結核感染および多発性硬化症の患者におけるQuantiFERON- TB- Plus結果の特徴
Elisa Petruccioli1, Luca Prosperini2, Serena Ruggieri2
1Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy.
Neurology international
|August 27, 2025
まとめ
多発性硬化症 (MS) と結核感染症 (TBI) の患者は,TBIのみの患者と比較して,QuantiFERON- TB- Plus (QFT- Plus) 試験への反応が低かった. Borderline QFT-Plusの結果は,MS-TBIグループではより頻繁であり,TBスクリーニングの精度に影響を与えました.
科学分野:
- 免疫学
- 神経科学
- 感染症
背景:
- 多発性硬化症 (MS) の治療薬 (DMD) は結核 (TB) のリスクの増加と関連しています.
- QuantiFERON-TB-Plus (QFT-Plus) 検査は,潜伏結核感染 (LTBI) のスクリーニングに使用される.
- MS患者におけるQFT-Plusの効能に関するデータは限られている.
研究 の 目的:
- TBI (MS- TBI) 患者とTBI (MS- TBI) 患者との間でQFT- Plusの反応を比較する.
- TB1/TB2刺激に対するQFT-Plus反応の不一致を記録する.
- 人口統計的要因,臨床データ,DMD使用,結核暴露歴に関連してQFT-Plusの結果を分析する.
主な方法:
- 2018年から2023年の間に810人の多発性硬化症患者のTBI検査
- QFT-Plus検査のために20人のMS-TBI患者と106人のNON-MS-TBI対照群を募集した.
- グループ間のインターフェロン-ガンマ (IFN-γ) 生成の比較
主要な成果:
- MS- TBI患者は,NON- MS- TBIと比較して,TB1 (p=0. 01) とTB2 (p=0. 02) の刺激に対する反応として,IFN- γの生産が著しく低下した.
- TB2刺激のグレーゾーンでは,MS- TBI患者より高い割合 (30%) がQFT- Plusの結果を示した (p=0. 002).
結論:
- MS- TBIの患者は,QFT- Plusの反応が低下し,TBIのみの患者と比較して,境界線の結果の頻度が高くなります.
- MS患者におけるこれらの境界線QFT-Plus結果の臨床的意義を明らかにするために,さらなる研究が必要である.
- この集団におけるQFT-Plusの解釈の明確化は,MS患者の結核の予測の精度を高める可能性があります.
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