Association between elevated pleural interleukin-33 levels and tuberculous pleurisy

• Published in: Annals of laboratory medicine Vol. 33; no. 1; pp. 45 - 51
• Main Authors: Lee, Koung-Sun, Kim, Hak-Ryul, Kwak, Seongae, Choi, Keum-Ha, Cho, Ji-Hyun, Lee, Young-Jin, Lee, Mi-Kyung, Lee, Jea-Hoon, Park, Seok-Don, Park, Do-Sim
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society for Laboratory Medicine 01.01.2013; 대한진단검사의학회
• Subjects: Adenosine Deaminase - analysis; Adult; Aged; Aged, 80 and over; Area Under Curve; Case-Control Studies; Cross-Sectional Studies; Female; Humans; Interferon-gamma - analysis; Interleukin-1 Receptor-Like 1 Protein; Interleukin-33; Interleukins - analysis; Interleukins - blood; Male; Middle Aged; Original; Pleural Cavity - metabolism; Pleural Effusion - diagnosis; Pleural Effusion - metabolism; Pleural Effusion, Malignant - diagnosis; Pleural Effusion, Malignant - metabolism; Receptors, Cell Surface - analysis; Receptors, Cell Surface - blood; ROC Curve; Tuberculosis, Pleural - diagnosis; Tuberculosis, Pleural - metabolism; 병리학; ST2; Pleural effusion; Tuberculosis; Interleukin-33
• ISSN: 2234-3806; 2234-3814
• DOI: 10.3343/alm.2013.33.1.45

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. 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. 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. 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.