白细胞介素-39在胸腔积液中的表达及其对结核性胸膜炎的诊断价值

Interleukin -39 Expression in Pleural Effusion and Its Diagnostic Value for Tuberculous Pleurisy.

作者信息

Song Xuxiang, Zhang Qipan, Cen Tiantian, Fan Wei, Chen Weili, Guo Lun, Du Yingying, Lv Chengna, Tang Pan, Dong Zhaoxing, Li Mingcai, Ding Qunli

机构信息

Health Science Center, Ningbo University, Ningbo, People's Republic of China.

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China.

出版信息

J Inflamm Res. 2025 Apr 5;18:4755-4770. doi: 10.2147/JIR.S488017. eCollection 2025.

DOI:10.2147/JIR.S488017

PMID:40206811

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11980934/

Abstract

OBJECTIVE

This study aimed to assess Interleukin-39 (IL-39) levels in various types of pleural effusion (PE), explore IL-39's diagnostic value in tuberculous pleurisy, analyze its correlation with other PE and tuberculosis indicators, and confirm the involvement of IL-39 in tuberculosis infection and the resulting inflammatory response.

METHODS

This study enrolled 113 patients with PE caused by different etiologies: 20 with transudative effusion, 39 with malignant pleural effusion (MPE), 15 with uncomplicated parapneumonic effusion (UPPE), and 39 with tuberculous pleural effusion (TPE). Enzyme-linked immunosorbent assay (ELISA) was used to measure IL-39, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) levels in the pleural fluid (PF) of each group. Adenosine deaminase (ADA) activity was determined using the colorimetric method.

RESULTS

IL-39 concentration was notably higher in the TPE compared to others. The IL-39 demonstrated an AUC of 0.944, with a cut-off value of 39.8 pg/mL, sensitivity of 94.9%, and specificity of 79.7% in distinguishing between the TPE and non-TPE. In discriminating between the TPE and MPE, the AUC for IL-39 was 0.941, with a cut-off value of 39.3 pg/mL, sensitivity of 94.9%, and specificity of 79.5%. For differentiating the TPE and UPPE, IL-39 yielded an AUC of 0.885, with a cut-off value of 235.0 pg/mL, sensitivity of 66.7%, and specificity of 100.0%. Moreover, based on these findings, multivariable diagnostic model and the rapid combination of IL-39 with other tuberculosis biomarkers (such as IFN-γ, TNF-α, and ADA) significantly enhanced the diagnostic and differential diagnostic performance for TPE. Additionally, IL-39, IFN-γ, TNF-α, and ADA levels in PF were positively correlated with each other.

CONCLUSION

IL-39 demonstrated good diagnostic and differential diagnostic value for TPE. Furthermore, the multivariate diagnostic model, as well as the joint detection of IL-39 with other tuberculosis biomarkers, can further increased the sensitivity or specificity. Additionally, IL-39 exhibited positive correlations with other tuberculosis biomarkers, suggesting its potential involvement in tuberculosis infection and the inflammatory response it may induce.

摘要

目的

本研究旨在评估不同类型胸腔积液（PE）中白细胞介素-39（IL-39）水平，探讨IL-39在结核性胸膜炎中的诊断价值，分析其与其他PE及结核病指标的相关性，并证实IL-39参与结核感染及其引发的炎症反应。

方法

本研究纳入113例由不同病因引起的PE患者：20例为漏出液，39例为恶性胸腔积液（MPE），15例为单纯性类肺炎性胸腔积液（UPPE），39例为结核性胸腔积液（TPE）。采用酶联免疫吸附测定（ELISA）法检测各组胸腔积液（PF）中IL-39、干扰素-γ（IFN-γ）和肿瘤坏死因子-α（TNF-α）水平。采用比色法测定腺苷脱氨酶（ADA）活性。

结果

与其他组相比，TPE组的IL-39浓度显著更高。IL-39在区分TPE与非TPE时，曲线下面积（AUC）为0.944，截断值为39.8 pg/mL，灵敏度为94.9%，特异度为79.7%。在区分TPE与MPE时，IL-39的AUC为0.941，截断值为39.3 pg/mL，灵敏度为94.9%，特异度为79.5%。在区分TPE与UPPE时，IL-39的AUC为0.885，截断值为235.0 pg/mL，灵敏度为66.7%，特异度为100.0%。此外，基于这些发现，多变量诊断模型以及IL-39与其他结核病生物标志物（如IFN-γ、TNF-α和ADA）的快速联合显著提高了TPE的诊断和鉴别诊断性能。此外，PF中的IL-39、IFN-γ、TNF-α和ADA水平彼此呈正相关。