title: Decreased proinflammatory cytokines production in children with complicated parapneumonic pleural effusion after intrapleural fibrinolytic treatment.
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.
authors.affiliation: Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan 70421, Taiwan.
authors.forename: Jieh-Neng
authors.initials: JN
authors.lastname: Wang
authors.forename: Jyh-Wei
authors.initials: JW
authors.lastname: Shin
authors.forename: Tsuey-Yu
authors.initials: TY
authors.lastname: Chang
authors.forename: Jiu-Yao
authors.initials: JY
authors.lastname: Wang
authors.forename: Jing-Ming
authors.initials: JM
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000037:antagonists & inhibitors* / Q000096:biosynthesis* / Q000502:physiology; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors* / Q000378:metabolism / Q000502:physiology; D008297:Male; D035422:Pleural Cavity / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D010996:Pleural Effusion / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology
chemical_list: D016207:Cytokines; D005343:Fibrinolytic Agents; D018836:Inflammation Mediators