Department of Rheumatology, Tel Aviv Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, 6 Weizman Street, 64239 Tel Aviv, Israel.
Rheumatol Int. 2013 Apr;33(4):949-53. doi: 10.1007/s00296-012-2487-0. Epub 2012 Aug 4.
The aim of this study is to determine the prevalence and effect of anti-tuberculosis treatment on anti-phospholipid antibodies and anti-neutrophil cytoplasmatic antibodies (ANCA) in patients with active mycobacterial infections. Thirty-three consecutive patients (age 56 years, 26 males) with recently diagnosed active tuberculosis (TB) were enrolled. Data included clinical disease features, symptom duration, multidrug resistance and presence of HIV. Serum samples taken before and after TB treatment were frozen at -20 °C and tested for anti-cardiolipin IgG (aCL), anti-β2 glycoprotein IgG (anti-β2GPI), anti-prothrombin, anti-proteinase 3 (PR3), myeloperoxidase (MPO), bactericidal/permeability (BPI) and lactoferrin. Thirty percent of patients had higher than cut-off value for anti-β2GPI, and 9 % had increased aCL. The levels of antibodies against β2GPI and aCL normalized post-treatment. A substantial proportion of patients had high baseline anti-PR3, MPO, BPI and lactoferrin levels. Most anti-lactoferrin and anti-MPO levels decreased post-treatment, while anti-PR3 increased in most of the baseline-positive patients. Some patients had de novo anti-PR3 and MPO formation after 6-month treatment. Patients with active TB have significantly increased anti-β2GPI and ANCA titers. While anti-β2GPI titers normalize post-treatment, ANCA behave in a complex way. Anti-TB treatment may induce normalization of anti-lactoferrin and anti-MPO, and de novo anti-PR3 and MPO formation.
本研究旨在确定抗结核治疗对活动性分枝杆菌感染患者抗磷脂抗体和抗中性粒细胞胞浆抗体（ANCA）的影响和流行率。共纳入 33 例连续确诊的活动性肺结核（TB）患者（年龄 56 岁，26 例男性）。数据包括临床疾病特征、症状持续时间、多药耐药和 HIV 感染情况。在 TB 治疗前后采集血清样本，于-20°C 冷冻，并检测抗心磷脂 IgG（aCL）、抗β2 糖蛋白 IgG（抗-β2GPI）、抗凝血酶原、抗蛋白酶 3（PR3）、髓过氧化物酶（MPO）、杀菌/通透性（BPI）和乳铁蛋白。30%的患者抗-β2GPI 值高于临界值，9%的患者 aCL 升高。治疗后β2GPI 和 aCL 抗体水平恢复正常。相当一部分患者的抗 PR3、MPO、BPI 和乳铁蛋白水平基线较高。大多数抗乳铁蛋白和抗 MPO 水平在治疗后下降，而大多数基线阳性患者的抗 PR3 增加。一些患者在 6 个月治疗后出现新的抗 PR3 和 MPO 形成。活动性 TB 患者抗β2GPI 和 ANCA 滴度显著升高。虽然抗β2GPI 滴度在治疗后恢复正常，但 ANCA 的表现较为复杂。抗结核治疗可能诱导抗乳铁蛋白和抗 MPO 正常化，并诱导新的抗 PR3 和 MPO 形成。
