fibrin and Pleurisy

Pleural fibrosis can result from a variety of inflammatory processes. The response of the pleural mesothelial cell to injury and the ability to maintain its integrity are crucial in determining whether normal healing or pleural fibrosis occurs. The pleural mesothelial cell, various cytokines, and disordered fibrin turnover are involved in the pathogenesis of pleural fibrosis. The roles of these mediators in producing pleural fibrosis are examined. This article reviews the most common clinical conditions associated with the development of pleural fibrosis. Fibrothorax and trapped lung are two unique and uncommon consequences of pleural fibrosis. The management of pleural fibrosis, including fibrothorax and trapped lung, is discussed.

Topics: Asbestosis; Coronary Artery Bypass; Epithelial Cells; Fibrin; Fibroblast Growth Factor 2; Fibrosis; Hemothorax; Platelet-Derived Growth Factor; Pleura; Pleural Diseases; Pleurisy; Tuberculosis, Pleural

Topics: Fibrin; Fibrosis; Humans; Pleura; Pleural Effusion; Pleurisy

Intrapleural loculation can increase morbidity in hemothoraces or parapneumonic effusions. Intrapleural fibrin precedes visceral-parietal pleural adhesions. We speculated that single-chain urokinase plasminogen activator alone or bound to its receptor could prevent these adhesions by their relative resistance to local inhibition by plasminogen activator inhibitors. We found that recombinant human single-chain urokinase-bound rabbit pleural mesothelial cells or lung fibroblasts with kinetics similar to that reported for human cells (kD of approximately 5 nM). The receptor-bound fibrinolysin maintained in vitro fibrinolytic activity in the presence of pleural fluids from rabbits with tetracycline-induced pleural injury over 24 hours. In rabbits given intrapleural single-chain urokinase 24 and 48 hours after intrapleural tetracycline (n = 10 animals), adhesions were prevented, whereas the receptor-complexed form (n = 12) attenuated adhesions versus vehicle/tetracycline-treated rabbits (n = 22, p

Topics: Animals; Anti-Bacterial Agents; Biomarkers; Body Fluids; Cell Count; Disease Models, Animal; Epithelium; Female; Fibrin; Fibroblasts; Pleura; Pleural Effusion; Pleurisy; Rabbits; Receptors, Cell Surface; Receptors, Urokinase Plasminogen Activator; Tetracycline; Tissue Adhesions; Urokinase-Type Plasminogen Activator

Topics: Exudates and Transudates; Fibrin; Humans; Patient Selection; Pleural Effusion; Pleurisy; Reproducibility of Results; Sensitivity and Specificity; Thoracoscopy; Time Factors

Turpentine was injected into the right pleural cavity of nude immune-incompetent mice, causing a temporary irritative exudative pleuritis. A transient occurrence of so-called rheumatoid arthritis cells was observed in the pleural fluid together with parallel characteristic biochemical changes. In similar experiments in nude mice, however, immunization followed by intrapleural application of bovine fibrin showed irritative "dry" pleuritis without the presence of rheumatoid arthritis cells. This is in contrast with previous results from similar experiments done using normal mice. The conclusion from the present experiments is that in nude immune-incompetent mice only the non-immunological, turpentine-induced pleuritis will generate cellular and biochemical changes typical of the rheumatoid disease in patients, while the fibrin-induced pleuritis fails to show similar changes. This suggests that the rheumatoid-like pleural changes described in the present experiments in nude mice have a non-immunological basis.

Topics: Animals; Blood Glucose; Blood Proteins; Fibrin; L-Lactate Dehydrogenase; Male; Mice; Mice, Nude; Pleural Effusion; Pleurisy; Proteins; Turpentine

In mice immunized with bovine fibrin, the same antigen was applied to the pleural cavity. A granulomatous pleuritis appeared affecting both the visceral and the parietal pleura, especially located around the antigen particle. Rheumatoid arthritis (RA) cells were constantly found in the pleural cavity when pleural lesions were present. This immunological, granulomatous pleuritis is the first experimental model for the study of RA cell-positive types of pleurisy in humans.

Topics: Animals; Arthritis, Rheumatoid; Disease Models, Animal; Fibrin; Granulocytes; Inclusion Bodies; Lung; Male; Mice; Mice, Inbred BALB C; Pleura; Pleural Effusion; Pleurisy

Topics: Child; Child, Preschool; Fibrin; Humans; Infant; Male; Pleural Effusion; Pleurisy; Tuberculosis, Pleural

Injection of a variety of irritants (saline, ovalbumin, compound 48/80 and powdered glass) into the rat pleural cavity induced the disappearance of pleural leucocytes during the first two hours of the reaction. This phenomenon, termed the leucocyte disappearance reaction (LDR), was suppressed by treatment with the anticoagulants heparin and warfarin. The in-vitro incubation of normal, or inflammatory pleural leucocytes resulted in the deposition of dense interconnecting meshwork of fibrin only upon addition of fibrinogen to the culture medium. It is suggested from these results that the LDR is related to the clotting system, involving leucocyte-derived enzyme(s) analogous to those of the clotting system (e.g., tissue thromboplastin), which convert fibrogen to fibrin, resulting in cell-trapping and subsequent "disappearance" of pleural leuococytes. Similarities were observed betweeen the LDR in non-immune inflammation and the macrophage disappearance reaction of cell-mediated immunity. The significance of these phenomena in the inflammatory process, both immune and non-immune, is discussed.

Topics: Animals; Anticoagulants; Cells, Cultured; Fibrin; Fibrinogen; Glass; Leukocyte Count; Leukocytes; Male; Ovalbumin; p-Methoxy-N-methylphenethylamine; Pleurisy; Rats

Fibrosing uremic pleuritis is a newly recognized late complication of uremia. Extreme incarceration of the lining and chest wall can occur with disabling restriction of pulmonary function. Decortication of the chest wall and the lung can be carried out safely with minimal bleeding and restoration of pulmonary function.

Topics: Adult; Female; Fibrin; Hemorrhage; Humans; Lung; Lung Diseases; Pleurisy; Radiography; Time Factors; Uremia; Wound Healing

Topics: Adult; Female; Fibrin; Humans; Male; Pleural Effusion; Pleurisy; Radiography

Topics: Aged; Autopsy; Calculi; Fibrin; Humans; Male; Pleura; Pleurisy; Radiography, Thoracic

Topics: Deoxyribonucleases; Enzymes; Exudates and Transudates; Fibrin; Fibrinolysin; Humans; Pleurisy; Streptococcus