muramidase and Pleural-Effusion

Lysozyme level was measured in the fluid and serum of 42 tuberculous (25 pleural, 11 ascites and 6 pericardial) and 29 non-tuberculous (5 malignant, 9 empyema thoracis, 10 transudative ascites and 5 pyopericardium) effusions. The mean fluid lysozyme level was significantly raised in tuberculous pleural, ascites, and pericardial effusions in comparison to malignant pleural (p <0.001), transudative ascites (p < 0.001), and pyopericardium (p < 0.02) cases, respectively. The mean fluid/serum lysozyme ratio did not differ significantly between tuberculous and their corresponding non-tuberculous effusions. The confirmed tuberculous pleural effusion patients had significantly higher mean fluid lysozyme level and fluid/serum lysozyme ratio when compared with clinical cases (p < 0.05). The cut-off fluid lysozyme level of > or = 50/UI(-1) and fluid/serum lysozyme ratio of > or = 1.1 were considered for the diagnosis of tuberculous effusions; the sensitivity and specificity of fluid lysozyme and fluid/serum lysozyme ratios were 100, 100 per cent, and 97.6, 33.3 per cent, respectively, on excluding the patients with purulent effusions. A significant correlation was observed between the fluid and serum lysozyme levels in tuberculous effusions (r = 0.39,p < 0.01). Thus, fluid lysozyme was found to be a better and reliable test than fluid/serum lysozyme ratio for the diagnosis of tuberculous effusions in children.

Topics: Adolescent; Ascitic Fluid; Biomarkers; Child; Child, Preschool; Female; Humans; Infant; Male; Muramidase; Pericardial Effusion; Pleural Effusion; Reference Values; Regression Analysis; Sensitivity and Specificity; Tuberculosis

Lung cancer remains the leading cause of cancer death over the world. Although new diagnostic methods have been discovered, new biomarkers of the cancer are still under studying. A human chitinolytic enzyme called chitotriosidase hydrolyzes chitin and chitotrioside substrates. It is specifically expressed by activating macrophages and seems to play a role in the defense against chitinous human pathogens. Recently it has been shown that chitotriosidase may also attend to the inflammatory process. The aim of the study was to determine chitotriosidase activity in serum of patients with lung cancer and patients with inflammatory exudate. We studied the usefulness of the above parameter determination in differentiation between lung cancer and inflammation. In addition, serum activity of lysozyme and cathepsin H was determined.. The study included 17 patients with inflammatory pleural exudate--group 1., 40 lung cancer patients with malignant pleural effusion--group 2. and 37 healthy subjects. All the patients of group 2. were divided into 2 subgroups: 2A without metastases (n = 23) and 2B with metastases (n = 17). Chitotriosidase and cathepsin H activity was determined in serum by a fluorometric methods. Serum lysozyme activity was measured by turbidimetric method with Micrococcus luteus as substrate.. We observed an increase of the chitotriosidase activity in serum patients of both studied group in comparison with the control. The activity of the chitotriosidase in lung cancer patients was significantly higher than in the control (36.7 vs 68.1 nmol/ml/h; p < 0.01). There were no significant differences in serum lysozyme and cathepsin H activity in patients in comparison to healthy subjects.. The results suggest that activity of the chitotriosidase can not be used to differentiation between inflammation and cancer in lung.

Topics: Aged; Biomarkers, Tumor; Cathepsin H; Cathepsins; Cysteine Endopeptidases; Diagnosis, Differential; Female; Hexosaminidases; Humans; Lung Neoplasms; Male; Muramidase; Pleural Effusion; Pleural Effusion, Malignant; Pleurisy

Topics: Adenosine Deaminase; Humans; Interferon-gamma; Muramidase; Pleural Effusion; Polymerase Chain Reaction; Sensitivity and Specificity; Tuberculosis, Pleural

A microparticle-enhanced nephelometric immunoassay, based on polystyrene beads coated with antihuman lysozyme antibody, has been developed for lysozyme quantification in sera and pleural effusions. The standard curve extends from 0.58 mg/l to 18.75 mg/l and no antigen effect was observed. The results showed a good serial precision. The intra-assay precision (n = 20) expressed as CV was between 2.2 and 4.2 in three different concentrations. The inter-assay precision, with different calibration curves (n = 12) was between 6.4 and 7.1. The analytical assay showed a sufficient linearity (r > 0.999). There were no interferences either with haemoglobin (up to 4 g/l), lipids (up to 0.5%, expressed as 1% Lipofundina content), or bilirubin (up to 5 mg/dl). The analytical sensitivity was lower than 0.6 mg/l. The correlation with a Micrococcus lysodeikticus turbidimetric assay showed a correlation coefficient of 0.915. We have studied 92 patients with pleural effusion. In each case, pleural fluid adenosine deaminase activity and pleural fluid to plasma lysozyme ratio were determined. The lysozyme ratio showed similar clinical sensitivity and specificity as to adenosine deaminase.

Topics: Adenosine Deaminase; Humans; Immunoassay; Muramidase; Nephelometry and Turbidimetry; Pleural Effusion; Polystyrenes; Sensitivity and Specificity

Identification of predictive factors for the development of residual pleural thickening (RPT).. Retrospective study.. A 1,500-bed tertiary hospital.. Patients with pleural tuberculosis diagnosed between December 1991 and February 1995 in our Respiratory Disease Service.. The clinical and radiologic characteristics, and measurements of microbiological and biochemical parameters and markers in pleural fluid were studied. RPT was defined in a posteroanterior chest radiograph as a pleural space of >2 mm measured in the lower lateral chest at the level of an imaginary line intersecting the diaphragmatic dome.. In 56 patients studied, 11 (19.6%) had RPT 10 mm and 24 (42.8%) had RPT >2 mm. The pleural fluid of patients with RPT 10 mm had a significantly lower glucose concentration and pH and higher lysozyme and tumor necrosis factor-alpha levels than the other patients. The pleural fluid of patients with RPT >2 mm showed no significant differences.. The development of RPT 10 mm was related to higher concentrations of lysozyme and tumor necrosis factor-alpha and lower glucose concentration and pH in pleural fluid compared with development of lower measurements of RPT.

Topics: Adolescent; Adult; Aged; Antitubercular Agents; Biomarkers; Exudates and Transudates; Female; Glucose; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Muramidase; Observer Variation; Pleura; Pleural Effusion; Radiography; Radioimmunoassay; Retrospective Studies; Thoracostomy; Tuberculosis, Pleural; Tumor Necrosis Factor-alpha

The catalytic concentration of pleural adenosine deaminase (ADA) and the ratio of pleural lysozyme (PL) to serum lysozyme (SL) were measured in consecutive patients (49 tuberculous and 179 nontuberculous) with two automated procedures in a Hitachi 717 analyzer. Using sensitivity and specificity curves, we established cutoff values at 33 U/L for ADA and 1.7 for the PL/SL ratio. The sensitivity of ADA activities for tuberculous effusion was 90%, specificity 85%. Combining ADA with the PL/SL ratio enhanced specificity to 99%. However, high values for ADA and lysozyme ratios are not, alone or in combination, sensitive or specific enough to replace pleural biopsy or culture of pleural fluid for the diagnosis of tuberculous empyema.

Topics: Adenosine Deaminase; Autoanalysis; Clinical Enzyme Tests; Diagnosis, Differential; Empyema, Tuberculous; HIV Infections; Humans; Muramidase; Pleural Effusion; Prospective Studies; Reference Values; Tuberculosis

Biochemical and cellular characteristics of pleural fluid from two patients with pleuropulmonary tularemia and 39 patients with tuberculous pleurisy were compared. High pleural fluid concentrations of adenosine deaminase, lysozyme, and beta 2-microglobulin occurred in both diseases. As is the case with tuberculous pleural effusions, pleural fluid in tularemia showed an abundance of lymphocytes, predominantly CD4-positive T lymphocytes. The similar pleural fluid findings suggest analogous local pathogenetic mechanisms in tularemia and tuberculosis. In the diagnostic evaluation of a lymphocyte-rich exudative pleural effusion with a high adenosine deaminase concentration, a possible cause to consider is tularemia.

Topics: Aged; Humans; Lung Diseases; Lymphocyte Subsets; Male; Middle Aged; Muramidase; Pleural Effusion; Tuberculosis, Pleural; Tularemia

We compared the parameters pleural adenosine deaminase (PADA, determined in 405 patients), the PADA/serum ADA ratio (P/SADA; 276 cases), pleural lysozyme (PLYS, 276 cases), the PLYS/serum LYS ratio (P/SLYS; 276 cases), and pleural interferon gamma (IFN, 145 cases) regarding their ability to differentiate tuberculous pleural effusions from others. The 405 pleural effusions were classified by previously established criteria as tuberculous (91), neoplastic (110), parapneumonic (58), empyemas (10), transudates (88), or miscellaneous (48). The intermean differences between the tuberculous group and each of the others were statistically significant for all five parameters (p < 0.01 for PLYS and P/SLYS with respect to the empyema group; p < 0.001 otherwise), except for PADA and P/SADA with respect to the empyema group. All the tuberculous pleurisy cases had PADA values of 47 U/L or more, as compared to only 5 percent of the other cases (sensitivity, 100 percent; specificity, 95 percent). P/SADA was above 1.5 in 85.7 percent of tuberculous effusions and 11 percent of the others (sensitivity, 85.7 percent; specificity, 89 percent). PLYS, with a diagnostic threshold of 15 g/ml, had a sensitivity of 85.7 percent and a specificity of 61.6 percent; P/SLYS, with a threshold of 1.1, had a sensitivity of 67.3 percent and a specificity of 90.3 percent; and IFN, with a threshold of 140 pg/ml, had a sensitivity of 94.2 percent and a specificity of 91.8 percent. The lowest misclassification rate was achieved by PADA, with statistically significant differences (p < 0.001) with respect to P/SADA, PLYS, and P/SLYS, but not with respect to IFN. The only significant pairwise correlations among these parameters were between P/SLYS and PADA and between P/SLYS and P/SADA. We conclude that PADA and IFN are useful parameters for early diagnosis of tuberculous pleurisy, and that the other parameters considered have no advantages over PADA and IFN for this purpose (though the high specificity of P/SLYS may be noted).

Topics: Adenosine Deaminase; Adult; Clinical Enzyme Tests; Female; Humans; Interferon-gamma; Male; Muramidase; Pleural Effusion; Predictive Value of Tests; Sensitivity and Specificity; Tuberculosis, Pleural

Topics: Adenosine Deaminase; Body Fluids; Humans; Muramidase; Pleural Effusion; Tuberculosis, Pleural

Topics: Adenosine Deaminase; Aged; Clinical Enzyme Tests; Humans; Male; Muramidase; Pleural Effusion; Tuberculosis

Topics: Clinical Enzyme Tests; Diagnosis, Differential; Humans; Muramidase; Neoplasms; Pleural Effusion; Predictive Value of Tests; Tuberculosis, Pleural

Topics: Arthritis, Rheumatoid; Clinical Enzyme Tests; Humans; Muramidase; Pleural Effusion

We have determined simultaneously the ADAp and Lp/Ls ratio in 138 pleural effusions: 61 tuberculous; 42 malignant; 14 transudates; five parapneumonic uncomplicated; six empyematous; and ten cases belonging to a miscellaneous group which included two disseminated lupus erythematosus; two posttraumatic; one pancreatitis; one pleuropericarditis by Mycoplasma; one viral pleuropericarditis; and three pulmonary embolisms. This has allowed us to clear the overlapping for the ADAp activity among tuberculous patients (two cases of lupus and three cases of malignant effusions) in our series. The overlap in the Lp/Ls ratio among tuberculous patients, two malignant, and two parapneumonic uncomplicated cases was also cleared. Fixing the ADAp values at 33 U and the Lp/Ls ratio at 1.2, the tuberculous pleural effusion cases were differentiated from the nontuberculous with a sensibility, positive predictive value, negative predictive value, and safety diagnosis of 100 percent. It has been proven that there is a good correlation between ADAp and Lp/Ls ratio (r = 0.717) and the ADAp and Lp (r = 0.660).

Topics: Adenosine Deaminase; Adolescent; Adult; Child; Empyema; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Muramidase; Nucleoside Deaminases; Pleural Effusion; Tuberculosis, Pulmonary

Topics: False Positive Reactions; Female; Humans; Middle Aged; Muramidase; Pleural Effusion; Tuberculosis, Pulmonary

Topics: Adenosine Deaminase; Adult; Aged; Carcinoembryonic Antigen; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Male; Middle Aged; Muramidase; Peptidyl-Dipeptidase A; Pleural Effusion; Tuberculosis, Pleural

Topics: Adult; Aged; Clinical Enzyme Tests; Diagnosis, Differential; Female; Humans; L-Lactate Dehydrogenase; Male; Middle Aged; Muramidase; Neoplasms; Pleural Effusion; Tuberculosis, Pleural

We determined the levels of lysozyme in pleural fluid and serum in 141 patients with the following different causes for their pleural effusions: tuberculosis; neoplasias; transudates; parapneumonic, not complicated; empyemas; and miscellaneous. The lysozyme level of the pleural fluid and the ratio of that level over the serum level of lysozyme (PL/SL ratio) was meaningfully increased in patients with empyema (p less than 0.01). The groups with tuberculous and neoplastic effusions showed significant differences in the PL/SL ratio (p less than 0.01). The existence of a raised PL/SL ratio suggested important local synthesis of lysozyme, and it came up in empyemas and tuberculosis, unlike the other groups. Excluding the patients with empyemas, a PL/SL ratio of 1.2 showed a sensitivity of 100 percent, specificity of 94.9 percent, positive predictive value of 94.7 percent, negative predictive value of 100 percent, and accuracy of 97.3 percent for the diagnosis of tuberculous pleural effusion. All of this suggests that the determination of the lysozyme level can be an easy method of great usefulness in the initial diagnosis of pleural effusions.

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Muramidase; Pleural Effusion; Tuberculosis, Pleural

Topics: Adult; Aged; Ascitic Fluid; Female; Heart Failure; Humans; Lung Diseases; Male; Middle Aged; Muramidase; Neoplasms; Pleural Effusion

Lysozyme (LZM) concentrations in synovial fluid were determined in patients with seropositive and seronegative rheumatoid arthritis (RA) and in patients whose arthritic exudates had been caused by Reiter's disease, a Yersinia enterocolitica infection, osteoarthritis, or trauma. Patients with rheumatoid disease had significantly higher levels of lysozyme in synovial fluid than patients with non-rheumatic diseases. The concentration of lysozyme correlated with the number of polymorphonuclear leukocytes in synovial fluid in seronegative--but not in seropositive--rheumatoid arthritis. In patients with rheumatic arthritis the lysozyme level correlated inversely with the concentration of glucose in synovial fluid. In patients with rheumatoid pleural effusion, lysozyme levels in pleural fluid were comparable to those in serum. The concentration of LZM in thoracic duct lymph was roughly the same as in serum. During drainage of thoracic duct lymph, the lysozyme level in serum decreased.

Topics: Adult; Aged; Arthritis, Rheumatoid; Female; Humans; Lymph; Male; Middle Aged; Muramidase; Pleural Effusion; Synovial Fluid; Thoracic Duct; Tissue Distribution

Topics: Adolescent; Adult; Aged; Complement System Proteins; Female; Humans; Immunoglobulins; L-Lactate Dehydrogenase; Male; Middle Aged; Muramidase; Pleural Effusion

Topics: Adenosine Deaminase; Biopsy; Carcinoembryonic Antigen; Chromosome Aberrations; Humans; Muramidase; Pleura; Pleural Effusion

Topics: Diagnosis, Differential; Humans; Muramidase; Pleural Effusion; Tuberculosis, Pleural

In pleural biopsy specimens and histological sections from the fibrin clots of pleural fluid aspirates it may be difficult to distinguish reactive mesothelial cells from malignant mesothelial cells and metastatic carcinoma. Reactive pleurisy with effusion is usually associated with loss of cohesion and exfoliation of mesothelial cells, which is consistent with the hypothesis that they act as facultative histiocytes. A series of biopsy specimens and sections of clots from benign and malignant pleural effusions have been stained by the immunoperoxidase technique for the histiocytic markers alpha 1-antitrypsin, alpha 1-antichymotrypsin, and lysozyme (muramidase). Eight cases of mesothelioma were included. Mesothelial cells when seen as a monolayer lining the pleural surface were negative. Reactive mesothelial cells, usually seen as exfoliated cells, were consistently strongly positive for alpha 1-antichymotrypsin and more variably for alpha 1-antitrypsin and lysozyme. Malignant cells, whether from carcinoma or from mesothelioma, were usually but not always negative. Consequently immunohistochemical staining for alpha 1-antichymotrypsin is often helpful in distinguishing reactive mesothelial cells from malignant cells.

Topics: alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Biopsy; Biopsy, Needle; Chymotrypsin; Humans; Immunoenzyme Techniques; Mesothelioma; Muramidase; Pleura; Pleural Effusion; Pleural Neoplasms; Pleurisy

The authors evaluated the usefulness of paired pleural fluid and serum lysozyme determination in the differential diagnosis of pleurisies in 118 patients. Lysozyme activity of tuberculous effusions was found significantly higher (P less than 0.001) than that of effusions due to malignancy or heart failure, but considerable overlap of the individual values was observed. All patients with tuberculous pleurisy or tuberculous empyema, as well as a group of patients with suspected tuberculous effusion, had pleural fluid to serum lysozyme ratio of 1.0 or greater. In the remaining groups, only three patients, one with malignancy, one with lupus erythematosus, and one with sarcoidosis, exceeded this value. Their results suggest that pleural fluid to serum lysozyme ratio can be applied effectively in the differential diagnosis of tuberculous pleurisy.

Topics: Adult; Aged; Diagnosis, Differential; Empyema, Tuberculous; Humans; Middle Aged; Muramidase; Pleural Effusion; Tuberculosis, Pleural

Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Male; Middle Aged; Muramidase; Pleural Effusion; Pleurisy; Pneumonia; Tuberculosis, Pulmonary

Topics: Humans; Muramidase; Pleural Effusion; Tuberculosis, Meningeal; Tuberculosis, Pleural

Pleural effusions from 105 patients with malignant and nonmalignant diseases were examined for tumor cells, content of CEA, beta2 microglobulin, ceruloplasmin, alpha2 macroglobulin, orosomucoid, lysozyme, and hexosaminidase. Only CEA and beta2 microglobulin determinations were of diagnostic value. CEA concentrations greater than 11 ng/ml were found only in malignant effusions. Beta 2 microglobulin values were increased in pleural effusions due to lymphoma or immune diseases. Measurement of CEA and beta2 microglobulin in addition to the cytologic examination could increase the diagnostic significance of the analysis of pleural effusions.

Topics: alpha-Macroglobulins; beta 2-Microglobulin; Beta-Globulins; Blood Protein Electrophoresis; Carcinoembryonic Antigen; Ceruloplasmin; Hexosaminidases; Muramidase; Orosomucoid; Pleural Effusion; Pleural Neoplasms

Lysozyme content was measured in the plasma and pleural fluid of 110 patients with pleural effusions of various causes. The concentration of pleural fluid lysozyme was significantly higher (P less than .001) in patients with tuberculous pleurisy than in those with primary pulmonary carcinoma, metastatic carcinoma of the lung, connective tissue disease, nonspecific pleurisy, or congestive heart failure. Tuberculous patients also had a significantly higher (P less than .001) pleural fluid-to-plasma lysozyme ratio than did the other patients. Plasma lysozyme activity did not differ significantly among the various patient groups. Lysozyme was identified immunohistochemically in epithelioid cell granulomas in tuberculosis, in activated macrophages in lymph nodes adjacent to tuberculous lesions, and in granulocytes in pleural empyema. No lysozyme was detected in neoplastic cells in pulmonary carcinoma. The results show that the determination of pleural fluid lysozyme is a simple, fast method for obtaining corroborative information in the differential diagnosis of tuberculous pleurisy.

Topics: Adolescent; Adult; Clinical Enzyme Tests; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Muramidase; Pleural Diseases; Pleural Effusion; Pleurisy; Tuberculosis, Pleural

Topics: Carcinoembryonic Antigen; Humans; Lung Neoplasms; Muramidase; Neoplasm Metastasis; Pleural Effusion; Tuberculosis, Pleural; Tuberculosis, Pulmonary

Topics: Diagnosis, Differential; Glycosaminoglycans; Humans; Leukocyte Count; Muramidase; Pleural Effusion

A prospective study was conducted to define the content, significance, and source of lysozyme present in the pleural fluid in human diseases. The pleural fluid lysozyme activity is similar in various malignant and nonmalignant transudates and exudates, and is of limited diagnostic value. The pleural fluid activity correlated well with that of paired serum samples but it had poor correlation with the disease state, the pleural fluid granulocyte counts, and total white blood cell counts. The data suggest that the pleural fluid lysozyme may be derived primarily from the blood and that it is not the product of inflammatory or neoplastic cells in the fluid itself.

Topics: Carcinoma; Female; Granulocytes; Heart Failure; Humans; Leukemia; Liver Cirrhosis; Lung Neoplasms; Lymphoma; Male; Muramidase; Pleural Effusion

Topics: Humans; Muramidase; Pleural Effusion; Pleurisy; Tuberculosis, Pleural

A study was made of 111 strains of plasma-negative spathylococci isolated from the blood, pleural fluid, urine, and exudate of the abdominal cavity of 30 patients. The studies were carried out by 18 criteria. A variety of biological properties and signs characteristic of pathogenic staphylococci (hemolytic activity, anaerobic splitting of mannite, the presence of phosphatase, lysozyme, protease, alpha-toxin, fibrinolysin) were noted. A high resistance to tetracycline and penicillin was found in the strains isolated from the blood and the pleural cavity.

Topics: Animals; Ascitic Fluid; Bacteriophage Typing; Bacteriuria; Cross Infection; Erythrocytes; Fibrinolysin; Hemolysis; Humans; Mannitol; Muramidase; Penicillin Resistance; Penicillins; Phospholipases; Phosphoric Monoester Hydrolases; Pleural Effusion; Pyelonephritis; Rabbits; Sepsis; Staphylococcal Infections; Staphylococcus; Surgical Procedures, Operative; Tetracycline; Toxins, Biological

Topics: Animals; Breast Neoplasms; Bronchial Neoplasms; Cattle; Cyclophosphamide; Drug Combinations; Female; Glucose; Gold Isotopes; Humans; Hydrazines; L-Lactate Dehydrogenase; Lactates; Lung Neoplasms; Male; Mannitol; Muramidase; Neoplasm Metastasis; Pancreatic Extracts; Papain; Plant Extracts; Pleural Effusion; Pleural Neoplasms; Podophyllin; Proteins; Radioisotopes; Thymus Extracts; Time Factors

Topics: Antineoplastic Agents; Cyclophosphamide; Female; Glucose; Gold Isotopes; Humans; Injections; L-Lactate Dehydrogenase; Lactates; Male; Muramidase; Pleural Effusion; Pleural Neoplasms

Topics: Aged; Alkaline Phosphatase; Bone Neoplasms; Eosinophilia; Humans; Male; Muramidase; Neoplasm Metastasis; Pericardium; Pleura; Pleural Effusion; Pleural Neoplasms; Ribs; Vitamin B 12