Elevation of lnterleukin-10 Levels in Malignant Pleural Effusion

¹ From the Chest Department; and Cancer Clinical Research Center, Institute of Biomedical Sciences, Academia Sinica, Veterans General Hospital-Taipei and School of Medicine, National Yang-Ming University, ROC.
² From Cancer Clinical Research Center, Institute of Biomedical Sciences, Academia Sinica, Veterans General Hospital-Taipei and School of Medicine, National Yang-Ming University, ROC.
³ From the Medical Department, Veterans General Hospital-Taipei and School of Medicine, National Yang-Ming University, ROC.
⁴ From the Chest Department, Veterans General Hospital-Taipei and School of Medicine, National Yang-Ming University, ROC.

Study objective: Human immunity has been found to have two major components, cellular and humoral immunity. T-helper type 1 (Thl) pathway favors cellular immunity and Th2 pathway favors humoral immunity. Early determination toward Thl and Th2 cells in the immune response is dependent on the balance between interleukin-12 (IL-12), which favors Thl responses, and IL-4, which favors Th2 responses. IL-2 and interferon- (IFN-) are produced in the Thl pathway, and IL-4 and IL-10 are produced in the Th2 pathway. Lack of cellular immunity, IL-2, and IFN- had been reported in malignant pleural effusions. However, to our knowledge, there are no previous reports on other cytokine components involving Thl or Th2 pathway. The present study was designed to answer these questions.

Design: Cytokine levels in peripheral blood and pleural fluid of 21 patients with malignant pleural effusion, including IL-4, IL-10, and IL-12, were analyzed with enzyme-linked immunosorbent assays. Lymphocyte subpopulations of peripheral blood and pleural effusion were also studied by using flow cytometry.

Measurements and results: The results showed a significant increase in IL-10 level as compared with blood samples. IL-4 and IL-12 were below minimal detectable concentrations both in the blood and the effusion. The ratio of pleural helper T cells was significantly higher than in the blood (p=0.0002). The ratio of pleural natural killer (NK) cells was significantly lower than in the blood (p=0.0001). The ratio of pleural suppressor T cells was lower than blood with borderline significance (p=0.0522). No significant change in B-lymphocyte ratio between blood and pleural effusion was found (p=0.2471). There was no correlation between difference in IL-10 level and lymphocyte subpopulation of pleural effusion and blood samples.

Conclusions: Helper T-cell subpopulations were increased while NK and suppressor T-cell subpopulations were decreased in malignant pleural effusions. The decrease in NK cell subpopulations with elevated IL-10 and minimal IL-12 concentration in neoplastic pleural effusion would suggest the usage of IL-12 or antibody of IL-10 to improve local cellular immunity. Further study is needed.

Key Words: helper T cell • interleukin 10 • natural killer cell • malignant pleural effusion

Submitted on December 11, 1995
Accepted on March 8, 1996

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