Department of Respiratory Medicine, Key Cite of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Front Immunol. 2023 Feb 3;14:1073884. doi: 10.3389/fimmu.2023.1073884. eCollection 2023.
Complement activation is essential for tuberculosis pleural effusion. However, little is known about the value of complement regulatory protein (CD46, CD55, and CD59) in the differential diagnosis of tuberculosis.
Ninety-nine patients with exudative pleural effusion admitted to Xiangya Hospital of Central South University from June 1, 2021to November 14, 2022 were enrolled. The expression levels of soluble CD46 (sCD46), soluble CD55 (sCD55), and soluble CD59 (sCD59) in pleural effusion were quantified by enzyme-linked immunosorbent assay, and the receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic and co-diagnostic values.
The ADA level is higher in TPE patients than non-TPE patients. It is well-found that TPE patients had lower levels of sCD46, sCD55, and sCD59 compared with non-TPE patients. Moreover, the expression of sCD46, sCD55, and sCD59 in pleural effusion was negatively correlated with ADA. In addition, the diagnostic efficacy of sCD46, sCD55 and sCD59 was comparable to that of ADA, with 0.896, 0.857, 0.858 and 0.893, respectively. Furthermore, combine detection of sCD46, sCD55, sCD59 and ADA could improve the diagnostic accuracy.
Complement regulatory factors (CD46, CD55, and CD59) were validated by this project to be promising candidate biomarkers for the diagnosis of TPE with high accuracy. The combination of the CD46, CD55, and CD59 and ADA assay exist a better diagnostic value in TPE.
补体激活对于结核性胸腔积液至关重要。然而，关于补体调节蛋白（CD46、CD55 和 CD59）在结核性胸腔积液鉴别诊断中的价值知之甚少。
本研究纳入了 2021 年 6 月 1 日至 2022 年 11 月 14 日期间中南大学湘雅医院收治的 99 例渗出性胸腔积液患者。采用酶联免疫吸附试验检测胸腔积液中可溶性 CD46（sCD46）、可溶性 CD55（sCD55）和可溶性 CD59（sCD59）的表达水平，并绘制受试者工作特征（ROC）曲线评估其诊断和辅助诊断价值。
结核性胸腔积液患者的 ADA 水平高于非结核性胸腔积液患者。研究发现，结核性胸腔积液患者的 sCD46、sCD55 和 sCD59 水平明显低于非结核性胸腔积液患者。此外，胸腔积液中 sCD46、sCD55 和 sCD59 的表达与 ADA 呈负相关。此外，sCD46、sCD55 和 sCD59 的诊断效能与 ADA 相当，分别为 0.896、0.857、0.858 和 0.893。进一步联合检测 sCD46、sCD55、sCD59 和 ADA 可提高诊断准确性。
本研究验证了补体调节因子（CD46、CD55 和 CD59）是结核性胸腔积液诊断的有前途的候选生物标志物，具有较高的准确性。sCD46、sCD55 和 CD59 与 ADA 联合检测在结核性胸腔积液诊断中具有更好的诊断价值。
