Interferon Gamma (IFN-γ) and Soluble Interleukin-2 Receptor (sIL-2R): Combined Diagnostic Markers of Tuberculous Pleural Effusion
International Journal of Immunology
Volume 1, Issue 1, April 2013, Pages: 7-13
Received: Mar. 30, 2013;
Published: Apr. 2, 2013
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Mohamed S. Abdel-Latif, Department of Medical Laboratory Technology, Faculty of Allied Medical Science, Pharos University in Alexandria, Egypt
Lobna A. Abou-Shamaa, Department of Immunology, Medical Research Institute, University of Alexandria, Egypt
Eglal A. El-Sherbini, Department of Microbiology, Medical Research Institute, University of Alexandria, Egypt
Mohamed S. M. Afifi, Department of Immunology, Medical Research Institute, University of Alexandria, Egypt
Background: pleural TB is a diagnostic challenge because of its nonspecific clinical manifestation. The efficiency of conventional laboratory method and the reliance on pleural biopsy have motivated the evaluation of alternative diagnostic strategies. The objective of the current study is to evaluate the diagnostic efficiency of IFN-γ and sIL-2R levels in pleural effusion for differential diagnosis of tuberculous pleurisy. Methods: estimated levels of IFN-γ and sIL-2R were compared with the result of conventional PCR and Z-N staining used for detection of M. tuberculosis DNA and acid fast bacilli screening of pleural effusion, respectively. Involved study population included 60 patients with pleural effusion, divided into two groups: Tuberculous group (40 patients: 7 confirmed TB and 33 probable TB cases) and control group (20 patients: 10 cases due to malignancy and 10 cases due to heart failure). Results: our results showed that IFN-γ and sIL-2R levels are significantly higher in tuberculous group than in control group. Conclusion: current study suggested that measurement of IFN-γ and sIL-2R in pleural effusion could be less invasive and quicker diagnostic tools of TPE compared to conventional microbiological diagnostic methods.
Mohamed S. Abdel-Latif,
Lobna A. Abou-Shamaa,
Eglal A. El-Sherbini,
Mohamed S. M. Afifi,
Interferon Gamma (IFN-γ) and Soluble Interleukin-2 Receptor (sIL-2R): Combined Diagnostic Markers of Tuberculous Pleural Effusion, International Journal of Immunology.
Vol. 1, No. 1,
2013, pp. 7-13.
A. Trajman, M. Pai, K. Dheda, et al. "Novel tests for diagnosing tuberculous pleural effusion: what works and what does not?" Eur Respir J, 31:1098-06, 2008.
J. Ellner, P. Barnes, R. Wallis, R. Modlin. "The Immunology of tuberculous pleurisy." Semin Respir Infect, 3:335-42, 1988.
S. Sharma, D. Mitra, A. Balamurugan, R. Pandey, N. Mehra. "Cytokine polarization in ilitary and pleural tuberculosis." J Clin Immunol, 22:345-52, 2002.
W. Somkiat, S. Udomsak, R. Kiat, U. Visit, L. Sakchai, C. Pradit, N. Chaivej. "Interferon gamma for diagnosing tuberculous pleural effusions." Thorax, 54:921-4, 1999.
K. Aoe, A. Hiraki, T. Murakami, R. Eda, T. Maeda, K. Sugi, H. Takeyama. "Diagnostic significance of interferon gamma in tuberculous pleural effusion." Chest, 123:740-4, 2003.
Y. K. Kim, S. Y. Lee, S. S Kwon, K. H. Kim, H. S. Moon, J. S. Song, S. H. Park. "Gamma-interferon and soluble interleukin 2 receptor in tuberculous pleural effusion." Lung, 176:175-84, 2001.
R. W. Light. "Establishing the diagnosis of tuberculous pleuritis." Arch Intern Med, 158:1967-8, 1998.
C. C. Boehme, M. P. Nicol, P. Nabeta, J. S. Michael, E. Gotuzzo, R. Tahirli et al. "Feasibility, diagnos¬tic accuracy, and effectiveness of ecentralized use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study." Lancet, 377(9776):1495-05, 2011.
L. M. Pinto, J. Grenier, S. G. Schumacher, C. M. Den¬kinger, K. R. Steingart, M. Pai. "Immunodiag¬nosis of tuberculosis: state of the art." Med Princ Pract, 21(1):4-13, 2012.
D. Yang, Y. Kim, J. Lee, S. Kim, W. Lee. "A prospective study of Ziehl-Neelsen stain and Mycobacterial culture of pleural fluid and closed pleural biopsy specimen in tuberculous pleural effusion." Korean J Infect Dis, 32:55-9, 2000.
S. Chakravorty, M. Sen, J. Tyagi. "Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology." Clin Microbiol, 43:4357-62, 2005.
J. Sambrook, E. Fritsch, T. Maniatis. "DNA extraction and purification in molecular cloning: a laboratory manual." 2nd edition. Cold Spring Harbor Laboratory Press USA, p. 21-110, 1989.
K. Eisenach, M. Cave, J. Bates, J. Crawford. "Polymerase chain reaction amplification of a repetitive DNA sequence specific for Mycobacterium tuberculosis." J Infect Dis, 161:977-981, 1990.
M. Leers, H. Kleinveld, V. Scharnhorst. "Differentiating transudative from exudative pleural effusion: should we measure effusion cholesterol dehydrogenase?" Clin Chem Lab Med, 45:1332-8, 2007.
J. Porcel, I. Gázquez, M. Vives, B. Pérez, M. Rubio, M. Rivas. "Diagnosis of tuberculous pleuritis by the measurement of soluble interleukin 2 receptor in pleural fluid." Int J Tuberc Lung Dis, 4:975-9, 2000.
S. Harita, N. Nogami, T. Kikuchi, M. Kibata. "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." Respirology, 7:311-5, 2002.
C. Alemán, L. Sanchez, J. Alegre, et al. "Differentiating between malignant and idiopathic pleural effusion: the value of diagnostic procedures." Quart J Med, 100:351-9, 2007.
L. Valdes, A. Pose, E. S. Jose et al. "Tuberculous pleural effusion." Eur Int Med, 14:77-88, 2003.
J. Jiang, H. Shi, Q. Liang, S. Qin, X. Qin. "Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis." Chest, 131:1133-44, 2007.
T. Tsao, C. Huang, W. Chiou, P. Yang, M. Hsieh, K. Tsao. "Levels of interferon-gamma and interleukin-2 receptor-alpha for bronchoalveolar lavage fluid and serum were correlated with clinical grade and treatment of pulmonary tuberculosis." Int J Tuberc Lung Dis, 6:720-7, 2002.
A. Hiraki, K. Aoe, R. Eda, T. Maeda, T. Murakami, K. Sugi, H. Takeyama. "Comparison of six biological markers for the diagnosis of tuberculous pleuritis." Chest, 125:987-9, 2004.
A. Bahador, H. Etemadi, B. Kazemi, R. Ghorbanzadeh, F. Nakhjavan, Z. Nejad. "Performance assessment of IS1081-PCR for direct detection of tuberculous pleural effusion: compared to rpoB-PCR." Res J Agric Biol Sci, 1:142-5, 2005.
D. I. Ling, L. L. Flores, L. W. Riley, M Pai. "Commer¬cial nucleic-acid amplification tests for diag¬nosis of pulmonary tuberculosis in respiratory specimens: meta-analysis and meta-regression." PLoS One, 3(2):e1536, 2008.