Pleural fluid cytokines correlate with tissue inflammatory expression in tuberculosis.
METHODS
A tertiary care research centre in São Paolo, Brazil.


OBJECTIVE
To quantify interleukin (IL) 8, tumour necrosis factor alpha (TNF-alpha), vascular endothelial growth factor (VEGF) and transforming growth factor beta(1) (TGF-beta(1)) in pleural fluid from tuberculous patients, correlating its values with the histopathological patterns in pleural biopsies.


METHODS
Cytokines were quantified in patients with transudates secondary to congestive heart failure (n = 8) and exudates secondary to tuberculosis (TB; n = 39). In parietal pleural biopsies from TB patients, the histological patterns of the inflammatory response were quantified by morphometric analysis (stereological point-counting method).


RESULTS
IL-8, TNF-alpha, VEGF and TGF-beta(1) levels were higher in TB than in transudates. A positive correlation existed between components of the fibrinoid exudative phase with pleural fluid IL-8 (R = 0.52, P = 0.004) and VEGF (R = 0.42, P = 0.0021) levels. A negative correlation existed between pleural fluid IL-8 (R = -0.37, P = 0.048) and VEGF (R = -0.44, P = 0.0015) levels with tissue components of fibroproliferation.


CONCLUSIONS
The high pleural levels of TNF-alpha, IL-8, VEGF and TGF-beta(1) suggest the involvement of these cytokines in the TB immunological response. The positive correlation between pleural fluid IL-8 and VEGF with the components of the acute exudative phase and the negative correlation between these cytokines with the fibroproliferative components suggest a temporary inflammatory response in the pleural space.
Seiscento
M
M
Laboratory of Pleura, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Vargas
F S
FS
Acencio
M M P
MM
Teixeira
L R
LR
Capelozzi
V L
VL
Sales
R K B
RK
Antonangelo
L
L
D000328:Adult; D000368:Aged; D001938:Brazil; D016207:Cytokines / Q000378:metabolism*; D005122:Exudates and Transudates / Q000276:immunology / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000276:immunology / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000276:immunology / Q000378:metabolism*; D011446:Prospective Studies; D014396:Tuberculosis, Pleural / Q000276:immunology* / Q000473:pathology; D055815:Young Adult
D016207:Cytokines