Osteoprotegerin (OPG) and TNF-related apoptosis-inducing ligand (TRAIL) levels in malignant and benign pericardial effusions.
OBJECTIVE
Osteoprotegerin (OPG) is a regulator of bone and vascular homeostasis and acts as a decoy receptor for proapoptotic TNF-related apoptosis-inducing ligand (TRAIL).


METHODS
We assessed pericardial and serum levels of OPG and TRAIL in pericardial effusions (PE) of malignant (mPE, n=24) or non-malignant (nPE, n=34) origin, and in pericardial fluid (PF, n=25) of coronary artery disease (CAD) patients by ELISA.


RESULTS
OPG was at least 5 fold higher in PE or PF compared to serum, with a significantly higher ratio of pericardial to serum OPG in patients with mPE or nPE compared to PF (mPE vs. PF, p=0.011; nPE vs. PF, p<0.001). TRAIL was only detectable in mPE and PF. Logistic regression analysis revealed that a high ratio of pericardial to serum OPG and high TRAIL in PE were the best variable combination to predict malignancy of PE.


CONCLUSIONS
Pericardial and systemic OPG or TRAIL are potential diagnostic tools to discriminate between malignant or benign PE.
Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany.
Konstantinos
K
Karatolios
Sabine
S
Pankuweit
Claudia
C
Goettsch
Lorenz C
LC
Hofbauer
Nina
N
Timmesfeld
Nadia
N
Al-Fakhri
Bernhard
B
Maisch
Michael
M
Schoppet
D003710:Demography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D053244:Osteoprotegerin / Q000097:blood*; D010490:Pericardial Effusion / Q000097:blood*; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*
D053244:Osteoprotegerin; D053221:TNF-Related Apoptosis-Inducing Ligand