Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics
Table 1
Immune cells and factors involved in the immunity against tuberculosis. List of some of the biological drugs used in the treatment of rheumatological disorders that inhibit immune paths.
Cytokine
Producing cell type
Role in tuberculosis
Biological drug inhibiting this path
References
IFN-γ
T lymphocytes, NK
(1) Activates iNOS pathway (2) Induces the process of acidification and maturation of phagosomes (3) Induces autophagy (4) Inhibits IL-17 production
(1) Maintain of granuloma integrity (2) Changes in TNF-α levels have been correlated with disease susceptibility (3) Acts synergistically with IFN-γ to stimulate the production of NO by macrophages (4) Influences the expression of chemokines
(1) Individuals with mutations in the IL-12/IFN-γ axis develop disseminated infection caused by BCG or nontuberculous species of mycobacteria (2) Important for MTb clearance
(1) Pro- and anti-inflammatory properties (2) Involved in the Th17 and Th22 cell differentiation (3) Early produced during mycobacterial infection (4) Involved in macrophage and cytotoxic T-cell differentiation (5) IL-6-deficient mice develops lethal TB
(1) Has protective immunity against hyper-virulent MTb strains (2) Removal of IL-17-producing cells enhanced recruitment of Th1 cells to the lung (3) Has pathogenic role of Th17 cells during chronic infection with MTb or BCG in mice