Potential diagnostic value of serum/pleural fluid IL-31 levels for tuberculous pleural effusion

Abstract

The aim of this study was to explore the diagnostic value of IL-31 levels in the pleural fluid and plasma to differentially diagnose tuberculous and malignant pleural effusion. We enrolled 91 cases, including tuberculous pleural effusion (TPE, n = 50), malignant pleural effusion (MPE, n = 41), other cases including pneumonia with pleural fluid, pulmonary tuberculosis and healthy people as controls. Whole blood was stimulated with the M. tuberculosis–specific antigens and plasma was collected. The multiplex bead-based cytokine immunoassay was employed to measure the levels of various cytokines. IL-31 was found to be the most prominent cytokine (P < 0.0001), and with an optimal cut-off value of 67.5 pg/mL, the sensitivity and specificity for the diagnosis of TPE were 86% and 100%, respectively. Furthermore, the tuberculosis-specific IL-31 levels in the plasma of TPE patients were higher than that of MPE patients (P = 0.0002). At an optimal cut-off value of 23.9 pg/mL, the sensitivity and specificity for the diagnosis of TPE were 92.9% and 85.7%, respectively. Ultimately, the combination of pleural fluid with the plasma tuberculosis-specific IL-31 levels improved the sensitivity and specificity to 94.0% and 95.1%, respectively. Thus, we identified a novel biomarker for the diagnosis of TPE for clinical application.

Development of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru

“…Recent papers have failed to provide conclusive evidence concerning the diagnostic accuracy of GeneXpert for PT (Denkinger et al, 2014), and a systematic review showed suboptimal performance of IGRAs in the diagnosis of PT (Aggarwal et al, 2015). More recently, the measurement of serum and pleural interleukins such as IL-31 (Gao et al, 2016) has shown sensitivities and specificities over 90% for the diagnosis of pleural TB, but once more these are high complexity tests that need further evaluation.…”

Cancer antigen-125 levels correlate with pleural effusions and COPD-related complications in people living at high altitude

“…A pleural effusion is excessive fluid that accumulates in the pleural cavity, which can impair breathing [11] and is commonly found among patients presenting with respiratory symptoms. [12,13] Pleural effusions are caused by a variety of diseases, including pulmonary infections, pleural tumor metastasis, and tuberculous pleurisy [14] ; the latter 2 conditions are difficult to differentiate in clinical practice. Accurate diagnosis of pleural effusion is extremely important for the treatment and prognosis of patients.…”

“…[16] Therefore, highly sensitive and specific biomarkers that are convenient and apply to differential diagnoses of pleural effusions are urgently needed. [14] Up until now, no clear association has been observed between serum CA-125 levels and radiological presentation, including pleural effusion, in patients with COPD.…”

Diagnostic Value of Interleukins in Tuberculous Pleural Effusion: A Systematic Review and Meta‐analysis

“…Our systematic review included 38 studies examining the ability of pleural concentrations of IL-2, IL-6, IL-12, IL-12p40, IL-18, IL-27, and IL-33 to diagnose TPE. Other ILs in the Table 1 were excluded for meta-analysis because relevant data were available from fewer than 3 studies [54][55][56][57][58] (Fig. 1).…”