Accuracy of interleukin-27 assay for the diagnosis of tuberculous pleurisy

Li, Min; Zhu, Wenye; Khan, Rana Sami Ullah; Saeed, Ummair; Wang, Rongchun; Shi, Shaoqing; Luo, Zhuojing

doi:10.1097/md.0000000000009205

Cited by 19 publications

(12 citation statements)

References 34 publications

(41 reference statements)

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“…TB enhances the production and secretion of IL-27 from antigen presenting cells (APCs) increasing its local concentration 16 . Our results confirm previous studies that have shown the high diagnostic value of IL-27 for the diagnosis of TPE 2,13,17,18 with higher levels of IL-27 in TPE than in non-TPE patients 13,19 . Wu and colleagues reported that the diagnostic accuracy of IL-27 better than that seen with IFN-γ or with ADA showing a sensitivity of 95% and specificity of 97.6% 13 .…”

Section: Discussionsupporting

confidence: 92%

“…Wu and colleagues reported that the diagnostic accuracy of IL-27 better than that seen with IFN-γ or with ADA showing a sensitivity of 95% and specificity of 97.6% 13 . A meta-analysis of IL-27 studies in TPE gave a pooled sensitivity of 0.92 and a specificity of 0.90 19 . In the current study, we found an equally high sensitivity and specificity of IL-27 for the diagnosis of TPE with a sensitivity and specificity significantly higher than that of the other biomarkers.…”

Section: Discussionmentioning

confidence: 99%

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Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

Roofchayee

Marjani

Dezfuli

et al. 2021

Sci Rep

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Patients with tuberculous pleural effusion (TPE) or malignant pleural effusions (MPE) frequently have similar pleural fluid profiles. New biomarkers for the differential diagnosis of TPE are required. We determined whether cytokine profiles in the PE of patients could aid the differential diagnosis of TPE. 30 patients with TPE, 30 patients with MPE, 14 patients with empyema (EMP) and 14 patients with parapneumonic effusion (PPE) were enrolled between Dec 2018 and 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL8, CCL-1 and IP-10 were determined in PE by ELISA along with measurements of adenosine deaminase (ADA). The best predictors of TPE were combined ADA.IL-27 [optimal cut-off value = 42.68 (103 U ng/l2), sensitivity 100%, specificity 98.28%], ADA [cut off value 27.5 (IU/l), sensitivity 90%, specificity 96.5%] and IL-27 [cut-off value = 2363 (pg/ml), sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001]. A high level of IL-6 [cut-off value = 3260 (pg/ml), sensitivity 100%, specificity 67.2%], CXCL8 [cut-off value = 144.5 (pg/ml), sensitivity 93.3%, specificity 58.6%], CCL1 [cut-off value = 54 (pg/ml), sensitivity 100%, specificity 70.7%] and IP-10 [cut-off value = 891.9 (pg/ml), sensitivity 83.3%, specificity 48.3%] were also predictive of TPE. High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy and may be useful clinically.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

Roofchayee

Marjani

Dezfuli

et al. 2021

Sci Rep

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“…Wu and colleagues reported that the diagnostic accuracy of IL-27 was even higher than seen with IFN-γ or with ADA with a sensitivity of 95% and speci city of 97.6% (16). A meta-analysis of IL-27 studies in TPE gave a pooled sensitivity of 0.92 (95% CI, 0.90-0.95) with a speci city of 0.90 (95% CI, 088-0.92) (26). In the current study, we found an equally high sensitivity and speci city of IL-27 for the diagnosis of TPE.…”

Section: Discussionsupporting

confidence: 57%

“…TB enhances the production and secretion of IL-27 from antigen presenting cells (APCs) increasing its local concentration (24). Previous studies have shown the high diagnostic value of IL-27 cytokine for the diagnosis of TPE (2,16,25) with higher levels of IL-27 in TPE than in non-TPE patients (16,26). Wu and colleagues reported that the diagnostic accuracy of IL-27 was even higher than seen with IFN-γ or with ADA with a sensitivity of 95% and speci city of 97.6% (16).…”

Section: Discussionmentioning

confidence: 99%

Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

Roofchayee

Marjani

Dezfuli

et al. 2020

Preprint

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Background: Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. Patients with tuberculous or malignant pleural effusions (MPE) frequently have similar clinical manifestations and pleural fluid profile. New biomarkers for the differential diagnosis of TPE are required. Objective: We sought to determine of whether cytokine profiles in the pleural effusion of patients were suitable as tools for the differential diagnosis of TPE. Methods: 30 patients with TPE, 30 patients with MPE, 14 patients with empyema and 14 patients with parapneumonic effusion were enrolled consecutively from the Masih Daneshvari Hospital, Tehran, Iran between Dec 2018-Dec 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL-8, CCL-1 and IP-10 were determined in pleural effusions by ELISA along with measurements of adenosine deaminase (ADA). Results: The levels of all analytes measured except IL-18 were higher in TPE compared with non-TPE subjects (all p < 0.01). The best predictors of TPE were combined ADA.IL-27 (optimal cut-off value = 42.68 103.U.ng/L2, sensitivity 100%, specificity 98.28%, p ≤ 0.0001), ADA (optimal cut off value 27.5 IU/L, sensitivity 90%, specificity 96.5%, p ≤ 0.0001) and IL-27 (optimal cut-off value = 2363 pg/ml, sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001). A high level of IL-6 (optimal cut-off value = 3260 pg/ml, sensitivity 100%, specificity 67.2%, p ≤ 0.0001), CXCL-8 (optimal cut-off value = 144.5 pg/m, sensitivity 93.3%, specificity 58.6%, p ≤ 0.0001), CCL-1 (optimal cut-off value = 54 pg/mL, sensitivity 100%, specificity 70.7%, p ≤ 0.0001) and IP-10 (optimal cut-off value = 891.9 pg/mL, sensitivity 83.3%, specificity 48.3%, p = 0.0001) were also predictive of TPE. Conclusion: High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy.

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“…To date, three meta-analyses have reported the diagnostic usefulness of PF IL-27 for TB effusions. 34 – 36 The most comprehensive one summarized seven studies (mostly from China) with a total of 1157 patients with PEs. 35 The main pooled estimates were as follows: sensitivity 93.8%, specificity 91.7%, LR positive 29.8, LR negative 0.08, and AUC 0.976.…”

Section: Biomarkers Of Pleural Tuberculosismentioning

confidence: 99%

Biomarkers in the diagnosis of pleural diseases: a 2018 update

Porcel

2018

Ther Adv Respir Dis

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The use of biomarkers on pleural fluid (PF) specimens may assist the decision-making process and enhance clinical diagnostic pathways. Three paradigmatic examples are heart failure, tuberculosis and, particularly, malignancy. An elevated PF concentration of the amino-terminal fragment of probrain natriuretic peptide (>1500 pg/ml) is a hallmark of acute decompensated heart failure. Adenosine deaminase, interferon-γ and interleukin-27 are three valuable biomarkers for diagnosing tuberculous pleurisy, yet only the first has been firmly established in clinical practice. Diagnostic PF biomarkers for malignancy can be classified as soluble-protein based, immunocytochemical and nucleic-acid based. Soluble markers (e.g. carcinoembryonic antigen (CEA), carbohydrate antigen 15–3, mesothelin) are only indicative of cancer, but not confirmatory. Immunocytochemical studies on PF cell blocks allow: (a) to distinguish mesothelioma from reactive mesothelial proliferations (e.g. loss of BAP1 nuclear expression, complemented by the demonstration of p16 deletion using fluorescence in situ hybridization, indicate mesothelioma); (b) to separate mesothelioma from adenocarcinoma (e.g. calretinin, CK 5/6, WT-1 and D2-40 are markers of mesothelioma, whereas CEA, EPCAM, TTF-1, napsin A, and claudin 4 are markers of carcinoma); and (c) to reveal tumor origin in pleural metastases of an unknown primary site (e.g. TTF-1 and napsin A for lung adenocarcinoma, p40 for squamous lung cancer, GATA3 and mammaglobin for breast cancer, or synaptophysin and chromogranin A for neuroendocrine tumors). Finally, PF may provide an adequate sample for analysis of molecular markers to guide patients with non-small cell lung cancer to appropriate targeted therapies. Molecular testing must include, at least, mutations of epidermal growth-factor receptor and BRAF V600E, translocations of rat osteosarcoma and anaplastic lymphoma kinase, and expression of programmed death ligand 1.

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Accuracy of interleukin-27 assay for the diagnosis of tuberculous pleurisy

Cited by 19 publications

References 34 publications

Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

Biomarkers in the diagnosis of pleural diseases: a 2018 update

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