Cytokine Content in Pleural Effusion

In this study, the levels of interleukin-1β (IL-1β) were measured in pleural fluid from patients with chronic malignant pleural effusions, before and during quinacrine-induced pleurodesis. IL-1β levels increased significantly within 24 h after the instillation of quinacrine (p < 0.001). The levels of IL-1β correlated with the amount of pleural fluid production as well as with the tube drainage treatment time. Thus, the more IL-1β levels increased the higher pleural fluid production was seen and a longer drainage treatment time was needed. There were no correlations between IL-1β levels and degree of fever, recruitment of pleural leucocytes, activity of pleural coagulation or inhibition of pleural fibrinolysis.

Section: Discussionsupporting

confidence: 93%

“…IL-ip has earlier been found in pleural exudates from patients with tuberculous pleurisy and in carcinomatous pleurisy, not treated with pleurodesis [12].…”

Section: Introductionmentioning

confidence: 86%

Quinacrine-lnduced Pleural Inflammation in Malignant Pleurisy: Relation Between Drainage Time of Pleural Fluid and Local lnterleukin-1β Levels

Agrenius

Ukale²,

Widström³

et al. 1993

“…There is T lymphocyte predominance in tuberculous pleural effusions [4, 5]and it has been suggested that high ADA activity in pleural effusion is specific and sensitive in the diagnosis of tuberculous pleurisy [6, 7, 8]. However, the pleural fluid ADA levels of some patients with tuberculosis are low.…”

Section: Discussionmentioning

confidence: 99%

Tumour Necrosis Factor-α in Comparison to Adenosine Deaminase in Tuberculous Pleuritis

Tahhan¹,

Uğurman²,

Gözü³

et al. 2003

Background: Adenosine deaminase (ADA) is already used for the differential diagnosis of tuberculosis pleurisy. Tumour necrosis factor-α (TNF) is another marker which has been investigated for this purpose. Objective: We evaluated the diagnostic value of pleural fluid and serum TNF concentrations in tuberculous pleuritis and compared them to ADA. Methods: Sixty-two patients (24 tuberculous pleuritis, 38 non-tuberculous pleuritis) with exudative pleurisy were included. Serum and pleural fluid TNF concentrations were determined in all patients and ADA activity in 54 patients. Pleural fluid TNF concentrations and pleural fluid/serum TNF were compared to pleural fluid ADA activity and pleural fluid/serum ADA. Results: When the tuberculous and non-tuberculous groups were compared, pleural fluid TNF concentrations (65.4 ± 136.9 pg/ml vs. 54.5 ± 144.2 pg/ml, respectively; p < 0.001), pleural fluid ADA activity (74.2 ± 33.3 U/l vs. 23 ± 16.3 U/l; p < 0.0001), pleural fluid/serum TNF (2.55 ± 5.23 vs. 0.26 ± 0.2; p < 0.001) and pleural fluid/serum ADA (4.58 ± 8.14 vs. 1.15 ± 0.7; p < 0.0001) were significantly higher in the tuberculous group. When cut-off points were assessed, 8 pg/ml and 40 U/l were found for pleural fluid TNF concentrations and pleural fluid ADA activity, respectively. Sensitivity, specificity, area under the curve were 87.5%, 76.3%, 0.772 for pleural fluid TNF concentrations and 90.9%, 89.5%, 0.952 for pleural fluid ADA activity, respectively; the difference between these areas under the curves was significant (p < 0.05). Conclusions: Pleural fluid TNF levels and pleural fluid/serum TNF were higher in tuberculous effusions than in other exudates, but their diagnostic value appears to be poorer than that of ADA.

“…IL-6 is an important regulator of inflammation and immunity and is produced by different types of inflammatory or neoplastic cells which may be found in the pleural effusion. It plays an important role in the induction of CRP, AMG and AAG [14, 15, 16, 17, 18, 19]. …”

Section: Discussionmentioning

confidence: 99%

Significance of Alpha-2-Macroglobulin, Alpha-1-Acid Glycoprotein, and C-Reactive Protein in Pleural Effusion Differentiation

Alexandrakis¹,

Coulocheri²,

Bouros³

et al. 2000

Background: The differentiation between exudates and transudates is fundamental when investigating the cause of pleural effusions. Acute-phase proteins could be potentially useful markers in this discrimination. Objective: The present study was designed to evaluate whether the acute-phase proteins: α₂-macroglobulin (AMG), α₁-acid glycoprotein (AAG) and C-reactive protein (CRP) are useful in investigating the pleural effusions. Methods: We prospectively measured the concentrations of the above proteins in the serum and pleural fluid of 84 consecutive patients with various diseases using a nephelometric assay. Results: Pleural effusion AMG, AAG and CRP were all significantly elevated in the group of patients with exudates compared to patients with transudates (p < 0.001, p < 0.001 and p < 0.01, respectively). An AAG value >63 mg/dl in a pleural effusion is predictive of an exudate with a sensitivity of 90% and a specificity 85%. Similarly, an AMG value >44 mg/dl in a pleural effusion is predictive of an exudate with a sensitivity and a specificity of 90% and 60%, respectively. Moreover, pleural AAG was significantly higher in cancerous exudates than in exudates and transudates of all other cause taken together (p < 0.001). Finally, to differentiate the same pleural effusion, the cut-off value of 1.0 mg/dl of pleural CRP has a sensitivity and a specificity of 74% and 74%, respectively. Conclusions: We conclude that both AAG and AMG concentrations in pleural effusions have a high sensitivity and are therefore useful parameters in distinguishing exudates from transudates, but the latter is inferior due to its unacceptably low specificity.