Significance of Endotoxin-triggered Products in the Peripheral Blood in Differentiating Bacterial Pneumonia from Pulmonary Tuberculosis_West China Medical Journal

Authors：

 ChenXuerong ¹ , XiaoJun ² ,  XueMiao ¹

1. Department of Respiratory Medicine; West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Critical Care Medicine; West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

XueMiao, Email: 876858067@qq.com

Keywords：

Pulmonary tuberculosis; Bacterial pneumonia; Cytokine; Flow cytometry; Procalcitonin

DOI：

10.7507/1002-0179.201600455

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Objective To investigate the diagnostic value of products triggered by endotoxin including cytokines and procalcitonin for differentiating bacterial pneumonia from pulmonary tuberculosis. Methods Fifty patients diagnosed to have hospital-acquired pneumonia and another 50 patients diagnosed with tuberculosis admitted into West China Hospital between January and August 2015 were recruited in this study. The frequencies of CD4⁺ interferon (IFN)-γ⁺, CD4⁺ tumor necrosis factor (TNF)-α⁺, CD4⁺ interleukin (IL)-2⁺, CD4⁺ IL-10⁺ as well as CD8⁺IFN-γ⁺, CD8⁺TNF-α⁺, CD8⁺IL-2⁺, CD8⁺IL-10⁺ populations in peripheral blood were detected by flow cytometry after endotoxin stimulation. Meanwhile, the levels of procalcitonin, IL-6 and C reactive protein were measured by immunofluorescence staining. Results The frequencies of CD4⁺ IFN-γ⁺, CD4⁺ TNF-α⁺, CD4⁺ IL-2⁺, CD4⁺ IL-10⁺ as well as CD8⁺ IFN-γ⁺, CD8⁺ TNF-α⁺, CD8⁺ IL-2⁺, CD8⁺ IL-10⁺ populations in the pneumonia group increased significantly compared with those in the tuberculosis group (P < 0.05). The levels of procalcitonin, IL-6 and C-reactive protein in the pneumonia group increased statistically compared with the counterparts in the tuberculosis group (P < 0.05). The positive rates of procalcitonin, IL-6 and C-reactive protein in the pneumonia group were significantly higher than those in the tuberculosis group (P < 0.05). Conclusion Measurement of products triggered by endotoxin is beneficial for differential diagnosis of pneumonia from tuberculosis.

Citation： ChenXuerong, XiaoJun, XueMiao. Significance of Endotoxin-triggered Products in the Peripheral Blood in Differentiating Bacterial Pneumonia from Pulmonary Tuberculosis. West China Medical Journal, 2016, 31(10): 1653-1656. doi: 10.7507/1002-0179.201600455 Copy

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2. 张培元.肺结核诊断和治疗指南[J].中华结核和呼吸杂志, 2001, 24(2): 70-74.
3. Gibson J, Gow N, Wong SC. Expression and functions of innate pattern recognition receptors in T and B cells[J]. Immun Endoc Metab Agents Med Chem, 2010, 10(10): 11-20.
4. Arranz A, Abad C, Juarranz Y, et al. Effect of VIP on TLR2 and TLR4 expression in lymph node immune cells during TNBS-induced colitis[J]. Ann N Y Acad Sci, 2006, 1070(7): 129-134.
5. Su WL, Perng WC, Huang CH, et al. Identification of cytokines in whole blood for differential diagnosis of tuberculosis versus pneumonia[J]. Clin Vaccine Immunol, 2010, 17(5): 771-777.
6. 戈海延, 王丹华.新生儿全身炎症反应综合征研究进展[J].中华医院感染学杂志, 2008, 18(7): 1045-1047.
7. Hausfater P. Biomarkers and infection in the emergency unit[J]. Med Mal Infect, 2014, 44(4): 139-145.
8. Shimetani N, Shimetani K, Mori M. Levels of three inflammation markers, C-reactive protein, serum amyloid A protein and procalcitonin, in the serum and cerebrospinal fluid of patients with meningitis[J]. Scand J Clin Lab Invest, 2001, 61(7): 567-574.
9. 匡红, 刘书蓉, 周琳瑶, 等.降钙素原在呼吸系统相关疾病中的应用探讨[J].国际检验医学杂志, 2015, 36(9): 1198-1199, 1202.
10. Huang SL, Lee HC, Yu CW, et al. Value of procalcitonin in differentiating pulmonary tuberculosis from other pulmonary infections: a meta-analysis[J]. Int J Tuberc Lung Dis, 2014, 18(4): 470-477.
11. 刘元明, 王茂筠, 梁宗安.血清降钙素原鉴别肺结核与社区获得性肺炎的价值[J].西部医学, 2014, 26(2): 166-168, 171.
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14. 陈艳, 王天.降钙素原对脓毒血症患者的早期诊断及预后判断的意义[J].中国医药指南, 2014(19): 45-46.
15. 柴家科, 吴焱秋, 胡森, 等.脓毒症大鼠血浆C反应蛋白变化及与内毒素水平关系的研究[J].中国危重病急救医学, 2001, 13(11): 656-658.

West China Medical Journal

Significance of Endotoxin-triggered Products in the Peripheral Blood in Differentiating Bacterial Pneumonia from Pulmonary Tuberculosis

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