Chest
Volume 93, Issue 2, February 1988, Pages 308-311
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Clinical Investigations
High Level of Interferon Gamma in Tuberculous Pleural Effusion

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It has been observed that T-lymphocytes of patients with tuberculosis produce interferon gamma (IFNγ) in vitro. Based on this idea, we studied IFNγ in pleural fluid and serum. We studied 80 patients with pleural effusion; 30 patients with tuberculous pleurisy had high IFNγ concentrations in pleural fluid. Patients with malignant pleural effusions, nonspecific pleural effusion, parapneumonic effusions and pleural transudates had low levels. The IFNγ levels were higher in those with massive tuberculous effusion and apparent pulmonary lesion on x-ray film. We found that the T4/T8 lymphocyte ratio was higher in pleural fluid than in peripheral blood. Numbers of T3 and T4 lymphocytes were higher in tuberculous pleural effusions compared with those in other patients. There is no correlation between IFNγ levels and lymphocyte subsets in pleural effusion. Perhaps pleural T-lymphocytes produce IFNγ after stimulation by mycobacterial antigens and this lymphokine activates macrophages, increasing their bactericidal activity against Mycobacterium tuberculosis.

Section snippets

Patients

We studied 80 inpatients of our hospital with pleural effusion. These patients were classified according to their final diagnosis into five major groups.

Group 1:30 patients with tuberculous pleural effusions. The diagnosis was confirmed by bacteriologic or histopathologic studies or both.
Based on the estimated amount of pleural fluid as assessed by the size of the opacity on the chest roentgenogram, these patients were further divided into three groups: group A: small, less than one

RESULTS

Table 1 shows the total number of lymphocytes, percentage of T-lymphocytes (T3), T-helper-lymphocytes (T4), T-suppressor-lymphocytes (T8), and the helper/suppressor ratio (T4/T8) in pleural fluid and peripheral blood of patients with tuberculous, malignant and nonspecific pleural effusions. In all these groups, there is an increase in the percentage of T3 and T4 lymphocytes and an elevated T4/T8 ratio in the pleural fluid compared with these values in the peripheral blood. The absolute T3 and

DISCUSSION

The T-lymphocyte response plays an important role in the pathogenesis of clinical manifestations and control of tuberculosis.9 Tuberculous pleural effusions have an increased percentage and an increased absolute number of T-lymphocytes compared with peripheral blood.10 Other types of effusions also have increased percentages of T-lymphocytes but the absolute number of lymphocytes is not elevated.10, 11 Our results confirm these observations; we found an increase in both the absolute number and

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    • Tuberculosis and Atypical Mycobacterial Infections

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    Supported in part by a grant from CIRIT (Ceneralitat de Catalunya) ana by Ortho Diagnostic Systems.

    Manuscript received April 10; revision accepted July 20.

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