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December 2, 2021Frontiers in ImmunologyOpen Access

T Helper Cell Subsets in the Pleural Fluid of Tuberculous Patients Differentiate Patients With Non-Tuberculous Pleural Effusions

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Key result

The frequency of Treg cells and CD4+IL-9+ cells was significantly lower in the pleural fluid of patients with tuberculous pleural effusion compared to those with non-tuberculous pleural effusions.

Why the study?

Does the frequency of T helper cell subsets in pleural fluid differentiate tuberculous pleural effusions from non-tuberculous pleural effusions?

Population

88 HIV-negative patients with exudate pleural effusions, aged 18-84 years.

Comparison

Measurement of T helper cell subsets and… vs Non-tuberculous pleural effusions (MPE, EMP, PPE).

Design

Cohort

Authors

NRNeda Dalil RoofchayeeIAIan Michael AdcockMMMajid Marjani

Discussion

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Overview

Th subtype profiling in pleural fluid may differentiate TPE from MPE; leaves open diagnostic utility pending larger validation studies.

Study Design

Type

Observational (n=88)

Multicenter

No

Structured PICO

Does the frequency of T helper cell subsets in pleural fluid differentiate tuberculous pleural effusions from non-tuberculous pleural effusions?

P
Population
88 HIV-negative patients with exudative pleural effusions (30 tuberculous, 58 non-tuberculous) evaluated for T helper cell subsets to differentiate etiologies.
E
Exposure
Measurement of T helper cell subsets (CD4+IL-9+, CD4+IL-17+, CD4+IL-22+, and CD4+CD25+FOXP3+ Treg cells) and adenosine deaminase (ADA) in pleural fluid.
C
Comparator
Non-tuberculous pleural effusions (MPE, EMP, PPE).
O
Outcome
Diagnostic accuracy (sensitivity, specificity, AUC) of T-cell subsets and ADA to differentiate TPE from non-TPE.surrogate

Main Result

Absolute Event Rate: 4.2% vs 26.3%

p-value: p=<0.0001

Pleural fluid Treg cells and CD4+IL-9+ cells are significantly lower in tuberculous pleural effusions compared to non-tuberculous effusions, offering potential diagnostic utility alongside ADA.

Limitations

  • Low number of participants
  • Limited range of T cell subsets and mediators investigated
  • Lack of a validation cohort
  • Use of anti-CD4 antibody rather than anti-CD3 antibody to identify T helper lymphocytes
  • low number of participants
  • limited range of T cell subsets and mediators investigated
  • lack of a validation cohort

Cite This Study

Roofchayee et al. (2021) conducted an observational in Pleural effusion (n=88). Tuberculous pleural effusion vs. Non-tuberculous pleural effusion was evaluated on Frequency of Treg cells (CD4+CD25+FOXP3+) in pleural fluid (p=<0.0001). The frequency of Treg cells and CD4+IL-9+ cells was significantly lower in the pleural fluid of patients with tuberculous pleural effusion compared to those with non-tuberculous pleural effusions.

synapsesocial.com/papers/6ab3250e60d5ce32ea6497e6https://doi.org/10.3389/fimmu.2021.780453
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