Abstract
In recent years, for the early diagnosis of tuberculosis pleurisy (TP) most widely studies of cellular immunity markers adenosine deaminase (ADA) and interferon-gamma (INF-γ). The growth of the ADA activity in pleural effusionis due to the increase of isoenzyme ADA-2. The data about diagnostic value another marker of cell-mediated immunity - neopterin (Np), as and about ADA-2 are few and controversy.
Objective: to compare the diagnostic efficiency of the ADA, ADA-2, INF-γ, Np in the definition of the specific nature of pleurisy.
Materials: to study 102 patients with pleural effusion, including 70 with clinically diagnosed TP. ADA and ADA-2 activity were measured by colorimetric method, INF-γ, Np level – with ELISA.
Results: ADA, ADA-2 activity and INF-γ production, but not Np level, were significantly higher in patients with TP than in non-TP. The following optimal cut-off values were used: for ADA – 35 U/l, for ADA-2 – 20 U/l, for INF-γ – 180 pg/ml, for Np – 13 nmol/l. The diagnostic sensitivity, specifity and diagnostic accuracy of ADA were 95,5%, 93% and 95%, of ADA-2 – 94%, 93% and 92%, of INF-γ – 91%, 96% and 93%, of Np – 45%, 83% and 56%. Only in TP group ADA, ADA-2 and IFN-γ levels were strongly correlated. The correlation coefficient was 0,77 for ADA and ADA-2, 0,35 for ADA and IFN-γ and 0,55 for ADA-2 and IFN-γ (p<0,01 for all).
Conclusion: ADA, ADA-2 and INF-γ could be used with a similar efficacy for the differential diagnostics of TP. Despite the fact that the Np level is less informative, however, this marker can be useful for monitoring diseases associated with the activation of cell-mediated immune response.
- Copyright ©the authors 2016
