title: Translational Research in Pleural Infection and Beyond.
abstract: The incidence of pleural infection has been rising in recent years. Intrapleural therapy with tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has significantly reduced the need for surgery, and its impact on clinical care is rising worldwide. Efforts are underway to optimize the delivery regimen and establish the short and longer term effects of this therapy. The complex interactions of bacterial infection within the pleura with inflammatory responses and clinical interventions (antibiotics and tPA/DNase or other fibrinolysins) require further studies to improve future treatment options. Intrapleural instillation of tPA potently induces pleural fluid formation, principally via a monocyte chemotactic protein (MCP)-1 dependent mechanism. Activation of transcriptional programs in pleural resident cells and infiltrating cells during pleural infection and malignancy results in the local secretion of a cocktail of proinflammatory signaling molecules (including MCP-1) within the pleural confines that contributes to effusion formation. Understanding the biology of these molecules and their interaction may provide novel targets for pleural fluid control.
authors: Department of Respiratory Medicine, Sir Charles Gairdner Hospital, University of Western Australia, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Pleural Medicine Unit, Institute of Respiratory Health, Perth, Australia. Electronic address: gary.lee@uwa.edu.au.
authors: Y C Gary
authors: YC
authors: Lee
authors: Department of Cellular and Molecular Biology and the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, TX.
authors: Steven
authors: S
authors: Idell
authors: Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Rio, Achaia, Greece; Comprehensive Pneumology Center, University Hospital, Ludwig Maximilian University and Helmholtz Zentrum München, Member of the German Center for Lung Research, Munich, Germany.
authors: Georgios T
authors: GT
authors: Stathopoulos
mesh_terms: D006801:Humans; D010995:Pleural Diseases / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D057170:Translational Research, Biomedical
keywords: CCL2; fibrinolysis; infection; inflammation; lung cancer; pneumonia