evaluated, using alveolar lavage cells, in 91 consecutively recruited South African patients suspected of having TB.Of 85 evaluable patients (29% HIV+), 24, 11, 48 and 2 had definite TB, probable TB, non-TB and an uncertain diagnosis, respectively. Between 34% (T-SPOT.TB) and 41% (QuantiFERON-TB-Gold-In-Tube) of all test results were inconclusive. Failure of the positive control was significantly higher with the QuantiFERON-TB-Gold-In-Tube than with T-SPOT.TB (85% vs 46% of inconclusive results; p = 0.001). Using staphylococcal enterotoxin B, compared with phytohaemagglutinin, substantially reduced failure of the positive control (25% to 3%; p = 0.02). In evaluable samples, when the definite and non-TB groups were used for outcome analysis, the percentage sensitivity, specificity, positive predictive value and negative predictive value for T-SPOT.TB (> or = 20 spots/million alveolar mononuclear cells) and QuantiFERON-TB-Gold-In-Tube (0.35 IU/ml) were 89, 94, 89 and 94% (n = 55) and 55, 86, 77 and 69% (n = 46), respectively. Rapid diagnosis of TB was achieved more frequently with T-SPOT.TB than with smear microscopy (14/24 (58%) vs. 7/24 (29%) of definite TB cases; p = 0.02). Heparin-binding haemagluttinin and purified protein derivative alveolar lymphocyte IFNgamma responses had poor performance outcomes.RESULTSOf 85 evaluable patients (29% HIV+), 24, 11, 48 and 2 had definite TB, probable TB, non-TB and an uncertain diagnosis, respectively. Between 34% (T-SPOT.TB) and 41% (QuantiFERON-TB-Gold-In-Tube) of all test results were inconclusive. Failure of the positive control was significantly higher with the QuantiFERON-TB-Gold-In-Tube than with T-SPOT.TB (85% vs 46% of inconclusive results; p = 0.001). Using staphylococcal enterotoxin B, compared with phytohaemagglutinin, substantially reduced failure of the positive control (25% to 3%; p = 0.02). In evaluable samples, when the definite and non-TB groups were used for outcome analysis, the percentage sensitivity, specificity, positive predictive value and negative predictive value for T-SPOT.TB (> or = 20 spots/million alveolar mononuclear cells) and QuantiFERON-TB-Gold-In-Tube (0.35 IU/ml) were 89, 94, 89 and 94% (n = 55) and 55, 86, 77 and 69% (n = 46), respectively. Rapid diagnosis of TB was achieved more frequently with T-SPOT.TB than with smear microscopy (14/24 (58%) vs. 7/24 (29%) of definite TB cases; p = 0.02). Heparin-binding haemagluttinin and purified protein derivative alveolar lymphocyte IFNgamma responses had poor performance outcomes.Provided evaluable results are obtained, the RD-1, but not the heparin-binding haemagglutinin or purified protein derivative, alveolar lymphocyte IFNgamma ELISPOT response is a useful rapid immunodiagnostic test for TB. However, test utility in high-burden settings may be limited by the high proportion of inconclusive results.CONCLUSIONProvided evaluable results are obtained, the RD-1, but not the heparin-binding haemagglutinin or purified protein derivative, alveolar lymphocyte IFNgamma ELISPOT response is a useful rapid immunodiagnostic test for TB. However, test utility in high-burden settings may be limited by the high proportion of inconclusive results.
Author	van Zyl-Smit, R N Maredza, A Whitelaw, A Semple, P Bateman, E D Meldau, R Meldau, S Dheda, K Zumla, A Wainwright, H Rosu, V Sechi, L A Symons, G Dawson, R Badri, M Khalfey, H Govender, N
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Copyright	BMJ Publishing Group Ltd and British Thoracic Society. All rights reserved. 2009 INIST-CNRS Copyright: 2009 BMJ Publishing Group Ltd and British Thoracic Society. All rights reserved.
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Keywords	Lung disease Respiratory disease Lung Pulmonary tuberculosis Cellular immunity Mycobacterial infection Infection Bacteriosis Anesthesia Circulatory system Diagnosis Cardiology Quantitative analysis
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References	Hougardy, Schepers, Place 2007; 2 Bossuyt, Reitsma, Bruns 2003; 49 Pai, Zwerling, Menzies 2008; 149 Dheda, Chang, Breen 2005; 172 Delogu, Bua, Pusceddu 2004; 239 Delogu, Sanguinetti, Posteraro 2006; 74 Zanetti, Bua, Delogu 2005; 12 Silver, Zukowski, Kotake 2003; 29 Ling, Flores, Riley 2008; 3 Pai, Dheda, Cunningham 2007; 7 Ribeiro-Rodrigues, Resende, Johnson 2002; 9 Barry, Lipman, Bannister 2003; 187 Gerosa, Nisii, Righetti 1999; 92 Temmerman, Pethe, Parra 2004; 10 Dheda, Chang, Breen 2005; 19 Breen, Barry, Smith 2008; 63 Robinson, Ying, Taylor 1994; 149 Guyot-Revol, Innes, Hackforth 2006; 173 Jafari, Ernst, Strassburg 2008; 31 Dheda, Udwadia, Huggett 2005; 11 Sable, Goyal, Verma 2007; 29 Condos, Rom, Liu 1998; 157 Locht, Hougardy, Rouanet 2006; 86 Hougardy, Place, Hildebrand 2007; 176 Wilkinson, Wilkinson, Pathan 2005; 40 Ortbals, Marr 1978; 117 Mazurek, Weis, Moonan 2007; 45 Nemeth, Winkler, Zwick 2009; 265 Jafari, Ernst, Kalsdorf 2006; 174 20805186 - Thorax. 2010 Sep;65(9):842; author reply 842-3
References_xml	– volume: 149 start-page: 989 year: 1994 article-title: Evidence for a Th1-like bronchoalveolar T-cell subset and predominance of interferon-gamma gene activation in pulmonary tuberculosis. publication-title: Am J Respir Crit Care Med – volume: 45 start-page: 837 year: 2007 article-title: Prospective comparison of the tuberculin skin test and 2 whole-blood interferon-gamma release assays in persons with suspected tuberculosis. publication-title: Clin Infect Dis – volume: 29 start-page: 117 year: 2003 article-title: Recruitment of antigen-specific Th1-like responses to the human lung following bronchoscopic segmental challenge with purified protein derivative of mycobacterium tuberculosis. publication-title: Am J Respir Cell Mol Biol – volume: 172 start-page: 501 year: 2005 article-title: In vivo and in vitro studies of a novel cytokine, interleukin-4delta2, in pulmonary tuberculosis. publication-title: Am J Resp Crit Care Med – volume: 63 start-page: 67 year: 2008 article-title: Clinical application of a rapid lung-orientated immunoassay in individuals with possible tuberculosis. publication-title: Thorax – volume: 92 start-page: 224 year: 1999 article-title: CD4(+) T cell clones producing both interferon-gamma and interleukin-10 predominate in bronchoalveolar lavages of active pulmonary tuberculosis patients. publication-title: Clin Immunol – volume: 117 start-page: 39 year: 1978 article-title: A comparative study of tuberculous and other mycobacterial infections and their associations with malignancy. publication-title: Am Rev Respir Dis – volume: 174 start-page: 1048 year: 2006 article-title: Rapid diagnosis of smear-negative tuberculosis by bronchoalveolar lavage enzyme-linked immunospot. publication-title: Am J Respir Crit Care Med – volume: 74 start-page: 3006 year: 2006 article-title: The hbha gene of Mycobacterium tuberculosis is specifically upregulated in the lungs but not in the spleens of aerogenically infected mice. publication-title: Infect Immun – volume: 49 start-page: 1 year: 2003 article-title: Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Standards for reporting of diagnostic accuracy. publication-title: Clin Chem – volume: 173 start-page: 803 year: 2006 article-title: Regulatory T cells are expanded in blood and disease sites in tuberculosis patients. publication-title: Am J Respir Crit Care Med – volume: 176 start-page: 409 year: 2007 article-title: Regulatory t cells depress immune responses to protective antigens in active tuberculosis. publication-title: Am J Respir Crit Care Med – volume: 7 start-page: 428 year: 2007 article-title: T-cell assays for the diagnosis of latent tuberculosis infection: moving the research agenda forward. publication-title: Lancet Infect Dis – volume: 31 start-page: 261 year: 2008 article-title: Local immunodiagnosis of pulmonary tuberculosis by enzyme-linked immunospot. publication-title: Eur Respir J – volume: 86 start-page: 303 year: 2006 article-title: Heparin-binding hemagglutinin, from an extrapulmonary dissemination factor to a powerful diagnostic and protective antigen against tuberculosis. publication-title: Tuberculosis (Edinb) – volume: 265 start-page: 163 year: 2009 article-title: Recruitment of Mycobacterium tuberculosis specific CD4+ T cells to the site of infection for diagnosis of active tuberculosis. publication-title: J Intern Med – volume: 2 start-page: e926 year: 2007 article-title: Heparin-binding-hemagglutinin-induced IFN-gamma release as a diagnostic tool for latent tuberculosis. publication-title: PLoS ONE – volume: 157 start-page: 729 year: 1998 article-title: Local immune responses correlate with presentation and outcome in tuberculosis. publication-title: Am J Respir Crit Care Med – volume: 12 start-page: 1135 year: 2005 article-title: Patients with pulmonary tuberculosis develop a strong humoral response against methylated heparin-binding hemagglutinin. publication-title: Clin Diagn Lab Immunol – volume: 29 start-page: 337 year: 2007 article-title: Lung and blood mononuclear cell responses of tuberculosis patients to mycobacterial proteins. publication-title: Eur Respir J – volume: 9 start-page: 818 year: 2002 article-title: Sputum cytokine levels in patients with pulmonary tuberculosis as early markers of mycobacterial clearance. publication-title: Clin Diagn Lab Immunol – volume: 239 start-page: 33 year: 2004 article-title: Expression and purification of recombinant methylated HBHA in Mycobacterium smegmatis. publication-title: FEMS Microbiol Lett – volume: 10 start-page: 935 year: 2004 article-title: Methylation-dependent T cell immunity to Mycobacterium tuberculosis heparin-binding hemagglutinin. publication-title: Nat Med – volume: 3 start-page: e1536 year: 2008 article-title: Commercial nucleic-acid amplification tests for diagnosis of pulmonary tuberculosis in respiratory specimens: meta-analysis and meta-regression. publication-title: PLoS ONE – volume: 11 start-page: 195 year: 2005 article-title: Utility of the antigen-specific interferon-gamma assay for the management of tuberculosis. publication-title: Curr Opin Pulm Med – volume: 187 start-page: 243 year: 2003 article-title: Purified protein derivative-activated type 1 cytokine-producing CD4+ T lymphocytes in the lung: a characteristic feature of active pulmonary and nonpulmonary tuberculosis. publication-title: J Infect Dis – volume: 19 start-page: 1601 year: 2005 article-title: Expression of a novel cytokine, IL-4delta2, in HIV and HIV–tuberculosis co-infection. publication-title: AIDS – volume: 149 start-page: 177 year: 2008 article-title: Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. publication-title: Ann Intern Med – volume: 40 start-page: 184 year: 2005 article-title: Ex vivo characterization of early secretory antigenic target 6-specific t cells at sites of active disease in pleural tuberculosis. publication-title: Clin Infect Dis – reference: 20805186 - Thorax. 2010 Sep;65(9):842; author reply 842-3
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Snippet	Background:The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T... Background: The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T... The diagnosis of smear-negative pulmonary tuberculosis (TB) is problematic. There are limited data on the profile of alveolar TB antigen-specific T cells, and...
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SubjectTerms	Adult Antigens Antigens, Bacterial - metabolism Bacterial diseases Bacterial diseases of the respiratory system Bacteriological Techniques - methods Biological and medical sciences Biopsy Bronchoalveolar Lavage Fluid - immunology Cardiology. Vascular system Drug resistance Enzyme-Linked Immunosorbent Assay Female Histology HIV Human bacterial diseases Human immunodeficiency virus Humans Infections Infectious diseases Interferon-gamma - metabolism Lavage Lymphocytes Male Medical sciences Microscopy Mycobacterium tuberculosis - immunology Patients Pneumology T-Lymphocytes - immunology Tuberculosis Tuberculosis and atypical mycobacterial infections Tuberculosis, Pulmonary - diagnosis Tuberculosis, Pulmonary - immunology
Title	Quantitative lung T cell responses aid the rapid diagnosis of pulmonary tuberculosis
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