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01.12.2015

Expression Profiles of Cytokine mRNAs in the Pleural Fluid Reveal Differences Among Tuberculosis, Malignancies, and Pneumonia-Exudative Pleural Effusions

verfasst von: Danillo Lucas Alves Espósito, Valdes Roberto Bollela, Ana Luisa Pereira Feitosa, Benedito Antonio Lopes da Fonseca

Erschienen in: Lung | Ausgabe 6/2015

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Abstract

Introduction

Tuberculosis (TB) and malignant diseases are the most common causes of lymphocytic pleural effusion in adults. Serum and pleural fluid cytokine levels have been analyzed to help in the differential diagnosis, but with limited results.

Purpose

This study investigates transcription levels of selected cytokine genes in pleural effusion of patients under investigation for TB.

Methods

This was a prospective study that included adult patients under investigation for pleural effusion in Brazil. The expression of 19 cytokine genes was analyzed by RT-qPCR.

Results

The majority of cytokine-related genes expressed in pleural fluid of TB patients were similar in non-TB patients, except for RORA and RORC genes, which showed a statistically higher level in TB. All cytokines in the Th17 pattern were induced in TB patients’ pleural fluid. Patients with malignant pleural effusion expressed higher levels of IFN-α1, IFN-β1, TNF-α, IL-4 and IL-6, and suppression of TGFβ-1.

Conclusion

There is still a lot to understand about the cytokine roles in the pro- and anti-inflammatory environment of exudative pleural effusions. The data presented here showed an increased expression of Th17 pattern cytokines genes in TB patients that could be used as markers to differentiate tuberculous pleuritis from other common causes of exudative pleural effusion.

Sahn SA (1988) State of the art. The pleura. Am Rev Respir Dis 138(1):184–234. doi:10.1164/ajrccm/138.1.184 CrossRefPubMed

Sharma SK, Mitra DK, Balamurugan A et al (2002) Cytokine polarization in miliary and pleural tuberculosis. J Clin Immunol 22(6):345–352CrossRefPubMed

Ye ZJ, Zhou Q, Du RH et al (2011) Imbalance of Th17 cells and regulatory T cells in tuberculous pleural effusion. Clin Vaccine Immunol 18(10):1608–1615. doi:10.1128/CVI.05214-11 PubMedCentralCrossRefPubMed

Hougardy JM, Place S, Hildebrand M et al (2007) Regulatory T cells depress immune responses to protective antigens in active tuberculosis. Am J Respir Crit Care Med 176(4):409–416. doi:10.1164/rccm.200701-084OC CrossRefPubMed

Gopi A, Madhavan SM, Sharma SK et al (2007) Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest 131(3):880–889. doi:10.1378/chest.06-2063 CrossRefPubMed

Sales RK, Vargas FS, Capelozzi VL et al (2009) Predictive models for diagnosis of pleural effusions secondary to tuberculosis or cancer. Respirology 14(8):1128–1133. doi:10.1111/j.1440-1843.2009.01621.x CrossRefPubMed

Chen YM, Yang WK, Whang-Peng J et al (2001) An analysis of cytokine status in the serum and effusions of patients with tuberculous and lung cancer. Lung Cancer 31(1):25–30CrossRefPubMed

Seah GT, Scott GM, Rook GA (2000) Type 2 cytokine gene activation and its relationship to extent of disease in patients with tuberculosis. J Infect Dis 181(1):385–389. doi:10.1086/315200 CrossRefPubMed

de Oliveira LR, Peresi E, Golim Mde A et al (2014) Analysis of toll-like receptors, iNOS and cytokine profiles in patients with pulmonary tuberculosis during anti-tuberculosis treatment. PLoS ONE 9(2):e88572. doi:10.1371/journal.pone.0088572 PubMedCentralCrossRefPubMed

10.

Porcel JM, Light RW (2006) Diagnostic approach to pleural effusion in adults. Am Fam Physician 73(7):1211–1220PubMed

11.

Livak KJ, Schmittgen TD (2001) Analysis of relative gene expression data using real-time quantitative PCR and the 2(-delta delta C(T)) method. Methods 25(4):402–408. doi:10.1006/meth.2001.1262 CrossRefPubMed

12.

Bollela VR, Sato DN, Fonseca BA (1999) McFarland nephelometer as a simple method to estimate the sensitivity of the polymerase chain reaction using Mycobacterium tuberculosis as a research tool. Braz J Med Biol Res 32(9):1073–1076CrossRefPubMed

13.

Martinson NA, Barnes GL, Moulton LH et al (2011) New regimens to prevent tuberculosis in adults with HIV infection. New Engl J Med 365(1):11–20. doi:10.1056/NEJMoa1005136 PubMedCentralCrossRefPubMed

14.

Agnello D, Lankford CS, Bream J et al (2003) Cytokines and transcription factors that regulate T helper cell differentiation: new players and new insights. J Clin Immunol 23(3):147–161CrossRefPubMed

15.

van Crevel R, Ottenhoff TH, van der Meer JW (2002) Innate immunity to Mycobacterium tuberculosis. Clin Microbiol Rev 15(2):294–309PubMedCentralCrossRefPubMed

16.

Rook GA, Hernandez-Pando R, Dheda K et al (2004) IL-4 in tuberculosis: implications for vaccine design. Trends Immunol 25(9):483–488. doi:10.1016/j.it.2004.06.005 CrossRefPubMed

17.

Ivanov II, McKenzie BS, Zhou L et al (2006) The orphan nuclear receptor RORgammat directs the differentiation program of proinflammatory IL-17+ T helper cells. Cell 126(6):1121–1133. doi:10.1016/j.cell.2006.07.035 CrossRefPubMed

18.

Tong ZH, Shi HZ (2013) Subpopulations of helper T lymphocytes in tuberculous pleurisy. Tuberculosis 93(3):279–284. doi:10.1016/j.tube.2013.02.014 CrossRefPubMed

19.

Babu S, Bhat SQ, Kumar NP et al (2010) Regulatory T cells modulate Th17 responses in patients with positive tuberculin skin test results. J Infect Dis 201(1):20–31. doi:10.1086/648735 PubMedCentralCrossRefPubMed

20.

Guyot-Revol V, Innes JA, Hackforth S et al (2006) Regulatory T cells are expanded in blood and disease sites in patients with tuberculosis. Am J Respi Crit Care Med 173(7):803–810. doi:10.1164/rccm.200508-1294OC CrossRef

21.

Sharma PK, Saha PK, Singh A et al (2009) FoxP3+ regulatory T cells suppress effector T-cell function at pathologic site in miliary tuberculosis. Am J Respir Crit Care Med 179(11):1061–1070. doi:10.1164/rccm.200804-529OC CrossRefPubMed

22.

Okamoto M, Imaizumi K, Hasegawa Y et al (2007) Macrophage-derived chemokine in malignant and tuberculous pleural effusions. Respirology 12(4):581–584. doi:10.1111/j.1440-1843.2007.01059.x CrossRefPubMed

23.

Zhu J, Yamane H, Cote-Sierra J et al (2006) GATA-3 promotes Th2 responses through three different mechanisms: induction of Th2 cytokine production, selective growth of Th2 cells and inhibition of Th1 cell-specific factors. Cell Res 16(1):3–10. doi:10.1038/sj.cr.7310002 CrossRefPubMed

24.

Roberts T, Beyers N, Aguirre A et al (2007) Immunosuppression during active tuberculosis is characterized by decreased interferon- gamma production and CD25 expression with elevated forkhead box P3, transforming growth factor-beta, and interleukin-4 mRNA levels. J Infect Dis 195(6):870–878. doi:10.1086/511277 CrossRefPubMed

25.

Wang T, Lv M, Qian Q et al (2011) Increased frequencies of T helper type 17 cells in tuberculous pleural effusion. Tuberculosis 91(3):231–237. doi:10.1016/j.tube.2011.02.002 CrossRefPubMed

Titel: Expression Profiles of Cytokine mRNAs in the Pleural Fluid Reveal Differences Among Tuberculosis, Malignancies, and Pneumonia-Exudative Pleural Effusions
verfasst von: Danillo Lucas Alves Espósito
Valdes Roberto Bollela
Ana Luisa Pereira Feitosa
Benedito Antonio Lopes da Fonseca
Publikationsdatum: 01.12.2015
Verlag: Springer US
Erschienen in: Lung / Ausgabe 6/2015
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-015-9809-4

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Abstract

Introduction

Purpose

Methods

Results

Conclusion

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