T and B Lymphocytes in Pleural Effusions

Pettersson, Tom; Klockars, Matti; Hellström, P E; Riska, Henrik; Wangel, A. G.

doi:10.1378/chest.73.1.49

Cited by 65 publications

(27 citation statements)

References 23 publications

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“…Total lymphocyte rate was statistically significant in our series, especially in the group with RPT. In tuberculous pleural effusions both the absolute number and percentage of T-lymphocytes are significantly higher than in the peripheral blood, a fact which could explain the increase in adenosine deaminase activity, an enzyme predominantly detected in T-cells [25].…”

Section: Discussionmentioning

confidence: 97%

The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

Uskul

Türker

Ulman

et al. 2005

Monaldi Arch Chest Dis

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Selvi, A. Kant, S. Arslan, M. Ozgel. Background: Residual pleural thickening (RPT) still occurs in most patients with tuberculosis pleurisy despite advances in the treatment of tuberculosis. The aim of this study was to evaluate the significance of RPT in tuberculosis pleurisy with the patients clinical findings, biochemical and microbiological properties of pleural effusion and with the total adenosine deaminase (ADA) and isoenzymes levels. Methods: 121 tuberculosis pleurisy patients were evaluated retrospectively. According to posteroanterior chest x-rays, the 63 (52%) cases with the thickness 2 mm or more in lower lateral hemithorax were grouped as I and the 58 (48%) cases without pleural thickness were grouped as II. The amount of pleural effusion was classified into small, medium or massive according to their chest x-rays. In both groups; sex, age, symptoms score, bacteriological and biochemical tests and ADA levels were recorded. Results: 81 (67%) male and 40 (33%) female, overall 121 patients were enrolled into the study. RPT was found higher in males (p=0.014) and the increase ran parallel with the amount of cigarette smoking (p=0.014). RPT was found to be lower in small effusions (p=0.001). The group with RPT, the serum albumin was found lower (p=0.002), pleural fluid total protein (p=0.047) and the ratio of pleural fluid protein to serum protein (p=0.002) were found higher. In group I, total ADA: 69.5±38.9 IU/L and ADA2: 41.3±31.6 IU/L were higher than the cases without RPT (p=0.032, p=0.017, respectively). Conclusions: We suggest that the immunological mechanisms are effective in the development of pleural thickening.

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Section: Discussionmentioning

confidence: 97%

The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

Uskul

Türker

Ulman

et al. 2005

Monaldi Arch Chest Dis

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“…Lymphocytes from tuberculous pleural effusions produce IFN-γ when stimulated with tuberculin [2,19,20], or with mycobacterial cell wall proteins [14]. IFN-γ activated murine bone marrow macrophages have been shown to inhibit the in vitro production of mycobacterial ribonucleic acid (RNA) and to reduce the number of viable mycobacteria [21].…”

Section: Discussionmentioning

confidence: 99%

“…Tuberculous pleural effusions typically show a predominance of T-lymphocytes [2][3], and high levels of adenosine deaminase (ADA) [4,5] and soluble interleukin-2 receptor (sIL-2R) [6]. In rheumatoid pleural effusions, high ADA and sIL-2R levels have also been reported [6,7].…”

mentioning

confidence: 99%

Pleural fluid interferon-gamma and tumour necrosis factor-alpha in tuberculous and rheumatoid pleurisy

Soderblom

Nyberg²,

Teppo³

et al. 1996

Eur Respir J

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“…Enzyme activity is found in all cells with the highest activity in lymphocytes and monocytes [10]. Both types of cells characterize tuberculous reactions and their presence has been shown in the lung parenchyma [11, 12], the tuberculin skin reaction [13]and in pleural fluid [14, 15, 16]. However, similar cell counts are also reported in malignant effusions where no significantly high ADA activity is usually detected [3, 14, 15, 17].…”

Section: Introductionmentioning

confidence: 99%

Tuberculous Effusion: ADA Activity Correlates with CD4+ Cell Numbers in the Fluid and the Pleura

Gaga

Papamichalis²,

Bakakos

et al. 2005

Respiration

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Background: Adenosine deaminase (ADA) is a commonly used marker in the diagnosis of tuberculous effusion and there is evidence that its production is linked to T cells and monocytes. Data on the correlation between ADA and T cells or macrophages in tuberculous effusions are conflicting. Furthermore, no studies have examined a possible correlation between pleural tissue infiltration and ADA. Objectives: We undertook this study to examine cell subsets in the fluid and the pleura in tuberculous effusion and their correlation to ADA. The use of cell subsets as a marker in the differential diagnosis was also examined. Methods: Pleural fluid from 36 patients with tuberculous and 34 patients with malignant effusion as well as pleural tissue biopsies from 16 patients with tuberculous pleurisy were examined. The APAAP and the avidin-biotin complex immunocytochemical methods were used to examine CD4+ T cells and macrophages (CD68+), while ADA activity was measured by the Giusti colorimetric method. Results: Our results showed that, in pleural fluid, CD4+ cells and ADA were significantly higher in tuberculous compared to malignant effusion (p < 0.001 for all measurements). In pleural tissue biopsies, macrophages were the predominant cells but CD4+ T cells were also abundant. A significant correlation was found between ADA and CD4+ numbers in pleural fluid and tissue (r = 0.45, p < 0.01; r = 0.75, p < 0.001, respectively). ADA had high sensitivity and specificity for differential diagnosis while cell subsets did not. Conclusions: These results indicate that ADA activity correlates to CD4+ T cell infiltration in the pleura and the fluid. Moreover, ADA but no cell subsets may be used as markers of tuberculous effusion.

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T and B Lymphocytes in Pleural Effusions

Cited by 65 publications

References 23 publications

The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

Pleural fluid interferon-gamma and tumour necrosis factor-alpha in tuberculous and rheumatoid pleurisy

Tuberculous Effusion: ADA Activity Correlates with CD4+ Cell Numbers in the Fluid and the Pleura

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