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Chapter 58 : Immunological Tests in Tuberculosis and Leprosy

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Abstract:

An inverse relationship between cell-mediated and humoral immunity has been described for different forms of tuberculosis and is the essential discriminator between lepromatous and tuberculoid leprosy. Studies of mice in which the genes for gamma interferon or IL-12 and their receptors have been deleted have conformed the importance of these cytokines in resisting the development of tuberculosis after aerosol challenge. Historically, antigens specific for have been identified by using pre-absorbed hyper-immune serum or monoclonal antibodies. A meta-analysis of studies, which included random allocation of subjects for BCG vaccination and measured the number of cases and/or deaths due to tuberculosis, also demonstrated significant benefit from BCG vaccination in preventing active tuberculosis. The overall relative risks for tuberculosis and for death due to tuberculosis were 0.49 and 0.29, respectively, in those who received BCG vaccination compared to non-vaccinated subjects. Four controlled trials have shown that BCG vaccination is effective against the development of leprosy, and in one trial in which both tuberculosis and leprosy were studied, benefit was confined to the prevention of leprosy. The WHO recommends BCG vaccination for children in areas where HIV infection and tuberculosis are common unless the children have symptoms of AIDS.

Citation: Bothamley G. 2006. Immunological Tests in Tuberculosis and Leprosy, p 501-509. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch58

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References

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Tables

Generic image for table
TABLE 1

Definition of a positive tuberculin test

Citation: Bothamley G. 2006. Immunological Tests in Tuberculosis and Leprosy, p 501-509. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch58
Generic image for table
TABLE 2

Summary of diagnostic value of cytokine-based and serological tests

Citation: Bothamley G. 2006. Immunological Tests in Tuberculosis and Leprosy, p 501-509. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch58

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