Petruccioli Elisa, Prosperini Luca, Ruggieri Serena, Vanini Valentina, Salmi Andrea, Cuzzi Gilda, Galgani Simonetta, Haggiag Shalom, Tortorella Carla, Parisi Gabriella, D'Agostino Alfio, Gualano Gina, Palmieri Fabrizio, Gasperini Claudio, Goletti Delia
Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy.
Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy.
Neurol Int. 2025 Aug 2;17(8):119. doi: 10.3390/neurolint17080119.
Disease-modifying drugs (DMDs) for multiple sclerosis (MS) slightly increase the risk of tuberculosis (TB) disease. The QuantiFERON-TB-Plus (QFT-Plus) test is approved for TB infection (TBI) screening. Currently, there are no data available regarding the characterization of QFT-Plus response in patients with MS.
This study aimed to compare the magnitude of QFT-Plus responses between patients with MS and TBI (MS-TBI) and TBI subjects without MS (NON-MS-TBI). Additionally, discordant responses to TB1/TB2 stimulation were documented. Results were evaluated considering demographic and clinical data, particularly the impact of DMDs and the type of TB exposure.
Patients with MS (N = 810) were screened for TBI (2018-2023). Thirty (3.7%) had an MS-TBI diagnosis, and 20 were recruited for the study. As a control group, we enrolled 106 NON-MS-TBI.
MS-TBI showed significantly lower IFN-γ production in response to TB1 ( = 0.01) and TB2 stimulation ( = 0.02) compared to NON-MS-TBI. The 30% of TB2 results of MS-TBI fell into the QFT-Plus grey zone (0.2-0.7 IU/mL). Only 7% of NON-MS-TBI showed this profile ( = 0.002).
MS-TBI had a lower QFT-Plus response and more borderline results compared to NON-MS-TBI. Future studies should clarify the significance of the borderline results in this vulnerable population to improve QFT-Plus accuracy regarding sensitivity, specificity, and TB prediction.
用于治疗多发性硬化症（MS）的疾病修正药物（DMDs）会略微增加患结核病（TB）的风险。QuantiFERON-TB-Plus（QFT-Plus）检测已被批准用于结核病感染（TBI）筛查。目前，尚无关于MS患者QFT-Plus反应特征的数据。
本研究旨在比较MS合并TBI患者（MS-TBI）和无MS的TBI受试者（非MS-TBI）之间QFT-Plus反应的程度。此外，记录了对TB1/TB2刺激的不一致反应。结合人口统计学和临床数据对结果进行评估，特别是DMDs的影响和TB暴露类型。
对MS患者（N = 810）进行TBI筛查（2018 - 2023年）。30例（3.7%）诊断为MS-TBI，其中20例被纳入研究。作为对照组，我们招募了106例非MS-TBI。
与非MS-TBI相比，MS-TBI对TB1刺激（P = 0.01）和TB2刺激（P = 0.02）的IFN-γ产生明显较低。MS-TBI的TB2结果中有30%落入QFT-Plus灰色区域（0.2 - 0.7 IU/mL）。只有7%的非MS-TBI显示出这种情况（P = 0.002）。
与非MS-TBI相比，MS-TBI的QFT-Plus反应较低，且更多结果处于临界状态。未来的研究应阐明这些临界结果在这一脆弱人群中的意义，以提高QFT-Plus在敏感性、特异性和TB预测方面的准确性。
