Corticosteroids and infliximab impair the performance of interferon-γ release assays used for diagnosis of latent tuberculosis

被引：36

作者：

Edwards, Alexander ^{[1
]}

Gao, Yifang ^{[2
,3
]}

Allan, Raymond N. ^{[1
,4
]}

Ball, Darran ^{[4
]}

de Graaf, Hans ^{[1
,4
,5
]}

Coelho, Tracy ^{[1
,6
]}

Clifford, Vanessa ^{[7
,8
]}

Curtis, Nigel ^{[7
,8
]}

Williams, Anthony ^{[2
,3
,9
,10
]}

Faust, Saul N. ^{[1
,4
,11
,12
]}

Mansour, Salah ^{[1
]}

Marshall, Ben ^{[1
,11
,13
]}

Elkington, Paul ^{[1
,11
,13
]}

Tebruegge, Marc ^{[1
,7
,8
,11
,12
]}

机构：

[1] Univ Southampton, Fac Med, Acad Unit Clin & Expt Sci, Southampton, Hants, England

[2] Univ Southampton, Acad Unit Canc Sci, Fac Med, Southampton, Hants, England

[3] Univ Hosp Southampton NHS Fdn Trust, CRUK NIHR Southampton Expt Canc Med Ctr, Southampton, Hants, England

[4] Univ Hosp Southampton NHS Fdn Trust, NIHR Wellcome Trust Clin Res Facil, Mailpoint 218,Tremona Rd, Southampton SO16 6YD, Hants, England

[5] Univ Hosp Southampton NHS Fdn Trust, Dept Paediat Rheumatol, Southampton, Hants, England

[6] Univ Hosp Southampton NHS Fdn Trust, Dept Paediat Gastroenterol, Southampton, Hants, England

[7] Univ Melbourne, Dept Paediat, Parkville, Vic, Australia

[8] Murdoch Childrens Res Inst, Parkville, Vic, Australia

[9] Univ Hosp Southampton NHS Fdn Trust, Dept Immunol, Southampton, Hants, England

[10] Univ Hosp Southampton NHS Fdn Trust, Wessex Invest Sci Hub, Southampton, Hants, England

[11] Univ Hosp Southampton NHS Fdn Trust, NIHR Resp Biomed Res Unit, Southampton, Hants, England

[12] Univ Hosp Southampton NHS Fdn Trust, Dept Paediat Infect Dis & Immunol, Southampton, Hants, England

[13] Univ Hosp NHS Fdn Trust, Dept Resp Med, Southampton, Hants, England

来源：

THORAX | 2017年 / 72卷 / 10期

基金：

英国惠康基金;

关键词：

QUANTIFERON-TB GOLD; MYCOBACTERIUM-TUBERCULOSIS; RHEUMATOID-ARTHRITIS; CYTOKINE PRODUCTION; BIOLOGICAL THERAPY; SCREENING-TESTS; ALPHA THERAPY; TUBE ASSAYS; INFECTION; SERUM;

D O I：

10.1136/thoraxjnl-2016-209397

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

The impact of immunosuppression on interferon-gamma release assays and novel cytokine biomarkers of TB infection, mycobacteria-specific IL-2, IP-10 and TNF-alpha responses was investigated in an ex vivo model. Cytokine responses in standard QuantiFERON-TB Gold in-Tube (QFT-GIT) assays were compared with duplicate assays containing dexamethasone or infliximab. Dexamethasone converted QFT-GIT results from positive to negative in 30% of participants. Antigen-stimulated interferon-gamma, IL-2 and TNF-alpha responses were markedly reduced, but IP-10 responses were preserved. Infliximab caused QFT-GIT result conversion in up to 30% of participants and substantial reductions in all cytokine responses. Therefore, corticosteroids and anti-TNF-alpha agents significantly impair interferon-gamma release assay performance. IP-10 may be a more robust TB biomarker than interferon-gamma in patients receiving corticosteroids.

引用

页码：946 / 949

页数：4

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