医学
支气管肺泡灌洗
细胞因子
胃肠病学
发病机制
肺结核
免疫学
内科学
肿瘤坏死因子α
病理
肺
作者
Eli̇f Küpeli̇,Demet Karnak,Sumru Beder,Oya Kayacan,Hüseyin Tutkak
出处
期刊:Respiration
[S. Karger AG]
日期:2007-11-01
卷期号:75 (1): 73-78
被引量:24
摘要
The determination of cytokine concentrations in serum and bronchoalveolar lavage fluid (BALF) may contribute to the diagnosis of tuberculosis (TB) since cytokines have been ascribed an important role in TB pathogenesis.To assess the diagnostic accuracy of TNF-alpha, IFN-gamma and IL-2 levels in serum and BALF of smear-negative pulmonary TB patients.BALF was obtained from the affected lobe in patients with smear-negative TB or other pulmonary diseases (OPD), and from the right middle lobe in healthy controls. ELISA and a nephelometric method were used to detect cytokine and albumin levels.TNF-alpha levels in BALF were significantly elevated in the TB group (n = 15) compared with the OPD patients (n = 40) and controls (n = 17; p < 0.001). Although these three cytokines correlated well with each other in BALF (p < 0.0001, and r >or= 0.7, respectively), BALF IL-2 and IFN-gamma levels were not significantly different among the groups (p > 0.05). BALF TNF-alpha or IFN-gamma levels were significantly higher in patients with cavitary disease (n = 11) versus those without (n = 61; p < 0.05). However, no significant difference was found between cavitary (n = 7) and non-cavitary TB in cytokine levels (p > 0.05). Neither gender nor smoking status showed any statistical differences in cytokines in the groups (p > 0.05). Sensitivity and specificity of BALF TNF-alpha were found to be 73 and 76%, respectively. The positive and negative predictive values for BALF TNF-alpha were 44 and 91%, respectively.In cases of smear-negative TB, BALF TNF-alpha can be a useful tool to identify healthy subjects rather than smear-negative TB patients.
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