Parapneumonic Effusions are characterized by elevated levels of Neutrophil Extracellular Traps (NETs)

Chest. 2021 Jul 19:S0012-3692(21)01357-X. doi: 10.1016/j.chest.2021.07.026. Online ahead of print.ABSTRACTBACKGROUND: Neutrophil Extracellular Traps (NETs) are increasingly implicated in acute and chronic conditions involving multiple organ systems.RESEARCH QUESTION: Are NETs concentrations higher in parapneumonic effusions compared to effusions of other etiologies and does this reflect the inflammatory nature of these effusions?STUDY DESIGN AND METHODS: Patients (N=101) presenting to hospital with undifferentiated pleural effusion for investigation had pleural fluid classified based on cytology, biochemical, microbiological characteristics, and clinical judgement. Concentrations of NETs markers (extracellular DNA, citrullinated histone H3 (citH3)), neutrophil (α-defensins) and inflammation (Interleukin-1β (IL-1β)) related proteins were quantified by ELISA. Differences between groups were analysed using Kruskal-Wallis one-way ANOVA. Correlations used Spearman's coefficient. Receiver Operating Characteristic (ROC) curves were calculated.RESULTS: Effusions were classified into four groups - parapneumonic (N=18), malignant (N=35), transudative (N=22) and unclassifiable (N=26). Concentrations of NETs markers were significantly higher in the parapneumonic group compared to malignant, transudative and unclassifiable groups (median eDNA 12.8 vs 0.77, 0.44 and 0.86 ng/mL, P<0.001 and median citH3 127.1 vs 0.44, 0.34 and 0.49 ng/mL, P<0.001). CitH3 and eDNA were highly correl...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research