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Free Content Interferon-inducible protein-10 as a marker to detect latent and active tuberculosis in rheumatoid arthritis

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SETTING: Effective tuberculosis (TB) screening should be performed before anti-tumour necrosis factor alpha (TNF-α) treatment in rheumatoid arthritis (RA). The usefulness of the tuberculin skin test (TST) and QuantiFERON┬«-TB Gold (QFT-G) for detecting latent tuberculosis infection (LTBI) is limited.

OBJECTIVE: We tested the diagnostic performance of interferon-gamma (IFN-γ) inducible protein 10 (IP-10) and IFN-γ for detecting LTBI in RA patients receiving anti-TNF-α treatment.

DESIGN: IP-10 levels were determined by enzyme-linked immunosorbent assay in 56 RA patients and 18 active TB patients. TST was performed using the Mantoux method and QFT-G was performed by measuring IFN-γ levels in whole blood treated with TB-specific antigens.

RESULTS: Twenty-four (42.9%) TST-positive patients were defined as having LTBI. Significantly higher levels of baseline, early secretory antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) stimulated IP-10 were observed in active TB patients (median 209.9 pg/ml, 899.0 pg/ml and 880.2 pg/ml, respectively) and RA patients with LTBI (165.3 pg/ml, 904.4 pg/ml and 747.5 pg/ml, respectively), compared to those without LTBI (89.3 pg/ml, 579.4 pg/ml and 515.0 pg/ml, respectively). Baseline IP-10 has high sensitivity (83.3% and 100%) and medium specificity (67.9% and 59.6%), while ESAT-6-stimulated IP-10 has high sensitivity (87.5% and 100%) and specificity (85.7% and 71.2%) for detecting LTBI and TB. The performance of IP-10 is superior to IFN-γ for detecting LTBI (TST+) and active TB.

CONCLUSION: IP-10 may be used for detecting LTBI and as a potential biomarker to identify active TB in RA patients receiving anti-TNF-α treatment.
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Keywords: IP-10; TNF-╬▒ inhibitors; isoniazid prophylaxis; rheumatoid arthritis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Respiratory and Critical Care Medicine, Taichung Veterans General Hospital, Taipei, Taiwan; and Department of Respiratory Therapy, China Medical University, Taipei, Taiwan 2: National Yang-Ming University, Taipei, Taiwan; Institute of Biomedical Science, National Chung-Hsing University, Taipei, Taiwan; and Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taipei, Taiwan 3: Institute of Biomedical Science, National Chung-Hsing University, Taipei, Taiwan; and Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taipei, Taiwan

Publication date: 2011-02-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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