Assay of pleural fluid interleukin-6, tumour necrosis factor-alpha and interferon-gamma in the diagnosis and outcome correlation of tuberculous effusion

Wong, Chin Fong; Yew, Wing‐Wai; Leung, Simon Kwok-fai; Chan, C N; Hui, Mamie; Au-Yeang, Carrie; Cheng, A. F. B.

doi:10.1016/j.rmed.2003.07.003

Cited by 45 publications

(47 citation statements)

References 31 publications

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“…Moreover, it is well mentioned in few studies that other diseases can also cause elevated INF-γ levels in PF such as haematologic malignancies and empyema. 24,25 The higher sensitivity and specificity of INF-γ as compared to ADA in this study was found to be in total agreement with the existing studies which reported PF INF-γ levels to be more sensitive and specific than ADA 28 and suggested INF-γ as a better marker than ADA for the diagnosis of tuberculous pleuritis.…”

Section: Discussionsupporting

confidence: 91%

Markers for differentiation of tubercular pleural effusion from non-tubercular effusion

Ambade

Arora

Rai

et al. 2011

Medical Journal Armed Forces India

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BACKGROUNDThe limitations of the conventional methods for diagnosing tuberculosis (TB) have spurred multi-faceted research activities throughout the world.This study aims to explore the levels of adenosine deaminase (ADA) and interleukins in pleural effusion of tuberculous, malignant, and miscellaneous origin for differential diagnosis of tubercular and non-tubercular effusion. METHODAdenosine deaminase was estimated by kinetic method employing xanthine oxidase while interleukins were measured using commercially available ELISA kits in pleural fluids of tubercular and non-tubercular origin. RESULTSPleural fluids INF-γ, sIL-2R, TNF-α and ADA were significantly higher in TB group (n = 48) as compared to the non-TB group (n = 33) (mean ± SD:INF-γ; 1,958.7 ± 896.5 pg/mL vs 356.9 ± 733.6 pg/mL, sIL-2R; 6,101 ± 1,753.8 pg/mL vs 3,166 ± 2,611.1 ± pg/mL, TNF-α; 195.5 ± 292.1 pg/mL vs 59.7 ± 128.9 pg/mL, ADA; 123.6 ± 81.8 IU/L vs 48 ± 48.5 IU/L, P < 0.01). CONCLUSIONINF-γ is more sensitive and specific than ADA for the diagnosis of TB and should be added to the armamentarium of the diagnostic workup of pleural fluids for timely and accurate diagnosis of TB and differentiation of tubercular pleural effusion from non-tubercular effusion.

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Section: Discussionsupporting

confidence: 91%

Markers for differentiation of tubercular pleural effusion from non-tubercular effusion

Ambade

Arora

Rai

et al. 2011

Medical Journal Armed Forces India

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“…This condition results in limited inflammation. Predicted ranges for IFN-␥ and IL-10 correlate with studies measuring cytokine levels at the site of disease (47,53,54), whereas simulated IL-4 is present at essentially undetectable levels during latency (Ͻ0.1 pg/ml), possibly explaining why IL-4 is difficult to detect in humans with latent infection (54,55). IL-12 levels in this particular latency simulation are higher than what might be found within the lungs, but this is likely due to the constraints of modeling within a single compartment, which means that priming of the T cell response occurs in the lungs instead of lymph nodes in this model.…”

Section: Latent Infectionmentioning

confidence: 83%

Contribution of CD8+ T Cells to Control of Mycobacterium tuberculosis Infection

Sud

Bigbee

Flynn

et al. 2006

The Journal of Immunology

133

109

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Tuberculosis is the number one cause of death due to infectious disease in the world today. Understanding the dynamics of the immune response is crucial to elaborating differences between individuals who contain infection vs those who suffer active disease. Key cells in an adaptive immune response to intracellular pathogens include CD8+ T cells. Once stimulated, these cells provide a number of different effector functions, each aimed at clearing or containing the pathogen. To explore the role of CD8+ T cells in an integrative way, we synthesize both published and unpublished data to build and test a mathematical model of the immune response to Mycobacterium tuberculosis in the lung. The model is then used to perform a series of simulations mimicking experimental situations. Selective deletion of CD8+ T cell subsets suggests a differential contribution for CD8+ T cell effectors that are cytotoxic as compared with those that produce IFN-γ. We also determined the minimum levels of effector memory cells of each T cell subset (CD4+ and CD8+) in providing effective protection following vaccination.

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“…In the past, several biological markers have been studied to aid the diagnosis of plTB, including the measurement of pleural fluid concentrations of adenosine deaminase [50,51], tumour necrosis factor-a [52][53][54] and whole IFN-c [50,55,56], with reported diagnostic sensitivities ranging from 72-88% and specificities from 88-100% [50][51][52][53][54][55][56]. Thus, reported sensitivities of adenosine deaminase and IFN-c measurements in PE for the diagnosis of plTB are similar to the sensitivity of the T-SPOT.TB test reported in the present study, although T-SPOT.TB specificity seems lower.…”

Section: Discussionmentioning

confidence: 99%

Use of a T-cell interferon- release assay for the diagnosis of tuberculous pleurisy

Losi¹,

Bossink²,

Codecasa³

et al. 2007

European Respiratory Journal

146

142

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The diagnosis of pleural tuberculosis (plTB) by the analysis of pleural effusions (PEs) with standard diagnostic tools is difficult. In routine clinical practice, the present authors evaluated the performance of a commercially available Mycobacterium tuberculosis (MTB)-specific enzyme-linked immunospot assay on peripheral blood mononuclear cells (PBMCs) and pleural effusion mononuclear cells (PEMCs) in patients with suspect plTB.The T-SPOT.TB test (Oxford Immunotec Ltd, Abingdon, UK) was performed on PBMCs and PEMCs in 20 patients with a clinical and radiological suspect of plTB and in 21 control subjects with a diagnosis of PE of nontuberculous origin at four centres participating in the European Tuberculosis Network.In total, 18 (90%) out of 20 patients with plTB tested T-SPOT.TB-positive on PBMCs and 19 (95%) out of 20 on PEMCs. Among controls, T-SPOT.TB was positive in seven out of 21 (33%) patients when performed on PBMCs (these patients were assumed to be latently infected with MTB) and five (23%) out of 21 when performed on PEMCs. Sensitivity and specificity of T-SPOT.TB for the diagnosis of active plTB when performed on PEMCs were 95 and 76%, respectively.Enumerating Mycobacterium tuberculosis-specific T-cells in pleural effusion mononuclear cells by ELISPOT is feasible in routine clinical practice and may be useful for a rapid and accurate diagnosis of pleural tuberculosis.

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Assay of pleural fluid interleukin-6, tumour necrosis factor-alpha and interferon-gamma in the diagnosis and outcome correlation of tuberculous effusion

Abstract: Pleural fluid IL-6, TNF-alpha and IFN-gamma assays are useful in the diagnosis of pleural TB. The initial IL-6 level correlates with the number of febrile days. The percentage change of cytokines after 2 weeks of treatment also helps to predict residual pleural scarring.

Cited by 45 publications

References 31 publications

Markers for differentiation of tubercular pleural effusion from non-tubercular effusion

Markers for differentiation of tubercular pleural effusion from non-tubercular effusion

Contribution of CD8+ T Cells to Control of Mycobacterium tuberculosis Infection

Use of a T-cell interferon- release assay for the diagnosis of tuberculous pleurisy

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