Immune-mediated inflammatory diseases differently affect IGRAs' accuracy for latent tuberculosis infection diagnosis in clinical practice
Latorre, Irene (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mínguez, Sonia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Carrascosa, José Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Naves, Juan Enrique (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Villar-Hernández, Raquel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Muriel-Moreno, Beatriz (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Prat i Aymerich, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
García-García, Esther (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Casas, Irma (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domènech, Eugeni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrándiz, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mateo, Lourdes (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domínguez, José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	Background. Clinical accuracy of IGRAs remains unclear on patients with immune-mediated inflammatory diseases (IMIDs). Here, we assess the impact of immunosuppressants and IMIDs on QuantiFERON-TB Gold In-Tube (QFN-G-IT) and T-SPOT. TB accuracy. Methods. Patients with IMIDs who required latent tuberculosis infection (LTBI) screening were enrolled and classified into: (i) 50 patients with inflammatory rheumatic diseases, (ii) 50 patients with psoriasis and (iii) 30 patients with Crohn's disease. A total of 44 healthy individuals without immunosuppression were also included as controls. Tuberculin skin test (TST), T-SPOT. TB and QFN-G-IT assays were performed. IGRAs were performed following manufacturer's instructions. Results. Immunosuppressant's intake was more frequent on patients with Crohn's disease and psoriasis. Positive IGRAs and TST results were reduced in Crohn's disease patients, whereas rate of indeterminate T-SPOT. TB results was increased in this group with respect to the other IMIDs analysed and controls. When IFN-γ response was studied, the levels of this cytokine after mitogen stimulation were significantly lower in Crohn's and inflammatoryrheumatic diseases than in psoriasis. Interestingly, psoriatic patients were the only ones not receiving corticosteroids. Furthermore, a negative correlation was observed between the IFN-γ secreted after mitogen stimulation and corticosteroids dose. Conclusions. IMIDs seem to negatively affect the clinical accuracy of IGRAs, being Crohn's disease patients the most affected individuals due to their concomitant drug-profile and impaired immune response.
Grants:	Instituto de Salud Carlos III PI13/01546 Instituto de Salud Carlos III PI16/01912
Note:	Altres ajuts: Sociedad Española de Neumología y Cirugía Torácica (SEPAR); Societat Catalana de Reumatologia (SCR); CERCA Programme/Generalitat de Catalunya
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 12 Núm. 12 (december 2017) , p. 1-11, ISSN 1932-6203

DOI: 10.1371/journal.pone.0189202
PMID: 29216277

11 p, 1.1 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles