Association between Elevated Pleural Interleukin-33 Levels and Tuberculous Pleurisy

BACKGROUND: Interferon-gamma (IFN-gamma) plays a crucial role in Mycobacterium tuberculosis induced pleural responses. Interleukin (IL)-33 up-regulates the production of IFN-gamma. 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-gamma, 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 (> or = 0.91) than in other PE cases (< or = 0.56). Pleural IL-33 levels correlated with those of pleural ADA and IFN-gamma. 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-gamma (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-gamma) as diagnostic markers of TPE.

A STUDY ABOUT THE CHANGE OF CERVICAL LYMPH NODE AND DENDRITIC CELL IN STREPTOZOTOCIN INDUCED DIABETIC RAT

Diabetes is a metabolic disease, leading to high blood glucose levels, and oral complications were as follows : cheilosis and a tendency toward drying cracking : burning sensations : decrease in salivary flow : alterations in the flora of the oral cavity with greater predominance of Candida albicans : and increased periodontal disease. The increase susceptibility of diabetics to infection has been well known. The cellular and humoral immune systems also require accessory cells, such as macrophages and antigen-presenting cells, for an optimal response to occur. Male rats weighing about 150-200 gm were induced to diabetes by streptozotocin, and were serially sacrificed on the 1st, 2nd, 3rd day and 1st, 2nd, 6th week of experiment. And then histologic examination on the cervical lymph node & S-100 protein positive dendritic cell were carried out under th light microscope. The results of this study were as follow : 1. In control group, cevical lymph node consists of a capsule, cortex, paracortex, medullary sinus and medullary cord. The germinal centers appear in the cortex. The medullary cord was composed of closely packed lymphocytes, and the medullary sinus was full of lymph. In the features of immunohistochemical stain, S-100 protein positive cells were seen in the germinal center. 2. In the 1 day experimental group, the germinal centers were more smaller than that of control group and most of them disappeared. The medullary cord was composed of loosely packed lymphocytes. In the features of immunohistochemical stain. S-100 positive protein cells were decreased and somewhere negative. 3. In the 3 day experimental group, it is similar to 1 day finding but the germinal center had clear margin than that of 1 day experimental group. In the features of immunohistochemical stain, the number of S-100 protein positive cell was decreased and somewhere negative. 4. In the 1 week experimental group, the germinal center was more clear than that of 3 day experimental group and T lymphocytes were scattered in the paracortex. In the medullary cord, density of lymphocyte was more increased. In the immunohistochemical stain, S-100 protein positive dendritic cells were increased in the margin of germinal center and somewhere negative. 5. In the 2 week experimental group, the germinal centers were more recovered. In the medullary cord, density of lymphocyte was increased. In the immunohistochemical stain, S-100 protein positive dendritic cell were increased in the germinal center. 6. In the 6 week experimental group, histologic pattern of cortex and paracortex was similar to control group finding, in the immunohistochemical stain, somewhere the number of S-100 protein positive dendritic cell was similar to control group. From above results, in the streptozotocin induced diabetic rat, as the germinal center of cervical lymph node were decreased and antigen-presenting cell, dendritic cell was affected, the function of cervical lymph node, which was responsible for maxillofacial immune system, was decreased.