The Expression And Clinical Significance Of IL-33in Tuberculous Pleural Effusion

ObjectiveTo investigate the expression and clinical significance of IL-33(Interleukin-33) in Tuberculous pleural effusion (TPE).MethodsPleural effusion (PE) samples were acquired from74patients,25with tuberculous pleural effusion (TPE),28with malignant pleural effusion (MPE),12with parapneumonic effusion (PPE),9with cardiogenic pleural effusion (CPE). IL-33, TNF-α were measured using sandwich enzyme-linked immune sorbent assays (ELISA). We examined IL-33expressions in specimens from12surgically resected samples of pleural tissue (7with tuberculous pleural effusion,3with malignant pleural effusion). The expressions of IL-33were measured by immunohistochemistry.Results1. A significantly higher concentrations of IL-33in TPE (7.78±3.44pg/ml) were detected when compared with non-TPE (5.22±3.19pg/ml)(P<0.001). In the subgroup analysis, the levels of IL-33in TPE were significant higher than those in MPE (4.63±2.37pg/ml)(P<0.001), and CPE (4.24±1.88pg/ml)(P<0.05). However, there was no statistical significance in the concentrations of IL-33in PPE (5.99±2.88pg/ml)(P>0.05).2. A significantly higher concentrations of TNF-α (tumor necrosis factor-a) in TPE (18.85±19.69pg/ml) were detected when compared with non-TPE (7.14±14.93pg/ml) (P<0.001). In the subgroup analysis, the levels of TNF-a in TPE were significant higher than those in MPE (6.17±18.08pg/ml)(P<0.001). However, there was no statistical significance in the concentrations of those in PPE(10.44±13.17pg/ml), and also no statistical significance in the concentrations of those in CPE (4.24±1.88pg/ml)(P<0.05).4. There were statistically significant positive correlations between IL-33levels and adenosine deaminase (ADA) levels (r=0.45, P<0.0001);. However, there were no statistically significant positive correlations between TNF-a levels and IL-33levels (r=0.07286, P=0.5402).5. When the cut-off value of pleural IL-33was5.845pg/ml, the diagnostic accuracies of pleural IL-33(0.7494) for discrimination between patients with TPE and patients with non-TPE were pretty good in Receiver Operating Characteristic (ROC curve) analysis, with the corresponding sensitivity of0.72and specificity of0.6735, respectively. The diagnostic accuracies of pleural TNF-a (0.7358) for discrimination between patients with TPE and patients with non-TPE were also good in ROC curve analysis, and the area under the ROC curve (AUC) of pleural was0.7358, with the corresponding sensitivity of0.667and specificity of0.68respectively.6. The sources of IL-33in the PE were lymphocytes, endothelial cells and stromal cells et al., parts of langhans cells express IL-33.ConclusionThe diagnostic accuracies of pleural IL-33for TPE were pretty good. The sources of IL-33in the PE were lymphocytes, endothelial cells and stromal cells et al., parts of langhans cells express IL-33.