title: Metalloproteinases and tissue inhibitors of metalloproteinases in exudative pleural effusions.
abstract: The aim of this study was to assess the expression of several metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in exudative pleural effusions, and their relationship with inflammatory and fibrinolytic mediators in parapneumonic effusions. The study included 51 parapneumonic effusions (30 empyema or complicated parapneumonic, 21 noncomplicated parapneumonic), 28 tuberculous, 30 malignant and 30 transudates. Inflammatory markers (tumour necrosis factor-alpha, interleukin-8, polymorphonuclear elastase), fibrinolytic system variables (tissue plasminogen activator (PA), urokinase PA (u-PA), plasminogen activation inhibitor (PAI)-1, PAI-2), and several MMPs (MMP-1, MMP-2, MMP-8, MMP-9) and TIMPs (TIMP-1, TIMP-2) were determined by ELISA in plasma and pleural fluid. Elevated MMP-2 and TIMP-1 concentrations were observed in all the pleural fluid samples studied. The group of empyema or complicated parapneumonic effusions showed higher MMP-1, MMP-8 and MMP-9 concentrations than the remaining exudates. There was no correlation between MMP and TIMP levels in plasma and pleural fluid in this group of effusions. In parapneumonic effusions, MMP-1, MMP-8 and MMP-9 showed a positive correlation with the inflammatory markers and with u-PA and PAI-1. Moreover, there was a relationship between MMP-8 concentration in pleural fluid and pleural thickening at the end of treatment. In conclusion, elevated metalloproteinase-1, -8 and -9 expression was found in parapneumonic pleural effusions. These metalloproteinases could be implicated in the local inflammatory response existing in this group of effusions.
authors.affiliation: Dept of Internal Medicine, Hospital Vall d'Hebrón, Barcelona, Spain. 30805dis@comb.es
authors.forename: D
authors.initials: D
authors.lastname: Iglesias
authors.forename: J
authors.initials: J
authors.lastname: Alegre
authors.forename: C
authors.initials: C
authors.lastname: Alemán
authors.forename: E
authors.initials: E
authors.lastname: Ruíz
authors.forename: T
authors.initials: T
authors.lastname: Soriano
authors.forename: L I
authors.initials: LI
authors.lastname: Armadans
authors.forename: R M
authors.initials: RM
authors.lastname: Segura
authors.forename: A
authors.initials: A
authors.lastname: Anglés
authors.forename: J
authors.initials: J
authors.lastname: Monasterio
authors.forename: T Fernández
authors.initials: TF
authors.lastname: de Sevilla
mesh_terms: D015331:Cohort Studies; D016724:Empyema, Pleural / Q000175:diagnosis / Q000201:enzymology; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis* / Q000378:metabolism; D008297:Male; D008666:Metalloendopeptidases / Q000032:analysis* / Q000378:metabolism; D010996:Pleural Effusion / Q000175:diagnosis* / Q000201:enzymology*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000201:enzymology; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000032:analysis* / Q000378:metabolism; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000032:analysis* / Q000378:metabolism; D014396:Tuberculosis, Pleural / Q000175:diagnosis / Q000201:enzymology
chemical_list: D018836:Inflammation Mediators; D019715:Tissue Inhibitor of Metalloproteinase-1; D019716:Tissue Inhibitor of Metalloproteinase-2; D008666:Metalloendopeptidases