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Autoantibody prevalence in active tuberculosis: reactive or pathognomonic?
Chieh-Yu Shen1, Song-Chou Hsieh, Chia-Li Yu
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
BMJ Open
|July 30, 2013
Summary
Elevated anticardiolipin IgG and anti-Scl-70 autoantibodies were found in tuberculosis (TB) patients. These autoantibodies may indicate underlying mycobacterial infection, warranting further investigation in endemic areas.
Area of Science:
- Immunology
- Infectious Diseases
- Rheumatology
Background:
- Autoantibodies are typically associated with autoimmune diseases.
- The presence of autoantibodies in patients without overt autoimmune symptoms is not fully understood.
- Chronic infections, such as tuberculosis (TB), may trigger autoantibody production.
Purpose of the Study:
- To investigate the prevalence and significance of autoantibodies in patients with tuberculosis (TB).
- To determine if specific autoantibodies are associated with TB and if their titres change after treatment.
Main Methods:
- A randomized, case-control cohort study was conducted.
- 100 TB patients and 100 controls (medical staff) were recruited from a tertiary medical center in Taiwan.
- Sera were tested for various autoantibodies, including anti-SSA, anti-SSB, anti-Sm, anti-RNP, anti-Scl-70, anticentromere, anti-dsDNA, and anticardiolipin IgG/IgM.
Main Results:
- Anticardiolipin IgG and anti-Scl-70 autoantibody titres were significantly higher in TB patients compared to controls.
- Anti-Scl-70 titres decreased after a 3-month anti-TB treatment.
- No correlation was observed between autoantibody titres and clinical conditions in TB patients.
Conclusions:
- A significant proportion of TB patients (32%) exhibit elevated autoantibody titres, particularly anticardiolipin IgG and anti-Scl-70.
- Elevated autoantibodies in TB endemic areas may suggest an underlying mycobacterial infection.
- Mycobacterial investigations are recommended for individuals with elevated autoantibodies but lacking typical autoimmune disease manifestations.
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