Pro- and anti-inflammatory cytokines levels in complicated and non-complicated parapneumonic pleural effusions.
Chest. 2011 Jun 16;
Authors: Marchi E, Vargas FS, Acencio MM, Sigrist RM, Biscaro MD, Antonangelo L, Teixeira LR, Light RW
Abstract OBJECTIVES: To evaluate a panel of pro- and anti-inflammatory cytokines in non-complicated and complicated parapneumonic pleural effusions and to correlate their levels with pleural fluid biochemical parameters. METHODS: Serum and pleural effusion were collected from 60 patients with non-complicated (n= 26) or complicated (n= 34) parapneumonic effusions and assayed for cytological, biochemical and pro- and anti-inflammatory cytokines. Student t-test was used to compare serum and pleural fluid values, Spearman correlation to analyze the relationship between pleural fluid cytokines and biochemical parameters, and accuracy of pleural fluid cytokine levels to determine the optimal cut-off value for identification of complicated effusions. Corrections for multiple comparisons were applied and a p value < 0.05 was accepted as significant. RESULTS: Serum and pleural fluid cytokines levels of IL-8, VEGF, IL-10 and TNF sRII were similar between groups. In contrast, complicated effusions had higher levels of pleural fluid IL-1?, IL-1ra and TNF sRI. Negative correlations were found between pleural fluid glucose with IL-1? and TNF sRI, and positive correlations between LDH with IL-1?, IL-8 and VEGF. Pleural fluid levels of IL-1?, IL-1ra and TNF sRI were more accurate than IL-8, VEGF, IL-10 and TNF sRII in discriminating complicated effusions. CONCLUSIONS: Both pro- and anti-inflammatory cytokine levels in pleural fluid are elevated in complicated in comparison to non-complicated parapneumonic pleural effusions, and correlate with both pleural fluid glucose and LDH levels. IL-1?, IL1-ra and TNF sRI had higher sensitivity and specificity than IL-8, VEGF, IL-10 and TNF sRII in discriminating complicated effusions.
PMID: 21680642 [PubMed - as supplied by publisher]