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Decreased Proinflammatory Cytokines Production in Children with Complicated Parapneumonic Pleural Effusion after Intrapleural Fibrinolytic Treatment

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Abstract

Intrapleural fibrinolytic therapy (IFT) provides clinical benefit in the treatment of complicated pleural parapneumonic effusion (CPE). Whether IFT influences the proinflammatory cytokines production and fibrinlytic activity is currently unclear. Therefore, we collected pleural effusion samples from CPE patients with IFT (study group) and patients without IFT (control group). A membrane human inflammatory cytokines array kit was used to compare the difference of targeted cytokine production between these two groups. Enzyme-linked immunosorbent assay (ELISA) methods were used for quantitative analysis of targeted cytokines and fibrinolytic enzymes. The results showed there were no significant differences between the study (n = 16) and control (n = 14) groups in patients’ demographic data. After fibrinolytic therapy, the patients in the study group had significant lower plasminogen activator inhibitor (PAI) level (732.36 ± 254.09 ng/mL vs 1,509.36 ± 1,340.11 ng/mL, p < 0.05) and higher urokinase plasminogen activator (u-PA) level (75.56 ± 41.70 ng/mL vs 6.87 ± 5.07 ng/mL, p < 0.05) than they did before treatment. Moreover, the tissue inhibitors of metalloproteinase-2 (TIMP-2) (1,560.03 ± 403.49 pg/mL vs 3,686.45 ± 1,263.83 pg/mL, p < 0.05) and inflammatory chemokine, regulated on activation normal T-cell expressed and secreted/chemokine (C-C motif) ligand 5 (RANTES), (293.58 ± 212.93 pg/mL vs 749.27 ± 53.79 pg/mL, p < 0.05), were also significantly lower in the study group after fibrinolytic therapy, but not in the control group. In conclusion, intrapleural fibrinolytic treatment with urokinase could enhance fibrinolytic activity and decrease TIMP-2 and RANTES production.

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Acknowledgements

The authors thank Ms. Li-Wen Chen for the laboratory assistance; and Dr. Robert Anderson for editing the English. We would also like to acknowledge the contributions of Drs. Chih-Ta Yao, and Ching-Chuan Liu for patient management and sample collection.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Financial Support

This study was supported by the Intramural Research Program of the National Cheng Kung University Hospital (NCKUH-9803036), and Taiwan National Science Council (NSC 98-2314-B-006-007-MY3).

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Authors and Affiliations

  1. Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, 70421, Taiwan

    Jieh-Neng Wang

  2. Department of Pediatrics, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan, 70428, Taiwan

    Jieh-Neng Wang, Jiu-Yao Wang & Jing-Ming Wu

  3. Department of Parasitology, National Cheng Kung University Medical College, Tainan, 70421, Taiwan

    Jyh-Wei Shin & Tsuey-Yu Chang

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  1. Jieh-Neng Wang
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Correspondence to Jing-Ming Wu.

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Wang, JN., Shin, JW., Chang, TY. et al. Decreased Proinflammatory Cytokines Production in Children with Complicated Parapneumonic Pleural Effusion after Intrapleural Fibrinolytic Treatment. Inflammation 32, 410–418 (2009). https://doi.org/10.1007/s10753-009-9150-2

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  • DOI: https://doi.org/10.1007/s10753-009-9150-2

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