1.Association between Elevated Pleural Interleukin-33 Levels and Tuberculous Pleurisy.
Koung Sun LEE ; Hak Ryul KIM ; Seongae KWAK ; Keum Ha CHOI ; Ji Hyun CHO ; Young Jin LEE ; Mi Kyung LEE ; Jea Hoon LEE ; Seok Don PARK ; Do Sim PARK
Annals of Laboratory Medicine 2013;33(1):45-51
BACKGROUND: Interferon-gamma (IFN-gamma) plays a crucial role in Mycobacterium tuberculosis induced pleural responses. Interleukin (IL)-33 up-regulates the production of IFN-gamma. We aimed to identify whether an association between pleural IL-33 levels and tuberculous pleurisy exists and determine its diagnostic value. METHODS: Pleural IL-33, ST2 (a receptor of IL-33), adenosine deaminase (ADA), and IFN-gamma, as well as serum IL-33 and ST2 were measured in 220 patients with pleural effusions (PEs). Patients with malignant (MPEs), parapneumonic (PPEs), tuberculous (TPEs), and cardiogenic (CPEs) pleural effusions were included. RESULTS: Pleural and serum IL-33 levels were highest or tended to be higher in patients with TPEs than in those with other types of PEs. The median pleural fluid-to-serum IL-33 ratio was higher in TPE cases (> or = 0.91) than in other PE cases (< or = 0.56). Pleural IL-33 levels correlated with those of pleural ADA and IFN-gamma. However, the diagnostic accuracies of pleural IL-33 (0.74) and pleural fluid-to-serum IL-33 ratio (0.75) were lower than that of ADA (0.95) or IFN-gamma (0.97). Pleural ST2 levels in patients with MPEs were higher than in patients with TPEs. Serum ST2 levels did not differ among the groups. CONCLUSIONS: We identified an association between elevated pleural IL-33 levels and tuberculous pleurisy. However, we recommend conventional pleural markers (ADA or IFN-gamma) as diagnostic markers of TPE.
Adenosine Deaminase/analysis
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Adult
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Aged
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Aged, 80 and over
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Area Under Curve
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Case-Control Studies
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Cross-Sectional Studies
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Female
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Humans
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Interferon-gamma/analysis
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Interleukins/*analysis/blood
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Male
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Middle Aged
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Pleural Cavity/*metabolism
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Pleural Effusion/diagnosis/metabolism
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Pleural Effusion, Malignant/diagnosis/metabolism
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ROC Curve
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Receptors, Cell Surface/analysis/blood
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Tuberculosis, Pleural/*diagnosis/metabolism