Cytokine production in patients with tuberculous pericarditis.

Abstract

SETTING:

An academic hospital in the Western Cape, South Africa.

OBJECTIVE:

To evaluate cytokine production (interferon-gamma [IFN-gamma], interleukin-1 [IL-1], interleukin-2 [IL-2], interleukin-6 [IL-6], interleukin-10 [IL-10], interleukin-4 [IL-4] and tumour necrosis factor-alpha [TNF-alpha]) in patients with tuberculous pericarditis.

DESIGN:

Subpopulation of a consecutive prospective case series.

PATIENTS:

Thirty patients presenting with pericardial effusions due to tuberculosis (n = 19), malignancy (n = 6) and non-tuberculous infections (n = 5), and five control subjects who had undergone open heart surgery.

RESULTS:

The concentration of IFN-gamma was significantly higher in tuberculous pericardial effusions than in the other diagnostic classes (P < 0.0005). The concentration of TNF-alpha was similar in both infective and tuberculous effusions, but was significantly higher than that of malignant effusions. IL-1 and IL-2 were undetectable in malignant effusions, but elevated in both infective and tuberculous pericardial effusions. The levels of IL-1 and IL-2 were furthermore significantly higher in pericardial effusions due to infective compared to tuberculous causes. The concentration of IL-6, while elevated in all diagnostic classes, was significantly higher in the malignant group. Elevated levels of IL-10 and undetectable levels of IL-4 were observed in all three diagnostic groups.

CONCLUSION:

These findings suggest that tuberculous pericardial effusions arise due to a hypersensitivity reaction that is orchestrated by the TH-1 lymphocytes.

• Authors: L J Burgess, H Reuter, M E Carstens, J J F Taljaard, A F Doubell
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 6 Issue 5 Pg. 439-46 (May 2002) ISSN: 1027-3719 [Print] France
• PMID: 12019920 (Publication Type: Journal Article)

Chemical References

• Cytokines
• Interleukin-1
• Interleukin-2
• Interleukin-6
• Tumor Necrosis Factor-alpha
• Interleukin-10
• Interleukin-4
• Interferon-gamma

Topics

• Adult
• Cytokines (analysis)
• Female
• Humans
• Interferon-gamma (analysis)
• Interleukin-1 (analysis)
• Interleukin-10 (analysis)
• Interleukin-2 (analysis)
• Interleukin-4 (analysis)
• Interleukin-6 (analysis)
• Male
• Pericardiocentesis
• Pericarditis, Tuberculous (immunology, surgery)
• Pericardium (immunology, surgery)
• Prospective Studies
• Tumor Necrosis Factor-alpha (analysis)