Interventional Pulmonology

Diagnostic Accuracy of Cytokine Levels (TNF-, IL-2 and IFN-) in Bronchoalveolar Lavage Fluid of Smear-Negative Pulmonary Tuberculosis Patients
Elif Küpeli^a, Demet Karnak^a, Sumru Beder^a, Oya Kayacan^a, Hüseyin Tutkak^b

Departments of
^aChest Diseases and
^bImmunology, Ankara University School of Medicine, Ankara, Turkey

Address of Corresponding Author

Respiration 2008;75:73-78 (DOI: 10.1159/000110744)

  Key Words

• Bronchoalveolar lavage fluid
• IFN-
• IL-2
• TNF-
• Tuberculosis

  Abstract

Background: 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. Objective: To assess the diagnostic accuracy of TNF-, IFN- and IL-2 levels in serum and BALF of smear-negative pulmonary TB patients. Method: 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. Results: TNF- 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 0.7, respectively), BALF IL-2 and IFN- levels were not significantly different among the groups (p > 0.05). BALF TNF- or IFN- 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- were found to be 73 and 76%, respectively. The positive and negative predictive values for BALF TNF- were 44 and 91%, respectively. Conclusion: In cases of smear-negative TB, BALF TNF- can be a useful tool to identify healthy subjects rather than smear-negative TB patients.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Assoc. Prof. Demet Karnak
Department of Chest Diseases, Ankara University School of Medicine
TR-06100 Cebeci-Ankara (Turkey)
Tel. +90 312 595 65 72, Fax +90 312 319 00 46
E-Mail karnak@medicine.ankara.edu.tr or demet.karnak@gmail.com

  Article Information

Received: June 21, 2007
Accepted after revision: August 28, 2007
Published online: November 1, 2007
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 2, Number of References : 38