Tuberculosis (TB) is among the most important diseases of worldwide distribution with respect to both morbidity and mortality. Annually, TB afflicts about 9 million people with 2 million deaths (18). The rapid spread of TB in developing countries of Africa and Asia is accelerated by the human immunodeficiency virus epidemic and the spread of multi-and extra-drug-resistant TB (46). To protect against TB, vaccination with Mycobacterium bovis BCG has been used for more than 70 years, but its efficacy varies tremendously in different parts of the world (49). In addition, the diagnostic value of the presently used skin test reagent, the purified protein derivative (PPD) of M. tuberculosis, is low due to cross-reactivity with environmental mycobacteria and the vaccine strains of M. bovis BCG (14). Furthermore, vaccination with M. bovis BCG is contraindicated in immunocompromised subjects, including AIDS patients who are usually at a very high risk of developing TB (19). Identification of M. tuberculosis antigens useful for diagnosis and development of new vaccines is therefore an important goal in TB research.The protection against TB requires cellular immune responses mediated by T helper 1 (Th1)-type cells that secrete large quantities of gamma interferon (IFN-␥) (2, 13, 15), and therefore a primary criterion for selecting candidate antigens for vaccine design has been their ability to induce IFN-␥ responses (reviewed in reference 27). M. tuberculosis is rich in antigens that induce IFN-␥ secretion, and the presence of such antigens has been reported in purified cell walls, the cytosolic fraction, and short-term culture filtrates (ST-CF) (reviewed in reference 25). However, several studies have suggested that antigens present in ST-CF are the primary inducers of IFN-␥ secretion and provide protection against TB in mice and guinea pigs (reviewed in reference 26). It has been previously shown that two M. tuberculosis-specific antigens present in ST-CF, i.e., ESAT6 and CFP10, are frequently recognized by human Th1 cells after natural infection and therefore are important in the specific diagnosis of active and latent TB (29,31,47). Interestingly, ESAT6 and CFP10, when tested together in IFN-␥ assays, have been shown to improve the diagnostic efficacy of TB compared to results with each antigen separately (20). In addition, vaccination with ESAT6 and CFP10 has been shown to provide protection against challenge with M. tuberculosis in animal models of TB (50). However, ESAT6 and CFP10 can be used either as vaccines or as diagnostic reagents but not as both. This necessitates the identification of additional M. tuberculosis antigens, some of which could be reserved for diagnosis and others for the development of new vaccines against TB.The analysis of the M. tuberculosis genome sequence has shown that genes encoding ESAT6 and CFP10 are located in region of difference 1 (RD1) that is deleted in all vaccine strains of M. bovis BCG but present in all of the tested strains and isolates of pathogenic M. tuberculosis and M. bov...