title: VEGF correlates with inflammation and fibrosis in tuberculous pleural effusion.
abstract: OBJECTIVE
  To investigate the relationship among angiogenic cytokines, inflammatory markers, and fibrinolytic activity in tuberculous pleural effusion (TBPE) and their clinical importance.
  
  
  METHODS
  Forty-two patients diagnosed with TBPE were studied. Based on chest ultrasonography, there were 26 loculated and 16 nonloculated TBPE patients. The effusion size radiological scores and effusion vascular endothelial growth factor (VEGF), interleukin- (IL-) 8, plasminogen activator inhibitor type-1 (PAI-1), and tissue type plasminogen activator (tPA) were measured. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up.
  
  
  RESULTS
  The effusion size and effusion lactate dehydrogenase (LDH), VEGF, IL-8, PAI-1, and PAI-1/tPA ratio were significantly higher, while effusion glucose, pH value, and tPA were significantly lower, in loculated than in nonloculated TBPE. VEGF and IL-8 correlated positively with LDH and PAI-1/tPA ratio and negatively with tPA in both loculated and nonloculated TBPE. Patients with higher VEGF or greater effusion size were prone to develop RPT (n=14; VEGF, odds ratio 1.28, P=0.01; effusion size, odds ratio 1.01, P=0.02), and VEGF was an independent predictor of RPT in TBPE (receiver operating characteristic curve AUC=0.985, P<0.001).
  
  
  CONCLUSIONS
  Effusion VEGF correlates with pleural inflammation and fibrosis and may be targeted for adjunct therapy for TBPE.
authors.affiliation: School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110, Taiwan ; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
authors.forename: Mauo-Ying
authors.initials: MY
authors.lastname: Bien
authors.affiliation: Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan 710, Taiwan ; Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Ming-Ping
authors.initials: MP
authors.lastname: Wu
authors.affiliation: Graduate Institute of Medical Sciences and Department of Pharmacology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Chen
authors.affiliation: School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110, Taiwan ; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
authors.forename: Chi-Li
authors.initials: CL
authors.lastname: Chung
mesh_terms: D016207:Cytokines / Q000378:metabolism; D003710:Demography; D005260:Female; D005342:Fibrinolysis; D005355:Fibrosis; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000000981:diagnostic imaging; D016015:Logistic Models; D008168:Lung / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010996:Pleural Effusion / Q000150:complications* / Q000000981:diagnostic imaging; D012372:ROC Curve; D013902:Radiography, Thoracic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000150:complications* / Q000000981:diagnostic imaging; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D016207:Cytokines; D042461:Vascular Endothelial Growth Factor A