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Diagnostic accuracy of cytokine levels (TNF-alpha, IL-2 and IFN-gamma) in bronchoalveolar lavage fluid of smear-negative pulmonary tuberculosis patients.
Respiration. 2008; 75(1):73-8.R

Abstract

BACKGROUND

The determination of cytokine concentrations in serum and bronchoalveolar lavage fluid (BALF) may contribute to the diagnosis of tuberculosis (TB) since cytokines have been ascribed an important role in TB pathogenesis.

OBJECTIVE

To assess the diagnostic accuracy of TNF-alpha, IFN-gamma and IL-2 levels in serum and BALF of smear-negative pulmonary TB patients.

METHOD

BALF was obtained from the affected lobe in patients with smear-negative TB or other pulmonary diseases (OPD), and from the right middle lobe in healthy controls. ELISA and a nephelometric method were used to detect cytokine and albumin levels.

RESULTS

TNF-alpha levels in BALF were significantly elevated in the TB group (n = 15) compared with the OPD patients (n = 40) and controls (n = 17; p < 0.001). Although these three cytokines correlated well with each other in BALF (p < 0.0001, and r >or= 0.7, respectively), BALF IL-2 and IFN-gamma levels were not significantly different among the groups (p > 0.05). BALF TNF-alpha or IFN-gamma levels were significantly higher in patients with cavitary disease (n = 11) versus those without (n = 61; p < 0.05). However, no significant difference was found between cavitary (n = 7) and non-cavitary TB in cytokine levels (p > 0.05). Neither gender nor smoking status showed any statistical differences in cytokines in the groups (p > 0.05). Sensitivity and specificity of BALF TNF-alpha were found to be 73 and 76%, respectively. The positive and negative predictive values for BALF TNF-alpha were 44 and 91%, respectively.

CONCLUSION

In cases of smear-negative TB, BALF TNF-alpha can be a useful tool to identify healthy subjects rather than smear-negative TB patients.

Authors+Show Affiliations

Küpeli E
Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
Karnak D
No affiliation info available
Beder S
No affiliation info available
Kayacan O
No affiliation info available
Tutkak H
No affiliation info available

MeSH

AdolescentAdultAgedBiomarkersBronchoalveolar Lavage FluidCase-Control StudiesCohort StudiesCytokinesEnzyme-Linked Immunosorbent AssayFemaleFollow-Up StudiesHumansInterferon-gammaInterleukin-2MaleMiddle AgedMycobacterium tuberculosisPredictive Value of TestsProbabilityReference ValuesRisk AssessmentSensitivity and SpecificitySeverity of Illness IndexSputumStatistics, NonparametricTuberculin TestTuberculosis, PulmonaryTumor Necrosis Factor-alpha

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17975298

Citation

Küpeli, Elif, et al. "Diagnostic Accuracy of Cytokine Levels (TNF-alpha, IL-2 and IFN-gamma) in Bronchoalveolar Lavage Fluid of Smear-negative Pulmonary Tuberculosis Patients." Respiration; International Review of Thoracic Diseases, vol. 75, no. 1, 2008, pp. 73-8.
Küpeli E, Karnak D, Beder S, et al. Diagnostic accuracy of cytokine levels (TNF-alpha, IL-2 and IFN-gamma) in bronchoalveolar lavage fluid of smear-negative pulmonary tuberculosis patients. Respiration. 2008;75(1):73-8.
Küpeli, E., Karnak, D., Beder, S., Kayacan, O., & Tutkak, H. (2008). Diagnostic accuracy of cytokine levels (TNF-alpha, IL-2 and IFN-gamma) in bronchoalveolar lavage fluid of smear-negative pulmonary tuberculosis patients. Respiration; International Review of Thoracic Diseases, 75(1), 73-8.
Küpeli E, et al. Diagnostic Accuracy of Cytokine Levels (TNF-alpha, IL-2 and IFN-gamma) in Bronchoalveolar Lavage Fluid of Smear-negative Pulmonary Tuberculosis Patients. Respiration. 2008;75(1):73-8. PubMed PMID: 17975298.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of cytokine levels (TNF-alpha, IL-2 and IFN-gamma) in bronchoalveolar lavage fluid of smear-negative pulmonary tuberculosis patients. AU - Küpeli,Elif, AU - Karnak,Demet, AU - Beder,Sumru, AU - Kayacan,Oya, AU - Tutkak,Hüseyin, Y1 - 2007/11/01/ PY - 2007/06/21/received PY - 2007/08/28/accepted PY - 2007/11/3/pubmed PY - 2008/2/6/medline PY - 2007/11/3/entrez SP - 73 EP - 8 JF - Respiration; international review of thoracic diseases JO - Respiration VL - 75 IS - 1 N2 - BACKGROUND: The determination of cytokine concentrations in serum and bronchoalveolar lavage fluid (BALF) may contribute to the diagnosis of tuberculosis (TB) since cytokines have been ascribed an important role in TB pathogenesis. OBJECTIVE: To assess the diagnostic accuracy of TNF-alpha, IFN-gamma and IL-2 levels in serum and BALF of smear-negative pulmonary TB patients. METHOD: BALF was obtained from the affected lobe in patients with smear-negative TB or other pulmonary diseases (OPD), and from the right middle lobe in healthy controls. ELISA and a nephelometric method were used to detect cytokine and albumin levels. RESULTS: TNF-alpha levels in BALF were significantly elevated in the TB group (n = 15) compared with the OPD patients (n = 40) and controls (n = 17; p < 0.001). Although these three cytokines correlated well with each other in BALF (p < 0.0001, and r >or= 0.7, respectively), BALF IL-2 and IFN-gamma levels were not significantly different among the groups (p > 0.05). BALF TNF-alpha or IFN-gamma levels were significantly higher in patients with cavitary disease (n = 11) versus those without (n = 61; p < 0.05). However, no significant difference was found between cavitary (n = 7) and non-cavitary TB in cytokine levels (p > 0.05). Neither gender nor smoking status showed any statistical differences in cytokines in the groups (p > 0.05). Sensitivity and specificity of BALF TNF-alpha were found to be 73 and 76%, respectively. The positive and negative predictive values for BALF TNF-alpha were 44 and 91%, respectively. CONCLUSION: In cases of smear-negative TB, BALF TNF-alpha can be a useful tool to identify healthy subjects rather than smear-negative TB patients. SN - 1423-0356 UR - https://www.unboundmedicine.com/medline/citation/17975298/Diagnostic_accuracy_of_cytokine_levels__TNF_alpha_IL_2_and_IFN_gamma__in_bronchoalveolar_lavage_fluid_of_smear_negative_pulmonary_tuberculosis_patients_ DB - PRIME DP - Unbound Medicine ER -