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ELISpot was performed to detect <jats:italic>Aspergillus<\/jats:italic>-specific T cells producing Interleukin-10.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In the discovery cohort, a derived cut-off of 40 spot forming cells (SFCs)\/10<jats:sup>6<\/jats:sup> PBMCs has shown to correctly classify IA cases with a sensitivity and specificity of 89.5% and 88.6%, respectively. This cut-off is lowered to 25 SFC when considering the subset of possible IA patients, with sensitivity and specificity of 76% and 93%, respectively. The application of the 40 SFCs cut-off to the validation cohort resulted in a positivity rate of 83.3% in proven\/probable cases and a negativity rate of 92.5% in possible\/non-IA cases. Adopting the 25 SCFs cut-off, the assay resulted positive in 83.3% of proven\/probable cases while it resulted negative in 66.7% of possible\/non-IA cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>ELISpot shows promises in the diagnosis of IA and the possibility to use two distinct cut-offs with similar diagnostic performances according to patients\u2019 different pre-test probability of infection can widen its use in patients at risk.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0306728","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T17:33:08Z","timestamp":1720546388000},"page":"e0306728","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Identification and validation of diagnostic cut-offs of the ELISpot assay for the diagnosis of invasive aspergillosis in high-risk 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