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Indian Journal of Clinical Biochemistry

, Volume 33, Issue 3, pp 334–340 | Cite as

Diagnostic Potential of Circulating Biomarkers in Adenosine Deaminase Diagnosed Pleural Tuberculosis Cases

  • Bineeta Kashyap
  • Nisha Goyal
  • N. P. Singh
  • Iqbal R. Kaur
Original Article
  • 55 Downloads

Abstract

Pleural tuberculosis accounts for nearly 20% of Extra pulmonary tuberculosis. Adenosine deaminase, commonly used biomarker for the diagnosis, is non specific and there is paucity of literature on its correlation with conventional or newer methods for the diagnosis of extra pulmonary forms of TB. The aim of the study was to assess diagnostic potential of T cell function markers [interferon (IFN-γ), interleukin (IL-2) and IFN-γ/IL-2 ratio]; macrophage activation marker [neopterin]; and oxidative stress markers [protein carbonyl and malondialdehyde (MDA)] in pleural tuberculosis. 26 pleural TB cases diagnosed on the basis of suggestive chest X-ray and raised serum ADA levels and healthy controls were included in the study. Pleural fluid specimens were subjected to Zeihl Neelsen staining and culture on Lowenstein Jensen medium. Serum IFN-γ, IL-2, neopterin and protein carbonyl levels detection were done by ELISA and MDA levels were determined by measuring the thiobarbituric acid reactive substances. Median serum levels of IFN-γ, IL-2, IFN-γ/IL-2 ratio, neopterin, protein carbonyl and MDA were significantly different between cases and controls. Levels of all biomarkers except IL-2 were significantly higher in cases with contact history. Mean levels of ADA and ESR were 46.27 U/L and 46.62 mm/hr in PTB cases. AUC for IFN-γ, IL-2, IFN-γ/IL-2 ratio, neopterin, protein carbonyl and MDA were significantly discriminative for cases and controls. IFN-γ/IL-2 ratio was best discriminatory biomarker with highest area under ROC curve. Though no correlation was seen between ADA and any of the six biomarkers, ESR levels correlated significantly with all biomarkers except IL-2 by spearman’s correlation coefficient. Though all the circulating biomarkers under study provide useful supportive evidence for the diagnosis of PTB, further studies involving diverse control groups particularly non-PTB effusion are needed to validate these results.

Keywords

Pleural Tuberculosis ADA Biomarkers 

Notes

Acknowledgements

Dr. Rahul Sharma for statistical analysis and Dr. Rajat Jhamb for clinical specimens.

Compliance with Ethical Standards

Conflict of interest

Author Nisha Goyal declares that she has no conflict of interest. Author Bineeta Kashyap declares that she has no conflict of interest. Author NP Singh declares that he has no conflict of interest. Author Iqbal R Kaur declares that she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Association of Clinical Biochemists of India 2017

Authors and Affiliations

  • Bineeta Kashyap
    • 1
    • 2
  • Nisha Goyal
    • 1
  • N. P. Singh
    • 1
  • Iqbal R. Kaur
    • 1
  1. 1.Department of MicrobiologyUniversity College of Medical Sciences & Guru Teg Bahadur HospitalNew DelhiIndia
  2. 2.New DelhiIndia

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