Interleukin 27 could be useful in the diagnosis of tuberculous pleural effusions

Respir Care. 2014 Mar;59(3):399-405. doi: 10.4187/respcare.02749. Epub 2013 Aug 20.

Abstract

Background: The diagnosis of tuberculous pleural effusion (TBPE) has some limitations. We studied the efficacy of interleukin-27 (IL-27) in the diagnosis of TBPE.

Methods: We measured IL-27, adenosine deaminase (ADA), ADA-2, interferon-gamma (IFNγ), and the ADA·IL-27 and ADA-2·IL-27 products in all the pleural effusion fluids. The diagnostic yield of IL-27 was evaluated with receiver operating characteristic curves.

Results: Of 431 pleural effusions, 70 were tuberculous, 146 were neoplastic, 58 were parapneumonic, 28 were empyemas, 88 were transudates, and 41 were other types. With a cutoff point of 0.55 ng/mL, IL-27 had a sensitivity of 91.4% and a specificity of 85.1%, which were significantly less than ADA, ADA-2, IFNγ, ADA·IL-27, or ADA-2·IL-27. The area under the receiver operating characteristic curve for IL-27 (0.963) was also significantly lower than that for the other markers, except for IFNγ. However, IL-27 improved the sensitivity of ADA and ADA-2 through ADA·IL-27 and ADA-2·IL-27 products (100% for both).

Conclusions: IL-27 is less efficient than ADA and ADA-2 in the diagnosis of TBPE. However, ADA·IL-27 and ADA-2·IL-27 improve the diagnostic sensitivity of ADA and ADA-2, and thus could be useful in situations of high clinical suspicion and low ADA level. A value above the cutoff point of the latter is practically diagnostic of TBPE.

Keywords: interleukin; pleural disease; tuberculosis.

MeSH terms

  • Adenosine Deaminase / analysis
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Extravascular Lung Water / chemistry
  • Female
  • Humans
  • Interferon-gamma / analysis
  • Interleukin-27 / analysis*
  • Male
  • Middle Aged
  • Pleural Effusion / diagnosis*
  • Pleural Effusion / etiology
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Tuberculosis, Pleural / complications
  • Tuberculosis, Pleural / diagnosis*
  • Young Adult

Substances

  • Interleukin-27
  • Interferon-gamma
  • Adenosine Deaminase