Diagnostic Value of Interferon-γ Release Assays on Pericardial Effusion for Diagnosis of Tuberculous Pericarditis.

Diagnosis of tuberculous pericarditis remains a challenge. We aimed in this study to evaluate the diagnostic value of T-SPOT.TB on pericardial effusion for diagnosis of tuberculous pericarditis. Patients with suspected tuberculous pericarditis were enrolled consecutively between August 2011 and December 2015. T-SPOT.TB was performed on both pericardial effusion mononuclear cells (PEMCs)and peripheral blood mononuclear cells (PBMCs). Sensitivity, specificity, predictive value (PV), and likelihood ratio (LR) of T-SPOT.TB on PEMCs and PBMCs were analyzed. Among the 75 patients enrolled, 24 patients (32%) were diagnosed with tuberculous pericarditis, 38 patients (51%) with nontuberculous pericarditis, and 13 patients (17%) were clinically indeterminate and were excluded from the final analysis. The sensitivity, specificity, positive PV (PPV), negative PV (NPV), positive LR (LR+), and negative LR (LR-) of T-SPOT.TB on PEMCs was 92%,92%,88%,95%,11.61, and 0.09, respectively, compared to 83%, 95%, 91%, 90%,15.83, and 0.18, respectively of T-SPOT.TB on PBMCs. In patients with tuberculous pericarditis, the median frequencies of spot-forming cells (SFCs) of T-SPOT.TB on PEMCs and PBMCs was 172SFCs/106MCs (IQR 39~486), and 66 SFCs/106MCs (IQR 24~526), respectively, but the difference was not statistically significant (P = 0.183). T-SPOT.TB on PEMCs appeared to be a valuable and rapid diagnostic method for diagnosis of tuberculous pericarditis with high sensitivity and specificity

Interplay of Breast Cancer Resistance Protein (BCRP) and Metabolizing Enzymes.

The recent identification of the interplay between metabolizing enzymes and BCRP has drawn more and more attention from people. BCRP, a transporter belonging to ATP-binding cassette (ABC) family, has been hypothesized to play roles in many aspects including protecting the human body against therapeutics because it is expressed in the tissues that function as barriers in vivo. Efficient coupling of BCRP and metabolizing enzymes enables rapid elimination of foreign compounds from the body because BCRP could facilitate the excretion of metabolites catalyzed by phase I and II enzymes into bile, urine and feces. Without BCRP coupling, pass through the cell membrane may be difficult for them by passive diffusion because of the increment of the molecular weight and water solubility. Thus the metabolism-efflux alliance has extraordinary importance to drug metabolism, distribution, pharmacological effect, toxicity and elimination. In this manuscript, a brief discussion about the interplays of BCRP and metabolizing enzymes in liver, intestine, kidney, lung and other organs were presented and summarized. Many endogenous and exogenous compounds belong to different chemical groups, for instance, the dietary flavonoids and the steroidal hormones were involved. Clarifying the cooperation mechanisms of BCRP and enzymes could lead to a better prediction of drug clearance in vitro

Diagnostic Value of Interferon-γ Release Assays on Pericardial Effusion for Diagnosis of Tuberculous Pericarditis

<div><p>Diagnosis of tuberculous pericarditis remains a challenge. We aimed in this study to evaluate the diagnostic value of T-SPOT.<i>TB</i> on pericardial effusion for diagnosis of tuberculous pericarditis. Patients with suspected tuberculous pericarditis were enrolled consecutively between August 2011 and December 2015. T-SPOT.<i>TB</i> was performed on both pericardial effusion mononuclear cells (PEMCs)and peripheral blood mononuclear cells (PBMCs). Sensitivity, specificity, predictive value (PV), and likelihood ratio (LR) of T-SPOT.<i>TB</i> on PEMCs and PBMCs were analyzed. Among the 75 patients enrolled, 24 patients (32%) were diagnosed with tuberculous pericarditis, 38 patients (51%) with nontuberculous pericarditis, and 13 patients (17%) were clinically indeterminate and were excluded from the final analysis. The sensitivity, specificity, positive PV (PPV), negative PV (NPV), positive LR (LR+), and negative LR (LR-) of T-SPOT.<i>TB</i> on PEMCs was 92%,92%,88%,95%,11.61, and 0.09, respectively, compared to 83%, 95%, 91%, 90%,15.83, and 0.18, respectively of T-SPOT.<i>TB</i> on PBMCs. In patients with tuberculous pericarditis, the median frequencies of spot-forming cells (SFCs) of T-SPOT.<i>TB</i> on PEMCs and PBMCs was 172SFCs/10⁶MCs (IQR 39~486), and 66 SFCs/10⁶MCs (IQR 24~526), respectively, but the difference was not statistically significant (P = 0.183). T-SPOT.<i>TB</i> on PEMCs appeared to be a valuable and rapid diagnostic method for diagnosis of tuberculous pericarditis with high sensitivity and specificity.</p></div

Cardiac involvement in patients with primary biliary cholangitis: A 14-year longitudinal survey-based study.

Patients with primary biliary cholangitis (PBC) can have extrahepatic manifestations. However, data about cardiac involvement of PBC is limited. We aimed in this study to analyze the clinical characteristics in patients with PBC complicated with and without cardiac involvement, and the risk factors of cardiac involvement in PBC. PBC patients admitted to Peking Union Medical College Hospital between January 2002 and February 2016 were consecutively enrolled. Structured interview, systemic rheumatologic examination, and laboratory tests were conducted for each patient, and risk factors of cardiac involvement were analyzed by comparing patients with and without cardiac involvement. In total, 580 PBC patients were enrolled, and cardiac involvement was identified in 24 patients (4%), with 11 male (46%) and a mean age of 57±8 year. Cardiomyopathy and arrhythmias were presented in 17 (70.8%) and 21 (87.5%) patients, respectively. Patients with cardiac involvement were more frequently male (46% vs. 11%, P<0.01), complicated with inflammatory myopathy (IM) (58% vs. 1%, P<0.01), and had a longer disease course (median, 72 vs 24 month, P<0.01). Furthermore, concomitant IM was the independent risk factor of cardiac involvement in PBC (OR = 77.333, 95% CI: 23.704-252.294). Cardiac involvement was a rare complication of PBC, which was more frequently observed in male or long-course patients. Importantly, concomitant IM was the strong independent risk factor of cardiac involvement in PBC. Given cardiac involvement is a serious complication, thorough evaluation of cardiac manifestation in high-risk PBC patients is highly recommended

Diagnostic category of tuberculous pericarditis.

<p>Diagnostic category of tuberculous pericarditis.</p

Flowchart of enrolling patients.

<p>Flowchart of enrolling patients.</p

Baseline clinical characteristics and laboratory tests in 75 patients with suspected tuberculous pericarditis.

<p>Baseline clinical characteristics and laboratory tests in 75 patients with suspected tuberculous pericarditis.</p

Sensitivity, specificity, PPV, NPV, LR+, LR-, and area under the receiver operating characteristic curve (AUC) of T-SPOT.TB on PEMCs and PBMCs of patients with tuberculous pericarditis.

<p>Sensitivity, specificity, PPV, NPV, LR+, LR-, and area under the receiver operating characteristic curve (AUC) of T-SPOT.TB on PEMCs and PBMCs of patients with tuberculous pericarditis.</p

Frequencies of T-SPOT.TB on PEMCs and PBMCs in patients with tuberculous pericarditis.

<p>Frequencies of T-SPOT.TB on PEMCs and PBMCs in patients with tuberculous pericarditis.</p