Diagnostic value of neopterin for detecting tuberculosis in rheumatoid arthritis patients with QuantiFERON conversion during biologic therapy

• Main Authors: Yea-Wen Yeh, 葉雅雯
• Other Authors: 林季千
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/89589998105549264858

碩士 === 國立中興大學 === 生命科學院碩士在職專班 === 103 === Frequent QuantiFERON-TB-Gold In Tube (QFT-GIT) conversion was observed in rheumatoid arthritis (RA) patients receiving biologic therapy. We aimed to evaluate the diagnostic utility of plasma cytokines and chemokines for identifying active tuberculosis (TB) in RA patients with QFT conversion. We prospectively evaluated 187 patients who received biologic therapy and serial QFT-GIT assays. QFT-GIT was performed by measuring IFN-γ levels in whole blood treated with TB-specific antigens. Levels of TB-related cytokines and chemokines at the time of QFT-GIT assays were determined by multiplex assay using the Milliplex MAP Human Cytokine/ Chemokine Panel and enzyme-linked immunosorbent assay. QFT conversion was observed in 54 (28.9%) of 187 RA patients, 54 RA patients with QFT conversion at baseline, 7 patients developed active TB (RA-TB) during the period of biologic therapy. Neopterin levels assessed at the time of active TB were higher in RA-TB patients than in RA non-TB subjects. The optimal cut-off neopterin level for detecting active TB using ROC curve analysis was 5045 pg/ml. RA patients with QFT conversion during the period of biologic therapy should be carefully evaluated and stimulated levels (TB-specific antigens) of neopterin may provide an useful information for identifying active TB.