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Lee, Y.C.* ; Idell, S.* ; Stathopoulos, G.T.

Translational research in pleural infection and beyond.

Chest 150, 1361-1370 (2016)
Publ. Version/Full Text Postprint DOI
Open Access Green
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 of surgery and its impact on clinical care is rising worldwide. Efforts are underway to optimize the delivery regime 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) 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 pro-inflammatory signalling 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.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Ccl2 ; Translating Basic Research Into Clinical Practice ; Fibrinolysis ; Infection ; Inflammation ; Lung Cancer ; Pneumonia; Nf-kappa-b; Tissue-plasminogen Activator; Complicated Parapneumonic Effusions; Growth-factor Levels; Cell Lung-cancer; Intrapleural Streptokinase; Mesothelial Cells; Fibrinolytic Therapy; Controlled-trial; T-cells
ISSN (print) / ISBN 0012-3692
e-ISSN 1931-3543
Journal Chest
Quellenangaben Volume: 150, Issue: 6, Pages: 1361-1370 Article Number: , Supplement: ,
Publisher American College of Chest Physicians
Publishing Place Glenview
Reviewing status Peer reviewed