Abstract
Purpose: Experimental study aimed at evaluating whether pleural neoplastic disease is associated with the degree of pleural fibrosis over time caused by talc pleurodesis. The study describes changes in levels of inflammatory mediators and determines whether the course of time involved in progression of neoplastic pleural disease is the factor that influences safety of talc pleurodesis usage in mice.Materials and Methods: Animals were randomized into two groups: Cancer group (CG) that received intrapleural injection of Lewis cells or Saline group (SG) that received saline injection. After, the animals were subdivided into Early (pleurodesis 3 days after pleural injection) and Late (pleurodesis 7 days after pleural injection) groups. Half of the animals in each group were euthanized 24 hours after pleurodesis (to obtain the inflammatory data); the remaining animals were killed after 8 days (to obtain the scores of pleural fibrosis).Results: CGs had lower fibrosis scores than SGs comparing early phases to late phases. Inflammation scores were lower in CGs, particularly in Late group. In SGs the inflammation was intense in 100% of the animals.In Late CG group pleural adhesions had the lowest scores; we found intense fibrosis only in SGs. VEGF and LDH levels had increased in animals with cancer, particularly in Late group. Systemic distribution of talc occurred only in Late CG.Conclusions: The time for pleural neoplasia to evolve is inversely proportional to the degree of pleural fibrosis. Earlier pleurodesis yielded the best results related to fibrosis, with less systemic inflammation and is safer in mice.
Highlights
IntroductionNeoplastic pleural effusion is frequent and associated with quality commitment and life expectancy of patients due to the spread of the disease [1]
Neoplastic pleural effusion is frequent and associated with quality commitment and life expectancy of patients due to the spread of the disease [1].Pleurodesis arises in this context with the purpose of preventing the accumulation of fluid in the thorax, minimizing dyspnea and improving quality of life
The time for pleural neoplasia to evolve is inversely proportional to the degree of pleural fibrosis
Summary
Neoplastic pleural effusion is frequent and associated with quality commitment and life expectancy of patients due to the spread of the disease [1]. Pleurodesis arises in this context with the purpose of preventing the accumulation of fluid in the thorax, minimizing dyspnea and improving quality of life. Several factors may interfere with pleurodesis results, the presence of mesothelial cells exposed to the talc is fundamental for better effectiveness in promoting pleural symphysis. The degree of neoplastic pleural involvement would not be solely responsible for the success or failure of pleurodesis when using talc. We do not know what other biological mechanisms may be involved in the failure of pleurodesis, www.oncotarget.com those related to the activation of the intrapleural inflammatory cascade, reflected by variations in TGF-β, IL-6 and VEGF levels
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