Interleukin 27 Could Be Useful in the Diagnosis of Tuberculous Pleural Effusions

Valdés, Luís; José, Esther San; Ferreiro, Lucía; Golpe, Antonio; Gudé, Francisco; Álvarez-Dobaño, José Manuel; Pereyra, Marco F.; Toubes, María E.; González‐Barcala, Francisco Javier

doi:10.4187/respcare.02749

Cited by 33 publications

(25 citation statements)

References 34 publications

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“…One study from Spain showed that IL-27 is less efficient than ADA in the diagnosis of TPE 8. In contrast, by a head-to-head comparison of the diagnostic measurements, we found in both the Beijing and Wuhan cohorts that IL-27 is significantly better than ADA for discriminating between TPEs and non-TPEs.…”

Section: Discussioncontrasting

confidence: 66%

“…In another study we indicated that the diagnostic efficiency of IL-27 is better than that of ADA 7. On the other hand, one study from a country with a low tuberculosis burden showed that IL-27 is less efficient than ADA,8 and two studies showed that the product of IL-27 and ADA improves the diagnostic sensitivity of ADA 8 9. We therefore performed these prospective studies, with two independent replication cohorts and a meta-analysis, to establish the precise role of IL-27 for the diagnosis of TPE.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis

Wang

Zhou

Zhai

et al. 2017

Thorax

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis

Wang

Zhou

Zhai

et al. 2017

Thorax

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“…Although the available evidence suggests that IL-18 and IL-27 seem to have higher accuracy than ADA, the higher-cost and more complicated determination of IL-27 and IL-18 may limit their practical applicability. [69,70] In addition, it has been reported that the combination of positive IL-27 with positive ADA values [16,31,46], can reach a sensitivity of 100% for the identification of TBP, Our meta-analysis, combined with previous ones, suggests that combining IL-18 and IL-27 with INF-γ and ADA may strengthen TPE diagnosis. We also suggest further studies should be carried out to determine the diagnostic accuracy of IL-27 and IL-18 combination or their combination with ADA or INF-γ.…”

Section: Discussionsupporting

confidence: 52%

Diagnostic Value of Interleukins in Tuberculous Pleural Effusion: A Systematic Review and Meta‐analysis

2017

Respirology

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Methods: Intervention utilized-Treatment supporters (TS) and mobile clinics. Intention to provide daily DOT by TS. At the end of March 2017, 63 TS are assigned for 454 TB patients. Number of patients supported by one TS varies from 1 to 20 according to the ease of location and the amount of patient support required. MSF mobile clinic team consists of health extension officer and community health worker and TB patients are reviewed on monthly basis during their regular visit of Malalua and Ihu BMU as well as health posts in covering area. MSF is offering to the patients dinghy and bus transport to these health centers.Results: Since commencing the activity multiple complexities have been notedTraining and supervision of treatment supporters who are very remote is difficult Heavy workload on TS with multiple activities added Patient's acceptance of TS in multicultural context Emphasis on TS approach distracted from patient centred approach Conclusions:The geographical difficulties in Gulf has led to using TS for follow up. This approach has shown some limitations. In such a context, to facilitate treatment adherence, an individualized approach accompanied by adequate patient education and counseling may be a more effective approach than TS for all. IndonesiaBackground and Aims: One of the main strategies for the early detection of pulmonary tuberculosis (PTB) is through the screening of individuals with symptoms compatible with TB. In the hospital, people with symptoms compatible with TB have an opportunity to get proper diagnosis and treatment. Yet this opportunity is often missed. We hypothesize that a respiratory triage system recommended by WHO for prevention of the spread of respiratory infection at the outpatient department, can be improved to enhance early detection of TB. With this hypothesis an intervention study was conducted at Zainal Abidin Hospital.The objective of this intervention study was to compare the proportion of patients with cough >2 weeks, offered sputum test and TB case detection rate before versus after a respiratory triage system introduced.Methods: Before-and-after interventional study. Intervention; training of health personnel and setting up a respiratory triage system, to detect patients with >2 weeks cough and offering sputum test for acid-fast bacilli. Data from "exit poll" and central laboratory were compared before vs after the triage set up.Results: After the intervention, sampled patients who visited the hospital were more likely to be asked on >2 weeks cough (85.3% vs17.9%).In the whole samples (99.2% vs 64.7%) among them have >2 weeks cough patients. For TB detection, the changes were 39 positive results from 220 AFB tests of 61,871 outpatients to 55 positive from 365 AFB tests among 53,056 outpatients. The rates of sputum testing and TB case detection increased from 3.5 to 6.8 per 1,000 (OR=1.9, 95% CI=1.6-2.3) and 6.3 to 10.4 per 10,000 (OR=1.7, 95% CI=1.1-2.6) respectively. Conclusions:Respiratory triage can significantly increase TB detection rate.

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“…It is reported that adenosine deaminase (ADA), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interlukine-12 (IL-12), interlukine-18 (IL-18), interlukine-10 (IL-10), interlukine-27 (IL-27), Immunosuppressive acidic protein (IAP), and soluble IL-2 receptor could serve as differential diagnosis biomarkers for pleural effusion caused by TB or malignant diseases [7,11,12]. Adenosine deaminase (ADA), a purine-degrading enzyme implicated in mononuclear phagocyte maturation, has been reported to accumulate in the pleural fluid of TB patients and being predict TB pleurisy with high sensitivity and specificity at 95% and 90% respectively [6].…”

Section: Introductionmentioning

confidence: 99%

“…And the up-regulated IFN-γ and IL-10 in fluid can be diagnostic parameters for tuberculous pleural effusion as well. Most recently, interlukine (IL)-27, a member of IL-12 family, has been verified useful in diagnosing TPE or discriminating pleural effusions caused by tuberculosis from other medical situations [12,18]. However, none of those is widely used in clinical practice currently but it is only restricted to research settings.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of tumor necrosis factor-alpha, interferon-gamma, interlukine-10 and adenosine deaminase 2 in differential diagnosis between tuberculous pleural effusion and malignant pleural effusion

Wang

et al. 2014

J Cardiothorac Surg

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BackgroundThe current study was performed to investigate the potential biomarkers for the differential diagnosis of tuberculous pleural effusion (TPE) and malignant pleural effusions (MPE).MethodsAmong ninety patients (n = 90) involved in the study, 47 with tuberculous pleural effusion aged from 18 to 70 and 43 with secondary malignant pleural effusion aged from 34 to 78. We tested the pleural levels of TNF-α, IFN-γ and IL-10 as well as the enzyme activity of ADA2, and then we compared the differential diagnostic efficiencies of those biochemical parameters with ADA between the two groups.ResultsOur results show that, the concentrations of pleural TNF-α (45.55 ± 15.85 ng/L), IFN-γ (114.97 ± 27.85 ng/L) as well as activities of ADA2 (35.71 ± 10.00 U/L) and ADA (39.39 ± 10.60 U/L) in tuberculous group were significantly higher compared to malignant group. Furthermore, according to the ROC curve analysis the thresholds of TNF-α, IFN-γ, ADA2 and ADA were found to be 30.3 ng/L, 103.65 ng/L, 29.45 U/L, and 39.00 U/L, respectively. TNF-α, IFN-γ and ADA2 yielded better sensitivity, specificity, and accuracy of the diagnosis than ADA. Our investigation further revealed that the combinations of TNF-α and ADA2 further increased the specificity and accuracy for the differential diagnosis.ConclusionIn conclusion, we found that TNF-α, IFN-γ, ADA and ADA2 all increased in TPE. Combinations of the TNF-α and ADA2 yielded the best specificity and accuracy for the differential diagnosis of TPE from MPE. Our investigation suggests that the applications of TNF-α together with ADA2 may contribute to more efficient diagnosis strategies in the management of discrimination between tuberculous and malignant pleural effusions.

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Interleukin 27 Could Be Useful in the Diagnosis of Tuberculous Pleural Effusions

Cited by 33 publications

References 34 publications

Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis

Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis

Diagnostic Value of Interleukins in Tuberculous Pleural Effusion: A Systematic Review and Meta‐analysis

Diagnostic accuracy of tumor necrosis factor-alpha, interferon-gamma, interlukine-10 and adenosine deaminase 2 in differential diagnosis between tuberculous pleural effusion and malignant pleural effusion

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