Perspective investigations of empyema pathogenesis
https://doi.org/10.18093/0869-0189-2016-26-3-345-351
Abstract
Pleural empyema is one of the most serious septic diseases. Despite favorable outcome, therapeutic and prognostic strategies in empyema are needed to be improved. Further investigation of pathology and diagnostic histological criteria of acute and chronic purulent pleural inflammation and fibrosis is a perspective research direction, as morphological characteristics are important for prognosis and the optimal treatment choice. However, complete histological examination of the lung tissue and the visceral pleura is difficult in real clinical practice, because any lung damage can cause bronchial fistula. Nevertheless, histological features of the visceral pleura and the lungs are closely related to macroscopic characteristics of the pleura. Detailed study of this relationship and the search of morphological similarity of lesions in parietal pleura, visceral pleura, and the lung in patients with empyema could improve the diagnostic value of thoracoscopy, contribute to a rapid histological diagnosis and improve therapeutic approach to empyema. Current approach to the basic mechanisms and risk factors of remodeling of the extracellular matrix in pleural fibrosis was reviewed in the article. Analysis of this process could determine new mechanisms of extracellular matrix remodeling and ways to avoid fibrosis development in the adjacent lung tissue that, in turn, could underlie staging the empyema.
About the Authors
P. V. Kosareva
E.A.Vagner Perm State Medical University, Healthcare Ministry of Russia; 26, Petropavlovskaya str., Perm, 614990, Russia
Russian Federation
Russian Federation
MD, Principal Researcher at Division of Morphological and Pathophysiological Investigations, Central Research Laboratory; Head of Course of Clinical Laboratory Diagnostics; Associate Professor at Department of Microbiology, Virusology and Clinical Laboratory Diagnostics, E.A.Vagner Perm State Medical University, Healthcare Ministry of Russia; tel.: (342) 2171031
A. V. Khorinko
Perm State Territorial Oncology Institution; 15, Baumana str., Perm, 614066, Russia
Russian Federation
Russian Federation
Head of the 1st Chemotherapeutic Department, Perm State Territorial Oncology Institution; tel.: (342) 2201657
D. G. Amarantov
E.A.Vagner Perm State Medical University, Healthcare Ministry of Russia; 26, Petropavlovskaya str., Perm, 614990, Russia
Russian Federation
Russian Federation
MD, Associate Professor at Department of General, Topographic and Clinical Anatomy, and Operative Surgery, E.A.Vagner Perm State Medical University, Healthcare Ministry of Russia; tel.: (342) 2171031;
References
1. Макаров В.В. Современные аспекты санации плевральной полости у больных с острой эмпиемой плевры. Буковинский медицинский вестник. 2008; 12 (3): 39–41. /Makarov V.V. Current aspects of pleural draining in acute empyema. Bukovinskiy meditsinskiy vestnik 2008; 12 (3): 39–41 (in Russian).
2. Дударев А.А., Сухоруков А.М., Большаков В.Н. и др. Оценка гемостазиологических сдвигов у больных с острой неспецифической эмпиемой плевры. В кн.: Материалы III Съезда хирургов Сибири и Дальнего Востока. Томск; 2009: 86–87. / Dudarev A.A., Sukhorukov A.M., Bol'shakov V.N. et al. Haemostatic change in patients with acute non"specific empyema. In: Proceedings of the 3rd Congress of Surgeons of Syberia and the Far East. Tomsk; 2009: 86–87 (in Russian).
3. Никольский В.И., Логинов С.Н., Баженов М.С., Семисаженов О.А. Динамическая торакоскопия с применением торакопорта в лечении больных с неспецифической эмпиемой плевры. Известия высших учебных заведений. Поволжский регион. 2010; 4 (16): 99–107. / Nikol'skiy V.I., Loginov S.N., Bazhenov M.S., Semisazhenov O.A. Dynamic thoracoscopy in patients with acute non-specific empyema using thoracoport. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. 2010; 4 (16): 99–107 (in Russian).
4. Lee S.F., Lawrence D., Booth H. et al. Thoracic empyema: current opinions in medical and surgical management. Curr. Opin. Pulm. Med. 2010; 16 (3): 194–200.
5. Черкасов В.А., Хусейн Х.С. Лечение больных эмпиемой плевры. Пермский медицинский журнал. 2009; 26 (2): 15–19. / Cherkasov V.A., Khuseyn Kh.S. Treatment of patients with empyema. Permskiy meditsinskiy zhurnal 2009; 26 (2): 15–19 (in Russian).
6. Проценко А.В. Выбор способа торакопластики при бронхиальном свище и эмпиеме плевры после пульмонэктомии. Анналы хирургии. 2009; 2: 40–42. / Protsenko A.V. A choice of thoracoplastics method in post"pneumonectomy bronchial fistula and empyema. Annaly khirurgii 2009; 2: 40–42 (in Russian).
7. Dudarev А.А., Sukhorukov А.М., Bolshakov V.N. et al. Use of thoracoscopy in local treatment of nonspecific pleural empyema. Bull. Intern. Sci. Surg. Ass. 2010; 5 (1): 11–12.
8. Cheah Y.L., Ng T., Shah K. et al. Video"assisted Thoracoscopic Surgery (VATS) drainage of salmonella enteritidis empyema and needle"localization for retrieval of a dropped gallstone. Surg. Laparosc. Endosc. Percutan. Tech. 2010; 20 (4): 265–268.
9. Лукомский Г.И. Неспецифические эмпиемы плевры. М.: Медицина; 1976. / Lukomskiy G.I. Non"specific empyema. Moscow: Meditsina; 1976 (in Russian).
10. Capelozzi V.L., da Rosa D.C., da Silva A.S.F. The value of cytology and pleural biopsy in the differential diagnostic of nonspecific pleural effusions. J. Pneumol. 2003; 29 (4): 225–234. On"line version: http://dx.doi.org/10.1590/S010235862003000400012.
11. Olgac G., Fazlioglu M., Kutlu C.A. VATS decortication in patients with stage 3 empyema. Thorac. Cardiovasc. Surg. 2005; 53 (5): 318–320.
12. Vyhnánek F., Fanta J., Jirava D., Ocadlík M. Contemporary approach to treatment of the posttraumatic empyema of the thorax. Rozhl. Chir. 2006; 85 (1): 4–8.
13. Koh D."M., Burke S., Davies N., Padley S.P.G. Transthoracic US of the chest: clinical uses and applications. RadioGraphics. 2002; 22 (1): e1. DOI: http://dx.doi.org/ 10.1148/radiographics.22.1.g02jae1e1.
14. Andrews N.C., Parker E.F., Shaw R.R. et al. Management of nontuberculous empyema. Am. Rev. Respir. Dis. 1962; 85: 935–936.
15. Вагнер Е.А., Перепелицын В.Н., Субботин В.М. и др. Эндоскопическая окклюзия культи главного бронха при ее несостоятельности. Грудная и сердечно#сосудистая хирургия. 1990; 2: 46–49. / Vagner E.A., Perepelitsyn V.N., Subbotin V.M.et al. Endoscopic occlusion of the main bronchus cuff in a case of its failure. Grudnaya i serdechno-sosudistaya khirurgiya 1990; 2: 46–49 (in Russian).
16. Light R.W. Parapneumonic effusions and empyema. Proc. Am. Thorac. Soc. 2006; 3 (1): 75–80.
17. Порханов В.А., Коровин А.Я. Новые возможности лечения постпневмонэктомической острой эмпиемы плевры со свищами главных бронхов: В кн.: Материалы III Конгресса ассоциации хирургов им. Н.И.Пирогова. М.; 2001: 122–124. / Porkhanov V.A., Korovin A.Ya. Novel approaches to treatment of acute post"pneumonectomy empyema and bronchial fistula of the main bronchus. In: Proceedings of the 3rd Congress of N.I.Pirogov Association of Surgeons. Moscow; 2001: 122–124 (in Russian).
18. Decologne N., Kolb M., Margetts P.J. et al. TGF"β1 induces progressive pleural scarring and subpleural fibrosis. J. Immunol. 2007; 179 (9): 6043– 6051.
19. Owens S., Jeffers A., Boren J. et al. Mesomesenchymal transition of pleural mesothelial cells is PI3K and NF"κB dependent. Am. J. Physiol. Lung Cell. Mol. Physiol. 2015; 308 (12): 1265–1273.
20. Heldin C."H., Miyazono K., Dijke P. TGF"b signalling from cell membrane to nucleus through SMAD proteins. Nature. 1997; 390: 465–471.
21. Chena L."J., Yeb H., Zhanga Q. et al. Bleomycin induced epithelial"mesenchymal transition (EMT) in pleural mesothelial cells. Toxicol. Appl. Pharmacol. 2015; 283 (2): 75–82.
22. Mutsaers S.E., Birnie K., Lansley S. et al. Mesothelial cells in tissue repair and fibrosis. Front. Pharmacol. 2015; 6: 113.
23. Lee Y.C., Malkerneker D., Devin C.J. et al. Comparing transforming growth factor β"2 and fibronectin as pleurodesing agents. Respirology. 2001; 6: 281–286.
24. Lee Y.C., Lane K.B., Zoia O. et al. Transforming growth factor"b induces collagen synthesis without inducing IL"8 production in mesothelial cells. Eur. J. Respir. 2003; 22: 197–202.
25. Kunz C.R., Jadus M.R., Kukes G.D. et al. Intrapleural injection of transforming growth factor"[beta] antibody inhibits pleural fibrosis in empyema. Laboratory and animal investigations. Chest. 2004; 126 (5): 1636–1644. http://business.highbeam.com/137522/article#1G1#125648645/intrapleu ral#injection#transforming#growth#factorbeta
26. Qing"qing Z., Geng"Yun S. Transforming growth factor"β and pleural fibrosis. Intern. J. Respir. 2009; 29 (10): 609–612.
27. Leask A. Signaling in fibrosis: targeting the TGF beta, endothelin"1 and CCN2 axis in scleroderma. Front. Biosci. 2009; 1: 115–122.
28. Итмезех А. Механизмы формирования пневмосклероза при хроническом эндотоксикозе (экспериментальное исследование): Дисс. … канд. мед. наук. Волгоград; 2006. / Itmezekh A. Mechanisms of the lung tissue fibrosis in chronic endotoxicosis: Diss. Volgograd; 2006 (in Russian).
29. Xaubet A., Marin"Arguedas A., Lario S. et al. Transforming growth factor"beta1 gene polymorphisms are associated with disease progression in idiopathic pulmonary fibrosis. Am. J. Respir. Crit. Care Med. 2003; 168: 431–435.
30. Lawson W.E., Crossno P.F., Polosukhin V.V. et al. Endoplasmic reticulum stress in alveolar epithelial cells is prominent in IPF: association with altered surfactant protein processing and herpesvirus infection. Am. J. Physiol. Lung Cell. Mol. Physiol. 2008; 294: 1119–1126.
31. Datta A., Scotton C.J., Chambers R.C. Novel therapeutic approaches for pulmonary fibrosis Pulmonary fibrosis. Br. J. Pharmacol. 2011; 163: 141– 172.
32. Moore B.B., Murray L., Das A. et al. The role of CCL12 in the recruitment of fibrocytes and lung fibrosis. Am. J. Respir. Cell. Mol. Biol. 2006; 35: 175–181.
33. Mehrad B., Burdick M.D., Strieter R.M. Fibrocyte CXCR4 regulation as a therapeutic target in pulmonary fibrosis. Int. J. Biochem. Cell. Biol. 2009; 41: 1708–1718.
34. Batra H., Antony V.B. Pleural mesothelial cells in pleural and lung diseases. J. Thorac. Dis. 2015; 7 (6): 961–963. http://www.jthoracdis.com/article/view/4274/html
35. Scotton C.J., Chambers R.C. Molecular targets in pulmonary fibrosis: the myofibroblast in focus. Chest. 2007;132: 1311–1321.
36. Moodley Y.P., Scaffidi A.K., Misso N.L. et al. Fibroblasts isolated from normal lungs and those with idiopathic pulmonary fibrosis differ in interleukin"6/gp130"mediated cell signaling and proliferation. Am. J. Pathol. 2003; 163: 345–354.
37. Moodley Y.P., Caterina P., Scaffidi A.K. et al. Comparison of the morphological and biochemical changes in normal human lung fibroblasts and fibroblasts derived from lungs of patients with idiopathic pulmonary fibrosis during FasLinduced apoptosis. J. Pathol. 2004; 202: 486–495.
38. Kogan E., Тuong V., Demoura S. Mechanism of bronchoalveolar duct junction (BADJ) remodeling in idiopathic pulmonary fibrosis (IPF) as base for new pathogenetic therapy. Eur. Respir. J. 2008; 32 (Suppl. 52): 3489.
39. Tuong V., Demoura S., Kogan E. Markers of cell proliferation, apoptosis and angiogenesis in remodeling of bronchoalveolar duct junctions. Polish Histochemichal et Cytological Society. Folia Histochemica et Cytobiologica.
40. ; 46 (2): 68.
41. Scotton C.J., Krupiczojc M.A., Konigshoff M. et al. Increased local expression of coagulation factor X contributes to the fibrotic response in human and murine lung injury. J. Clin. Invest. 2009; 119: 2550–2563.
42. Scotton C.J., Chambers R.C. Pulmonary fibrosis. Br. J. Pharmacol. 2011; 163: 141–172.
43. Sun Z."M., Li F."Y., Wang L. et al. Expression of fibroblast specific protein"1 in pleural tuberculosis and its clinical biological significance. World J. Surg. Oncol. 2014; 12: 151.
44. Miles S.E., Sandrini A., Johnson A.R., Yates D.H. Clinical consequences of asbestos"related diffuse pleural thickening: A review. J. Occup. Med. Toxicol. 2008; 3: 1–10.
45. Huang S.X.L., Jaurand M."C., Kamp D.W. et al. Role of Mutagenicity in asbestos fiber"induced carcinogenicity and other diseases. J. Toxicol. Environment. Health. Part B. Crit. Rev. 2011; 14 (1–4): 179–245.
46. Broaddus V.C., Everitt J.I., Black B., Kane A.B. Non"neoplastic and neoplastic pleural endpoints following fiber exposure. J. Toxicol. Environ. Health. Part B. Crit. Rev. 2011; 14 (1–4): 153–178.
47. Sasse S.A., Jadus M.R., Kukes G.D. Pleural fluid transforming growth factor"β1 correlates with pleural fibrosis in experimental empyema. Am. J. Respir. Crit. Care Med. 2003; 168: 700–705.
48. Papaioannou A.I., Kostikas K., Kollia P., Gourgoulianis K.I. Clinical implications for vascular endothelial growth factor in the lung: friend or foe? Respir. Res. 2006; 7: 128.
49. Compernolle V., Brusselmans K., Acker T. et al. Loss of HIF"2alpha and inhibition of VEGF impair fetal lung maturation, whereas treatment with VEGF prevents fatal respiratory distress in premature mice. Nat. Med. 2002; 8 (7): 702–710.
50. Kazi A.S., Lotfi S., Goncharova E.A. et al. Vascular endothelial growth factor"induced secretion of fibronectin is ERK dependent. Am. J. Physiol. Lung Cell. Mol. Physiol. 2004; 286 (3): 539–545.
51. Mura M., dos Santos C.C., Stewart D., Liu M. Vascular endothelial growth factor and related molecules in acute lung injury. J. Appl. Physiol. 2004; 97 (5): 1605–1617.
52. Grove C.S., Lee Y.C. Vascular endothelial growth factor: the key mediator in pleural effusion formation. Curr. Opin. Pulm. Med. 2002; 8 (4): 294–301.
53. Mohammed K.A., Nasreen N., Hardwick J. et al. Bacterial induction of pleural mesothelial monolayer barrier dysfunction. Am. J. Physiol. Lung Cell. Mol. Physiol. 2001; 281 (1): 119–125.
54. Humadi H.Y.A. Matrix Metalloproteinases and TIMPs Expression in Pleural Effusion of Different Origins. Thesis submitted for fulfillment of Master Degree in Pulmonology. Faculty of Medicine Cairo University; 2012.
55. Oikonomidi S., Kostikas K., Kalomenidis I. et al. Matrix metalloproteinase levels in the differentiation of parapneumonic pleural effusions. Respiration. 2010; 80: 285–291.
56. El Margoushya N.M., Khaleel A.T. Metalloproteinase and tissue inhibitor of metalloproteinase in tuberculosis and malignant pleural effusion. Egypt. J. Chest Dis. Tub. 2013; 62 (2): 235–240.
57. Yamashita C.M., Dolgonos L., Zemans R.L. et al. Matrix metalloproteinase 3 is a mediator of pulmonary fibrosis. Am. J. Pathol. 2011; 179( 4): 1733–1745.
58. Kim J.Y., Choeng H.C., Ahn C. Cho S."H. Early and late changes of MMP"2 and MMP"9 in bleomycin"induced pulmonary fibrosis. Yonsei Med. J. 2009; 50 (1): 68–77.
59. Sheen P., O’Kane C.M., Chaudhary K. et al. High MMP"9 activity characterises pleural tuberculosis correlating with granuloma formation. Eur. Respir. J. 2009; 33 (1): 134–141.
Review
For citations:
Kosareva P.V., Khorinko A.V., Amarantov D.G. Perspective investigations of empyema pathogenesis. PULMONOLOGIYA. 2016;26(3):345-351. (In Russ.) https://doi.org/10.18093/0869-0189-2016-26-3-345-351
Views:
1483
Email this article 