دورية أكاديمية
The Biological Role of Pleural Fluid PAI-1 and Sonographic Septations in Pleural Infection: Analysis of a Prospectively Collected Clinical Outcome Study.
| العنوان: | The Biological Role of Pleural Fluid PAI-1 and Sonographic Septations in Pleural Infection: Analysis of a Prospectively Collected Clinical Outcome Study. |
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| المؤلفون: | Bedawi EO; Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Oxford Respiratory Trials Unit.; National Institute for Health Research Oxford Biomedical Research Centre.; Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom., Kanellakis NI; Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Oxford Respiratory Trials Unit.; National Institute for Health Research Oxford Biomedical Research Centre.; Laboratory of Pleural and Lung Cancer Translational Research, Nuffield Department of Medicine.; Chinese Academy of Medical Sciences Oxford Institute, Nuffield Department of Medicine, and., Corcoran JP; Department of Respiratory Medicine, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom., Zhao Y; Laboratory of Pleural and Lung Cancer Translational Research, Nuffield Department of Medicine., Hassan M; Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Chest Diseases Department, Alexandria University Faculty of Medicine, Alexandria, Egypt., Asciak R; Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom; and., Mercer RM; Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom; and., Sundaralingam A; Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Oxford Respiratory Trials Unit., Addala DN; Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Oxford Respiratory Trials Unit., Miller RF; Institute for Global Health, University College London, London, United Kingdom., Dong T; Chinese Academy of Medical Sciences Oxford Institute, Nuffield Department of Medicine, and.; Medical Research Council Human Immunology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom., Condliffe AM; Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom., Rahman NM; Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Oxford Respiratory Trials Unit.; National Institute for Health Research Oxford Biomedical Research Centre.; Laboratory of Pleural and Lung Cancer Translational Research, Nuffield Department of Medicine.; Chinese Academy of Medical Sciences Oxford Institute, Nuffield Department of Medicine, and. |
| المصدر: | American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2023 Mar 15; Vol. 207 (6), pp. 731-739. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Thoracic Society Country of Publication: United States NLM ID: 9421642 Publication Model: Print Cited Medium: Internet ISSN: 1535-4970 (Electronic) Linking ISSN: 1073449X NLM ISO Abbreviation: Am J Respir Crit Care Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2000- : New York, NY : American Thoracic Society Original Publication: New York, NY : American Lung Association, c1994- |
| مواضيع طبية MeSH: | Infections*/metabolism , Plasminogen Activator Inhibitor 1*/analysis , Plasminogen Activator Inhibitor 1*/metabolism , Pleural Diseases*/diagnostic imaging , Pleural Diseases*/metabolism, Humans ; Fibrinolysis ; Pleura/diagnostic imaging ; Pleura/metabolism ; Pleural Effusion/genetics ; Prospective Studies ; Tissue Plasminogen Activator/analysis ; Tissue Plasminogen Activator/metabolism ; Ultrasonography |
| مستخلص: | Rationale: Sonographic septations are assumed to be important clinical predictors of outcome in pleural infection, but the evidence for this is sparse. The inflammatory and fibrinolysis-associated intrapleural pathway(s) leading to septation formation have not been studied in a large cohort of pleural fluid (PF) samples with confirmed pleural infection matched with ultrasound and clinical outcome data. Objectives: To assess the presence and severity of septations against baseline PF PAI-1 (Plasminogen-Activator Inhibitor-1) and other inflammatory and fibrinolysis-associated proteins as well as to correlate these with clinically important outcomes. Methods: We analyzed 214 pleural fluid samples from PILOT (Pleural Infection Longitudinal Outcome Study), a prospective observational pleural infection study, for inflammatory and fibrinolysis-associated proteins using the Luminex platform. Multivariate regression analyses were used to assess the association of pleural biological markers with septation presence and severity (on ultrasound) and clinical outcomes. Measurements and Main Results: PF PAI-1 was the only protein independently associated with septation presence ( P < 0.001) and septation severity ( P = 0.003). PF PAI-1 concentrations were associated with increased length of stay ( P = 0.048) and increased 12-month mortality ( P = 0.003). Sonographic septations alone had no relation to clinical outcomes. Conclusions: In a large and well-characterized cohort, this is the first study to associate pleural biological parameters with a validated sonographic septation outcome in pleural infection. PF PAI-1 is the first biomarker to demonstrate an independent association with mortality. Although PF PAI-1 plays an integral role in driving septation formation, septations themselves are not associated with clinically important outcomes. These novel findings now require prospective validation. |
| التعليقات: | Comment in: Am J Respir Crit Care Med. 2023 Mar 15;207(6):653-655. (PMID: 36269762) Comment in: Am J Respir Crit Care Med. 2023 Apr 1;207(7):949. (PMID: 36413774) |
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| معلومات مُعتمدة: | G1001128 United Kingdom MRC_ Medical Research Council; United Kingdom DH_ Department of Health |
| فهرسة مساهمة: | Keywords: empyema; fibrinolysis; pleural infection; septations |
| المشرفين على المادة: | 0 (Plasminogen Activator Inhibitor 1) 0 (SERPINE1 protein, human) EC 3.4.21.68 (Tissue Plasminogen Activator) |
| تواريخ الأحداث: | Date Created: 20221003 Date Completed: 20230322 Latest Revision: 20230916 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10037470 |
| DOI: | 10.1164/rccm.202206-1084OC |
| PMID: | 36191254 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1535-4970 |
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| DOI: | 10.1164/rccm.202206-1084OC |