风湿性疾病合并结核分枝杆菌潜伏感染的诊治进展

doi:10.19982/j.issn.1000-6621.20220236

摘要/Abstract

摘要：

随着风湿性疾病患者糖皮质激素、免疫抑制剂、生物制剂和小分子靶向药物的使用,结核分枝杆菌潜伏感染激活的风险增加,现已成为管控结核病的一大重点。笔者对风湿性疾病合并结核分枝杆菌潜伏感染的流行病学、诊断方法、危险因素、筛查策略和治疗等方面的研究进展进行综述,为临床诊疗提供参考。

关键词: 风湿性疾病, 分枝杆菌感染, 结核, 共病现象, 综述文献(主题)

Abstract:

With the use of glucocorticoids, immunosuppressants, biological agents, and small-molecule targeted drugs in patients with rheumatic diseases, the activation of latent tuberculosis infection gradually increased which has become an important front for controlling tuberculosis epidemic. To provide a reference for clinical diagnosis and treatment, this review summarizes the research progress in the epidemiology, diagnostic methods, risk factors, screening strategies and treatment of rheumatic diseases complicated with latent tuberculosis infection.

Key words: Rheumatic disease, Mycobacterium infections, Tuberculosis, Comorbidity, Review literature as topic

中图分类号:

R52
R593.2

陈秋奇, 韩婷婷, 王庆文, 邓国防. 风湿性疾病合并结核分枝杆菌潜伏感染的诊治进展[J]. 中国防痨杂志, 2022, 44(9): 960-965. doi: 10.19982/j.issn.1000-6621.20220236

Chen Qiuqi, Han Tingting, Wang Qingwen, Deng Guofang. Recent advances in treatment of latent tuberculosis infection complicated with rheumatic diseases[J]. Chinese Journal of Antituberculosis, 2022, 44(9): 960-965. doi: 10.19982/j.issn.1000-6621.20220236

参考文献 50

[1]	Miltinienė D, Deresevicˇienė G, Nakcˇerienė B, et al. Incidence of Tuberculosis in Inflammatory Rheumatic Diseases: Results from a Lithuanian Retrospective Cohort Study. Medicina (Kaunas), 2020, 56(8):392. doi: 10.3390/medicina56080392. doi: 10.3390/medicina56080392
[2]	Rotar Z, Svetina P, Tomsic M, et al. Tuberculosis among patients treated with TNF inhibitors for rheumatoid arthritis,ankylosing spondylitis and psoriatic arthritis in Slovenia:a cohort study. BMJ Open, 2020, 10(2):e034356. doi: 10.1136/bmjopen-2019-034356. doi: 10.1136/bmjopen-2019-034356 URL
[3]	潘艳艳, 吴园园, 蔡红娇, 等. 不同的风湿免疫性疾病患者免疫功能差异分析. 当代医学, 2020, 26(19):1-4. doi: 10.3969/j.issn.1009-4393.2020.19.001. doi: 10.3969/j.issn.1009-4393.2020.19.001
[4]	Dolff S, Quandt D, Feldkamp T, et al. Increased percentages of PD-1 on CD4⁺ T cells is associated with higher INF-γ production and altered IL-17 production in patients with systemic lupus erythematosus. Scand J Rheumatol, 2014, 43(4):307-313. doi: 10.3109/03009742.2013. 869830. doi: 10.3109/03009742.2013.869830 pmid: 25088926
[5]	Anton C, Machado FD, Ramirez JMA, et al. Latent tuberculosis infection in patients with rheumatic diseases. J Bras Pneumol, 2019, 45(2):e20190023. doi: 10.1590/1806-3713/e201 90023. doi: 10.1590/1806-3713/e201 90023
[6]	Scrivo R, Armignacco O. Tuberculosis risk and anti-tumour necrosis factor agents in rheumatoid arthritis: a critical appraisal of national registry data. Int J Rheum Dis, 2014, 17(7):716-724. doi: 10.1111/1756-185X.12375. doi: 10.1111/1756-185X.12375 URL
[7]	Ehlers S. Role of tumour necrosis factor (TNF) in host defence against tuberculosis: implications for immunotherapies targeting TNF. Ann Rheum Dis, 2003, 62 Suppl 2:ii37-42. doi: 10.1136/ard.62.suppl_2.ii37. doi: 10.1136/ard.62.suppl_2.ii37 pmid: 14532147
[8]	Robert M, Miossec P. Reactivation of latent tuberculosis with TNF inhibitors: critical role of the beta 2 chain of the IL-12 receptor. Cell Mol Immunol, 2021, 18(7):1644-1651. doi: 10.1038/s41423-021-00694-9. doi: 10.1038/s41423-021-00694-9 pmid: 34021269
[9]	Garziera G, Morsch ALB, Otesbelgue F, et al. Latent tuberculosis infection and tuberculosis in patients with rheumatic diseases treated with anti-tumor necrosis factor agents. Clin Rheumatol, 2017, 36(8):1891-1896. doi: 10.1007/s10067-017-3714-6. doi: 10.1007/s10067-017-3714-6 pmid: 28589321
[10]	Long W, Cai F, Wang X, et al. High risk of activation of latent tuberculosis infection in rheumatic disease patients. Infect Dis (Lond), 2020, 52(2):80-86. doi: 10.1080/23744235.2019.1682187. doi: 10.1080/23744235.2019.1682187
[11]	Pettipher C, Benitha R. Tuberculosis in biologic users for rheumatic diseases: results from the South African Biologics Registry (SABIO). Ann Rheum Dis, 2020, 79(2):292-299. doi: 10.1136/annrheumdis-2019-216128. doi: 10.1136/annrheumdis-2019-216128 pmid: 31791950
[12]	Malaviya AN, Aggarwal VK, Rawat R, et al. Screening for latent tuberculosis infection among patients with rheumatoid arthritis in the era of biologics and targeted synthetic disease-modifying anti-rheumatic drugs in India, a high-burden TB country: The importance of Mantoux and Quantiferon-TB Gold tests. Int J Rheum Dis, 2018, 21(8):1563-1571. doi: 10.1111/1756-185X.13261. doi: 10.1111/1756-185X.13261 pmid: 29345081
[13]	Lee J, Kim E, Jang EJ, et al. Efficacy of Treatment for Latent Tuberculosis in Patients Undergoing Treatment with a Tumor Necrosis Factor Antagonist. Ann Am Thorac Soc, 2017, 14(5):690-697. doi: 10.1513/AnnalsATS.201608-647OC. doi: 10.1513/AnnalsATS.201608-647OC URL
[14]	Cuomo G, D’Abrosca V, Iacono D, et al. The conversion rate of tuberculosis screening tests during biological therapies in patients with rheumatoid arthritis. Clin Rheumatol, 2017, 36(2):457-461. doi: 10.1007/s10067-016-3462-z. doi: 10.1007/s10067-016-3462-z URL
[15]	中国医学科学院病原生物学研究所, 中国疾病预防控制中心,中国科学院地理科学与资源研究所. 全国结核分枝杆菌潜伏感染率估算专家共识. 中国防痨杂志, 2022, 44(1):4-8. doi: 10.19982/j.issn.1000-6621.20210662. doi: 10.19982/j.issn.1000-6621.20210662
[16]	邱可为, 郭欣, 黄启当, 等. T细胞酶联免疫斑点法对风湿病患者感染结核分支杆菌的诊断价值. 临床医学工程, 2016, 23(9):1184-1186. doi: 10.3969/j.issn.1674-4659.2016.09.1184. doi: 10.3969/j.issn.1674-4659.2016.09.1184
[17]	黄安芳, 罗妍, 赵毅, 等. 风湿病患者合并潜伏性结核感染的分析. 中华内科杂志, 2016, 55(4):307-310. doi: 10.3760/cma.j.issn.0578-1426.2016.04.012. doi: 10.3760/cma.j.issn.0578-1426.2016.04.012
[18]	邓国防, 王玉香, 陈涛, 等. 风湿免疫性疾病并发结核感染的临床特征分析. 中国防痨杂志, 2018, 40(4):392-396. doi: 10.3969/j.issn.1000-6621.2018.04.009. doi: 10.3969/j.issn.1000-6621.2018.04.009
[19]	朱翠云. 对人类免疫缺陷病毒感染者潜伏性结核感染的筛查和干预. 上海医药, 2020, 41(11):14-16,20. doi: 10.3969/j.issn.1006-1533.2020.11.005. doi: 10.3969/j.issn.1006-1533.2020.11.005
[20]	Lloyd N, Martin D, Peter DOD. Clinical Tuberculosis-Sixth Edition. CRC Press, 2020:154.
[21]	中国防痨协会, 中国防痨协会学校与儿童结核病防治专业分会,《中国防痨杂志》编辑委员会. 重组结核杆菌融合蛋白(EC)临床应用专家共识. 中国防痨杂志, 2020, 42(8):761-768. doi: 10.3969/i.issn.1000-6621.2020.08.001. doi: 10.3969/i.issn.1000-6621.2020.08.001
[22]	Pai M, Zwerling A, Menzies D. Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. Ann Intern Med, 2008, 149(3):177-184. doi: 10.7326/0003-4819-149-3-200808050-00241. doi: 10.7326/0003-4819-149-3-200808050-00241 URL
[23]	Metcalfe JZ, Everett CK, Steingart KR, et al. Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis. J Infect Dis, 2011, 204 Suppl 4:S1120-1129. doi: 10.1093/infdis/jir410. doi: 10.1093/infdis/jir410
[24]	赵静, 刘轩, 沈广萍, 等. T-SPOT. TB对风湿免疫病患者活动性肺结核诊断准确性的影响因素分析. 国际检验医学杂志, 2020, 41(7):850-855. doi: 10.3969/j.issn.1673-4130.2020.07.019. doi: 10.3969/j.issn.1673-4130.2020.07.019
[25]	许敏殷, 刘银, 刘丽蓉, 等. γ干扰素释放试验联合IL-6检测对活动性肺结核的诊断价值. 中国现代医学杂志, 2020, 30(10):18-21. doi: 10.3969/j.issn.1005-8982.2020.10.004. doi: 10.3969/j.issn.1005-8982.2020.10.004
[26]	Wang PH, Lin CH, Chang TH, et al. Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients. BMC Pulm Med, 2020, 20(1):232. doi: 10.1186/s12890-020-01274-9. doi: 10.1186/s12890-020-01274-9 URL
[27]	Chung TT, Ko HJ, Lau CS, et al. A retrospective study on the risk of tuberculosis in patients with rheumatoid arthritis. Rheumatol Int, 2020, 40(6):983-990. doi: 10.1007/s00296-020-04583-8. doi: 10.1007/s00296-020-04583-8 pmid: 32318800
[28]	Ciang NC, Chan SCW, Lau CS, et al. Risk of tuberculosis in patients with spondyloarthritis:data from a centralized electronic database in Hong Kong. BMC Musculoskelet Disord, 2020, 21(1):832. doi: 10.1186/s12891-020-03855-5. doi: 10.1186/s12891-020-03855-5 URL
[29]	Dey M, Zhao SS, Moots RJ. Anti-TNF biosimilars in rheumatology:the end of an era? Expert Opin Biol Ther, 2021, 21(1):29-36. doi: 10.1080/14712598.2020.1802421. doi: 10.1080/14712598.2020.1802421 URL
[30]	Evangelatos G, Koulouri V, Iliopoulos A, et al. Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors. Ther Adv Musculoskelet Dis, 2020, 12:1759720X20930116. doi: 10.1177/1759720X20930116. doi: 10.1177/1759720X20930116
[31]	Goel N, Torralba K, Downey C, et al. Screening for acquired latent tuberculosis in rheumatoid arthritis patients on tumor necrosis factor inhibition therapy in Southern California. Clin Rheumatol, 2020, 39(8):2291-2297. doi: 10.1007/s10067-020-04991-y. doi: 10.1007/s10067-020-04991-y URL
[32]	Yu CL, Yang CH, Chi CC. Drug Survival of Biologics in Treating Ankylosing Spondylitis:A Systematic Review and Meta-analysis of Real-World Evidence. BioDrugs, 2020, 34(5):669-679. doi: 10.1007/s40259-020-00442-x. doi: 10.1007/s40259-020-00442-x URL
[33]	Chiu YM, Chen DY. Infection risk in patients undergoing treatment for inflammatory arthritis:non-biologics versus biologics. Expert Rev Clin Immunol, 2020, 16(2):207-228. doi: 10.1080/1744666X.2019.1705785. doi: 10.1080/1744666X.2019.1705785 URL
[34]	Elewski BE, Baddley JW, Deodhar AA, et al. Association of Secukinumab Treatment With Tuberculosis Reactivation in Patients With Psoriasis,Psoriatic Arthritis,or Ankylosing Spondylitis. JAMA Dermatol, 2021, 157(1):43-51. doi: 10.1001/jamadermatol.2020.3257. doi: 10.1001/jamadermatol.2020.3257 URL
[35]	Cantini F, Blandizzi C, Niccoli L, et al. Systematic review on tuberculosis risk in patients with rheumatoid arthritis receiving inhibitors of Janus Kinases. Expert Opin Drug Saf, 2020, 19(7):861-872. doi: 10.1080/14740338.2020.1774550. doi: 10.1080/14740338.2020.1774550 URL
[36]	Cantini F, Niccoli L, Capone A, et al. Risk of tuberculosis reactivation associated with traditional disease modifying anti-rheumatic drugs and non-anti-tumor necrosis factor biologics in patients with rheumatic disorders and suggestion for clinical practice. Expert Opin Drug Saf, 2019, 18(5):415-425. doi: 10.1080/14740338.2019.1612872. doi: 10.1080/14740338.2019.1612872 URL
[37]	Singh S, Singh S. JAK-STAT inhibitors: Immersing therapeutic approach for management of rheumatoid arthritis. Int Immunopharmacol, 2020, 86:106731. doi: 10.1016/j.intimp.2020.106731. doi: 10.1016/j.intimp.2020.106731 URL
[38]	Angelini J, Talotta R, Roncato R, et al. JAK-Inhibitors for the Treatment of Rheumatoid Arthritis:A Focus on the Present and an Outlook on the Future. Biomolecules, 2020, 10(7):1002. doi: 10.3390/biom10071002. doi: 10.3390/biom10071002 URL
[39]	辉瑞公司. 枸橼酸托托法替布片说明书. [2022.04.28]. https://labeling.pfizer.com/ShowLabeling.aspx?id=14493.
[40]	Mohamed DF, Habeeb RA, Hosny SM, et al. Incidence and risk of infection in egyptian patients with systemic lupus erythematosus. Clin Med Insights Arthritis Musculoskelet Disord, 2014, 7:41-48. doi: 10.4137/CMAMD.S15346. doi: 10.4137/CMAMD.S15346
[41]	Lao M, Chen D, Wu X, et al. Active tuberculosis in patients with systemic lupus erythematosus from Southern China: a retrospective study. Clin Rheumatol, 2019, 38(2):535-543. doi: 10.1007/s10067-018-4303-z. doi: 10.1007/s10067-018-4303-z URL
[42]	Lorenzetti R, Zullo A, Ridola L, et al. Higher risk of tuberculosis reactivation when anti-TNF is combined with immunosuppressive agents:a systematic review of randomized controlled trials. Ann Med, 2014, 46(7):547-554. doi: 10.3109/07853890.2014.941919. doi: 10.3109/07853890.2014.941919 pmid: 25105206
[43]	Alaşan F, Güleç Balbay E, Cangür Ş, et al. Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test?. Aging Male, 2020, 23(5):1109-1114. doi: 10.1080/13685538.2019.1678582. doi: 10.1080/13685538.2019.1678582 URL
[44]	World Health Organization. Latent tuberculosis infection-Updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2018.
[45]	Sterling TR, Njie G, Zenner D, et al. Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep, 2020, 69(1):1-11. doi: 10.15585/mmwr.rr6901a1. doi: 10.15585/mmwr.rr6901a1
[46]	Tang P, Johnston J. Treatment of Latent Tuberculosis Infection. Curr Treat Options Infect Dis, 2017, 9(4):371-379. doi: 10.1007/s40506-017-0135-7. doi: 10.1007/s40506-017-0135-7 URL
[47]	Hong Kong Chest Service, Tuberculosis Research Centre, Madras/British Medical Research Council. A double-blind placebo-controlled clinical trial of three antituberculosis chemoprophylaxis regimens in patients with silicosis in Hong Kong. Hong Kong Chest Service/Tuberculosis Research Centre, Madras/British Medical Research Council. Am Rev Respir Dis, 1992, 145(1):36-41. doi: 10.1164/ajrccm/145.1.36. doi: 10.1164/ajrccm/145.1.36 URL
[48]	Njie GJ, Morris SB, Woodruff RY, et al. Isoniazid-Rifapentine for Latent Tuberculosis Infection: A Systematic Review and Meta-analysis. Am J Prev Med, 2018, 55(2):244-252. doi: 10.1016/j.amepre.2018.04.030. doi: 10.1016/j.amepre.2018.04.030 URL
[49]	Menzies D, Trajman A. New short regimens for latent tuberculosis treatment:safety first!. Eur Respir J, 2018, 52(6):1802180. doi: 10.1183/13993003.02180-2018. doi: 10.1183/13993003.02180-2018
[50]	World Health Organization. WHO operational handbook on tuberculosis (Module 1-Prevention): Tuberculosis preventive treatment. Geneva: World Health Organization, 2020.