干扰素-γ释放试验诊断银屑病患者结核感染。

Diagnosis of tuberculosis infection by interferon-gamma release assays in patients with psoriasis.

机构信息

Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain.

Servei de Dermatologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.

出版信息

J Infect. 2014 Dec;69(6):600-6. doi: 10.1016/j.jinf.2014.07.026. Epub 2014 Aug 19.

DOI:10.1016/j.jinf.2014.07.026

PMID:25148944

Abstract

OBJECTIVE

In this study, we have performed a direct comparison between both T-cell based assays (QFN-G-IT and T-SPOT.TB) and TST in patients with psoriasis taking different immunosuppressant drug-regimens.

METHODS

We have prospectively studied 103 patients with moderate-to-severe psoriasis who required latent tuberculosis infection (LTBI) screening before starting systemic immunosuppressive treatment or during its sustained use.

RESULTS

Overall number of positive results was 16.5%, 17.5% and 8.7% using T-SPOT.TB, QFN-G-IT and TST, respectively. Differences in the percentage of positive results between TST with T-SPOT.TB and QFN-G-IT were significant (p = 0.005 and p = 0.008, respectively). A total of 24.3% of the subjects enrolled were positive for at least one of the three tests performed. Sixteen patients with negative TST (17%) were positive for one of the two IGRAs. We obtained seven indeterminate results by T-SPOT.TB and two by QFN-G-IT. Seven patients with negative TST presented indeterminate results by either of two IFN-γ assays. Positive TST, T-SPOT.TB and QFN-G-IT results were not affected by clinical therapeutic profile.

CONCLUSIONS

Our results reveal that in vitro assays are useful methods for LTBI diagnosis in patients with psoriasis, suggesting that they might be less influenced by immunosuppression than TST.

摘要

目的

在这项研究中，我们对接受不同免疫抑制剂治疗方案的银屑病患者进行了基于 T 细胞的两种检测方法（QFN-G-IT 和 T-SPOT.TB）与 TST 的直接比较。

方法

我们前瞻性地研究了 103 例中重度银屑病患者，这些患者在开始全身免疫抑制治疗前或在持续使用期间需要进行潜伏性结核感染（LTBI）筛查。

结果

T-SPOT.TB、QFN-G-IT 和 TST 的阳性结果总比例分别为 16.5%、17.5%和 8.7%。TST 与 T-SPOT.TB 和 QFN-G-IT 的阳性结果百分比差异具有统计学意义（p=0.005 和 p=0.008）。三项检测中至少有一项阳性的受试者比例为 24.3%。16 例 TST 阴性（17%）的患者有一项 IGRAs 阳性。T-SPOT.TB 有 7 例不确定结果，QFN-G-IT 有 2 例不确定结果。7 例 TST 阴性的患者在两种 IFN-γ检测中有 1 例出现不确定结果。TST、T-SPOT.TB 和 QFN-G-IT 的阳性结果不受临床治疗方案的影响。