Source: Annual Congress 2012 - Prognostic indices in respiratory infections
Disease area: Respiratory infections

Abstract

LL-37 is an antimicrobial peptide produced by neutrophils, respiratory epithelial and mesothelial cells that has been studied for its broad spectrum activity against microorganisms. It also recruits inflammatory cells and promotes immune responses. It has never been measured in pleural fluid.
Aims And Objectives
The objective of our study is to measure the pleural and serum levels of LL-37 in pleural effusion patients, and to compare these levels and the pleural-to-serum LL-37 ratio among pleural fluids of three frequent etiologies: infectious, malignant and congestive heart failure(CHF).
Methods
We obtained 42 pleural effusions and divided them into 3 diagnostic categories. LL-37 was measured in the pleural fluid and serum of 23 infectious effusions, 10 malignant effusions and 9 CHF effusions by ELISA. Statistical analyses were performed using software SPSS 17.0.
Results
Results are presented: mean +/- Std. Deviation(median, minimun-maximun).
Pleural Fluid LL-37 levels: Infectious 3.77±4.81 ng/ml (1.64, 0.38-19.4) malignant 2.58±4.17 (0.87, 0.09-135), CHF 1.59±1.02 (0.99, 0.47-3.3) (p= 0.4).
Serum LL-37 levels: Infectious 2.09±3.42 ng/ml(0.98, 0.06-16.35) malignant 3.44±4.3(1.19, 0.17-12.6), CHF 3.44±3.02(2.6, 0.71-10.3)(p=0.13)
Pleural fluid-to-Serum LL-37 ratio levels: Infectious 1.33±1.88(1.29, 100-0.43) malignant 0.60±0.92(0.72, 1.11-0.21), CHF 0.46±0.93(0.44, 1.12-0.24)(p< 0.001. Infectious vs malignant p=0.002, infectious vs CHF p<0.001, malignant vs CHF not significant).
Conclusions
Pleural fluid-to-Serum LL-37 ratios are significantly elevated in infectious pleural effusions in comparison with malignant or CHF pleural effusions, suggesting that LL-37 is actively produced intrapleurally in infectious effusions.

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C.A. Amado, J. Villuela, M. García-Unzueta, J.J. Ruiz-Cubillan, A. Daly, B. Abascal, D. Ferrer, F. Santos, D. Iturbe, R. Agüero (Santander, Spain). LL-37 is produced intrapleurally in infectious pleural effusion. Eur Respir J 2012; 40: Suppl. 56, 2520

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