Cellular Immune Responses to ESAT-6 Discriminate between Patients with Pulmonary Disease Due toMycobacterium aviumComplex and Those with Pulmonary Disease Due toMycobacterium tuberculosis

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Abstract
ESAT-6 (for 6-kDa early secreted antigenic target) is a secreted antigen found almost exclusively in organisms of theMycobacterium tuberculosiscomplex. We compared in vitro gamma interferon (IFN-γ) responses by peripheral blood mononuclear cells to this antigen in patients with pulmonary disease due to eitherMycobacterium aviumcomplex (MAC) orMycobacterium tuberculosiswith those in healthy, skin test-negative, control subjects. Significant IFN-γ responses to ESAT-6 were detected in 16 (59%) of 27M. tuberculosispulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0 (0%) of 8 controls. Significant IFN-γ responses toM. tuberculosispurified protein derivative were detected in 23 (85%) of 27M. tuberculosisdisease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls.M. aviumsensitin was recognized in 24 (89%) of 27M. tuberculosisdisease patients, 4 (50%) of 8 MAC disease patients, and 1 (13%) of 8 controls. IFN-γ responses to ESAT-6 are specific for disease due toM. tuberculosisand are not observed in patients with MAC disease or in healthy controls.

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