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T helper cell subsets in the pleural fluid of tuberculous patients differentiate patients with non-tuberculous pleural effusions

Title: T helper cell subsets in the pleural fluid of tuberculous patients differentiate patients with non-tuberculous pleural effusions
Authors: Roofchayee, ND
Adcock, IM
Marjani, M
Dezfuli, NK
Varahram, M
Garssen, J
Mortaz, E
Item Type: Journal Article
Abstract: Background: Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis (Tb). Patients with TPE or malignant pleural effusions (MPE) frequently have a similar lymphocytic pleural fluid profile. Since the etiology of PE in various diseases is different, identifying the cellular components may provide diagnostic clues for understanding the pathogenesis. Objective: We determined the frequency of T helper (Th) subtypes in the PEs for differentiation of Tb and non-Tb patients. Methods: Thirty patients with TPE, 30 patients with MPE, 14 patients with empyema (EMP), and 14 patients with parapneumonic effusion (PPE) were enrolled between December 2018 and December 2019. Five-milliliter fresh PE in tubes containing heparin as an anticoagulant was obtained from patients. The frequencies of CD4+IL-9+, CD4+IL-22+, CD+IL-17+, and regulatory T-cells CD4+CD25+ FOXP3+ (Treg) were determined by flow cytometry. Results: Treg cells have a lower frequency in TPE patients [4.2 (0.362–17.24)] compared with non-TPE patients [26.3 (3.349–76.93, p < 0.0001)]. The frequency of CD4+IL-9+ cells was significantly lower in TPE patients [3.67 (0.87–47.83)] compared with non-TPE groups [13.05 (1.67–61.45), p < 0.0001]. On the contrary, there was no significant difference in the frequency of CD4+IL-17+ and CD4+IL-22+ cells between TPE and non-TPE patients (p = 0.906 and p = 0.2188). Receiver-operator curve (ROC) analysis demonstrated that CD4+CD25+FOXP3+ T cells [optimal cutoff value = 13.6 (%), sensitivity 90%, specificity 75.86%] could be considered as predictor for TPE. However, adenosine deaminase [cutoff value 27.5 (IU/l), sensitivity 90%, specificity 96.5%] levels had an even greater predictive capacity. Conclusion: ADA, Treg cells, and CD4+IL-9+ cells may differentiate TPE from non-TPE patients. However, these results need validation in an independent large cohort.
Issue Date: 2-Dec-2021
Date of Acceptance: 10-Nov-2021
URI: http://hdl.handle.net/10044/1/93651
DOI: 10.3389/fimmu.2021.780453
ISSN: 1664-3224
Publisher: Frontiers Media
Start Page: 1
End Page: 10
Journal / Book Title: Frontiers in Immunology
Volume: 12
Copyright Statement: © 2021 Roofchayee, Adcock, Marjani, Dezfuli, Varahram, Garssen and Mortaz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
T helper
differentiation
frequency
tuberculous
pleural effusion
IMMUNE-RESPONSE
ADENOSINE-DEAMINASE
MESOTHELIAL CELLS
TH17 CELLS
DIAGNOSIS
LYMPHOCYTES
T helper
differentiation
frequency
pleural effusion
tuberculous
Science & Technology
Life Sciences & Biomedicine
Immunology
T helper
differentiation
frequency
tuberculous
pleural effusion
IMMUNE-RESPONSE
ADENOSINE-DEAMINASE
MESOTHELIAL CELLS
TH17 CELLS
DIAGNOSIS
LYMPHOCYTES
1107 Immunology
1108 Medical Microbiology
Publication Status: Published
Article Number: ARTN 780453
Online Publication Date: 2021-12-02
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



This item is licensed under a Creative Commons License Creative Commons