Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Shin, Hyeonsook; Kim, Tae-Ok; Oh, Hyung-Hoon; Park, Ha Young; Chang, Jin-Sun; Ahn, Seong Hwan; Kim, Yu-Il; Lim, Sung‐Chul; Kwon, Yong Soo

doi:10.1371/journal.pone.0181887

Cited by 10 publications

(10 citation statements)

References 27 publications

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“…The poor secretion of IFN-γ might account for the low detection rate of LTBI, among the KDM subjects. Thus, IGRA might increase the false negative cases among chronic diabetes subjects and might not be an ideal test for LTBI screening among these patients, as was reported previously (Shin et al, 2017 ). The poor secretion of IFN-γ was mainly due to the failure to upregulate T-bet expression, following antigenic stimulation.…”

Section: Discussionmentioning

confidence: 77%

Unique Reciprocal Association Seen Between Latent Tuberculosis Infection and Diabetes Is Due to Immunoendocrine Modulation (DM-LTB-1)

et al. 2022

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AimThe prevalence of latent tuberculosis infection (LTBI) among diabetes patients is poorly studied. In the present study, the prevalence of LTBI among pre-diabetes and diabetes patients was studied, along with immunoendocrine biomarkers (n = 804).MethodsLTBI was screened by Quantiferon TB gold in Normal glucose tolerance [(NGT); n = 170, [Pre-diabetes (PDM; n = 209), Newly diagnosed diabetes (NDM; n = 165) and Known diabetes (KDM; n = 260) subjects. CRP, TNF-α, IL-6, IL-1β, IFN-β, IL-12, IFN-γ, IL-2, insulin, leptin, and adiponectin levels in serum and IFN-γ levels in quantiferon supernatants were quantified by ELISA. The expression of T-bet was quantified using qRT-PCR. Serum TBARS and nitrite levels were quantified by colorimetry.ResultsThe LTBI prevalence was 32% in NGT, 23% in PDM, 24% in NDM, and 32% in KDM groups, with an adjusted OR of 0.61 (p < 0.05). Downregulation of CRP, TNF-α, and nitrites and upregulation of adiponectin could be responsible for LTBI mediated protection against insulin resistance (IR), while the high levels of IL-1β, IL-12, and leptin could be responsible for IR mediated anti-TB immunity. The defective antigen-specific IFN-γ response, as seen in the KDM group, could be responsible for the low detection rate of LTBI and high probability of endogenous reactivation.ConclusionThere appears to be a biphasic relationship between diabetes-latent tuberculosis: At the early stages of diabetes it is reciprocal, while at a late stage it is synergistic, this important phenomenon obviously needs further research.

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Section: Discussionmentioning

confidence: 77%

Unique Reciprocal Association Seen Between Latent Tuberculosis Infection and Diabetes Is Due to Immunoendocrine Modulation (DM-LTB-1)

et al. 2022

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“…However, existing literature on the relationship of diabetes mellitus and results of QuantiFERON assay is equivocal, with some suggesting a greater likelihood of "indeterminate" results in diabetics while others showing no such relationship. 4 Of note, we did not have any indeterminate reading of results in our sample.…”

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confidence: 79%

Genital tuberculosis screening at an academic fertility center in the United States: a reply

Tal

Pal

2021

American Journal of Obstetrics and Gynecology

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“…Unlike other immunocompromised, patients with diabetes show their capacity to secrete high levels of IFN-γ. Therefore, diabetes does not affect the sensitivity of IGRAs [ 113 ] and the proportion of indeterminate results in diagnosing LTBI [ 114 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Interferon-Gamma Release Assays for Tuberculosis in the Immunocompromised Population

Yang

Wang

et al. 2022

Diagnostics

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Interferon-gamma release assays (IGRAs) are widely used in the diagnosis of Mycobacterium tuberculosis (M. tuberculosis) infection by detecting interferon-γ released by previously sensitized T-cells in-vitro. Currently, there are two assays based on either enzyme-linked immunosorbent assay (ELISA) or enzyme-linked immunospot (ELISPOT) technology, with several generations of products available. The diagnostic value of IGRAs in the immunocompromised population is significantly different from that in the immunocompetent population because their results are strongly affected by the host immune function. Both physiological and pathological factors can lead to an immunocompromised situation. We summarized the diagnostic value and clinical recommendations of IGRAs for different immunocompromised populations, including peoplewith physiological factors (pregnant and puerperal women, children, and older people), as well as people with pathological factors (solid organ transplantation recipients, combination with human immunodeficiency virus infection, diabetes mellitus, end-stage renal disease, end-stage liver disease, and chronic immune-mediated inflammatory diseases). Though the performance of IGRAs is not perfect and often requires a combination with other diagnostic strategies, it still has some value in the immunocompromised population. Hopefully, the newly developed IGRAs could better target this population.

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Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Cited by 10 publications

References 27 publications

Unique Reciprocal Association Seen Between Latent Tuberculosis Infection and Diabetes Is Due to Immunoendocrine Modulation (DM-LTB-1)

Unique Reciprocal Association Seen Between Latent Tuberculosis Infection and Diabetes Is Due to Immunoendocrine Modulation (DM-LTB-1)

Genital tuberculosis screening at an academic fertility center in the United States: a reply

Diagnostic Value of Interferon-Gamma Release Assays for Tuberculosis in the Immunocompromised Population

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