EMPIRE – European Multicentre Pleural Infection Research Collaborative

About EMPIRE 

The EMPIRE (European Multicentre Pleural Infection Research Collaborative) Clinical Research Collaboration (CRC) was launched by the European Respiratory Society (ERS) in 2025.

Pleural infection, a condition characterised by infection in the pleural space surrounding the lungs, is becoming increasingly common worldwide. Despite this rise, the outcomes for patients have not improved significantly over the past two decades. This condition has been largely neglected, with its causes and the variability in its clinical presentation not well understood. Most research to date has focused on the best methods for draining the infected pleural space, but there is a critical need for large-scale studies to explore the underlying biology and progression of the disease.

In response to this need, EMPIRE aims to establish a pan-European network of centres specialising in pleural disease and respiratory infections that will create a platform for conducting a series of research projects using standardised data and sample collection methods. The ultimate goal will be to enhance the understanding of the mechanisms driving pleural infection and the differences in how it affects various patient groups. By identifying reliable predictors of disease progression and outcomes, the research aims to improve patient care and inform the development of new treatment strategies.

Specific aims

The CRC EMPIRE aims specifically to:

• Build a network of researchers and clinical experts in pleural infection to identify translational research priorities.
• Streamline and facilitate translational research initiatives across a pan-European pleural network.
• Facilitate applications to industry and European Union funding sources to build pleural infection research capacity.
• Attract new translational researchers to the field of pleural infection and pleural disease more widely.
• Support and encourage early career researchers through involvement in network activities.

Operational aspects

Several aspects of pleural infection are particularly suited for translational collaboration. The following areas are initially proposed as primary workstreams:

• I Proteomics: This workstream will compare proteomic profiles in different pleural infection states to identify key parameters influencing clinical outcomes, with initial findings indicating significant variations in neutrophil, fibrinolytic indices, and nutrition profiles.
• II Predictive biomarkers: This workstream aims to validate and explore the predictive ability of pleural fluid PAI-1 and SUPAR, ultimately developing outcome prediction biomarkers to personalize treatment approaches.
• III Multicompartment Immunobiology: This workstream will investigate immunobiology and cellular responses in serum and pleural fluid. It will focus on neutrophil and immune cell trafficking, interactions with the fibrinolytic cascade, and the role of hypoxia-inducible factor (HIF)-1 and pleural macrophages in inflammation and neutrophil recruitment.
• IV Microbiology: This workstream aims to improve diagnostics and develop targeted antimicrobial therapies, addressing crucial antimicrobial stewardship.
• V Radiology and AI: This workstream will use machine learning for risk stratification and AI imaging models, developed by Hungary’s Academic Radiology department and validated by Sheffield and Oxford, to enhance assessment and diagnosis.
  

Stakeholders

The CRC EMPIRE is composed of the CRC Chairs, experts in clinical research, early career members, and patient representatives.

Contact

If you are interested in more information about the EMPIRE CRC or would like to join the network, please contact scientific@ersnet.org.