Zafari Parisa, Golpour Monireh, Hafezi Nasim, Bashash Davood, Esmaeili Seyed-Alireza, Tavakolinia Naeimeh, Rafiei Alireza
Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
IUBMB Life. 2021 Jan;73(1):26-39. doi: 10.1002/iub.2413. Epub 2020 Nov 20.
Rheumatoid arthritis (RA) is known to be related to an elevated risk of infections because of its pathobiology and the use of immunosuppressive therapies. Reactivation of latent tuberculosis (TB) infection is a serious issue in patients with RA, especially after receiving anti-TNFs therapy. TNF blocking reinforces the TB granuloma formation and maintenance and the growth of Mycobacterium tuberculosis (Mtb). After intercurrent of TB infection, the standard recommendation is that the treatment with TNF inhibitors to be withheld despite its impressive effect on suppression of inflammation until the infection has resolved. Knowing pathways and mechanisms that are common between two diseases might help to find the mechanistic basis of this comorbidity, as well as provide us a new approach to apply them as therapeutic targets or diagnostic biomarkers. Also, screening for latent TB before initiation of an anti-TNF therapy can minimize complications. This review summarizes the shared gene signature between TB and RA and discusses the biomarkers for early detection of this infection, and screening procedures as well.
类风湿性关节炎（RA）因其病理生物学特性和免疫抑制疗法的使用而与感染风险升高有关。潜伏性结核（TB）感染的重新激活在RA患者中是一个严重问题，尤其是在接受抗TNF治疗后。TNF阻断会加强结核肉芽肿的形成、维持以及结核分枝杆菌（Mtb）的生长。并发结核感染后，标准建议是尽管TNF抑制剂对抑制炎症有显著效果，但在感染解决之前应停止使用，以防止潜在的结核再激活。了解两种疾病之间的共同途径和机制可能有助于找到这种合并症的机制基础，并为我们提供一种将其用作治疗靶点或诊断生物标志物的新方法。此外，在开始抗TNF治疗前筛查潜伏性结核可以将并发症降至最低。本综述总结了结核和RA之间共享的基因特征，并讨论了这种感染的早期检测生物标志物以及筛查程序。
