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

被引：38
|
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
收藏
页码：946 / 949
页数：4
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