S12 PAI-1 is the predominant biological factor associated with septation formation in pleural infection

• DOI: 10.1136/thorax-2021-btsabstracts.18
• Publication Date: 2021-11-08T12:55:31Z
• Authors: EO Bedawi; N Kanellakis; Y Zhao; A Sundaralingam; D Addala; M Ellayeh; R Hallifax; JP Corcoran; AM Condliffe; NM Rahman
• Keywords: Pathogenesis; Plasminogen activator inhibitor-1

<h3>Introduction</h3> Plasminogen Activator Inhibitor-1 (PAI-1) plays an essential role in the pathogenesis of lung and pleural injury. PAI-1 levels infection have been shown to be significantly elevated compared malignant effusions heart failure. A significant variation was seen protein activity fluid from participants with recruited MIST-2 study. Rabbit models injury demonstrated that, along other pro-inflammatory cytokines, is important contributor impaired fibrin clearance subsequent loculation. To date, this has not studied context prospectively collected samples patients confirmed documented baseline ultrasound septation status. <h3>Methods</h3> Pleural (n=214) Infection Longitudinal OuTcomes study (PILOT) were analysed. Protein measurement assays performed using a commercial Luminex assay for Serpin E1/PAI-1 (Luminex high performance assay, R&amp;D) as analyte interest addition TNF-alpha, MCP-1/CCL-2, IFN-gamma, urokinase plasminogen activator (uPA) D-dimer. The independent T-test used compare mean values each between two groups (septated vs non-septated). multinomial regression model assess predictive ability status outcome. <h3>Results</h3> Complete data available 166 cases, these final analysis. There difference septated group (n=122; mean=1790.59 ng/mL, SD=2027.28) non-septated (n=44; mean=948.82ng/mL, SD=911.41); t(166)=2.65, p=0.009 (Normal ref 2–46 ng/mL). In model, only predictor (ß=0.000, p=0.003). <h3>Conclusion</h3> These confirm that whilst several biological factors may contribute fibrinolysis formation infection, appears most important. imply likely useful target further studies involving intrapleural fibrinolytic therapy infection. Further work assessing effect on clinical outcomes dataset ongoing.