title: Single-chain urokinase in empyema induced by Pasturella multocida.
abstract: Intrapleural fibrin deposition and subsequent fibrosis characterize evolving empyema and contribute to the morbidity associated with this condition. Single-chain urokinase (scuPA) is proenzyme form of the urokinase plasminogen activator, which has recently been shown to effectively clear intrapleural loculation in tetracycline-induced pleurodesis in rabbits. The authors therefore hypothesized that scuPA could likewise improve intrapleural injury associated with empyema. The authors used a rabbit model of empyema induced by intrapleural administration of Pasturella multocida to test this hypothesis and determined the effects of intrapleural scuPA on pleural fluids indices of inflammation and intrapleural fibrosis. The authors found that intrapleural administration of scuPA was well tolerated, generated readily detectable fibrinolytic activity in the empyema fluids and did not induce intrapleural or systemic bleeding. Pleural fluid volume, intrapleural protein, and D-dimer concentrations were increased at 24 and 48 hours (P < .01, respectively) after induction of empyema. Intrapleural loculation did not occur in the scuPA- or vehicle control-treated animals and there was no significant change in the pleural empyema or thickening scores. These findings confirm that intrapleural scuPA generates fibrinolysis in empyema fluids but does not alter fibrotic repair at the pleural surface or the intensity of intrapleural inflammation in this empyema model.
authors.affiliation: The Texas Lung Injury Institute, The University of Texas Health Science Center at Tyler, Tyler, Texas 75708, USA. steven.idell@uthct.edu
authors.forename: Steven
authors.initials: S
authors.lastname: Idell
authors.forename: Moon
authors.initials: M
authors.lastname: Jun Na
authors.forename: Huai
authors.initials: H
authors.lastname: Liao
authors.forename: A E
authors.initials: AE
authors.lastname: Gazar
authors.forename: Wonder
authors.initials: W
authors.lastname: Drake
authors.forename: Kirk B
authors.initials: KB
authors.lastname: Lane
authors.forename: Kathy
authors.initials: K
authors.lastname: Koenig
authors.forename: Andrey
authors.initials: A
authors.lastname: Komissarov
authors.forename: Torry
authors.initials: T
authors.lastname: Tucker
authors.forename: Richard W
authors.initials: RW
authors.lastname: Light
mesh_terms: D000818:Animals; D016724:Empyema, Pleural / Q000201:enzymology / Q000209:etiology / Q000382:microbiology*; D005122:Exudates and Transudates / Q000737:chemistry / Q000187:drug effects; D005342:Fibrinolysis / Q000187:drug effects; D007249:Inflammation; D016979:Pasteurella multocida; D010994:Pleura / Q000473:pathology; D011817:Rabbits; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D014568:Urokinase-Type Plasminogen Activator