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首页> 外文期刊>Nature clinical practice. Rheumatology >A novel assay for screening patients for latent tuberculosis infection prior to anti-TNF therapy.
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A novel assay for screening patients for latent tuberculosis infection prior to anti-TNF therapy.

机译：一种在抗TNF治疗之前筛查患者潜伏性结核感染的新方法。

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摘要

Screening for latent tuberculosis (TB) infection (LTBI) prior to anti-tumor necrosis factor (TNF) therapy is complicated by the decreased sensitivity of the purified protein derivative tuberculin skin test in immunosuppressed patients, as well as the poor specificity of the tuberculin skin test in bacillus Calmette-Guerin (BCG)-vaccinated patients. Interferon-gamma-release assays that utilize specific TB antigens (e.g. ESAT-6/CFP-10) have greater specificity for LTBI, but their relative sensitivity is unknown in the setting of immune suppression. Dinser et al. evaluated a novel flow-cytometric interferon-gamma detection assay in 97 patients with inflammatory arthritis during LTBI screening for anti-TNF therapy. Overall, 39% of patients had purified protein derivative reactivity in vitro versus 14% cutaneously, and 16% exhibited reactivity in vitro to ESAT-6/CFP-10. The results suggest that flow cytometry using TB-specific antigens might eventually provide another tool for diagnosing LTBI in patients undergoing screening prior to anti-TNF or other immunosuppressive therapies. Further evaluation of the sensitivity and specificity of this novel whole-blood assay is warranted.
机译：抗免疫坏死因子（TNF）治疗之前筛查潜伏性结核（TB）感染的原因是免疫抑制患者中纯化的蛋白衍生物结核菌素皮肤试验的敏感性降低，结核菌素皮肤的特异性较差卡介苗（BCG）接种疫苗的患者进行化验。利用特异性TB抗原（例如ESAT-6 / CFP-10）的干扰素-γ释放测定法对LTBI具有更高的特异性，但是在免疫抑制的情况下它们的相对敏感性尚不清楚。 Dinser等。在LTBI筛选抗TNF治疗过程中，对97位炎症性关节炎患者的新型流式细胞术干扰素-γ检测方法进行了评估。总体而言，39％的患者在体外具有纯化的蛋白衍生物反应性，而皮肤方面为14％，16％的患者对ESAT-6 / CFP-10具有体外反应性。结果表明，使用TB特异性抗原的流式细胞术可能最终为诊断抗TNF或其他免疫抑制疗法之前进行筛查的患者提供另一种诊断LTBI的工具。有必要进一步评估这种新颖的全血检测方法的敏感性和特异性。

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