HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Papageorgiou, E. Articles by Gourgoulianis, K. I. Search for Related Content PubMed PubMed Citation Articles by Papageorgiou, E. Articles by Gourgoulianis, K. I.

Increased Oxidative Stress in Exudative Pleural Effusions^*

A New Marker for the Differentiation Between Exudates and Transudates?

^* From the Department of Respiratory Medicine, University of Thessaly, University Hospital of Larissa, Greece.

Correspondence to: Konstantinos Kostikas, Department of Respiratory Medicine, University of Thessaly, University Hospital of Larissa, 41110 Mezourlo, Larissa, Greece; e-mail: ktk{at}otenet.gr

Study objectives: Oxidative stress has been associated with various respiratory disorders. We tested the hypothesis that exudates would present higher levels of oxidative stress compared to transudates, expressing the increased local oxidative burst in the former.

Design: Prospective, cross-sectional study.

Patients or participants: One hundred six consecutive patients who had undergone thoracentesis were studied. Ninety patients with a final diagnosis of pleural effusion were further analyzed.

Setting: The respiratory department and a clinical laboratory of a tertiary hospital.

Interventions: Subjects underwent diagnostic thoracentesis, and standard biochemical parameters (ie, total protein, lactate dehydrogenase, and albumin levels) were measured in pleural fluid and serum. Oxidative stress levels were assessed with a commercially available method (d-ROMs test; Diacron; Grosseto, Italy) that uses conventional Carratelli units (UCarr). In 14 patients, duplicate measurements of oxidative stress and a second thoracentesis were performed on the following day for the assessment of the repeatability of measurements. Receiver operating characteristic (ROC) analysis was performed in order to determine the optimal cutoff level for the differentiation between exudates and transudates.

Measurements and results: Oxidative stress levels were higher in exudates compared to transudates (mean [± SD] stress level, 274 ± 72 vs 126 ± 34 UCarr, respectively; p < 0.0001). No significant differences were found among the levels of oxidative stress in exudative effusions of different etiologies. The area under the ROC curve was 0.992 (95% confidence interval, 0.945 to 0.997), and the method provided high sensitivity (96.8%), high specificity (96.3%), and high accuracy (96.7%) for the diagnosis of exudates at a cutoff level for oxidative stress of 186 UCarr. Consecutive measurements of oxidative stress in the same samples and on fluid from two different thoracenteses performed on 2 consecutive days presented excellent repeatability.

Conclusions: Oxidative stress levels are higher in exudative pleural effusions compared to transudative effusions, probably due to reactive oxygen species produced in the former.

Key Words: exudates • hydroperoxides • oxidative stress • pleural effusion • transudates

This article has been cited by other articles:

				M. I. Harma, M. Harma, O. Erel, K. Kostikas, E. Papageorgiou, T. S. Kiropoulos, and K. I. Gourgoulianis d-ROMs Test Detects Ceruloplasmin, Not Oxidative Stress. Chest, October 1, 2006; 130(4): 1276 - 1277. [Full Text] [PDF]