%0 Journal Article %1 matulis_detection_2008 %A Matulis, G %A Jüni, P %A Villiger, P M %A Gadola, S D %D 2008 %J Annals of the Rheumatic Diseases %K Adult, Aged, Agents, Antibodies, Antigens, Assay, Bacterial, Combination, Diseases, Drug Factor-alpha Factors, Female, Glucocorticoids, Host, Humans, Immunocompromised Immunologic Immunosorbent Immunosuppressive Interferon-gamma, Logistic Male, Methotrexate, Middle Models, Monoclonal, Mycobacterium Necrosis Odds Prospective Ratio, Rheumatic Risk Studies, Test, Tests, Therapy, Tuberculin Tuberculosis, Tumor Vaccine, tuberculosis, {BCG} {Enzyme-Linked} %N 1 %P 84--90 %R 10.1136/ard.2007.070789 %T Detection of latent tuberculosis in immunosuppressed patients with autoimmune diseases: performance of a Mycobacterium tuberculosis antigen-specific interferon gamma assay %U http://www.ncbi.nlm.nih.gov/pubmed/17644549 %V 67 %X OBJECTIVE: To analyse the performance of a new M. tuberculosis-specific interferon gamma (IFNgamma) assay in patients with chronic inflammatory diseases who receive immunosuppressive drugs, including tumour necrosis factor alpha (TNFalpha) inhibitors. METHODS: Cellular immune responses to the M. tuberculosis-specific antigens ESAT-6, CFP-10, TB7.7 were prospectively studied in 142 consecutive patients treated for inflammatory rheumatic conditions. Results were compared with tuberculin skin tests (TSTs). Association of both tests with risk factors for latent M. tuberculosis infection (LTBI) and BCG vaccination were determined and the influence of TNFalpha inhibitors, corticosteroids, and disease modifying antirheumatic drugs (DMARDs) on antigen-specific and mitogen-induced IFNgamma secretion was analysed. RESULTS: 126/142 (89\%) patients received immunosuppressive therapy. The IFNgamma assay was more closely associated with the presence of risk factors (odds ratio (OR) = 23.8 (95\% CI 5.14 to 110) vs OR = 2.77 (1.22 to 6.27), respectively; p = 0.009), but less associated with BCG vaccination than the TST (OR = 0.47 (95\% CI 0.15 to 1.47) vs OR = 2.44 (0.74 to (8.01), respectively; p = 0.025). Agreement between the IFNgamma assay and TST results was low (kappa = 0.17; 95\% CI 0.02 to 0.32). The odds for a positive IFNgamma assay strongly increased with increasing prognostic relevance of LTBI risk factors. Neither corticosteroids nor conventional DMARDs significantly affected IFNgamma responses, but the odds for a positive IFNgamma assay were decreased in patients treated with TNFalpha inhibitors (OR = 0.21 (95\% CI 0.07 to 0.63), respectively; p = 0.006). CONCLUSIONS: These results demonstrate that the performance of the M. tuberculosis antigen-specific IFNgamma ELISA is better than the classic TST for detection of LTBI in patients receiving immunosuppressive therapy for treatment of systemic autoimmune disorders.

@article{matulis_detection_2008, abstract = {{OBJECTIVE:} To analyse the performance of a new M. tuberculosis-specific interferon gamma {(IFNgamma)} assay in patients with chronic inflammatory diseases who receive immunosuppressive drugs, including tumour necrosis factor alpha {(TNFalpha)} inhibitors. {METHODS:} Cellular immune responses to the M. tuberculosis-specific antigens {ESAT-6,} {CFP-10,} {TB7.7} were prospectively studied in 142 consecutive patients treated for inflammatory rheumatic conditions. Results were compared with tuberculin skin tests {(TSTs).} Association of both tests with risk factors for latent M. tuberculosis infection {(LTBI)} and {BCG} vaccination were determined and the influence of {TNFalpha} inhibitors, corticosteroids, and disease modifying antirheumatic drugs {(DMARDs)} on antigen-specific and mitogen-induced {IFNgamma} secretion was analysed. {RESULTS:} 126/142 (89\%) patients received immunosuppressive therapy. The {IFNgamma} assay was more closely associated with the presence of risk factors (odds ratio {(OR)} = 23.8 (95\% {CI} 5.14 to 110) vs {OR} = 2.77 (1.22 to 6.27), respectively; p = 0.009), but less associated with {BCG} vaccination than the {TST} {(OR} = 0.47 (95\% {CI} 0.15 to 1.47) vs {OR} = 2.44 (0.74 to (8.01), respectively; p = 0.025). Agreement between the {IFNgamma} assay and {TST} results was low (kappa = 0.17; 95\% {CI} 0.02 to 0.32). The odds for a positive {IFNgamma} assay strongly increased with increasing prognostic relevance of {LTBI} risk factors. Neither corticosteroids nor conventional {DMARDs} significantly affected {IFNgamma} responses, but the odds for a positive {IFNgamma} assay were decreased in patients treated with {TNFalpha} inhibitors {(OR} = 0.21 (95\% {CI} 0.07 to 0.63), respectively; p = 0.006). {CONCLUSIONS:} These results demonstrate that the performance of the M. tuberculosis antigen-specific {IFNgamma} {ELISA} is better than the classic {TST} for detection of {LTBI} in patients receiving immunosuppressive therapy for treatment of systemic autoimmune disorders.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Matulis, G and Jüni, P and Villiger, P M and Gadola, S D}, biburl = {https://www.bibsonomy.org/bibtex/29e5064b1abfde5378e8b3fe985121302/jelias}, doi = {10.1136/ard.2007.070789}, interhash = {5f314cd4b3603cca750aa4bbdb60f20f}, intrahash = {9e5064b1abfde5378e8b3fe985121302}, issn = {1468-2060}, journal = {Annals of the Rheumatic Diseases}, keywords = {Adult, Aged, Agents, Antibodies, Antigens, Assay, Bacterial, Combination, Diseases, Drug Factor-alpha Factors, Female, Glucocorticoids, Host, Humans, Immunocompromised Immunologic Immunosorbent Immunosuppressive Interferon-gamma, Logistic Male, Methotrexate, Middle Models, Monoclonal, Mycobacterium Necrosis Odds Prospective Ratio, Rheumatic Risk Studies, Test, Tests, Therapy, Tuberculin Tuberculosis, Tumor Vaccine, tuberculosis, {BCG} {Enzyme-Linked}}, month = jan, note = {{PMID:} 17644549}, number = 1, pages = {84--90}, shorttitle = {Detection of latent tuberculosis in immunosuppressed patients with autoimmune diseases}, timestamp = {2011-03-11T10:06:08.000+0100}, title = {Detection of latent tuberculosis in immunosuppressed patients with autoimmune diseases: performance of a Mycobacterium tuberculosis antigen-specific interferon gamma assay}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17644549}, volume = 67, year = 2008 }