Study on relationship between Th1/Th2 cells/cell cytokines and tuberculosis pleural effusion adhesion / 实用医学杂志

Objective To investigate the relationship between cellular immune response which is related with Th1/Th2 cells and the different severities of tuberculosis pleural effusion adhesion.Methods A total of 66 in-patients diagnosed with different severities of tuberculosis pleural effusion adhesion by internal thoracoscope were enrolled from August 2014 to December 2016.ELISA was used to determine levels of INF-γ,TNF-α,IL-2 and IL-4. The ratio of Th1 and Th2 cells was detected by flow cytometry. Results All the patients were divided into 3 groups:9 cases without pleural adhesion,32 cases with mild pleural adhesion,25 cases with severe pleural adhe-sion. The levels of 4 cytokines in pleural fluid were significantly higher than those in serum in each group(P <0.05,respectively).The concentrations of INF-γ and TNF-α were increased with the severity of tuberculosis pleu-ral effusion adhesion. The levels of INF-γ and TNF-α in the severe pleural adhesion group were markedly higher than those in the other two groups(P<0.05,respectively).The proportion of Th1 cells in the severe pleural adhe-sion group was significantly higher than that in the none pleural adhesion group and in the mild pleural adhesion group(P<0.05,respectively).Conclusions The proportion of Th1 cells and levels of INF-γ and TNF-α are pos-itively related with pleural adhesion severity. Cellular immune response which is related with Th1 cells contributes to pathological immune pleural damage and intensify the severity of pleural adhesions.

Correlation between Fibrinogen in Pleural Effusion and Pleural Adhesion in Tuberculosis Pleurisy / 中国康复理论与实践

@#ObjectiveTo investigate the corelation between fibrinogen in pleural effusion and pleural adhesion in tuberculosis exudative pleurisy.Methods234 cases of primary tuberculosis pleurisy were divided into 3 groups (A、B、C) according to their level of fibrinogen in pleural effusion from low to high. The incidence rates of pleural adhesion were assessed during the course of treatment and after treatment.ResultsThe incidence rate of pleural adhesion in the course of treatment were as those: group A 10.5%, group B 32.3%, group C 54.5%. After treatment, it was as those: group A 10.5%, group B 16.9%, group C 42.4%. Whenever, there was significant difference between group C and group A or B (P<0.05).ConclusionThe level of fibrinogen in pleural effusion may be associated with pleural adhesion, which hinder the recovery of patients.

Diagnostic Efficacy of Adenosine Deaminase Isoenzyme in Tuberculous Pleurisy / 대한진단검사의학회지

BACKGROUND: Tuberculosis is the most common cause of pleural effusion in Korea. But the differential diagnosis of pleural effusion is important because malignancy and pneumonia are also other common causes of pleural effusion. Adenosine deaminase (ADA) activity is used to differentiate tuberculous pleurisy from non-tuberculous pleural effusion. However, some cases of non-tubercu-lous effusion show increased activity of ADA. Therefore, this study is for evaluating diagnostic efficacy of the ADA isoenzyme activity in the diagnosis of tuberculous pleurisy. METHODS: The activity of total ADA and ADA2 isoenzyme activity and ratio of ADA2/ADA in 293 patients with pleural effusion were measured. Then, it was compared to conventional and PCR-hybridization methods for tuberculous pleurisy. RESULTS: Total ADA and ADA2 isoenzyme activity in tuberculous pleurisy were 81.8+/-29.5 U/L and 67.0+/-23.2, respectively, which were significantly higher than non-tuberculous effusion (20.3+/-21.3 U/L and 12.5+/-9.0 U/L1). With a cut-off level of 45 U/L in total ADA activity and the ratio of ADA2/ADA 0.6 or greater, the sensitivity and specificity for tuberculous pleurisy were 92.1% and CONCLUSIONS: Total ADA and ADA isoenzyme activities are useful to differentiate tuberculous pleurisy from non-tuberculous pleural effusion compared to conventional methods. Especially, various combinations of the total ADA, the ADA2 isoenzyme activities, and the ratio of ADA2/total ADA show high diagnostic efficacy for tuberculous pleurisy.

The Levels of Interferon-gamma, Interleukin-2 Receptor, Interleukin-6 and Interleukin-10 in the patients with Malignant Pleural Effusion, Tuberculosis Effusion, Parapneumonic Effusion, and Lung Emphysema? / 결핵

BACKGROUND: Cytokines are chemical mediators that control and modulate many infalmmatory processes. They work in different fashions in a variety of diseases. Discriminating between malignant effusion, tuberculous effusion, and parapneumonic effusion are crucial from the clinical view-point in Korea. In the current study, interferon-gamma(INF-γ), soluble interleukin-2 receptor(IL-2R), interleukin-6(IL-6) and interleukin-10(IL-10) were measured for this purpose. METHODS: Pleural fluids from patients with malignant disease, tuberculosis, parapneumonic effusion and lung empysema were collected and gauged using commercial ELISA kits. RESULTS: 34 patients were enrolled in this study. among these 15 cases were malignant effusions, 12 were tuberculosis pleurisy and 7 were paraneumonic effusion and lung empyema. The levels of cytokines measured in this study were as follows, in order of frequency, malignant effusion, tuberculous effusion, parapneumonic effusion and lung empyema. The levels of INF-γ were higher in tuberculous effusion than in malignant or parapneumonic effusion(295.5±585.5 vs. 16.7±50 vs. 10.0±0 pg/ml, p>0.05). The levels of IL-2R were higher in tuberculous effusion than in malignant or parapneumonic effusion(7423.5±3752.8 vs. 3247.4±1713.3 vs. 3790.2±3201.1 pg/ml, p<0.05). No significant differences were found in the levels of IL-6 between the groups(600±12.8 pg/ml in malignant effusion, 556.4±161.7 pg/ml in tuberculous effusion, 514.4±224.8 pg/ml in parapneumonic effusion). IL-10 levels were higher in parapneumonic effusion than in malignant or tuberculous effusions(98.4±141.7 vs. 28.2±55.5 vs. 11.3±11.7 pg/ml, p<0.05). CONCLUSION: These results suggest that the measurement of IL-2R levels in pleural fluids may be a useful means of differentiating between tuberculous effusion and pleural effusions of other origins, and that the measurement of IL-10 levels in pleural fluids may be useful to differentiate between parapneumonic effusion and pleural effusions of other origins.