Key result
Higher effusion VEGF levels independently predicted the development of residual pleural thickening at 6 months in patients with tuberculous pleural effusion (OR 1.28, P=0.01).
Cohort (n=42)
Effusion VEGF levels correlate with pleural inflammation and fibrosis, serving as an independent predictor of residual pleural thickening in tuberculous pleural effusion.
VEGF may identify TBPE patients at fibrosis risk; leaves open whether targeting it alters outcomes in prospective trials.
OBJECTIVE: To investigate the relationship among angiogenic cytokines, inflammatory markers, and fibrinolytic activity in tuberculous pleural effusion (TBPE) and their clinical importance. METHODS: Forty-two patients diagnosed with TBPE were studied. Based on chest ultrasonography, there were 26 loculated and 16 nonloculated TBPE patients. The effusion size radiological scores and effusion vascular endothelial growth factor (VEGF), interleukin- (IL-) 8, plasminogen activator inhibitor type-1 (PAI-1), and tissue type plasminogen activator (tPA) were measured. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up. RESULTS: The effusion size and effusion lactate dehydrogenase (LDH), VEGF, IL-8, PAI-1, and PAI-1/tPA ratio were significantly higher, while effusion glucose, pH value, and tPA were significantly lower, in loculated than in nonloculated TBPE. VEGF and IL-8 correlated positively with LDH and PAI-1/tPA ratio and negatively with tPA in both loculated and nonloculated TBPE. Patients with higher VEGF or greater effusion size were prone to develop RPT (n=14; VEGF, odds ratio 1.28, P=0.01; effusion size, odds ratio 1.01, P=0.02), and VEGF was an independent predictor of RPT in TBPE (receiver operating characteristic curve AUC=0.985, P<0.001). CONCLUSIONS: Effusion VEGF correlates with pleural inflammation and fibrosis and may be targeted for adjunct therapy for TBPE.
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Bien et al. (2015) conducted a cohort in tuberculous pleural effusion (TBPE) (n=42). Effusion VEGF was evaluated on radiological residual pleural thickening (RPT) (OR 1.28, p=0.01). Higher effusion VEGF levels independently predicted the development of residual pleural thickening at 6 months in patients with tuberculous pleural effusion (OR 1.28, P=0.01).
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