Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Association between Elevated Pleural Interleukin-33 Levels and Tuberculous Pleurisy

  • Lee, Koung-Sun (Department of Laboratory Medicine, Wonkwang University School of Medicine) ;
  • Kim, Hak-Ryul (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Kwak, Seongae (Department of Laboratory Medicine, Wonkwang University School of Medicine) ;
  • Choi, Keum-Ha (Department of Pathology, Wonkwang University School of Medicine) ;
  • Cho, Ji-Hyun (Department of Laboratory Medicine, Wonkwang University School of Medicine) ;
  • Lee, Young-Jin (Department of Laboratory Medicine, Wonkwang University School of Medicine) ;
  • Lee, Mi-Kyung (Department of Thoracic Surgery, Wonkwang University School of Medicine) ;
  • Lee, Jea-Hoon (Department of Otorhinolaryngology-Head and Neck Surgery, Wonkwang University School of Medicine) ;
  • Park, Seok-Don (Department of Dermatology, Wonkwang University School of Medicine) ;
  • Park, Do-Sim (Department of Laboratory Medicine, Wonkwang University School of Medicine)
  • Published : 2013.01.02
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Abstract

Background: Interferon-${\gamma}$ (IFN-${\gamma}$) plays a crucial role in Mycobacterium tuberculosis induced pleural responses. Interleukin (IL)-33 up-regulates the production of IFN-${\gamma}$. 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-${\gamma}$, 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 (${\geq}0.91$) than in other PE cases (${\leq}0.56$). Pleural IL-33 levels correlated with those of pleural ADA and IFN-${\gamma}$. 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-${\gamma}$ (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-${\gamma}$) as diagnostic markers of TPE.

Keywords

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