QuantiFERON test interpretation in patients receiving immunosuppressive agents: an alert

Béllière, Julie; Blancher, Antoine

doi:10.1183/13993003.02102-2016

Cited by 15 publications

(10 citation statements)

References 13 publications

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“…Westall et al revealed that IFN-γ levels in response to mitogen measured with the QuantiFERON ® -CMV assay (Cellestis Ltd., Melbourne, Australia) were often negative after early lung transplant, because of immune suppression (14). Changes in IFN-γ levels in response to mitogen may depend on the immune system condition of the individual patient (15). In our study, low IFN-γ levels in response to mitogen before ICIs may also indicate the suppressed immune system state, which could Figure 3.…”

Section: Discussionmentioning

confidence: 99%

Significance of Quantitative Interferon-gamma Levels in Non-small-cell Lung Cancer Patients' Response to Immune Checkpoint Inhibitors

Kanai¹,

Suzuki²,

Yoshida³

et al. 2020

Anticancer Res

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Background/Aim: We aimed to study the association between the quantitative interferon-gamma (IFNγ) levels and clinical outcomes in non-small-cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors (ICIs). Patients and Methods: Sample collection for IFN-γ release assay (IGRA) was performed within 14 days before treatment (T1), on day 22±7 (T3), and on day 43±7 (T4). The stored specimens over 10 IU/ml in IGRA were re-examined using the dilution method (with saline as the dilution medium). The patients were classified into Lower and Higher groups by 7.06 IU/ml as a cut-off of IFN-γ levels at T1. Results: Median progression-free survival in the Higher group was significantly longer than that in the Lower group. IFN-γ levels in the nonprogression disease group were significantly higher than those in the progression disease group. IFN-γ levels at T1 in patients with immune-related adverse events were significantly lower compared to those at T3. Conclusion: IFN-γ could be a biomarker for NSCLC patients receiving ICIs.Immune checkpoint Inhibitors (ICIs) are widely used as immunotherapy for a number of cancers. Cytotoxic Tlymphocyte-associated antigen 4 antibodies for melanoma were the first ICIs used in a clinical situation (1). After the programmed cell death-1 (PD-1) gene was cloned (2), an anti-PD-1 antibody (3) was also rapidly developed as one of the ICIs. Apart from treating melanomas, ICIs are being approved for different types of cancers, such as lymphomas (4) and gastric cancers (5).Non-small cell lung cancer (NSCLC) is one of the cancers usually treated with ICIs (6, 7). Programmed death-ligand 1 (PD-L1) is highly expressed in NSCLC and is the only biomarker that is used in the clinical practice to predict response to ICIs (8). However, this biomarker is not ideal because in some patients ICIs were less effective, even when PD-L1 expression level was high. In previous studies, many factors have been reported as biomarkers for ICIs response (9). However, none of the biomarkers were more effective than PD-L1. In our recent study (10), we examined the association between clinical outcomes of ICIs and levels of interferongamma (IFN-γ) release. We concluded that changes in the PD-1/PD-L1 axis by ICI treatment affected IFN-γ release by T lymphocytes, and IFN-γ levels could be a biomarker for the early detection of severe immune-related adverse events (irAEs), such as ICI-induced interstitial pneumonitis (ICI-IP), and for patient selection for ICI treatment. However, in our previous study (10) IFN-γ was examined qualitatively with an upper cut-off level of 10 IU/ml, while quantitative levels of IFN-γ in response to ICI are still unknown. As a result, the patients enrolled in our previous study were classified into three groups according to the IFN-γ levels at pre-treatment and on treatment, because the cut-off level of interferon-gamma release assay (IGRA) was 10 IU/ml. Because of this limitation in our previous study, we herein quantitatively re-examined the levels of IFN-γ >10 IU/ml using the diluti...

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Section: Discussionmentioning

confidence: 99%

Significance of Quantitative Interferon-gamma Levels in Non-small-cell Lung Cancer Patients' Response to Immune Checkpoint Inhibitors

Kanai¹,

Suzuki²,

Yoshida³

et al. 2020

Anticancer Res

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“…The CCI, as adapted by Deyo et al [ 15 ], was utilized to assess the level of general comorbid medical conditions. In this study, we also adjusted for medications that may increase infection risk, including corticosteroids and immunosuppressive agents, including azathioprine, methotrexate, and cyclophosphamide [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

The risk of nontuberculous mycobacterial infection in patients with Sjögren’s syndrome: a nationwide, population-based cohort study

et al. 2017

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BackgroundNontuberculous mycobacterial (NTM) infection in immunocompromized patients is currently a growing health concern, and we aimed to examine the relative risk of NTM infection in patients with Sjögren’s syndrome (SS) compared with that in non-SS individuals.MethodsWe used the 2003–2012 Taiwanese National Health Insurance Research Database to identify 6554 incident SS cases during 2007–2012 and selected 98,310 non-SS controls matched (1:15) for age, gender, and the year of first SS diagnosis date after excluding those who had rheumatoid arthritis or systemic lupus erythematosus.ResultsWe identified four NTM-infected patients in the SS group (three in the first year) and nine in the non-SS group (three in the first year). SS patients had a higher incidence rate of NTM infection than that in non-SS individuals (IRR, 7.56; 95% CI, 2.33–24.55), especially during the first year (IRR, 16.05; 95% CI, 3.24–79.51). After adjusting for potential confounders, the risk of NTM infection was not increased in SS patients during the entire follow-up period or during the first year, but the risk increased in SS patients treated with immunosuppressants during the entire follow-up period (HR, 17.77; 95% CI, 4.53–69.61), especially during the first year (HR, 33.33; 95% CI, 4.37–254.23).ConclusionAn increased risk of NTM infection was found in SS patients treated with immunosuppressants during the first year after SS diagnosis.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2930-7) contains supplementary material, which is available to authorized users.

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“…A low IFN-γ response to mitogen (<0.5 IU/mL) indicates an indeterminate result when a blood sample also has a negative response to the TB antigens. This pattern may occur with insufficient lymphocytes, reduced lymphocyte activity due to improper specimen handling, or an inability of the patient's lymphocytes to generate IFN-γ [23].…”

Section: Medical Frameworkmentioning

confidence: 99%

“…The reported prevalence of indeterminate results is higher in patients with chronic inflammatory conditions compared to healthy people. Also, patients who receive at least one immunosuppressive drug (especially steroids) are more likely to have an indeterminate result [23,24].…”

Section: Medical Frameworkmentioning

confidence: 99%

Analyzing Tuberculosis Reactivation in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis Treated with Biological Therapy Using Machine Learning Methods

et al. 2021

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This study is based on the consideration that the patients with rheumatoid arthritis and ankylosing spondylitis undergoing biological therapy have a higher risk of developing tuberculosis. The QuantiFERON-TB Gold test result was the output of the models and a series of features related to the patients and their treatments were chosen as inputs. A distribution of patients by gender and biological therapy, followed at the time of inclusion in the study, and at the end of the study, is made for both rheumatoid arthritis and ankylosing spondylitis. A series of classification algorithms (random forest, nearest neighbor, k-nearest neighbors, C4.5 decision trees, non-nested generalized exemplars, and support vector machines) and attribute selection algorithms (ReliefF, InfoGain, and correlation-based feature selection) were successfully applied. Useful information was obtained regarding the influence of biological and classical treatments on tuberculosis risk, and most of them agreed with medical studies.

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QuantiFERON test interpretation in patients receiving immunosuppressive agents: an alert

Cited by 15 publications

References 13 publications

Significance of Quantitative Interferon-gamma Levels in Non-small-cell Lung Cancer Patients' Response to Immune Checkpoint Inhibitors

Significance of Quantitative Interferon-gamma Levels in Non-small-cell Lung Cancer Patients' Response to Immune Checkpoint Inhibitors

The risk of nontuberculous mycobacterial infection in patients with Sjögren’s syndrome: a nationwide, population-based cohort study

Analyzing Tuberculosis Reactivation in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis Treated with Biological Therapy Using Machine Learning Methods

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