Tumour necrosis factor, interleukin-1 and adenosine deaminase in tuberculous pleural effusion

AbstractTumour necrosis factor (TNF) and interleukin-1 (IL-1) are powerful mediators with a key role in inflammation. This study was undertaken to study the presence of TNF and IL-1 in tuberculous effusion where there is marked inflammation and where examination of the pleural fluid may give information about the local inflammatory reaction. Adenosine deaminase activity (ADA, a marker of TB pleurisy) was also tested. Tumour necrosis factor, IL-1 and ADA levels were measured in the pleural fluid and serum of 97 patients; 33 with tuberculous effusion, 33 with malignant effusion, and 31 patients with benign non-tuberculous effusion. Pleural fluid TNF and ADA levels were higher in tuberculous (TB) patients than in patients with benign disorders or cancer (P<0·01). Serum TNF levels were also higher in TB patients than other benign (P<0·01) or malignant (P<0·05) effusions. There was a positive correlation between serum and pleural fluid values (r=0·998–0·999, P<0·001) although pleural fluid concentration was higher (P