Author | Medeiros, Vanessa Lucília Silveira de | |
Author | Santos, Fabiana Cristina Fulco | |
Author | Montenegro, Lílian Maria Lapa | |
Author | Silva, Maria da Conceição | |
Author | Souza, Valdênia Maria Oliveira de | |
Author | Lima Neto, Reginaldo Gonçalvez de | |
Author | Moura, Líbia Cristina Rocha Vilela | |
Author | Magalhães, Vera | |
Access date | 2021-04-08T15:04:17Z | |
Available date | 2021-04-08T15:04:17Z | |
Document date | 2020 | |
Citation | MEDEIROS, V. L. S. de. et al. TST conversions and systemic interferon-gamma increase after methotrexate introduction in psoriasis patients. PLoS One, 15 (12), p. 1-13, 3 dez. 2020. | pt_BR |
ISSN | 1932-6203 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/46570 | |
Language | eng | pt_BR |
Rights | open access | pt_BR |
MeSH | Adult | pt_BR |
MeSH | C-Reactive Protein / metabolism | pt_BR |
MeSH | Female | pt_BR |
MeSH | Humans | pt_BR |
MeSH | Immunosuppressive Agents / administration & dosage | pt_BR |
MeSH | Interferon-gamma / blood | pt_BR |
MeSH | Latent Tuberculosis / complications | pt_BR |
MeSH | Latent Tuberculosis / drug therapy | pt_BR |
MeSH | Latent Tuberculosis / epidemiology | pt_BR |
MeSH | Latent Tuberculosis / microbiology | pt_BR |
MeSH | Male | pt_BR |
MeSH | Mass Screening | pt_BR |
MeSH | Methotrexate / administration & dosage | pt_BR |
MeSH | Methotrexate / adverse effects | pt_BR |
MeSH | Middle Aged | pt_BR |
MeSH | Psoriasis / blood | pt_BR |
MeSH | Psoriasis / complications | pt_BR |
MeSH | Psoriasis / drug therapy | pt_BR |
MeSH | Psoriasis / epidemiology | pt_BR |
MeSH | Severity of Illness Index | pt_BR |
MeSH | Tuberculin Test / adverse effects | pt_BR |
MeSH | Tumor Necrosis Factor-alpha / blood | pt_BR |
MeSH | Young Adult | pt_BR |
Title | TST conversions and systemic interferon-gamma increase after methotrexate introduction in psoriasis patients | pt_BR |
Type | Article | pt_BR |
DOI | 10.1371/journal.pone.0242098 | |
Abstract | Background: Tuberculosis screening in psoriasis patients is complex due to the immunological alterations associated with psoriasis, the presence of comorbidities, and the effect of immunosuppressive treatment. However, it is not established whether the results of screening tests are affected by these factors in psoriasis patients.
Objectives: To determine whether there is a change in the results of the tuberculin skin test (TST) or the interferon-gamma release assay (IGRA) in psoriasis patients living in tuberculosis (TB)-endemic area after 12 weeks of methotrexate (MTX) treatment and to investigate the association of the test results with clinical and inflammatory markers.
Methods: Forty-five patients were selected for a prospective single-arm self-controlled study and followed for at least 18 months. The TST, IGRA, Psoriasis Area and Severity Index (PASI), and inflammatory factors (erythrocyte sedimentation rate (ESR), C-reactive protein, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha levels), were determined before and after 12 weeks of oral 15 mg per week MTX administration and compared. The associations between the IGRA and TST results were verified before and after treatment according to inflammatory factors and clinical characteristics (age, blood glucose, weight, body mass index, disease duration, and PASI).
Results: We collected data on 25 patients who completed the full course of therapy and the follow-up. None of the patients developed TB. TST positivity was significantly elevated at week 12 (25% baseline vs 44% at week 12, P < 0.037). Three IGRAs followed the TST conversions. There was no difference between TST and IGRA pre- or posttreatment. Serum IFN-γ increased significantly in week 12 (15.95 pg/ml baseline vs 18.82 pg/ml at week 12, P < 0.005) and tended to be higher among TST-positive patients (P = 0.072). The baseline IGRA was associated with a higher ESR (P = 0.038). None of the test results were associated with clinical characteristics.
Conclusions: In addition to the classic booster effect, TST conversions in patients using MTX can occur due to an increase in IFN-γ. However, it is not possible to exclude true TST conversions. Therefore, other diagnostic methods, like IGRA or chest tomography, should be used when the TST has intermediate results. | pt_BR |
Affilliation | Universidade Federal de Pernambuco. Hospital das Clínicas. Clínica de Dermatologia. Recife, PE, Brasil. / Universidade Federal de Pernambuco. Hospital das Clínicas. Departamento de Medicina Tropical. Recife, PE, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento de Imunologia. Laboratório de Imunoepidemiologia. Recife, PE, Brasil / Universidade Federal de Pernambuco. Recife, PE, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento de Imunologia. Laboratório de Imunoepidemiologia. Recife, PE, Brasil / Universidade Federal de Pernambuco. Recife, PE, Brasil. | pt_BR |
Affilliation | Universidade Federal de Pernambuco. Hospital das Clínicas. Departamento de Medicina Tropical. Recife, PE, Brasil. | pt_BR |
Affilliation | Universidade Federal de Pernambuco. Hospital das Clínicas. Departamento de Medicina Tropical. Recife, PE, Brasil. / Universidade Federal de Pernambuco. Laboratório de Imunopatologia Keizo Asami-LIKA. Recife, PE, Brasil. | pt_BR |
Affilliation | Universidade Federal de Pernambuco. Hospital das Clínicas. Departamento de Medicina Tropical. Recife, PE, Brasil. | pt_BR |
Affilliation | Universidade Federal de Pernambuco. Hospital das Clínicas. Departamento de Medicina Tropical. Recife, PE, Brasil. | pt_BR |
Affilliation | Universidade Federal de Pernambuco. Hospital das Clínicas. Departamento de Medicina Tropical. Recife, PE, Brasil. | pt_BR |
DeCS | Adulto | pt_BR |
DeCS | Proteína C-Reativa / metabolismo | pt_BR |
DeCS | Feminino | pt_BR |
DeCS | Humanos | pt_BR |
DeCS | Imunossupressores / administração & dosagem | pt_BR |
DeCS | Interferon gama / sangue | pt_BR |
DeCS | Tuberculose Latente / complicações | pt_BR |
DeCS | Tuberculose Latente / tratamento farmacológico | pt_BR |
DeCS | Tuberculose Latente / epidemiologia | pt_BR |
DeCS | Tuberculose Latente / microbiologia | pt_BR |
DeCS | Masculino | pt_BR |
DeCS | Programas de Rastreamento | pt_BR |
DeCS | Metotrexato / administração & dosagem | pt_BR |
DeCS | Metotrexato / efeitos adversos | pt_BR |
DeCS | Pessoa de Meia-Idade | pt_BR |
DeCS | Psoríase / sangue | pt_BR |
DeCS | Psoríase / complicações | pt_BR |
DeCS | Psoríase / tratamento farmacológico | pt_BR |
DeCS | Psoríase / epidemiologia | pt_BR |
DeCS | Índice de Gravidade de Doença | pt_BR |
DeCS | Teste Tuberculínico / efeitos adversos | pt_BR |
DeCS | Fator de Necrose Tumoral alfa / sangue | pt_BR |
DeCS | Adulto Jovem | pt_BR |