Journal of Inflammation Research (Aug 2020)
Activity Disease in SLE Patients Affected IFN-γ in the IGRA Results
Abstract
Winni Maharani,1,2 Dwi Febni Ratnaningsih,3 Fitria Utami,3 Fajar Awalia Yulianto,4 Anneke Dewina,5 Laniyati Hamijoyo,5,6 Nur Atik5,7 1Department of Microbiology, Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia; 2Biomedical Sciences Master Program, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia; 3Immunology Laboratory, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia; 4Department of Public Health, Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia; 5Lupus Study Centre, Immunology Study Group, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia; 6Department of Internal Medicine, Faculty of Medicine, Padjadjaran University/Hasan Sadikin Hospital, Bandung, Indonesia; 7Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaCorrespondence: Nur AtikDepartment of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaTel +62 812-8095-6825Email [email protected]: Highly active systemic lupus erythematosus (SLE) causes a high risk of tuberculosis (TB) infection in SLE patients in Indonesia, a country in which the disease, especially extrapulmonary TB, is endemic. Interferon (IFN)-γ releasing assay (IGRA) can detect latent or previous TB infection. This study sought to determine latent TB infection and levels of IFN-γ, a key player in various inflammation and autoimmune disease, in patients with SLE and relate findings to disease activity.Patients and Methods: This experimental study included 79 female subjects distributed into three groups of active SLE, quiescent SLE and healthy controls. We used SLE Disease Activity Index– 2000 (SLEDAI-2K) scores to stratify the subjects. Each group underwent IGRA testing using the QuantiFERON-TB Gold Plus kit.Results: We recruited 59 female patients with SLE. The patients had a median age and disease duration 30 and 5 years, respectively. Statistical analysis using the Kruskal–Wallis test showed that active condition, high SLEDAI-2K score and immunosuppressive therapies affect IGRA results. Specifically, healthy controls (n=20) were most likely to have negative IGRA results (67.09%), whilst 27.27% of active cases (n=33) and 3.85% of quiescent cases (n=26) had indeterminate results (p=0.02). The number of immunosuppressant therapies was significantly negatively correlated with IFN-γ (p=0.004). No difference in IFN-γ concentration was detected amongst the active and other groups (p> 0.05).Conclusion: High-activity SLE and immunosuppressive therapies cause dysregulation of the immune response, which, in turn, influences IGRA results. Thus, additional testing is necessary to detect TB infection in patients with SLE.Keywords: SLE, active, quiescent, IFN-γ, IGRA
