To assess serum and pleural fluid expression of TNF-a, IL-8, VEGF and TGF-b1 in pleural effusion of patients with tuberculosis (TB) and transudate. We looked for the tuberculosis group correlated pleural cytokines levels with biochemical (total proteins, lactic dehydrogenase), adenosine deaminase and histopathological parameters.
Prospective descriptive study. We evaluated, a total of 47 pleural fluid samples from patients with pleural effusions, which included TB (n = 39) and transudate (n = 8). Transudate pleural effusion was used as control. Using the ELISA method, the cytokines levels of the serum and pleural fluid were analyzed. For TB group we performed pleural biopsy and by morphometry method was analyzed pleural tissue type (connective tissue, granulation tissue, fibrocellular proliferation, fibrin, polymorphonuclear cells, mononuclear cells and mesothelial cells. Statistical analyzes were made by correlation Pearson product moment and ANOVA.
The median levels of pleural fluid of TNF-a, IL-8, VEGF and TGF-b1 in TB group were significantly higher than transudate group. In serum only TGF-b1 serum demonstrates levels higher significantly and it could distinguish TB from transudates. In TB pleural fluid, there was not demonstrated correlation between the cytokines and the cells, and biochemical parameters but a significant although not a close correlation were demonstrated with TNF-α and lactate dehydrogenase (R=0,426). Also in TB , using an ANOVA to analyze the factors the were significant we observed a significant and positive correlation’s between VEGF, TNF-α and fibrin (R=0,628), IL-8 also presented a significant and positive correlation with fibrin and negative correlation with granuloma (R=0,339) .CONCLUSIONS: This study brings insight that TNF-a, IL-8 and VEGF can be associated with initial phase inflammatory process in pleural tuberculosis where were correlated with high levels of lactic dehydrogenase enzyme and histopathological presence of fibrin.
These cytokines may have an essential role in coordination the acute phases inflammatory process, contribute to granuloma formation and can be associated the increase vascular permeability and pleural fluid formation in TB pleural effusion.
M. Seiscento, None.