Diagnostic accuracy of biomarkers of oxidative stress in parapneumonic pleural effusions
Article first published online: 1 DEC 2010
© 2010 The Authors. European Journal of Clinical Investigation © 2010 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 41, Issue 4, pages 349–356, April 2011
How to Cite
Tsilioni, I., Kostikas, K., Kalomenidis, I., Oikonomidi, S., Tsolaki, V., Minas, M., Gourgoulianis, K. I. and Kiropoulos, T. S. (2011), Diagnostic accuracy of biomarkers of oxidative stress in parapneumonic pleural effusions. European Journal of Clinical Investigation, 41: 349–356. doi: 10.1111/j.1365-2362.2010.02413.x
- Issue published online: 9 MAR 2011
- Article first published online: 1 DEC 2010
- Received 9 May 2010; accepted 23 September 2010
- Diagnostic accuracy;
- inflammatory cells;
- oxidative stress;
- pleural effusion;
- pleural infection
Eur J Clin Invest 2011; 41 (4): 349–356
Background The imbalance between oxidants and antioxidants is referred to as oxidative stress and has been associated with various respiratory disorders. The aim of this study was the assessment of 8-isoprostane (8-iso-PGF2α) and Cu/Zn superoxide dismutase (Cu/Zn SOD) in exudative pleural effusions in order to examine the diagnostic accuracy of these markers in the differentiation between complicated and uncomplicated parapneumonic effusions.
Methods The study included 214 consecutive patients with pleural effusions [68 parapneumonic (31 uncomplicated parapneumonic, 20 complicated parapneumonic, 17 empyemas), 24 tuberculous, 88 malignant and 34 transudates]. 8-Isoprostane and Cu/Zn SOD were determined by ELISA in pleural fluid and serum.
Results Parapneumonic effusions were characterized by higher pleural fluid 8-isoprostane levels compared to transudative, malignant and tuberculous effusions. Pleural fluid Cu/Zn SOD levels were lower in transudates, while serum levels were higher in transudative compared to all exudative pleural effusions. Both pleural fluid 8-isoprostane and Cu/Zn SOD were higher in complicated parapneumonic effusions and empyemas compared to uncomplicated parapneumonic effusions. Pleural fluid 8-isoprostane was the most accurate test to differentiate between complicated and uncomplicated parapneumonic pleural effusions with a sensitivity of 100% and a specificity of 58·1% at a cut-off point of 35·1 (AUC = 0·848).
Conclusions Pleural fluid 8-isoprostane and Cu/Zn SOD may provide useful information for the differentiation between uncomplicated and complicated parapneumonic effusions and empyemas.