In order to know the degree of interleukin-8 (IL-8) production in the pleural space and its relationship to neutrophil activation, IL-8, neutrophil elastase (NE), and myeloperoxidase (MPO) were assessed in blood and pleural fluid (PF) of 219 patients with pleural effusions. Correlations between blood and PF IL-8, NE, and MPO were either absent or weak, except for IL-8 in transudates (r = 0.6745, p < 0.001). PF IL-8, NE, and MPO concentrations in cases of empyema were higher than in cases of effusion of other causes (p < 0.001). No significant differences in inflammatory markers were observed between parapneumonic and tuberculous fluids. IL-8, NE, and MPO levels in malignant, nonspecific, and transudative effusions were lower than in those due to infection, the lowest levels corresponding to transudates. No significant correlation was observed between PF IL-8 and neutrophil count in any group; in contrast, IL-8 was associated with NE and MPO in empyema (r = 0.7545, and r = 0.7283; p < 0.001), tuberculosis (r = 0.4016, p = 0.008 and r = 0.6545, p < 0.001), and nonspecific effusions (r = 0.3748, p = 0.007 and r = 0.3085, p = 0.028). Our results indicate that local production of markers of the nonspecific inflammatory response is high in both chronic and acute pleural infection, and suggest a role for IL-8 in the release of NE and MPO.
Smoking cessation was associated with a significant decrease in mortality in patients with CAD, a non-significant decrease in those with CVD, and a non-significant increase in those with PAD.
Analysis of nondeproteinized samples with an enzymatic method to determine d-lactate indicated interferences. The presence of l-lactate dehydrogenase (LD) and l-lactate in the sample led to underestimation of d-lactate content when a sample blank was processed and overestimation when it was omitted. We proved that this interference is not due to lack of d-LD stereospecificity. Moreover, assessment of d-LD and l-LD KM for NAD+ allowed us to rule out the different affinities for this coenzyme as a cause of the interference. Our results underline the importance of deproteinizing samples for d-lactate analysis when enzymatic methods are used. The ultrafiltration procedure we propose is convenient and shows acceptable mean recovery (108%) and good imprecision (within-run CV = 4.2% and 3.0% for d-lactate at 31 and 107 μmol/L, respectively; between-run CVs were 7.3% at 49 μmol/L d-lactate and 3.1% at 115 μmol/L d-lactate).
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