Pleural fluid neopterin levels in tuberculous pleurisy.
OBJECTIVE
Neopterin is produced by stimulated macrophages under the influence of gamma interferon of lymphocyte origin. It is regarded as a biochemical marker of cell-mediated immune response. This study was designed to assess the diagnostic value of pleural fluid neopterin levels in tuberculous pleurisy in comparison with adenosine deaminase activity.


METHODS
Pleural fluid adenosine deaminase (ADA) activity and neopterin levels were measured in 16 patients with tuberculous pleurisy (TP) and 19 patients with malignant pleurisy (MP). ADA activity was determined by a colorimetric method, whereas neopterin levels were determined by a reversed-phase liquid chromatography technique. All values were given as median (min-max).


RESULTS
The mean age was 45.43+/-20.39 years in the TP group and 60.42+/-11.02 years in the MP group (p=0.026). The median pleural fluid ADA activity was 51.75 U/L (3.50-62.40 U/L) in the TP group and was 2.30 U/L (1-8.20 U/L) in the MP group. The difference was statistically significant (p<0.001). The median pleural fluid neopterin levels were 13.15 nmol/L (1.86-59.50 nmol/L) and 2.44 nmol/L (0.92-27.60 nmol/L) in the TP group and the MP group, respectively (p=0.021). In order to evaluate the diagnostic value of pleural fluid neopterin concentrations, receiver-operating-characteristic curve analysis was performed.


CONCLUSIONS
Pleural fluid neopterin concentration is significantly higher in TP when compared to MP, however when compared, its clinical use as a diagnostic marker is not valuable as ADA.
Cok
Gursel
G
Department of Chest Disease, School of Medicine, Ege University, Bornova, 35100, Izmir, Turkey. gurselcok@gmail.com
Parildar
Zuhal
Z
Basol
Gunes
G
Kabaroglu
Ceyda
C
Bayindir
Ulku
U
Habif
Sara
S
Bayindir
Oya
O
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000032:analysis* / Q000097:blood; D010994:Pleura / Q000378:metabolism* / Q000473:pathology*; D012372:ROC Curve; D014396:Tuberculosis, Pleural / Q000175:diagnosis / Q000378:metabolism*
D019798:Neopterin