Rheumatoid arthritis (RA) is an autoimmune disease characterised by the destruction
of articular cartilage and bone damage. The chronic treatment of RA patients causes a
higher susceptibility to infectious diseases such as tuberculosis (TB); one-third of
the world’s population is latently infected (LTBI) with Mycobacterium
tuberculosis (Mtb). The tuberculin skin test is used to identify
individuals LTBI, but many studies have shown that this test is not suitable for RA
patients. The goal of this work was to test the specific cellular immune responses to
the Mtb malate synthase (GlcB) and heat shock protein X (HspX) antigens of RA
patients and to correlate those responses with LTBI status. The T-helper (Th)1, Th17
and Treg-specific immune responses to the GlcB and HspX Mtb antigens were analysed in
RA patients candidates for tumour necrosis factor-α blocker treatment. Our results
demonstrated that LTBI RA patients had Th1-specific immune responses to GlcB and
HspX. Patients were followed up over two years and 14.3% developed active TB. After
the development of active TB, RA patients had increased numbers of Th17 and Treg
cells, similar to TB patients. These results demonstrate that a GlcB and HspX antigen
assay can be used as a diagnostic test to identify LTBI RA patients.
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