Neopterin, Soluble lnterleukin-2 Receptor and Adenosine Deaminase Levels in Pleural Effusions

Abstract

We evaluated soluble interleukin-2 receptors (sIL-2R), neopterin and adenosine deaminase (ADA) in pleural effusions from 93 patients with tuberculosis, malignancies, uremia, pneumonia and other kinds of pleurisy. There were significantly elevated ADA (102.7 ± 47 U/1) and sIL-2R (8,238 ± 4,117 U/ml) values in tuberculous (TB) pleural fluids as compared with other non-TB pleural fluids (p < 0.005). The neopterin levels in pleural fluid were significantly lower in the cancer group (17.3 ± 7.8 nmol/l; p < 0.005) and most strikingly elevated (309.4 ± 112.2 nmol/l; p < 0.0001) in patients with uremic pleural effusions. Using cut-off values of 60 U/l in ADA and 5,000 U/l in sIL-2R, 92.0 and 86.9% of pleural effusions were TB in origin. Eighty-four percent of patients with malignant pleural effusions had neopterin levels less than 25 nmol/l.

Preliminary evaluation of soluble IL‐2 receptor and type III procollagen N‐terminal aminopeptide in pleural fluid for differentiating tuberculous, carcinomatous and parapneumonic pleural effusions

“…Chiang et al reported that if an sIL-2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9%. 8 In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively. 9 In the present study, although the concentrations of sIL-2R in tuberculous effusions were significantly higher than those in carcinomatous effusions, there was a wide range of overlapping data between the groups with tuberculosis and carcinoma.…”

“…Chiang et al. reported that if an sIL‐2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9% 8 . In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively 9 .…”

Preliminary evaluation of soluble IL‐2 receptor and type III procollagen N‐terminal aminopeptide in pleural fluid for differentiating tuberculous, carcinomatous and parapneumonic pleural effusions

“…Chiang et al reported that if an sIL-2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9%. 8 In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively. 9 In the present study, although the concentrations of sIL-2R in tuberculous effusions were significantly higher than those in carcinomatous effusions, there was a wide range of overlapping data between the groups with tuberculosis and carcinoma.…”

“…Chiang et al. reported that if an sIL‐2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9% 8 . In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively 9 .…”

A Case of Tuberculous Peritonitis in a Hemodialysis Patient with High Serum Soluble Interleukin-2 Receptor and CA-125 Levels

“…It is likely that many cases are left unreported. Although sIL-2R levels in ascitic fluid were not measured in the present case, high sIL-2R levels are expected, given the high levels of sIL-2R in pleural effusions in patients with tuberculous pleurisy (7)(8)(9). These studies showed that tuberculous pleurisy could be distinguished from non-tuberculous effusions with a sensitivity of 74-91% and a specificity of 93.9-100% by evaluation of pleural sIL-2R levels (7)(8)(9).…”

“…Although sIL-2R levels in ascitic fluid were not measured in the present case, high sIL-2R levels are expected, given the high levels of sIL-2R in pleural effusions in patients with tuberculous pleurisy (7)(8)(9). These studies showed that tuberculous pleurisy could be distinguished from non-tuberculous effusions with a sensitivity of 74-91% and a specificity of 93.9-100% by evaluation of pleural sIL-2R levels (7)(8)(9). Seventeen weeks after initiation of anti-tuberculosis therapy, the patient's sIL-2R level decreased from 9,170 U/mL to 1,620 U/mL, which is appropriate value for hemodialysis patients as reported by Shu et al (10).…”

Pleural Fluid Soluble Interleukin-2 Receptor as a Biomarker for the Diagnosis of Tuberculosis Pleural Effusion: A Systematic Review and Meta-Analysis

“…The summary of the eligible studies is noted in Table 1 . Two of the included studies were from China [ 32 , 33 ], two were from Japan [ 30 , 35 ], and each of the remaining five studies were from Turkey [ 27 ], Poland [ 28 ], India [ 29 ], Spain [ 31 ], and Greece [ 34 ]. Sample sizes of the eligible studies ranged from 38 to 173 patients.…”

Preliminary evaluation of soluble IL‐2 receptor and type III procollagen N‐terminal aminopeptide in pleural fluid for differentiating tuberculous, carcinomatous and parapneumonic pleural effusions

“…Chiang et al reported that if an sIL-2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9%. 8 In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively. 9 In the present study, although the concentrations of sIL-2R in tuberculous effusions were significantly higher than those in carcinomatous effusions, there was a wide range of overlapping data between the groups with tuberculosis and carcinoma.…”

“…Chiang et al. reported that if an sIL‐2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9% 8 . In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively 9 .…”

A Case of Tuberculous Peritonitis in a Hemodialysis Patient with High Serum Soluble Interleukin-2 Receptor and CA-125 Levels

“…It is likely that many cases are left unreported. Although sIL-2R levels in ascitic fluid were not measured in the present case, high sIL-2R levels are expected, given the high levels of sIL-2R in pleural effusions in patients with tuberculous pleurisy (7)(8)(9). These studies showed that tuberculous pleurisy could be distinguished from non-tuberculous effusions with a sensitivity of 74-91% and a specificity of 93.9-100% by evaluation of pleural sIL-2R levels (7)(8)(9).…”

“…Although sIL-2R levels in ascitic fluid were not measured in the present case, high sIL-2R levels are expected, given the high levels of sIL-2R in pleural effusions in patients with tuberculous pleurisy (7)(8)(9). These studies showed that tuberculous pleurisy could be distinguished from non-tuberculous effusions with a sensitivity of 74-91% and a specificity of 93.9-100% by evaluation of pleural sIL-2R levels (7)(8)(9). Seventeen weeks after initiation of anti-tuberculosis therapy, the patient's sIL-2R level decreased from 9,170 U/mL to 1,620 U/mL, which is appropriate value for hemodialysis patients as reported by Shu et al (10).…”

Pleural Fluid Soluble Interleukin-2 Receptor as a Biomarker for the Diagnosis of Tuberculosis Pleural Effusion: A Systematic Review and Meta-Analysis

“…The summary of the eligible studies is noted in Table 1 . Two of the included studies were from China [ 32 , 33 ], two were from Japan [ 30 , 35 ], and each of the remaining five studies were from Turkey [ 27 ], Poland [ 28 ], India [ 29 ], Spain [ 31 ], and Greece [ 34 ]. Sample sizes of the eligible studies ranged from 38 to 173 patients.…”

Preliminary evaluation of soluble IL‐2 receptor and type III procollagen N‐terminal aminopeptide in pleural fluid for differentiating tuberculous, carcinomatous and parapneumonic pleural effusions

“…Chiang et al reported that if an sIL-2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9%. 8 In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively. 9 In the present study, although the concentrations of sIL-2R in tuberculous effusions were significantly higher than those in carcinomatous effusions, there was a wide range of overlapping data between the groups with tuberculosis and carcinoma.…”

“…Chiang et al. reported that if an sIL‐2R concentration of 5000 U/mL was used as a cutoff value, tuberculous effusions could be differentiated from carcinomatous effusions with a sensitivity of 94.1% and a specificity of 93.9% 8 . In another study, similar conclusions were reported using a cutoff point of 4291 U/mL, which yielded a specificity and sensitivity of 100 and 81%, respectively 9 .…”

A Case of Tuberculous Peritonitis in a Hemodialysis Patient with High Serum Soluble Interleukin-2 Receptor and CA-125 Levels

“…It is likely that many cases are left unreported. Although sIL-2R levels in ascitic fluid were not measured in the present case, high sIL-2R levels are expected, given the high levels of sIL-2R in pleural effusions in patients with tuberculous pleurisy (7)(8)(9). These studies showed that tuberculous pleurisy could be distinguished from non-tuberculous effusions with a sensitivity of 74-91% and a specificity of 93.9-100% by evaluation of pleural sIL-2R levels (7)(8)(9).…”

“…Although sIL-2R levels in ascitic fluid were not measured in the present case, high sIL-2R levels are expected, given the high levels of sIL-2R in pleural effusions in patients with tuberculous pleurisy (7)(8)(9). These studies showed that tuberculous pleurisy could be distinguished from non-tuberculous effusions with a sensitivity of 74-91% and a specificity of 93.9-100% by evaluation of pleural sIL-2R levels (7)(8)(9). Seventeen weeks after initiation of anti-tuberculosis therapy, the patient's sIL-2R level decreased from 9,170 U/mL to 1,620 U/mL, which is appropriate value for hemodialysis patients as reported by Shu et al (10).…”

Pleural Fluid Soluble Interleukin-2 Receptor as a Biomarker for the Diagnosis of Tuberculosis Pleural Effusion: A Systematic Review and Meta-Analysis

“…The summary of the eligible studies is noted in Table 1 . Two of the included studies were from China [ 32 , 33 ], two were from Japan [ 30 , 35 ], and each of the remaining five studies were from Turkey [ 27 ], Poland [ 28 ], India [ 29 ], Spain [ 31 ], and Greece [ 34 ]. Sample sizes of the eligible studies ranged from 38 to 173 patients.…”