Proinflammatory and Antiinflammatory Cytokine Levels in Complicated and Noncomplicated Parapneumonic Pleural Effusions

Marchi, Evaldo; Vargas, Francisco S.; Acencio, Milena Marques Pagliarelli; Sigrist, R; Biscaro, Marjourie D.A.; Antonângelo, Leila; Teixeira, Lisete R.; Light, Richard W.

doi:10.1378/chest.10-3181

Cited by 24 publications

(26 citation statements)

References 16 publications

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“…However, Marchi et at failed to demonstrate the superiority of effusion VEGF and IL in distinguishing CPPE from UPPE as compared with effusion glucose and LDH. At variance with the results of the previous study [27], our results indicated that IL-8>1937 pg/ml or VEGF>1975 pg/ml had a better sensitivity and specificity to identify CPPE than did convention biochemical markers. The discrepancy might be due to the different definition of CPPE used in the present study [15], [16], which seemed more stringent than that of the previous report [27].…”

Section: Discussioncontrasting

confidence: 99%

“…At variance with the results of the previous study [27], our results indicated that IL-8>1937 pg/ml or VEGF>1975 pg/ml had a better sensitivity and specificity to identify CPPE than did convention biochemical markers. The discrepancy might be due to the different definition of CPPE used in the present study [15], [16], which seemed more stringent than that of the previous report [27]. The usefulness of effusion angiogenic cytokines in determining CPPE may be limited in usual clinical practice, since measuring cytokines is time consuming.…”

Section: Discussioncontrasting

confidence: 99%

“…In agreement with previous report by Marchi et al [27], the present study showed that effusion levels of VEGF and IL-8 were significantly higher in CPPE than in UPPE and were positively correlated with LDH values. However, Marchi et at failed to demonstrate the superiority of effusion VEGF and IL in distinguishing CPPE from UPPE as compared with effusion glucose and LDH.…”

Section: Discussionsupporting

confidence: 94%

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Clinical Importance of Angiogenic Cytokines, Fibrinolytic Activity and Effusion Size in Parapneumonic Effusions

Chung

Hsiao

et al. 2013

PLoS ONE

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ObjectiveTo investigate the relationship among angiogenic cytokines, fibrinolytic activity and effusion size in parapneumonic effusion (PPE) and their clinical importance.MethodsFrom January 2008 through December 2010, 26 uncomplicated (UPPE) and 38 complicated (CPPE) PPE were studied. Based on chest ultrasonography, there were non-loculated in 30, uni-loculated in 12, and multi-loculated effusions in 22 patients. The effusion size radiological scores, and effusion vascular endothelial growth factor (VEGF), interleukin (IL)-8, plasminogen activator inhibitor type-1 (PAI-1) and tissue type plasminogen activator (tPA) were measured on admission. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up.ResultsThe effusion size and effusion VEGF, IL-8 and PAI-1/tPA ratio were significantly higher in CPPE than in UPPE, and significantly higher in multi-loculated PPE than in non-locualted and uni-loculated PPE, respectively. VEGF (cutoff value 1975 pg/ml) and IL-8 (cutoff value 1937 pg/ml) seemed best to discriminate between UPPE and CPPE. VEGF, IL-8 and effusion size correlated positively with PAI-1/tPA ratio in both UPPE and CPPE. Moreover, the level of VEGF, but not IL-8, correlated positively with effusion size in all patients (r = 0.79, p<0.001) and in UPPE (r = 0.64, p<0.001) and CPPE (r = 0.71, p<0.001) groups. The patients with higher VEGF or greater effusion were prone to have medical treatment failure (n = 10; VEGF, odds ratio 1.01, p = 0.02; effusion size, odds ratio 1.26, p = 0.01). Additionally, ten patients with RPT had larger effusion size and higher levels of VEGF and PAI-1/tPA ratio than did those without.ConclusionsIn PPE, VEGF and IL-8 levels are valuable to identify CPPE, and higher VEGF level or larger effusion is associated with decreased fibrinolytic activity, development of pleural loculation and fibrosis, and higher risk of medical treatment failure.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

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Clinical Importance of Angiogenic Cytokines, Fibrinolytic Activity and Effusion Size in Parapneumonic Effusions

Chung

Hsiao

et al. 2013

PLoS ONE

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“…Exudative effusions, such as pyothorax, occur when inflammatory conditions within the pleural space lead to the release of cytokines and vasoactive mediators and subsequent changes in capillary wall permeability or lymphatic outflow impairment . During inflammation, the release of mediators, such as kinins and histamines, as well as increases in body temperature may lead to endothelial damage and subsequent increases in capillary permeability .…”

Section: Pathophysiologymentioning

confidence: 99%

A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats

Stillion¹,

Letendre²

2015

J Vet Emergen Crit Care

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“…To improve PPE diagnosis, numerous biomarkers, such as inflammatory cytokines (tumour necrosis factor-alpha/TNF-α, interleukin-8/IL-8, and IL-1β), enzymes (neutrophil elastase, myeloperoxidase/MPO, and metalloproteinases/MMPs), C-reactive protein (CRP), and soluble triggering receptor expressed on myeloid cells (sTREM-1), have been evaluated 4–9 . In these reports, the candidates were selected by a literature search and confirmed by immunoassays 10 .…”

Section: Introductionmentioning

confidence: 99%

Proteome profiling reveals novel biomarkers to identify complicated parapneumonic effusions

Chen

et al. 2017

Sci Rep

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Patients with pneumonia and parapneumonic effusion (PPE) have elevated mortality and a poor prognosis. The aim of this study was to discover novel biomarkers to help distinguish between uncomplicated PPE (UPPE) and complicated PPE (CPPE). Using an iTRAQ-based quantitative proteomics, we identified 766 proteins in pleural effusions from PPE patients. In total, 45 of these proteins were quantified as upregulated proteins in CPPE. Four novel upregulated candidates (BPI, NGAL, AZU1, and calprotectin) were selected and further verified using enzyme-linked immunosorbent assays (ELISAs) on 220 patients with pleural effusions due to different causes. The pleural fluid levels of BPI, NGAL, AZU1, and calprotectin were significantly elevated in patients with CPPE. Among these four biomarkers, BPI had the best diagnostic value for CPPE, with an AUC value of 0.966, a sensitivity of 97%, and a specificity of 91.4%. A logistic regression analysis demonstrated a strong association between BPI levels > 10 ng/ml and CPPE (odds ratio = 341.3). Furthermore, the combination of pleural fluid BPI levels with LDH levels improved the sensitivity and specificity to 100% and 91.4%, respectively. Thus, our findings provided a comprehensive effusion proteome data set for PPE biomarker discovery and revealed novel biomarkers for the diagnosis of CPPE.

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Proinflammatory and Antiinflammatory Cytokine Levels in Complicated and Noncomplicated Parapneumonic Pleural Effusions

Cited by 24 publications

References 16 publications

Clinical Importance of Angiogenic Cytokines, Fibrinolytic Activity and Effusion Size in Parapneumonic Effusions

Clinical Importance of Angiogenic Cytokines, Fibrinolytic Activity and Effusion Size in Parapneumonic Effusions

A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats

Proteome profiling reveals novel biomarkers to identify complicated parapneumonic effusions

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