CVI Accepts, published online ahead of print on 18 June 2008

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Clin. Vaccine Immunol. doi:10.1128/CVI.00434-07
Copyright (c) 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Kinetics of immune response in tularemia: comparison between ELISA, tube agglutination and a novel whole blood lymphocyte stimulation test

Henrik Eliasson^*, Per Olcén, Anders Sjöstedt, Margareta Jurstrand, Erik Bäck, and Sören Andersson

Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden; Department of Clinical Microbiology and Immunology, Örebro University Hospital, Örebro, Sweden; Department of Clinical Medicine, Örebro University, Örebro, Sweden; Department of Clinical Microbiology, Umeå University Hospital, Umeå, Sweden; Clinical Research Centre, Örebro University Hospital, Örebro, Sweden; Department of Virology, Immunology and Vaccinology, Swedish Institute for Infectious Disease Control, Stockholm, Sweden

^* To whom correspondence should be addressed. Email: henrik.eliasson{at}orebroll.se.

We have developed and evaluated a novel and simplified whole blood lymphocyte stimulation assay, focusing on the measurement of interferon-gamma after 24-h stimulation with whole cell tularemia antigen, and a tularemia ELISA based on highly purified lipopolysaccharide antigen. Comparison of the kinetics of the two assays and the traditional tube agglutination test shows that the cellular immune response can be detected earlier through the lymphocyte stimulation assay. This test shows a high proportion of positive results already during the first week after onset of the disease, may be applicable in everyday laboratory practice, and has the potential of changing routine diagnostics in tularemia. The new ELISA has a high sensitivity and becomes positive to a high degree during the second week of disease.