The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion

Abstract Background There is substantial evidence indicating that cytokines play a role in the immune defense against tuberculosis. This study aims to evaluate the levels of various cytokines in pleural effusion to ditinguish between tuberculosis pleurisy and malignant pleurisy. Methods A total of 8...

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Main Authors: Yuzhen Xu, Jing Wu, Qiuju Yao, Qianqian Liu, Huaxin Chen, Bingyan Zhang, Yuanyuan Liu, Sen Wang, Lingyun Shao, Wenhong Zhang, Qinfang Ou, Yan Gao
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Immunology
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Online Access:https://doi.org/10.1186/s12865-024-00652-w
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author Yuzhen Xu
Jing Wu
Qiuju Yao
Qianqian Liu
Huaxin Chen
Bingyan Zhang
Yuanyuan Liu
Sen Wang
Lingyun Shao
Wenhong Zhang
Qinfang Ou
Yan Gao
author_facet Yuzhen Xu
Jing Wu
Qiuju Yao
Qianqian Liu
Huaxin Chen
Bingyan Zhang
Yuanyuan Liu
Sen Wang
Lingyun Shao
Wenhong Zhang
Qinfang Ou
Yan Gao
author_sort Yuzhen Xu
collection DOAJ
description Abstract Background There is substantial evidence indicating that cytokines play a role in the immune defense against tuberculosis. This study aims to evaluate the levels of various cytokines in pleural effusion to ditinguish between tuberculosis pleurisy and malignant pleurisy. Methods A total of 82 participants with pleural effusion were included in the training cohort, and 76 participants were included in the validation cohort. The individuals were divided into tuberculosis and malignant pleurisy groups. The concentrations of interleukin-1β (IL-1β), IL-4, IL-6, IL-10, IL-17 A, IL-17 F, IL-21, IL-22, IL-25, IL-31, IL-33, interferon-γ (IFN-γ), soluble CD40 ligand (sCD40L) and tumor necrosis factor-α (TNF-α) in pleural effusion were measured using a multiplex cytokine assay. The threshold values were calculated according to the receiver operating characteristic (ROC) curve analysis to aid in diagnosing tuberculosis pleurisy. Furthermore, the combined measure was validated in the validation cohort. Results The levels of all 14 cytokines in pleural effusion were significantly higher in participants with tuberculosis compared to those with malignant pleurisy (all P < 0.05). The area under the curve (AUC) was ≥ 0.920 for the IL-22, sCD40L, IFN-γ, TNF-α and IL-31, which were significantly increased in tuberculous pleural effusion (TPE) compared to MPE in the training cohort. Threshold values of 95.80 pg/mL for IFN-γ, 41.80 pg/mL for IL-31, and 18.87 pg/mL for IL-22 provided ≥ 90% sensitivity and specificity in distinguishing between tuberculosis pleurisy and malignant pleurisy in the training cohort. Among these, IL-22 combined with sCD40L showed the best sensitivity and specificity (94.0% and 96.9%) for diagnosing tuberculosis pleurisy, and this finding was validated in the validation cohort. Conclusion We demonstrated that the levels of IL-1β, IL-4, IL-6, IL-10, IL-17 A, IL-17 F, IL-21, IL-22, IL-25, IL-31, IL-33, IFN-γ, sCD40L and TNF-α in pleural effusion had significant difference between tuberculosis pleurisy and malignant pleurisy. Specifically, IL-22 ≥ 18.87 pg/mL and sCD40L ≥ 53.08 pg/mL can be clinically utilized as an efficient diagnostic strategy for distinguishing tuberculosis pleurisy from malignant pleurisy.
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spelling doaj-art-1bed41940b284402a920f8eb1a5a98702025-01-12T12:14:01ZengBMCBMC Immunology1471-21722024-10-012511910.1186/s12865-024-00652-wThe diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusionYuzhen Xu0Jing Wu1Qiuju Yao2Qianqian Liu3Huaxin Chen4Bingyan Zhang5Yuanyuan Liu6Sen Wang7Lingyun Shao8Wenhong Zhang9Qinfang Ou10Yan Gao11Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Respiratory MedicineDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Tuberculosis DiseasesDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityDepartment of Tuberculosis DiseasesDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Medical College, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan UniversityAbstract Background There is substantial evidence indicating that cytokines play a role in the immune defense against tuberculosis. This study aims to evaluate the levels of various cytokines in pleural effusion to ditinguish between tuberculosis pleurisy and malignant pleurisy. Methods A total of 82 participants with pleural effusion were included in the training cohort, and 76 participants were included in the validation cohort. The individuals were divided into tuberculosis and malignant pleurisy groups. The concentrations of interleukin-1β (IL-1β), IL-4, IL-6, IL-10, IL-17 A, IL-17 F, IL-21, IL-22, IL-25, IL-31, IL-33, interferon-γ (IFN-γ), soluble CD40 ligand (sCD40L) and tumor necrosis factor-α (TNF-α) in pleural effusion were measured using a multiplex cytokine assay. The threshold values were calculated according to the receiver operating characteristic (ROC) curve analysis to aid in diagnosing tuberculosis pleurisy. Furthermore, the combined measure was validated in the validation cohort. Results The levels of all 14 cytokines in pleural effusion were significantly higher in participants with tuberculosis compared to those with malignant pleurisy (all P < 0.05). The area under the curve (AUC) was ≥ 0.920 for the IL-22, sCD40L, IFN-γ, TNF-α and IL-31, which were significantly increased in tuberculous pleural effusion (TPE) compared to MPE in the training cohort. Threshold values of 95.80 pg/mL for IFN-γ, 41.80 pg/mL for IL-31, and 18.87 pg/mL for IL-22 provided ≥ 90% sensitivity and specificity in distinguishing between tuberculosis pleurisy and malignant pleurisy in the training cohort. Among these, IL-22 combined with sCD40L showed the best sensitivity and specificity (94.0% and 96.9%) for diagnosing tuberculosis pleurisy, and this finding was validated in the validation cohort. Conclusion We demonstrated that the levels of IL-1β, IL-4, IL-6, IL-10, IL-17 A, IL-17 F, IL-21, IL-22, IL-25, IL-31, IL-33, IFN-γ, sCD40L and TNF-α in pleural effusion had significant difference between tuberculosis pleurisy and malignant pleurisy. Specifically, IL-22 ≥ 18.87 pg/mL and sCD40L ≥ 53.08 pg/mL can be clinically utilized as an efficient diagnostic strategy for distinguishing tuberculosis pleurisy from malignant pleurisy.https://doi.org/10.1186/s12865-024-00652-wTuberculosis pleural pleurisyMalignant pleural effusionIFN-γIL-22sCD40L
spellingShingle Yuzhen Xu
Jing Wu
Qiuju Yao
Qianqian Liu
Huaxin Chen
Bingyan Zhang
Yuanyuan Liu
Sen Wang
Lingyun Shao
Wenhong Zhang
Qinfang Ou
Yan Gao
The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion
BMC Immunology
Tuberculosis pleural pleurisy
Malignant pleural effusion
IFN-γ
IL-22
sCD40L
title The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion
title_full The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion
title_fullStr The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion
title_full_unstemmed The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion
title_short The diagnostic value and validation of IL-22 combined with sCD40L in tuberculosis pleural effusion
title_sort diagnostic value and validation of il 22 combined with scd40l in tuberculosis pleural effusion
topic Tuberculosis pleural pleurisy
Malignant pleural effusion
IFN-γ
IL-22
sCD40L
url https://doi.org/10.1186/s12865-024-00652-w
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