Cytokine production in patients with tuberculous pericarditis.
METHODS
An academic hospital in the Western Cape, South Africa.


OBJECTIVE
To evaluate cytokine production (interferon-gamma [IFN-gamma], interleukin-1 [IL-1], interleukin-2 [IL-2], interleukin-6 [IL-6], interleukin-10 [IL-10], interleukin-4 [IL-4] and tumour necrosis factor-alpha [TNF-alpha]) in patients with tuberculous pericarditis.


METHODS
Subpopulation of a consecutive prospective case series.


METHODS
Thirty patients presenting with pericardial effusions due to tuberculosis (n = 19), malignancy (n = 6) and non-tuberculous infections (n = 5), and five control subjects who had undergone open heart surgery.


RESULTS
The concentration of IFN-gamma was significantly higher in tuberculous pericardial effusions than in the other diagnostic classes (P < 0.0005). The concentration of TNF-alpha was similar in both infective and tuberculous effusions, but was significantly higher than that of malignant effusions. IL-1 and IL-2 were undetectable in malignant effusions, but elevated in both infective and tuberculous pericardial effusions. The levels of IL-1 and IL-2 were furthermore significantly higher in pericardial effusions due to infective compared to tuberculous causes. The concentration of IL-6, while elevated in all diagnostic classes, was significantly higher in the malignant group. Elevated levels of IL-10 and undetectable levels of IL-4 were observed in all three diagnostic groups.


CONCLUSIONS
These findings suggest that tuberculous pericardial effusions arise due to a hypersensitivity reaction that is orchestrated by the TH-1 lymphocytes.
Burgess
L J
LJ
Department of Chemical Pathology, Tygerberg Hospital and University of Stellenbosh, South Africa. lburgess@iafrica.com
Reuter
H
H
Carstens
M E
ME
Taljaard
J J F
JJ
Doubell
A F
AF
D000328:Adult; D016207:Cytokines / Q000032:analysis*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis*; D007375:Interleukin-1 / Q000032:analysis*; D016753:Interleukin-10 / Q000032:analysis*; D007376:Interleukin-2 / Q000032:analysis*; D015847:Interleukin-4 / Q000032:analysis*; D015850:Interleukin-6 / Q000032:analysis*; D008297:Male; D020519:Pericardiocentesis; D010495:Pericarditis, Tuberculous / Q000276:immunology* / Q000601:surgery; D010496:Pericardium / Q000276:immunology / Q000601:surgery; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D016207:Cytokines; D007375:Interleukin-1; D007376:Interleukin-2; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma