[Recent advances in immunological diagnosis for tuberculosis].
Recent advances in immunological diagnosis for tuberculosis including tuberculin Mantoux test and serodiagnosis were reviewed. New tuberculins (T1327, T1456) were reported to be more specific than the conventional one (RT23). Tuberculins from atypical mycobacteria (PPD-B, PPD-Y, PPD-F) were reported as a useful tool for the diagnosis of atypical mycobacteriosis. Optical density index method is a most appropriate method for a clinical use among several methods for the expression of antigen titer in serodiagnosis using ELISA. The duration of disease is important for understanding the results. IgM antibody rises in the early stage of the disease and comes down in 10 weeks after onset, while IgG antibody rises lately. Anti-cord factor antibody is a highly specific antibody for tuberculosis and may be a potent candidate for a clinical diagnostic tool. Anti-PPD-B antibody was elevated in atypical mycobacteriosis and pulmonary tuberculosis also. The ratio of anti-PPD-B antibody to anti-PPDs antibody was elevated in atypical mycobacteriosis while it was lowered in pulmonary tuberculosis. It may be helpful for suggesting the causative organism when the sputum smear is positive. The opposite results have been reported on the serodiagnosis in HIV infection. The usefulness of serodiagnosis for tuberculosis in HIV infected patients remained controversial.