Lymphocyte subset analysis in QuantiFERON-TB Gold Plus and T-Spot.TB for latent tuberculosis infection in rheumatoid arthritis

Igari, Hidetoshi; Ishikawa, Satoshi; Nakazawa, Takahiro; Oya, Yoshihiro; Futami, Hidekazu; Tsuyuzaki, Mizue; Suzuki, Kiminori; Matsumura, Ryutaro

doi:10.1016/j.jiac.2017.09.012

Cited by 21 publications

(10 citation statements)

References 28 publications

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“…Therefore, in clinic, if there is a suspicious TB patient with negative IGRA result, it is necessary to distinguish whether it is truenegative, not infected with M. tb, or false-negative due to insu cient lymphocyte count or functional de ciency. It has been reported that lymphocyte subsets were strongly associated with immune response in both QFT-Plus and T-SPOT, and the patients with CD4 + T cell ≥ 650/ L and CD8 + T cell ≥ 400/ L had signi cantly higher positivity rates in both QFT-Plus and T-SPOT, which was a good evidence of our view (23).…”

Section: Lymphocyte Subsets and Clinical Featuressupporting

confidence: 80%

Clinical value and characteristic of absolute counts of lymphocyte subsets in patients with pulmonary tuberculosis: a large-scale Hospital-Based Study

Liang¹,

Bai²,

An³

et al. 2020

Preprint

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Background This research aimed to investigate the clinical value and characteristics of peripheral blood lymphocyte subsets in tuberculosis (TB) patients by flow cytometry. Methods The Absolute counts of T, CD4+ T, CD8+ T, NK, NKT and B lymphocytes were detected in 217 cases of pulmonary TB (PTB), 163 cases of PTB & extra-PTB and 65 cases of extra-PTB patients. We analyzed the change characteristic of subset counts with the clinical parameters in PTB and compared the subsets differences among PTB, PTB with extra-PTB, and extra-PTB patients. Results The absolute counts of six subsets in 75.3% of PTB patients were lower than the normal reference range, and 44% patients showed lower CD4+ lymphocytes. (1) The absolute counts of T, CD4+ T, CD8+ T and B lymphocytes was significantly lower in patients older than 60 years old. (2) The NKT cell counts was significantly lower in female patients than the males; (3) 40.8% of patients with positive etiological results and 49.2% of extra-PTB patients showed lower CD8+ T and NK cell counts below the reference range respectively. (4) The T and CD4+ T lymphocyte counts in PTB with positive IGRA were significantly higher than those with negative IGRA; (5) The T and CD8+ T cell counts in PTB with positive IgG antibody were decreased; (6) The T, CD4+ T, CD8+ T and B cell counts reduced with the increasing lesion lobe numbers, accelerated ESR, complications with anemia and low serum albumin, and NK cells also decreased in patients with anemia and low serum albumin; and the T, CD8+, and B cells significantly decreased in PTB patients with diabetes, while NKT increased. Conclusions The immune function in most TB patients is impaired and the absolute counts of lymphocyte subsets could be used as the evidence for immune intervention and monitoring the curative effect.

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Section: Lymphocyte Subsets and Clinical Featuressupporting

confidence: 80%

Clinical value and characteristic of absolute counts of lymphocyte subsets in patients with pulmonary tuberculosis: a large-scale Hospital-Based Study

Liang¹,

Bai²,

An³

et al. 2020

Preprint

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“…T‐SPOT assay with high specificity and sensitivity can be used to reduce false positive and false negative TST results respectively. Accordance to another study QFT‐Plus which is more accurate than QFT gives more positive results than T‐Spot and seems more sensitive 78 …”

Section: Screening For Latent Tb Infection In Rasupporting

confidence: 51%

“…Accordance to another study QFT-Plus which is more accurate than QFT gives more positive results than T-Spot and seems more sensitive. 78 The low specificity of TST is a common event due to the interference effect of non-TB infections especially in areas with a high prevalence of non-TB involvement and BCG vaccination. 79 Although the IGRA test has high specificity in the detection of TB infection, there are confounding factors that can make positive results uncertain.…”

Section: False Positive Tb Test Results In Ramentioning

confidence: 99%

“…94 Similar to the previous study, one evaluation in Japan showed in RA patients underlying treatment with anti-TNF agents, higher positive results of QFT-Plus and T-Spot tests were associated with CD4 T-cell >650/μl and CD8 T-cell >400/ μl compared to other groups and the rate of negative results increase with CD4 and CD8 T-cell less than these values. 78 As a result, in RA patients receiving DMARD or anti-TNF agents, reduction in lymphocyte count and activity can cause unreliable IGRA results, so assessment of TB just based on the IFN-γ value may not be an appropriate approach.…”

Section: False Negative Tb Test Results In Ramentioning

confidence: 99%

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Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening

et al. 2020

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Rheumatoid arthritis (RA) is known to be related to an elevated risk of infections because of its pathobiology and the use of immunosuppressive therapies. Reactivation of latent tuberculosis (TB) infection is a serious issue in patients with RA, especially after receiving anti-TNFs therapy. TNF blocking reinforces the TB granuloma formation and maintenance and the growth of Mycobacterium tuberculosis (Mtb). After intercurrent of TB infection, the standard recommendation is that the treatment with TNF inhibitors to be withheld despite its impressive effect on suppression of inflammation until the infection has resolved. Knowing pathways and mechanisms that are common between two diseases might help to find the mechanistic basis of this comorbidity, as well as provide us a new approach to apply them as therapeutic targets or diagnostic biomarkers. Also, screening for latent TB before initiation of an anti-TNF therapy can minimize complications. This review summarizes the shared gene signature between TB and RA and discusses the biomarkers for early detection of this infection, and screening procedures as well.

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“…Studies evaluating the new QFT-Plus assay are continuing to emerge and have primarily been performed in patients outside North America with active TB infection or as part of TB contact investigations (9,11,12,18,19). Fewer reports have focused on the performance of this new IGRA in patients with LTBI (13,20,21). To date, a single manuscript evaluating this assay has been published from the United States, which compared the performance of the QFT-Plus to that of the QFT-GIT for TB screening of HCWs practicing in a low-TB-incidence setting (8).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-Tube Interferon Gamma Release Assays in Patients at Risk for Tuberculosis and in Health Care Workers

et al. 2018

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The QuantiFERON-TB Gold Plus (QFT-Plus; Qiagen, Germantown, MD) interferon gamma release assay (IGRA) received FDA clearance in 2017 and will replace the prior version of the assay, the QFT-Gold In-Tube (QFT-GIT). Here, we compared performances of the QFT-Plus assay and the QFT-GIT version in a diverse patient population, including patients undergoing evaluation for or follow-up of latent tuberculosis infection (LTBI; = 39) or active TB infection ( = 3), and in health care workers (HCWs; = 119) at Mayo Clinic (Rochester, MN). Compared to the QFT-GIT, the QFT-Plus assay showed 91.2% (31/34) positive, 98.4% (124/126) negative, and 96.6% (156/161) overall qualitative agreement among the 161 enrolled subjects, with a Cohen's kappa value of 0.91 (excellent interrater agreement). Among the 28 patients diagnosed with LTBI at the time of enrollment, the QFT-GIT and QFT-Plus assays agreed in 24 (85.7%) patients; in all four discordant patients, the positivity of the QFT-GIT or QFT-Plus IGRA was associated with low-level interferon gamma (IFN-γ) reactivity, ranging from 0.36 IU/ml to 0.66 IU/ml. Additionally, we document a high degree of correlation between IFN-γ levels in the QFT-GIT TB antigen tube and each of the two QFT-Plus TB antigen tubes, as well as between the QFT-Plus TB1 and TB2 tubes (Pearson's correlation coefficients [] > 0.95). Overall, we show comparable results between the QFT-GIT and QFT-Plus assays in our study population composed of subjects presenting with a diverse spectrum of TB infections. Our findings suggest that the necessary transition to the QFT-Plus assay will be associated with a minimal difference in assay performance characteristics.

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Lymphocyte subset analysis in QuantiFERON-TB Gold Plus and T-Spot.TB for latent tuberculosis infection in rheumatoid arthritis

Cited by 21 publications

References 28 publications

Clinical value and characteristic of absolute counts of lymphocyte subsets in patients with pulmonary tuberculosis: a large-scale Hospital-Based Study

Clinical value and characteristic of absolute counts of lymphocyte subsets in patients with pulmonary tuberculosis: a large-scale Hospital-Based Study

Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening

Comparison of the QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-Tube Interferon Gamma Release Assays in Patients at Risk for Tuberculosis and in Health Care Workers

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