title: Association between elevated pleural interleukin-33 levels and tuberculous pleurisy.
abstract: BACKGROUND
  Interferon-γ (IFN-γ) plays a crucial role in Mycobacterium tuberculosis induced pleural responses. Interleukin (IL)-33 up-regulates the production of IFN-γ. We aimed to identify whether an association between pleural IL-33 levels and tuberculous pleurisy exists and determine its diagnostic value.
  
  
  METHODS
  Pleural IL-33, ST2 (a receptor of IL-33), adenosine deaminase (ADA), and IFN-γ, as well as serum IL-33 and ST2 were measured in 220 patients with pleural effusions (PEs). Patients with malignant (MPEs), parapneumonic (PPEs), tuberculous (TPEs), and cardiogenic (CPEs) pleural effusions were included.
  
  
  RESULTS
  Pleural and serum IL-33 levels were highest or tended to be higher in patients with TPEs than in those with other types of PEs. The median pleural fluid-to-serum IL-33 ratio was higher in TPE cases (≥ 0.91) than in other PE cases (≤ 0.56). Pleural IL-33 levels correlated with those of pleural ADA and IFN-γ. However, the diagnostic accuracies of pleural IL-33 (0.74) and pleural fluid-to-serum IL-33 ratio (0.75) were lower than that of ADA (0.95) or IFN-γ (0.97). Pleural ST2 levels in patients with MPEs were higher than in patients with TPEs. Serum ST2 levels did not differ among the groups.
  
  
  CONCLUSIONS
  We identified an association between elevated pleural IL-33 levels and tuberculous pleurisy. However, we recommend conventional pleural markers (ADA or IFN-γ) as diagnostic markers of TPE.
authors.affiliation: Department of Laboratory Medicine, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Koung-Sun
authors.initials: KS
authors.lastname: Lee
authors.forename: Hak-Ryul
authors.initials: HR
authors.lastname: Kim
authors.forename: Seongae
authors.initials: S
authors.lastname: Kwak
authors.forename: Keum-Ha
authors.initials: KH
authors.lastname: Choi
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Cho
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Lee
authors.forename: Mi-Kyung
authors.initials: MK
authors.lastname: Lee
authors.forename: Jea-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Seok-Don
authors.initials: SD
authors.lastname: Park
authors.forename: Do-Sim
authors.initials: DS
authors.lastname: Park
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D007378:Interleukins / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D035422:Pleural Cavity / Q000378:metabolism*; D010996:Pleural Effusion / Q000175:diagnosis / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000378:metabolism; D012372:ROC Curve; D011956:Receptors, Cell Surface / Q000032:analysis / Q000097:blood; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000378:metabolism
chemical_list: C079241:IL1RL1 protein, human; C506536:IL33 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D007378:Interleukins; D011956:Receptors, Cell Surface; D007371:Interferon-gamma; D000243:Adenosine Deaminase
keywords: Interleukin-33; Pleural effusion; ST2; Tuberculosis