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KMID : 1100720130330010045
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Annals of Laboratory Medicine
2013 Volume.33 No. 1 p.45 ~ p.51
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Association between Elevated Pleural Interleukin-33 Levels and Tuberculous Pleurisy
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Lee Koung-Sun
Park Seok-Don
Kim Hak-Ryul
Cho Ji-Hyun
Lee Young-Jin
Kwak Seong-Ae
Park Do-Sim
Lee Jea-Hoon
Choi Keum-Ha
Lee Mi-Kyung
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Abstract
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Background: Interferon-γ (IFN-γ) plays a crucial role in Mycobacterium tuberculosis induced pleural responses. Interleukin (IL)-33 up-regulates the production of IFN-γ. We aimed to identify whether an association between pleural IL-33 levels and tuberculous pleurisy exists and determine its diagnostic value.
Methods: Pleural IL-33, ST2 (a receptor of IL-33), adenosine deaminase (ADA), and IFN-γ, as well as serum IL-33 and ST2 were measured in 220 patients with pleural effusions (PEs). Patients with malignant (MPEs), parapneumonic (PPEs), tuberculous (TPEs), and cardiogenic (CPEs) pleural effusions were included.
Results: Pleural and serum IL-33 levels were highest or tended to be higher in patients with TPEs than in those with other types of PEs. The median pleural fluid-to-serum IL-33 ratio was higher in TPE cases (≥ 0.91) than in other PE cases (≤ 0.56). Pleural IL-33 levels correlated with those of pleural ADA and IFN-γ. However, the diagnostic accuracies of pleural IL-33 (0.74) and pleural fluid-to-serum IL-33 ratio (0.75) were lower than that of ADA (0.95) or IFN-γ (0.97). Pleural ST2 levels in patients with MPEs were higher than in patients with TPEs. Serum ST2 levels did not differ among the groups.
Conclusions: We identified an association between elevated pleural IL-33 levels and tuberculous pleurisy. However, we recommend conventional pleural markers (ADA or IFN-γ) as diagnostic markers of TPE.
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KEYWORD
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Interleukin-33, ST2, Tuberculosis, Pleural effusion
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