PAI-1 Level Differences in Malignant Plural Effusion, Parapneumonic Pleuritis, and Cardiac Hydrothorax

• Main Authors: Dace Zentina, Inga Stukena, Alvils Krams, Aivars Lejnieks
• Format: Article
• Language: English
• Published: MDPI AG 2019-09-01
• Series: Medicina
• Subjects: pleural effusion; malignant pleural effusion; plasminogen activator inhibitor-1
• Online Access: https://www.mdpi.com/1010-660X/55/9/567

<i>Background and Objectives:</i> Plasminogen activator inhibitor-1 (PAI-1) is a fibrinolytic system enzyme whose role in various fibrinolytic processes is currently unknown. In clinical manifestations of pleural liquids of diverse etiology, various levels of fibrinolytic activity can be observed&#8212;parapneumonic processes tend to loculate in fibrin septa, while malignant pleural effusion (MPE) does not. The purpose of this study was to determine possible differences in PAI-1 levels in pleural effusions of varied etiology. <i>Material and Methods:</i> PAI-1 level in pleural effusion and serum was determined in 144 patients with pleural effusions of various etiology (cardiac hydrothorax&#8212;42 patients (29.2%), MPE&#8212;67 patients (46.5%), parapneumonic pleuritis&#8212;27 (18.8%), tuberculous pleuritis&#8212;6 patients (4.1%), pancreatogenic pleuritis&#8212;1 patient (0.7%) and pulmonary artery thromboembolism with pleuritis&#8212;1 patient (0.7%)). <i>Results:</i> The median PAI-1 level (ng/mL) was the highest in the parapneumonic pleuritis group both in the effusion and the serum, with values of 291 (213&#8722;499) ng/mL and 204 (151&#8722;412) ng/mL, respectively, resulting in a statistically significant difference (<i>p</i> &lt; 0.001) from the cardiac hydrothorax and MPE groups. However, there was no statistically significant difference between PAI-1 levels in the pleural effusion and serum in the cardiac hydrothorax and MPE groups. <i>Conclusion:</i> The PAI-1 level in MPE and cardiac hydrothorax was statistically significantly lower than in parapneumonic pleuritis.