Proinflammatory cytokines, fibrinolytic system enzymes, and biochemical indices in children with infectious para-pneumonic effusions

Chih Yung Chiu, Kin Sun Wong, Jing Long Huang, Ming Han Tasi, Tzou Yien Lin, Sen Yung Hsieh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: In children, pleural empyema is a recognized complication of severe pneumonia and is characterized by loculated effusions with fibrin septations. The aim of this study was to evaluate the relationship between proinflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6], intrapleural fibrinolytic system enzymes [tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI-1)], and common biochemical indices during pleural infection. Methods: Children with pneumonia complicated by para-pneumonic effusions were enrolled into our study and underwent real-time chest sonography. The patients were divided into 3 groups by ultrasound using a recognized staging system of pleural effusions. Staging of progressive pleural infection was used to correlate with the characteristics of pleural effusions. The correlation of various pleural variables with the formation of complicated para-pneumonic effusions (CPE) was performed and pleural variables for predicting subsequent intervention procedures were also analyzed. Results: A total of 57 patients were enrolled in the present study. Univariate analysis revealed that the amounts of biochemical indices (pH, glucose, lactate dehydrogenase), proinflammatory cytokines (TNF-α, IL-1β, IL-6), and fibrinolytic system enzymes (tPA, PAI-1) were significantly different with the progressive stages of para-pneumonic effusions (Ptrend < 0.05). For all proinflammatory cytokines, a positive correlation was found with lactate dehydrogenase and PAI-1, whereas a negative correlation was found with pH, glucose, and tPA. Moreover, these cytokines were also significantly correlated with PAI-1 in both non-CPE and CPE. The pleural fluid findings of IL-1β (≥50 pg/mL), PAI-1 ((≥1252 ng/mL), and pH (≤7.30) were the most significant predictive factors for subsequent intervention procedures (P < 0.001). Conclusions: The increased release of proinflammatory cytokines in pleural fluid caused by bacteria may result in an imbalance of the fibrinolytic system, which can subsequently lead to fibrin deposition and intervention procedures.

Original languageEnglish
Pages (from-to)699-703
Number of pages5
JournalPediatric Infectious Disease Journal
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 2008
Externally publishedYes

Fingerprint

Plasminogen Activator Inhibitor 1
Cytokines
Lung
Interleukin-1
Enzymes
Plasminogen Activators
Pleural Effusion
Fibrin
L-Lactate Dehydrogenase
Interleukin-6
Pneumonia
Tumor Necrosis Factor-alpha
Enzyme Activators
Glucose 1-Dehydrogenase
Pleural Empyema
Tissue Plasminogen Activator
Infection
Ultrasonography
Thorax
Bacteria

Keywords

  • Complicated para-pneumonic effusions
  • Interleukin-1β
  • Plasminogen activator inhibitor type 1

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Proinflammatory cytokines, fibrinolytic system enzymes, and biochemical indices in children with infectious para-pneumonic effusions. / Chiu, Chih Yung; Wong, Kin Sun; Huang, Jing Long; Tasi, Ming Han; Lin, Tzou Yien; Hsieh, Sen Yung.

In: Pediatric Infectious Disease Journal, Vol. 27, No. 8, 08.2008, p. 699-703.

Research output: Contribution to journalArticle

Chiu, Chih Yung ; Wong, Kin Sun ; Huang, Jing Long ; Tasi, Ming Han ; Lin, Tzou Yien ; Hsieh, Sen Yung. / Proinflammatory cytokines, fibrinolytic system enzymes, and biochemical indices in children with infectious para-pneumonic effusions. In: Pediatric Infectious Disease Journal. 2008 ; Vol. 27, No. 8. pp. 699-703.
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AU - Chiu, Chih Yung

AU - Wong, Kin Sun

AU - Huang, Jing Long

AU - Tasi, Ming Han

AU - Lin, Tzou Yien

AU - Hsieh, Sen Yung

PY - 2008/8

Y1 - 2008/8

N2 - Background: In children, pleural empyema is a recognized complication of severe pneumonia and is characterized by loculated effusions with fibrin septations. The aim of this study was to evaluate the relationship between proinflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6], intrapleural fibrinolytic system enzymes [tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI-1)], and common biochemical indices during pleural infection. Methods: Children with pneumonia complicated by para-pneumonic effusions were enrolled into our study and underwent real-time chest sonography. The patients were divided into 3 groups by ultrasound using a recognized staging system of pleural effusions. Staging of progressive pleural infection was used to correlate with the characteristics of pleural effusions. The correlation of various pleural variables with the formation of complicated para-pneumonic effusions (CPE) was performed and pleural variables for predicting subsequent intervention procedures were also analyzed. Results: A total of 57 patients were enrolled in the present study. Univariate analysis revealed that the amounts of biochemical indices (pH, glucose, lactate dehydrogenase), proinflammatory cytokines (TNF-α, IL-1β, IL-6), and fibrinolytic system enzymes (tPA, PAI-1) were significantly different with the progressive stages of para-pneumonic effusions (Ptrend < 0.05). For all proinflammatory cytokines, a positive correlation was found with lactate dehydrogenase and PAI-1, whereas a negative correlation was found with pH, glucose, and tPA. Moreover, these cytokines were also significantly correlated with PAI-1 in both non-CPE and CPE. The pleural fluid findings of IL-1β (≥50 pg/mL), PAI-1 ((≥1252 ng/mL), and pH (≤7.30) were the most significant predictive factors for subsequent intervention procedures (P < 0.001). Conclusions: The increased release of proinflammatory cytokines in pleural fluid caused by bacteria may result in an imbalance of the fibrinolytic system, which can subsequently lead to fibrin deposition and intervention procedures.

AB - Background: In children, pleural empyema is a recognized complication of severe pneumonia and is characterized by loculated effusions with fibrin septations. The aim of this study was to evaluate the relationship between proinflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6], intrapleural fibrinolytic system enzymes [tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI-1)], and common biochemical indices during pleural infection. Methods: Children with pneumonia complicated by para-pneumonic effusions were enrolled into our study and underwent real-time chest sonography. The patients were divided into 3 groups by ultrasound using a recognized staging system of pleural effusions. Staging of progressive pleural infection was used to correlate with the characteristics of pleural effusions. The correlation of various pleural variables with the formation of complicated para-pneumonic effusions (CPE) was performed and pleural variables for predicting subsequent intervention procedures were also analyzed. Results: A total of 57 patients were enrolled in the present study. Univariate analysis revealed that the amounts of biochemical indices (pH, glucose, lactate dehydrogenase), proinflammatory cytokines (TNF-α, IL-1β, IL-6), and fibrinolytic system enzymes (tPA, PAI-1) were significantly different with the progressive stages of para-pneumonic effusions (Ptrend < 0.05). For all proinflammatory cytokines, a positive correlation was found with lactate dehydrogenase and PAI-1, whereas a negative correlation was found with pH, glucose, and tPA. Moreover, these cytokines were also significantly correlated with PAI-1 in both non-CPE and CPE. The pleural fluid findings of IL-1β (≥50 pg/mL), PAI-1 ((≥1252 ng/mL), and pH (≤7.30) were the most significant predictive factors for subsequent intervention procedures (P < 0.001). Conclusions: The increased release of proinflammatory cytokines in pleural fluid caused by bacteria may result in an imbalance of the fibrinolytic system, which can subsequently lead to fibrin deposition and intervention procedures.

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