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KMID : 0383820080650010007
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Tuberculosis and Respiratory Diseases
2008 Volume.65 No. 1 p.7 ~ p.14
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The Relation of Residual Pleural Thickening with Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases of Pleural Effusion in Patients with Tuberculous Pleuritis
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Choi Young-Kwon
Kim Yu-Jin
Kyung Sun-Yong
An Chang-Hyeok
Lee Sang-Pyo
Park Jung-Woong
Jeong Sung-Hwan
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Abstract
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Background: Residual pleural thickening (RPT) is the most frequent complication of tuberculous pleurisy (TP), and this can happen despite of administering adequate anti-tuberculous (TB) therapy. Yet there was no definite relation
between RPT and other variables. The aim of this study was to examine matrix metalloproteinases (MMPs) and the inhibitors of metalloproteinases (TIMPs) and to identify the factors that can predict the occurrence of RPT.
Methods: The patients with newly-detected pleural effusions were prospectively enrolled in this study from January 2004 to June 2005. The levels of MMP-1, -2, -8 and -9, and TIMP-1 and -2 were determined in the serum and
pleural fluid by ELISA. The residual pleural thickness was measured at the completion of treatment and at the point of the final follow-up with the chest X-ray films.
Results: The study included 39 patients with pleural fluid (PF). Twenty-three had tuberculous effusion, 7 had
parapneumonic effusion, 7 had malignant effusion and 2 had transudates. For the 17 patients who completed the anti-TB treatment among the 23 patients with TP, 7 (41%) had RPT and 10 (59%) did not. The level of PF TIMP-1 in the patients with RPT (41,405.9±9,737.3 ng/mL) was significantly higher than that of those patients without RPT (29,134.9±8,801.8) at the completion of treatment (p=0.032). In 13 patients who were followed-up until a mean of 8±5 months after treatment, 2 (15%) had RPT and 11 (85%) did not. The level of PF TIMP-2 in the patients with RPT (34.4±6.5 ng/mL) was lower than that of those patients without RPT (44.4±15.5) at the point of the final follow-up (p=0.038).
Conclusion: The residual pleural thickening in TP might be related to the TIMP-1 and TIMP-2 levels in the pleural
fluid. (Tuberc Respir Dis 2008;65:7-14)
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KEYWORD
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Matrix metalloproteinase, Pleural effusion, Residual pleural thickening, Tissue inhibitor of metalloproteinase, Tuberculous pleuritis
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