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

Video：

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Abstract Full text Figures/Tables Video References Cited by

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

1.	中華醫學會呼吸病學分會.醫院獲得性肺炎診斷和治療指南(草案)[J].現代實用醫學, 2002, 14(3): 160-161.
2.	張培元.肺結核診斷和治療指南[J].中華結核和呼吸雜志, 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, 王丹華.新生兒全身炎癥反應綜合征研究進展[J].中華醫院感染學雜志, 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.	匡紅, 劉書蓉, 周琳瑤, 等.降鈣素原在呼吸系統相關疾病中的應用探討[J].國際檢驗醫學雜志, 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.	劉元明, 王茂筠, 梁宗安.血清降鈣素原鑒別肺結核與社區獲得性肺炎的價值[J].西部醫學, 2014, 26(2): 166-168, 171.
12.	Niu WY, Wan YG, Li MY, et al. The diagnostic value of serum procalcitonin, IL-10 and C-reactive protein in community acquired pneumonia and tuberculosis[J]. Eur Rev Med Pharmacol Sci, 2013, 17(24): 3329-3333.
13.	邢豫賓, 戴路明.血清降鈣素原在早期診斷和監控膿毒癥中的臨床應用評價[J].國際呼吸雜志, 2008, 28(15): 914-917.
14.	陳艷, 王天.降鈣素原對膿毒血癥患者的早期診斷及預后判斷的意義[J].中國醫藥指南, 2014(19): 45-46.
15.	柴家科, 吳焱秋, 胡森, 等.膿毒癥大鼠血漿C反應蛋白變化及與內毒素水平關系的研究[J].中國危重病急救醫學, 2001, 13(11): 656-658.

1. 中華醫學會呼吸病學分會.醫院獲得性肺炎診斷和治療指南(草案)[J].現代實用醫學, 2002, 14(3): 160-161.
2. 張培元.肺結核診斷和治療指南[J].中華結核和呼吸雜志, 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, 王丹華.新生兒全身炎癥反應綜合征研究進展[J].中華醫院感染學雜志, 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. 匡紅, 劉書蓉, 周琳瑤, 等.降鈣素原在呼吸系統相關疾病中的應用探討[J].國際檢驗醫學雜志, 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. 劉元明, 王茂筠, 梁宗安.血清降鈣素原鑒別肺結核與社區獲得性肺炎的價值[J].西部醫學, 2014, 26(2): 166-168, 171.
12. Niu WY, Wan YG, Li MY, et al. The diagnostic value of serum procalcitonin, IL-10 and C-reactive protein in community acquired pneumonia and tuberculosis[J]. Eur Rev Med Pharmacol Sci, 2013, 17(24): 3329-3333.
13. 邢豫賓, 戴路明.血清降鈣素原在早期診斷和監控膿毒癥中的臨床應用評價[J].國際呼吸雜志, 2008, 28(15): 914-917.
14. 陳艷, 王天.降鈣素原對膿毒血癥患者的早期診斷及預后判斷的意義[J].中國醫藥指南, 2014(19): 45-46.
15. 柴家科, 吳焱秋, 胡森, 等.膿毒癥大鼠血漿C反應蛋白變化及與內毒素水平關系的研究[J].中國危重病急救醫學, 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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