The response of the fibrinolytic system to inflammatory mediators in empyema and complicated parapneumonic pleural effusions is still uncertain. We prospectively analysed 100 patients with pleural effusion: 25 with empyema or complicated parapneumonic effusion, 22 with tuberculous effusion, 28 with malignant effusion and 25 with transudate effusion. Inflammatory mediators, tumour necrosis factor-α (TNF-α), interleukin-8 (IL-8) and polymorphonuclear elastase, were measured in serum and pleural fluid. Fibrinolytic system parameters, plasminogen, tissue-type plasminogen activator (t-PA) and urokinase PA, PA inhibitor type 1 (PAI 1) and PAI type 2 concentrations and PAI 1 activity, were quantified in plasma and pleural fluid. The Wilcoxon signed-rank test was used to compare plasma and pleural values and to compare pleural values according to the aetiology of the effusion. The Pearson correlation coefficient was used to assess the relationship between fibrinolytic and inflammatory markers in pleural fluid. Significant differences were found between pleural and plasma fibrinolytic system levels. Pleural fluid exudates had higher fibrinolytic levels than transudates. Among exudates, tuberculous, empyema and complicated parapneumonic effusions demonstrated higher pleural PAI levels than malignant effusions, whereas t-PA was lowest in empyema and complicated parapneumonic pleural effusions. PAI concentrations correlated with TNF-α, IL-8 and polymorphonuclear elastase when all exudative effusions were analysed, but the association was not maintained in empyema and complicated parapneumonic effusions. A negative association found between t-PA and both IL-8 and polymorphonuclear elastase in exudative effusions was strongest in empyema and complicated parapneumonic effusions. Blockage of fibrin clearance in empyema and complicated parapneumonic effusions was associated with both enhanced levels of PAIs and decreased levels of t-PA.
Skip Nav Destination
Article navigation
November 2003
-
Cover Image
Cover Image
- PDF Icon PDF LinkTable of Contents
Research Article|
November 01 2003
Association between inflammatory mediators and the fibrinolysis system in infectious pleural effusions
Carmen ALEMÁN;
*Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain
Correspondence: Dr Carmen Alemán (e-mail [email protected]).
Search for other works by this author on:
José ALEGRE;
José ALEGRE
*Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Jasone MONASTERIO;
Jasone MONASTERIO
†Department of Haemostasis, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Rosa M. SEGURA;
Rosa M. SEGURA
‡Department of Biochemistry, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Lluís ARMADANS;
Lluís ARMADANS
§Department of Preventive Medicine and Epidemiology, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Ana ANGLÉS;
Ana ANGLÉS
†Department of Haemostasis, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Encarna VARELA;
Encarna VARELA
‡Department of Biochemistry, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Eva RUIZ;
Eva RUIZ
*Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Tomás FERNÁNDEZ DE SEVILLA
Tomás FERNÁNDEZ DE SEVILLA
*Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain
Search for other works by this author on:
Publisher: Portland Press Ltd
Received:
March 26 2003
Revision Received:
June 11 2003
Accepted:
June 25 2003
Accepted Manuscript online:
June 26 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2003 The Biochemical Society
2003
Clin Sci (Lond) (2003) 105 (5): 601–607.
Article history
Received:
March 26 2003
Revision Received:
June 11 2003
Accepted:
June 25 2003
Accepted Manuscript online:
June 26 2003
Citation
Carmen ALEMÁN, José ALEGRE, Jasone MONASTERIO, Rosa M. SEGURA, Lluís ARMADANS, Ana ANGLÉS, Encarna VARELA, Eva RUIZ, Tomás FERNÁNDEZ DE SEVILLA; Association between inflammatory mediators and the fibrinolysis system in infectious pleural effusions. Clin Sci (Lond) 1 November 2003; 105 (5): 601–607. doi: https://doi.org/10.1042/CS20030115
Download citation file:
Sign in
Don't already have an account? Register
Sign in to your personal account
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Biochemical Society Member Sign in
Sign InSign in via your Institution
Sign in via your InstitutionGet Access To This Article
Open Access for all
We offer compliant routes for all authors from 2025. With library support, there will be no author nor reader charges in 5 journals. Check here |
![]() |