TST conversions and systemic interferon-gamma increase after methotrexate introduction in psoriasis patients

dc.creatorMedeiros, Vanessa Lucília Silveira de
dc.creatorSantos, Fabiana Cristina Fulco
dc.creatorMontenegro, Lílian Maria Lapa
dc.creatorSilva, Maria da Conceição
dc.creatorSouza, Valdênia Maria Oliveira de
dc.creatorLima Neto, Reginaldo Gonçalvez de
dc.creatorMoura, Líbia Cristina Rocha Vilela
dc.creatorMagalhães, Vera
dc.date2021-04-08T15:04:17Z
dc.date2021-04-08T15:04:17Z
dc.date2020
dc.date.accessioned2023-09-26T23:57:45Z
dc.date.available2023-09-26T23:57:45Z
dc.identifierMEDEIROS, 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.
dc.identifier1932-6203
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/46570
dc.identifier10.1371/journal.pone.0242098
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8896028
dc.descriptionBackground: 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.
dc.formatapplication/pdf
dc.languageeng
dc.rightsopen access
dc.subjectAdult
dc.subjectC-Reactive Protein / metabolism
dc.subjectFemale
dc.subjectHumans
dc.subjectImmunosuppressive Agents / administration & dosage
dc.subjectInterferon-gamma / blood
dc.subjectLatent Tuberculosis / complications
dc.subjectLatent Tuberculosis / drug therapy
dc.subjectLatent Tuberculosis / epidemiology
dc.subjectLatent Tuberculosis / microbiology
dc.subjectMale
dc.subjectMass Screening
dc.subjectMethotrexate / administration & dosage
dc.subjectMethotrexate / adverse effects
dc.subjectMiddle Aged
dc.subjectPsoriasis / blood
dc.subjectPsoriasis / complications
dc.subjectPsoriasis / drug therapy
dc.subjectPsoriasis / epidemiology
dc.subjectSeverity of Illness Index
dc.subjectTuberculin Test / adverse effects
dc.subjectTumor Necrosis Factor-alpha / blood
dc.subjectYoung Adult
dc.subjectAdulto
dc.subjectProteína C-Reativa / metabolismo
dc.subjectFeminino
dc.subjectHumanos
dc.subjectImunossupressores / administração & dosagem
dc.subjectInterferon gama / sangue
dc.subjectTuberculose Latente / complicações
dc.subjectTuberculose Latente / tratamento farmacológico
dc.subjectTuberculose Latente / epidemiologia
dc.subjectTuberculose Latente / microbiologia
dc.subjectMasculino
dc.subjectProgramas de Rastreamento
dc.subjectMetotrexato / administração & dosagem
dc.subjectMetotrexato / efeitos adversos
dc.subjectPessoa de Meia-Idade
dc.subjectPsoríase / sangue
dc.subjectPsoríase / complicações
dc.subjectPsoríase / tratamento farmacológico
dc.subjectPsoríase / epidemiologia
dc.subjectÍndice de Gravidade de Doença
dc.subjectTeste Tuberculínico / efeitos adversos
dc.subjectFator de Necrose Tumoral alfa / sangue
dc.subjectAdulto Jovem
dc.titleTST conversions and systemic interferon-gamma increase after methotrexate introduction in psoriasis patients
dc.typeArticle


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