Ranaivomanana Paulo, Razafimahefa Arimanitra, Ndiaye Mame, Razafimahatratra Crisca, Ramamonjisoa Haja, Herindrainy Perlinot, Raherison Mamy, Raherinandrasana Antso Hasina, Rakotonirina Julio, Hoffmann Jonathan, Ratovoson Rila, Rakotosamimanana Niaina
Mycobacteriology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Front Immunol. 2025 Jan 17;15:1451046. doi: 10.3389/fimmu.2024.1451046. eCollection 2024.
Diabetes mellitus (DM) is an important risk factor for the development of active tuberculosis (TB). QuantiFERON-TB Gold Plus (QFT-P), white blood cell count (WBC) assays and monocyte-to-lymphocyte ratio (MLR) reflect the inflammatory reactions associated with TB and offer the potential to monitor TB treatment to allow a better management of the disease. The aim of this study was to assess the influence of DM on the respective performances of QFT-P and WBC assays in their capacities to monitor the treatment of drug-sensitive pulmonary TB (TBP). The QFT-P and WBC were prospectively compared between TB patients with and without DM at inclusion (D0), at the end of treatment (M6) and two months after the end of treatment (M8). After laboratory measurement of glycated hemoglobin (HbA1c), the patients were categorized into two groups: the TBP (n=43) and the TBDM (n=30) groups. The TBDM patients were characterized by an elevated -specific QFT-P IFN-γ response after TB treatment compared to the TBP group (p<0.001 and p<0.05, respectively, after TB1 and TB2 antigens stimulation). A significantly higher proportion of positive QFT-P tests was observed in the TBDM group compared to the TBP group (91.3% vs 64.1%) at the end of the treatment (p=0.03). MLR analysis showed a decrease of MLR value after TB treatment for both diabetic and nondiabetic TB patients (p<0.001 and p<0.05). These data reflected from immune-host based tests used to monitor the TB treatment, seemed to further suggest that TB with concomitant DM is associated with a persistent inflammatory response after TB treatment.
糖尿病（DM）是活动性肺结核（TB）发生的重要危险因素。结核感染T细胞检测（QFT）-Plus、白细胞计数（WBC）检测和单核细胞与淋巴细胞比值（MLR）反映了与结核病相关的炎症反应，并具有监测结核病治疗以更好地管理该疾病的潜力。本研究的目的是评估DM对QFT-Plus和WBC检测在监测药物敏感型肺结核（TBP）治疗能力方面各自表现的影响。在纳入研究时（D0）、治疗结束时（M6）以及治疗结束后两个月（M8），对有和没有DM的TB患者的QFT-Plus和WBC进行前瞻性比较。在实验室测量糖化血红蛋白（HbA1c）后，将患者分为两组：TBP组（n = 43）和TBDM组（n = 30）。与TBP组相比，TBDM组患者在结核病治疗后特异性QFT-Plus IFN-γ反应升高（分别在TB1和TB2抗原刺激后，p<0.001和p<0.05）。在治疗结束时，TBDM组中QFT-Plus检测呈阳性的比例显著高于TBP组（91.3%对64.1%）（p = 0.03）。MLR分析显示，糖尿病和非糖尿病TB患者在结核病治疗后MLR值均下降（p<0.001和p<0.05）。这些从用于监测结核病治疗的基于免疫宿主的检测中反映的数据，似乎进一步表明合并DM的TB与结核病治疗后持续的炎症反应有关。
