title: The effect of anti-tuberculosis treatment on levels of anti-phospholipid and anti-neutrophil cytoplasmatic antibodies in patients with active tuberculosis.
abstract: The aim of this study is to determine the prevalence and effect of anti-tuberculosis treatment on anti-phospholipid antibodies and anti-neutrophil cytoplasmatic antibodies (ANCA) in patients with active mycobacterial infections. Thirty-three consecutive patients (age 56 years, 26 males) with recently diagnosed active tuberculosis (TB) were enrolled. Data included clinical disease features, symptom duration, multidrug resistance and presence of HIV. Serum samples taken before and after TB treatment were frozen at -20 °C and tested for anti-cardiolipin IgG (aCL), anti-β2 glycoprotein IgG (anti-β2GPI), anti-prothrombin, anti-proteinase 3 (PR3), myeloperoxidase (MPO), bactericidal/permeability (BPI) and lactoferrin. Thirty percent of patients had higher than cut-off value for anti-β2GPI, and 9 % had increased aCL. The levels of antibodies against β2GPI and aCL normalized post-treatment. A substantial proportion of patients had high baseline anti-PR3, MPO, BPI and lactoferrin levels. Most anti-lactoferrin and anti-MPO levels decreased post-treatment, while anti-PR3 increased in most of the baseline-positive patients. Some patients had de novo anti-PR3 and MPO formation after 6-month treatment. Patients with active TB have significantly increased anti-β2GPI and ANCA titers. While anti-β2GPI titers normalize post-treatment, ANCA behave in a complex way. Anti-TB treatment may induce normalization of anti-lactoferrin and anti-MPO, and de novo anti-PR3 and MPO formation.
authors.affiliation: Department of Rheumatology, Tel Aviv Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, 6 Weizman Street, 64239 Tel Aviv, Israel. oribe14@netvision.net.il
authors.forename: Ori
authors.initials: O
authors.lastname: Elkayam
authors.forename: Daniele
authors.initials: D
authors.lastname: Bendayan
authors.forename: Refael
authors.initials: R
authors.lastname: Segal
authors.forename: Yinon
authors.initials: Y
authors.lastname: Shapira
authors.forename: Boris
authors.initials: B
authors.lastname: Gilburd
authors.forename: Sandra
authors.initials: S
authors.lastname: Reuter
authors.forename: Nancy
authors.initials: N
authors.lastname: Agmon-Levin
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood* / Q000276:immunology; D017152:Antibodies, Antiphospholipid / Q000097:blood* / Q000276:immunology; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014376:Tuberculosis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D017152:Antibodies, Antiphospholipid; D000995:Antitubercular Agents