Cytokines in pleural liquid for diagnosis of tuberculous pleurisy.

Abstract

An elevated level of adenosine deaminase (ADA) in pleural liquid has been considered as a supplemental diagnostic marker for tuberculous pleurisy. However, this is complicated by false-positives and -negatives. Recently, it has been revealed that various cytokines are intimately involved in the pathognomonic physiology of tuberculosis. In this study, interleukin-8 (IL-8), tumour necrosis factor alpha (TNFalpha) and interferon gamma (IFNgamma) were compared with ADA in pleural liquid of patients with inflammatory (21 cases), malignant (28 cases) and tuberculous (21 cases) disease. The pleural ADA, IL-8, TNFalpha and IFNgamma levels in the tuberculous group were higher than in the other three groups. Analysis of receiver operating characteristic (ROC) curves, to evaluate the utility of the various parameters, demonstrates values for the area under the curve (AUC) of 0.770, 0.875, 0.892 and 0.987, respectively for IL-8, TNFalpha, ADA and IFNgamma. No false-positives were encountered with IFNgamma and only one case with a small volume of pleural liquid was a false-negative. This indicates that IFNgamma is a very reliable marker of tuberculous pleurisy.

• Authors: Y Yamada, A Nakamura, M Hosoda, T Kato, T Asano, K Tonegawa, M Itoh
• Journal: Respiratory medicine (Respir Med) Vol. 95 Issue 7 Pg. 577-81 (Jul 2001) ISSN: 0954-6111 [Print] England
• PMID: 11453314 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biomarkers
• Interleukin-8
• Tumor Necrosis Factor-alpha
• Interferon-gamma
• Adenosine Deaminase

Topics

• Adenosine Deaminase (analysis)
• Aged
• Area Under Curve
• Biomarkers (analysis)
• Female
• Humans
• Interferon-gamma (analysis)
• Interleukin-8 (analysis)
• Male
• Pleural Effusion (chemistry, etiology)
• Pleural Effusion, Malignant (chemistry, diagnosis)
• Pleurisy (complications, diagnosis)
• Predictive Value of Tests
• ROC Curve
• Sensitivity and Specificity
• Statistics, Nonparametric
• Tuberculosis, Pleural (complications, diagnosis)
• Tumor Necrosis Factor-alpha (analysis)