PURPOSE: The inflammatory cytokine profile in tuberculous (TB) effusions and parapneumonic effusions (PPE) was different. In addition, the levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) were reported to be higher in PPE than in TB effusions. In this study, we compared the effusion levels of inflammatory cytokines and biomarkers between TB effusions and PPE, and explored their clinical role.
METHODS: The study consisted of 33 patients with TB pleurisy and 33 patients with PPE including 15 patients with non-complicated PPE and 18 patients with complicated PPE/empyema. The levels of interleukin(IL)-6, IL-8, macrophage inflammatory protein (MIP)-1β, monocyte chemoattractant protein-1, transforming growth factor-β1, sTREM-1, high mobility group box (HMGB)-1, surfactant protein D (SP-D) and KL-6 were measured by enzyme-linked immunosorbent assay.
RESULTS: The levels of IL-8 and MIP-1β were higher in PPE than in TB effusions with a p value of 0.023 and 0.066, respectively. In contrast, the levels of KL-6 were significantly higher in TB effusions (p = 0.022). Of the patients with PPE, the levels of MIP-1β, IL-8 and sTREM-1 were significantly higher in complicated PPE/empyema than in uncomplicated PPE. In contrast, the levels of SP-D were significantly higher in uncomplicated PPE than in complicated PPE/empyema.
CONCLUSION: Our results indicated that the difference in the levels of IL-8 and MIP-1β might be related to the recruitment of different leukocytes in TB and PPE. The levels of sTREM-1 had limited value in differentiating TB and PPE. The effusion levels of MIP-1β, IL-8, sTREM-1 and SP-D might be of value in differentiating uncomplicated PPE and complicated PPE/empyema.
CLINICAL IMPLICATIONS: MIP-1β, IL-8, sTREM-1 and SP-D may serve as useful biomarkers for differentiating uncomplicated PPE and complicated PPE/empyema.
DISCLOSURE: Han-Chen Tsai, No Financial Disclosure Information; No Product/Research Disclosure Information