Autoantibody prevalence in active tuberculosis: reactive or pathognomonic?

Abstract

ObjectivesTo evaluate the autoantibody in patients without corresponding symptoms, whether these autoantibody are pathognomonic or not. We hypothesised that autoantibody may be reactive to chronic infection, such as tuberculosis (TB).DesignRandomised, case–control cohort study.SettingA tertiary centre in Taiwan.ParticipantsWe randomly chose 100 patients out of the data bank of patients with TB in a tertiary medical centre. All patients completed the sera sampling. We chose 100 patients according to autoantibody prevalence in previous literature. We also chose 100 medical staff as control group.InterventionsWe tested anti-SSA, anti-SSB, anti-Sm, anti ribonucleoprotein, anti-Scl 70, anticentromere, anti-double-stranded DNA, anticardiolipin IgG and IgM in all patient and control groups. The clinical symptoms and the underlying disease were all recorded.Primary and secondary outcome measuresThe result of sera antibody titre was recorded. For those with specific positive serology results, following examination was carried out after a 3-month anti-TB medication.ResultsAnticardiolipin IgG titre was significantly higher in patients with TB than in control group. We compared the result with previous population study and found that anti-Scl70 is also significantly higher in patients with TB. The following up data in anti-Scl70 revealed decreased titre after treatment. No correlation between sera titre and clinical conditions was observed.ConclusionsIn TB endemic areas, a significant proportion (32%) of patients with TB have elevated autoantibody titres, especially anticardiolipin IgG and anti-Scl-70. Mycobacterial studies should be performed in patients with elevated serum autoantibody titres but without the typical or multiple manifestations of autoimmune diseases.Trial registrationThe study was approved by the Institutional Review Board of the hospital (NTUH REC: 9561707008) after informed consent had been obtained from the patients.

Interactions between Type 1 Interferons and the Th17 Response in Tuberculosis: Lessons Learned from Autoimmune Diseases

“…However, high BAFF levels also predispose for the development of autoreactive B-cells in AID (341). Thus, elevated BAFF levels in TB could relate to the observation that up to 32% of patients with active TB have elevated autoantibody levels (12). Such correlations between elevated BAFF levels and autoimmunity have been demonstrated in other chronic infections (342).…”

“…TB is even hypothesized to be an infection-induced AID based on the observation that diverse clinical autoimmune phenomena frequently occur in TB patients (9, 10). Furthermore, up to 32% of patients with active TB have elevated autoantibody titers (11, 12). Rational explanations for these findings could be that either TB or AID activate common immunological pathways (10), or protective immunity in TB increases the chance to develop AID (2).…”

Serum antiphospholipid antibody levels as biomarkers for diagnosis of pulmonary tuberculosis patients

“…18,19 In line with our results, higher levels of anti-CL antibodies were observed in TB patients than in other control groups before treatment. 19,20 However, anti-CL antibodies are also considered to be auto-antibodies produced by the immune system that non-specifically target the body's CLs, which are found almost exclusively in the inner mitochondrial membrane. 21 As anti-CL antibody levels in TB patients have rarely been investigated, it is not clear if these antibodies represent auto-antibodies or result from polyclonal B cell activation after stimulation by mycobacterial CLs.…”

The transcription, translation, transport-trail and autoimmunity: Guilt by association

“…Chronic bacterial or protozoal infections such as occur with Mycobacteria or Plasmodium species are generally not associated with the full complement of ANA specificities [52]. Furthermore they are more likely to cause ssDNA antibody positivity than consistent elevations of dsDNA autoantibodies [53].…”