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Activity Disease in SLE Patients Affected IFN-γ in the IGRA Results.
Journal of Inflammation Research ( IF 4.5 ) Pub Date : 2020-08-14 , DOI: 10.2147/jir.s258235 Winni Maharani 1, 2 , Dwi Febni Ratnaningsih 3 , Fitria Utami 3 , Fajar Awalia Yulianto 4 , Anneke Dewina 5 , Laniyati Hamijoyo 5, 6 , Nur Atik 5, 7
Journal of Inflammation Research ( IF 4.5 ) Pub Date : 2020-08-14 , DOI: 10.2147/jir.s258235 Winni Maharani 1, 2 , Dwi Febni Ratnaningsih 3 , Fitria Utami 3 , Fajar Awalia Yulianto 4 , Anneke Dewina 5 , Laniyati Hamijoyo 5, 6 , Nur Atik 5, 7
Affiliation
Purpose: Highly active systemic lupus erythematosus (SLE) causes a high risk of tuberculosis (TB) infection in SLE patients in Indonesia, a country in which the disease, especially extrapulmonary TB, is endemic. Interferon (IFN)-γ releasing assay (IGRA) can detect latent or previous TB infection. This study sought to determine latent TB infection and levels of IFN-γ, a key player in various inflammation and autoimmune disease, in patients with SLE and relate findings to disease activity.
Patients and Methods: This experimental study included 79 female subjects distributed into three groups of active SLE, quiescent SLE and healthy controls. We used SLE Disease Activity Index– 2000 (SLEDAI-2K) scores to stratify the subjects. Each group underwent IGRA testing using the QuantiFERON-TB Gold Plus kit.
Results: We recruited 59 female patients with SLE. The patients had a median age and disease duration 30 and 5 years, respectively. Statistical analysis using the Kruskal–Wallis test showed that active condition, high SLEDAI-2K score and immunosuppressive therapies affect IGRA results. Specifically, healthy controls (n=20) were most likely to have negative IGRA results (67.09%), whilst 27.27% of active cases (n=33) and 3.85% of quiescent cases (n=26) had indeterminate results (p=0.02). The number of immunosuppressant therapies was significantly negatively correlated with IFN-γ (p=0.004). No difference in IFN-γ concentration was detected amongst the active and other groups (p> 0.05).
Conclusion: High-activity SLE and immunosuppressive therapies cause dysregulation of the immune response, which, in turn, influences IGRA results. Thus, additional testing is necessary to detect TB infection in patients with SLE.
Keywords: SLE, active, quiescent, IFN-γ, IGRA
中文翻译：
SLE 患者的活动性疾病影响 IGRA 结果中的 IFN-γ。
目的：高度活跃的系统性红斑狼疮 (SLE) 会导致印度尼西亚 SLE 患者感染结核病 (TB) 的风险很高，而印度尼西亚是该病特别是肺外结核病流行的国家。干扰素 (IFN)-γ 释放测定 (IGRA) 可以检测潜在或既往的结核感染。本研究旨在确定 SLE 患者的潜伏结核感染和 IFN-γ（各种炎症和自身免疫性疾病的关键因素）水平，并将结果与疾病活动相关联。
患者和方法：这项实验研究包括 79 名女性受试者，分为三组：活动性 SLE、静态 SLE 和健康对照。我们使用 SLE 疾病活动指数 – 2000 (SLEDAI-2K) 分数对受试者进行分层。每组均使用 QuantiFERON-TB Gold Plus 试剂盒进行 IGRA 测试。
结果：我们招募了 59 名女性 SLE 患者。患者的中位年龄和病程分别为 30 和 5 年。使用 Kruskal-Wallis 检验的统计分析表明，活跃状态、高 SLEDAI-2K 评分和免疫抑制治疗会影响 IGRA 结果。具体而言，健康对照 (n=20) 最有可能获得阴性 IGRA 结果 (67.09%)，而 27.27% 的活动病例 (n=33) 和 3.85% 的静止病例 (n=26) 的结果不确定 (p= 0.02）。免疫抑制剂治疗次数与 IFN-γ 呈显着负相关（p=0.004）。活性组和其他组之间未检测到 IFN-γ 浓度存在差异 (p> 0.05)。
结论：高活性 SLE 和免疫抑制治疗会导致免疫反应失调，进而影响 IGRA 结果。因此，需要进行额外的检测来检测 SLE 患者的结核感染。
关键词： SLE，活动性，静止性，IFN-γ，IGRA
更新日期：2020-08-14
Patients and Methods: This experimental study included 79 female subjects distributed into three groups of active SLE, quiescent SLE and healthy controls. We used SLE Disease Activity Index– 2000 (SLEDAI-2K) scores to stratify the subjects. Each group underwent IGRA testing using the QuantiFERON-TB Gold Plus kit.
Results: We recruited 59 female patients with SLE. The patients had a median age and disease duration 30 and 5 years, respectively. Statistical analysis using the Kruskal–Wallis test showed that active condition, high SLEDAI-2K score and immunosuppressive therapies affect IGRA results. Specifically, healthy controls (n=20) were most likely to have negative IGRA results (67.09%), whilst 27.27% of active cases (n=33) and 3.85% of quiescent cases (n=26) had indeterminate results (p=0.02). The number of immunosuppressant therapies was significantly negatively correlated with IFN-γ (p=0.004). No difference in IFN-γ concentration was detected amongst the active and other groups (p> 0.05).
Conclusion: High-activity SLE and immunosuppressive therapies cause dysregulation of the immune response, which, in turn, influences IGRA results. Thus, additional testing is necessary to detect TB infection in patients with SLE.
Keywords: SLE, active, quiescent, IFN-γ, IGRA
中文翻译：
SLE 患者的活动性疾病影响 IGRA 结果中的 IFN-γ。
目的：高度活跃的系统性红斑狼疮 (SLE) 会导致印度尼西亚 SLE 患者感染结核病 (TB) 的风险很高，而印度尼西亚是该病特别是肺外结核病流行的国家。干扰素 (IFN)-γ 释放测定 (IGRA) 可以检测潜在或既往的结核感染。本研究旨在确定 SLE 患者的潜伏结核感染和 IFN-γ（各种炎症和自身免疫性疾病的关键因素）水平，并将结果与疾病活动相关联。
患者和方法：这项实验研究包括 79 名女性受试者，分为三组：活动性 SLE、静态 SLE 和健康对照。我们使用 SLE 疾病活动指数 – 2000 (SLEDAI-2K) 分数对受试者进行分层。每组均使用 QuantiFERON-TB Gold Plus 试剂盒进行 IGRA 测试。
结果：我们招募了 59 名女性 SLE 患者。患者的中位年龄和病程分别为 30 和 5 年。使用 Kruskal-Wallis 检验的统计分析表明，活跃状态、高 SLEDAI-2K 评分和免疫抑制治疗会影响 IGRA 结果。具体而言，健康对照 (n=20) 最有可能获得阴性 IGRA 结果 (67.09%)，而 27.27% 的活动病例 (n=33) 和 3.85% 的静止病例 (n=26) 的结果不确定 (p= 0.02）。免疫抑制剂治疗次数与 IFN-γ 呈显着负相关（p=0.004）。活性组和其他组之间未检测到 IFN-γ 浓度存在差异 (p> 0.05)。
结论：高活性 SLE 和免疫抑制治疗会导致免疫反应失调，进而影响 IGRA 结果。因此，需要进行额外的检测来检测 SLE 患者的结核感染。
关键词： SLE，活动性，静止性，IFN-γ，IGRA
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