Elevated Neopterin Levels Are Associated with Increased Tuberculosis Risk in Rheumatoid Arthritis Patients with QuantiFERON Conversion during Biologic Therapy

• DOI: 10.1371/journal.pone.0166301
• Publication Date: 2016-11-18T18:36:40Z
• Authors: Der-Yuan Chen; Ju-Pi Li; Yi-Ming Chen; Tsai-Ling Liao; Hsin-Hua Chen; Chia-Wei Hsieh; Yea-Wen Yeh; Joung-Liang Lan
• Keywords: Neopterin; QuantiFERON

QuantiFERON-TB-Gold (QFT-G) conversion is frequently observed in rheumatoid arthritis (RA) patients receiving biologic therapy. However, there have not been any known biomarkers available for detecting tuberculosis (TB) QFT-G converters. We aimed to evaluate clinical utility of cytokines/chemokines TB with conversion. Among a total 227 RA who underwent assay, 187 QFT-G-negative received therapy without isoniazid prophylaxis. assay was repeated at week 52 or the time diagnosis. Levels were determined by magnetic bead array ELISA converters and 12 non-RA (non-RA TB). found 54 (28.9%) baseline patients, which 7 (13.0%) developed active during one-year follow-up period. examined cytokines/chemokines, non-stimulated TB-antigen-stimulated neopterin levels significantly higher (RA-TB) (median, 24.5pg/ml 23053pg/ml, respectively) (12.2pg/ml 9633pg/ml, compared (3.0pg/ml 2720pg/ml, respectively, both p<0.001). Rising relative (non-stimulated levels, 4.4pg/ml vs. 24.5pg/ml; 1801pg/ml 23053pg/ml) TB. A high proportion (85.7%) plasma In conclusion, period should be carefully monitored elevation associated risk converters, particularly TB-endemic areas.