T-cell profiling and the immunodiagnosis of latent tuberculosis infection in patients with inflammatory bowel disease

Miguel Arias-Guillén, Sabino Riestra, Ruth De Francisco, Juan José Palacios, José Belda, Patricio Escalante, Isabel Pérez-Martínez, Luis M. Molinos, Marta Garcia-Clemente, Ana Pando-Sandoval, Luis Rodrigo, Amador Prieto, Pablo Martínez-Camblor, Ana Losada, Pere Casan

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Factors associated with performance of interferon-g release assays (IGRA) and the tuberculin skin test (TST) in screening for latent tuberculosis infection in patients with inflammatory bowel diseases (IBD) are still poorly understood. The influence of peripheral T-cell subset counts on the results also remain unclear. Methods: Prospective single-center study in 205 patients with IBD. Latent tuberculosis infection screening included a chest radiograph, TST (retest if negative), and 2 IGRAs: QuantiFERON-TB Gold In-Tube (QFT-GIT) and TSPOT-TB (TSPOT). T-cell subpopulations were determined by flow cytometry. Results: Twenty-one (10.2%) patients had an abnormal chest radiograph, 55 (26.8%) had a positive TST, 16 (7.8%) had a positive QFT-GIT, and 25 (12.6%) had a positive TSPOT. TST positivity was lower in patients on ≥2 immunosuppressants compared with the controls (5-aminosalicylic acid treatment) (10.4% versus 38.2%, respectively) (P = 0.0057). No other drugs influenced TST or IGRA positivity. In patients on corticosteroid treatment, anti-TNF treatment, or ≥2 immunosuppressants, IGRAs detected 10 cases of latent tuberculosis infection not identified by TST. TSPOT and QFT-GIT increased yield by 56% and 22%, respectively. No significant differences in T-cell subpopulations were found between patients with positive or negative TST or TSPOT results. However, patients with positive QFT-GIT findings had more CD8+ T cells (mean, 883 ± 576 versus 484 ± 385 cells per microliter in patients with negative results) (P = 0.022). Conclusions: IGRAs can improve TST-based screening in patients with IBD on immunosuppressive therapy. A low CD8+ count can affect QFT-GIT results. We suggest combining TSPOT and TST screening in patients with IBD on immunosuppressants.

Original languageEnglish (US)
Pages (from-to)329-338
Number of pages10
JournalInflammatory bowel diseases
Volume20
Issue number2
DOIs
StatePublished - Feb 2014

Keywords

  • Immunodiagnosis
  • Inflammatory bowel diseases
  • Interferon gamma release assays
  • Latent tuberculosis infection
  • T-cell profiling
  • Tuberculin skin test

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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