The Expression And Analysis Of Cytokines Related To Th1 And Th2 From The Patients With Tuberculous And Malignant Pleural Effusion

Objective: To explore the characteristics of immune response in patients with tuberculous pleural effusion and malignant pleural effusion.The distribution of serum cytokines was analyzed and compared as to to provide a theoretical basis for differential diagnosis of tuberculous and malignant pleural effusion in clinical.Methods: 50 cases of patients with tuberculous pleurisy,50 cases of patients with malignant pleural effusion and 30 cases of healthy subjects from January 2014 to October 2016 in our hospital were chosen for research as tuberculosis,tumor and control group,respectively.Interleukin-2(IL-2),Interferon-?(IFN-?),interleukin-4(IL-4),interleukin-10(IL-10)in pleural effusion and serum were measured by using double antibody sandwich enzyme-linked immunosorbent assay(ELISA).Results: 1 Comparison of cytokines in pleural effusion of patients in two groups Levels of IL-2,IL-10,IFN-? and IFN-?/ IL-4 of patients in tuberculosis group were significantly higher than those in tumor group(P< 0.05),while the level of IL-4 of patients in tuberculosis group were slightly higher than that of tumor group,but the difference between the two groups was not statistically significant(P> 0.05).2 Comparison of serum cytokine levels amont the three groups:Compared with control group,the levels of IL-2 and IL-4 were significantly higher,and the value of IFN-?/ IL-4 was significantly lower in tuberculosis group and tumor group(P< 0.05).Compared with tuberculosis group,the levels of IL-2,IL-10,and value of IFN-?/IL-4 were significantly lower,and the level of IL-4 was significantly in tumor group(P> 0.05).3 Comparison of cytokines in pleural effusion and serum of tuberculosis group:In tuberculosis group,the levels of IL-2,IFN-?,IL-4,IL-10 and IFN-?/IL-4 ratio in pleural effusion were significantly higher than those in serum(P< 0.05).4 Comparison of cytokines in pleural effusion and serum of tumor group:In tumor group,the levels of IL-2,IFN-?,IL-4 and IFN-?/IL-4 ratio in pleural effusion were significantly lower,and the level of IL-10 was significantly higher than those in serum(P< 0.05).Conclusion: 1 In patients with tuberculous pleural effusion,the Th1 immune pattern was dominant,while in patients with malignant pleural effusion,the immune response of T cells is decreased,and the Th2 immune response pattern is predominant.2 The local Th1/Th2 balance is damaged,which drift from Th1 to Th2 in malignant pleural effusion.Th1 type cytokines have potential therapeutic effect on malignant pleural effusion.3 Determination of IL-2,IFN-? level in pleural effusion is helpful to identify the nature and cause of pleural effusion.4Determination of IL-10 level in serum can be used to identify the nature of pleural effusion.