RT Journal Article SR Electronic T1 Immune responses in the lungs of patients with tuberculous pleural effusion without parenchymal tuberculosis JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P429 VO 40 IS Suppl 56 A1 Won-Il Choi YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/P429.abstract AB Background: Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. Because most studies of TPE focused on the pleural space, little information regarding lung parenchyma is available. We therefore aimed to investigate immune responses in the lung parenchyma of TPE patients without active parenchymal tuberculosis.Methods: Patients with any evidence of active parenchymal tuberculosis, either from radiologic or bacteriologic evaluation, were excluded. Bronchoalveolar lavage fluid (BALF) was collected from 10 newly diagnosed, untreated, HIV-negative TPE patients and 10 healthy controls. We analyzed T-lymphocyte subpopulations and measured 10 cytokines in BALF. Cytokine levels in BALF were standardised using urea.Results: The concentrations of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and the CD4+/CD8+ ratio of T-lymphocytes were significantly higher in TPE patients without active parenchymal tuberculosis than in the controls. Of the cytokines measured in BALF, VEGF showed the highest concentration. No difference was observed in T-helper type 2 cytokines between the 2 groups.Conclusion: There were significant immune responses and increases in IFN-γ, TNF-α, and VEGF in the lung parenchyma of TPE patients without active parenchymal tuberculosis. This result suggests that TPE may induce a significant immune response in lung parenchyma.