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Vol. 32. Issue 10.
Pages 523-526 (December 1996)
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Vol. 32. Issue 10.
Pages 523-526 (December 1996)
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Estudio comparativo de los niveles de receptor soluble de interleucina 2 y adenosín-desaminasa en líquidos pleurales tuberculosos y de otras etiologías
Comparative assessment of soluble interleukin 2 receptor and adenosin-desaminase levels in pleural fluid of patients with tubercsulosis or other diseases
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M.J. Avilés Inglés1, C. Contessotto
Sección de Neumología. Hospital Los Arcos. Santiago de la Ribera. Murcia
J. Ontañón*, M. Muro*, P. Berlinches**, J. de la Torre**, F. Sánchez Gascón***, M.R. Álvarez López*
* Sección de Neumología. Hospital Santa María del Rosell. Cartagena
** Sección de Inmunología. Hospital Virgen de la Arrixaca. Murcia
*** Sección de Neumología. Hospital General de Murcia. Murcia
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En el marco de las investigaciones básicas dirigidas a esclarecer los mecanismos inmunológicos que configuran la respuesta del huésped frente a la infección por Mycobacterium tuberculosis, se han valorado los niveles de receptor soluble de interleucina 2 (sIL-2R) en exudados pleurales tuberculosos, en comparación con líquidos de etiología no micobacteriana.

Para ello, se han estudiado 40 enfermos con derrame pleural: 10 con pleuresía tuberculosa, 10 con neoplasia, 10 con neumonía bacteriana no tuberculosa y 10 con trasudado. La determinación de la concentración de sIL-2R se efectuó mediante técnica ELISA.

En pacientes con tuberculosis, el valor de sIL-2R en líquido pleural fue 14.666±5.634 U/ml, significativamente superior a los niveles encontrados en cualquier otro grupo de patología, que fueron 4.341±2.655 U/ml en los derrames neumónicos, 5.542±3.682 U/ml en los neoplásicos y 1.377±125 U/ml en los trasudados

En la tuberculosis pleuropulmonar, la compartimentalización de la respuesta inmune de la cavidad pleural determina la existencia de niveles significativamente más elevados de sIL-2R con respecto a los detectados en los líquidos pleurales de otraetiología. Esta observación, así como la demostración de una estrecha correlación entre sIL-2R y ADA, permite plantear la posible utilización de esta molécula como un parámetro accesorio en el diagnóstico diferencial de los derrames pleurales, aunque en este estudio no parece alcanzar el grado de fiabilidad de la ADA.

Palabras clave:
Derrame pleural tuberculoso
Receptor soluble de interleucina 2
Adenosín-desaminasa
Inmunología de la tuberculosis
Derrame pleural

In order to better understand the immunological mechanisms involved in host protection against Mycobacterium tuberculosis infection, we studied soluble interleukin 2 receptor (sIL-2R) concentration in tuberculous pleural exudates as well as in pleural fluids of non-mycobacterial etiology.

We collected pleural fluid from 40 patients: 10 with tuberculous pleurisy, 10 with neoplasia, 10 with non-tuberculous bacterial pneumonía and 10 with trasudate. Soluble IL-2R was measured in the stored specimens using a standard ELISA technique.

In patients with tuberculosis, sIL-2R in pleural fluid was 14,666±5,634 U/ml, significantly higher than was detected in any other group, being 4,341±2,655 U/ml in pneumonic exudates, 5,542±3,682 U/ml in neoplasic exudates and 1,377±125 in trasudates (p < 0.001). Also, an excellent correlation was demonstrated between adenosin-desaminase (ADA) and sIL-2R in tuberculous pleural fluids, with p < 0.001 and r= 0,805.

In pleuropulmonary tuberculosis, compartmentalization of the immune response in the pleural space is responsable for the significantly higher levels of sIL-2R that were found in tuberculous pleural liquids compared with the ones detected in other diseases. This observation, as well as the demonstration of a good correlation between sIL-2R and ADA, suggest the possible usefulness of this molecule as an additional marker in the differential diagnosis of pleural effusions, though in the present study it appears to be less reliable than ADA.

Key words:
Tuberculous pleural exudate
Soluble receptor of interleukin 2
Adenosin-desaminase
Immunology in tuberculosis
Pleural effusions
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
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