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Tuberculosis (TB) is the most important zoonotic bacterial disease in nonhuman primates (NHP). The current diagnostic method, the intradermal palpebral tuberculin test, has serious shortcomings. We characterized antibody responses in NHP againstMycobacterium tuberculosisto identify immunodominant antigens and develop a rapid serodiagnostic test for TB. A total of 422 NHP were evaluated, including 243 rhesus (Macaca mulatta), 46 cynomolgus (Macaca fascicularis), and 133 African green (Cercopithecus aethiops sabaeus) monkeys at five collaborative centers. Of those, 50 monkeys of the three species were experimentally inoculated withM. tuberculosis. Antibody responses were monitored every 2 to 4 weeks for up to 8 months postinfection by MultiAntigen Print ImmunoAssay with a panel of 12 recombinant antigens. All of the infected monkeys produced antibodies at various levels and with different antigen recognition patterns. ESAT-6 and MPB83 were the most frequently recognized proteins during infection. A combination of selected antigens which detected antibodies in all of the infected monkeys was designed to develop the PrimaTB STAT-PAK assay by lateral-flow technology. Serological evaluation demonstrated high diagnostic sensitivity (90%) and specificity (99%). The highest rate of TB detection was achieved when the skin test was combined with the PrimaTB STAT-PAK kit. This novel immunoassay provides a simple, rapid, and accurate test for TB in NHP.

Pulmonary toxicity occurs after the administration of several different chemotherapeutic agents. Pulmonary toxicity due to melphalan alone has not been documented. In the patient we describe respiratory symptoms and pulmonary infiltrates developed twice within two weeks of the second course of a monthly melphalan and prednisone regimen. Open lung biopsy revealed interstitial pneumonitis. The infiltrates cleared on both occasions when melphalan was withheld. Special studies performed seven weeks after the last dose of melphalan had been given revealed that the patient's alveolar macrophages suppressed phytohemagglutinin induced blastogenesis of his peripheral lymphocytes. Melphalan itself did not stimulate the blastogenesis of the peripheral lymphocytes. Melphalan should be added to the list of therapeutic agents that induce pulmonary disease. However, the pathogenesis of the disease remains to be elucidated.

Significantly decreased lymphocyte reactivity to a suboptimal concentration of phytohemagglutinin (PHA) was found in patients with Sjogren's syndrome (SS), whereas the response to an optimal concentration was generally normal. Kinetic studies were performed on control lymphocytes. Only suboptimal PHA concentrations stimulated tritiated thymidine (3H-TdR) incorporation in proportion to the number of potentially reactive lymphocytes. Kinetic studies of SS patients suggested that their low reactivity was attributable to fewer functionally reactive lymphocytes rather than to a decreased rate of proliferation.