BackgroundInterferon-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.MethodsPleural 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.ResultsPleural 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.ConclusionsWe 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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eISSN 2093-6338 단검사(molecular diagnostic tests)는 배양을 포함한 기존검사에 비하여 가장 예민한 방법으로 평가되고 있다. 또한 높은 민감도를 가지므로 비교적 감염 초기에도 정확한 진단이 가능하게 되었고, 항바이러스제 치료, 불필요한 검사의 중단, 병원 내 감염관리와 보 건정책의 설정에 매우 유용한 도구가 되었다[1]. 2009년 전세계적 인 신종플루(The 2009 H1N1 Pandemic)의 유행에 따라 국내에서 도 비인두플록트스왑(flocked nasopharyngeal swab)을 포함한 호 흡기검체에서 바이러스 검출에 분자진단검사가 널리 사용되게 되 었다[2]. 검체로부터 핵산을 추출하는 과정은 분자진단검사의 첫 단계로 서, 이 과정의 자동화는 수작업과 비교하여 업무흐름을 개선할 뿐 만 아니라, 추출된 핵산의 질을 일정하게 하고, 추출의 여러 단계에 서 검체 간 오염을 방지할 수 있고, 작업자의 감염원에 대한 노출 서 론 최근 호흡기바이러스감염의 진단에 널리 사용되고 있는 분자진Background: Automated nucleic acid extraction offers a standardized sample treatment method, low error rate, and avoids sample nucleic acid contamination for use in molecular diagnostics. Here, we evaluated the performance of automated ExiPrep16 system (Bioneer Co.) in comparison with the manual Viral Gene-spin Viral DNA/RNA Extraction kit (VGspin; iNtRON Biotechnology Inc.) for the detection of respiratory viruses from nasopharyngeal flocked swabs. Methods: To compare the agreement rate and analytical sensitivity between ExiPrep16 and VGspin, previously collected 78 patient samples and 11 pooled samples of each respiratory viruses and their serially diluted samples (until 1/10 8 ), were tested by multiplex reverse-transcriptase PCR (Seeplex RV 12 ACE Detection kit; SeeGene Inc.). In addition, we repeatedly analyzed the threshold cycle of the pooled and 1/10 3 dilution of adenovirus (ADV) and influenza virus A (Flu-A) by using real-time PCR to evaluate the precision and crossover of the ExiPrep16 system. Results: The analytical sensitivity of the ExiPrep16 was comparable to that of VGspin, and the highest detectable dilution varied in the range of 1/10 to 1/10 6 depending on the viruses. The total, overall positive and negative percent agreements of ExiPrep16 in comparison with VGspin were 95.7%, 96.2%, and 95.2%, respectively. The mean (CV%) of pooled and 1/10 3 dilution of ADV were, respectively, 19.2 cycle (2.1%) and 31.6 cycle (4.3%) and those for Flu-A were 22.6 cycle (3.1%) and 35.5 cycle (2.6%). No carryover was detected. Conclusions: Compared to the manual VGspin, ExiPrep16 ensured nucleic acid extraction for efficient detection of respiratory viruses.