Pleurodesis In Rabbits Research Articles

The influence of tramadol and parecoxib on erythmyocin or bleomycin-induced pleurodesis in rabbit: A pilot study

Introduction: Recurrent pleural effusion secondary to advanced malignant diseases can lead to poor quality of life, recurrent hospital stays and increased hospital costs, which has yet to be extensively explored. Aim: To compare the effectiveness of erythromycin and bleomycin in producing pleurodesis in rabbits and to determine the influence of different analgesic drugs namely tramadol sodium and parecoxib sodium intramuscular on experimental pleurodesis induced by erythromycin or bleomycin intrapleural on the aforementioned rabbits. Material and methods: This was an experimental animal pilot study involving 28 white New Zealand rabbits which were divided into 4 groups of 7 specimens. They received different agents as follow: group A (erythromycin and parecoxib sodium), B (erythromycin and tramadol sodium), C (bleomycin and parecoxib sodium), and D (bleomycin and tramadol sodium) at the right hemithorax. The control was marked at the contralateral left hemithorax. After 30 days the rabbits were euthanized to allow for evaluation of macroscopic and microscopic pleural and parenchymal adhesions by a blinded respective pathologist. Results and discussion: The degree of pleurodesis induced by the intrapleural injection of erythromycin indicated that it was superior to bleomycin as a sclerosing agent in the rabbit sample (P = 0.003). The concomitant use of analgesics revealed that tramadol sodium reduces the degree of pleurodesis to a greater extent than parecoxib sodium (P = 0.009). Conclusions: The use of intrapleural erythromycin as a potent agent of chemical pleurodesis that is insensitive to the concomitant analgesic effect of parecoxib sodium has important clinical implications in relation to the effectiveness of chemical pleurodesis as a procedure.

Abrasion Plus Local Fibrin Sealant Instillation Produces Pleurodesis Similar to Pleurectomy in Rabbits

Pleurodesis performed either by pleurectomy or pleural abrasion is recommended in the approach to primary spontaneous pneumothorax to avoid recurrence. However, the efficacy of parietal pleural abrasion in producing pleurodesis is questioned. This study aims to determine the efficacy of apical abrasion alone, abrasion plus fibrin sealant application, and pleurectomy in producing pleurodesis in rabbits. Rabbits were subjected to video-assisted thoracic surgery alone (control) or to video-assisted thoracic surgery with apical gauze abrasion, abrasion plus fibrin sealant instillation, or apical pleurectomy. Blood samples were collected preoperatively and 48h and 28days postoperatively to measure total leukocytes (white blood cell count), neutrophil counts, and serum interleukin (IL)-8 levels. After 28days the animals were sacrificed for macroscopic evaluation of the degree of apical pleurodesis and microscopic evaluation of local pleural fibrosis and collagen deposition. White blood cell and neutrophil counts were similar in all groups, whereas the serum IL-8 level peaked at 48h in all groups and decreased after 28days, except in the pleurectomy group. After 28days the abrasion plus fibrin sealant and pleurectomy groups had significantly more pleural adhesions, pleural fibrosis, and collagen deposition than the abrasion alone group, mainly due to thick mature fibers. Abrasion with local fibrin sealant instillation is as effective as pleurectomy in producing pleurodesis in rabbits. Apical pleurectomy elicits a more persistent elevation of serum IL-8 levels than apical abrasion alone or abrasion plus fibrin adhesive instillation.

Is silver nitrate an effective means of pleurodesis?

A best evidence topic was written according to a structured protocol. The question addressed was whether silver nitrate (SN) is an effective means of pleurodesis. A total of 42 papers were identified using the reported search, of which 8 represented the best evidence to address the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Three studies assessed the efficacy of SN in inducing pleurodesis in patients with malignant pleural effusion (MPE). Using intrapleural injections of SN in concentrations of 0.5-1%, they reported success rates of 89-96% at 30 days. One of these studies compared SN with talc slurry and found equally effective pleurodesis at monthly intervals up to 4 months (P = 0.349-1). Another two studies retrospectively reviewed the efficacy of thoracosopic SN instillation (1 or 10%) in patients with primary spontaneous pneumothorax (PSP). Recurrence rates were 0-1.1% during long-term follow-up. One of these compared SN with simple drainage and reported a therapeutic gain of 45 ± 30% (95% CI) with SN, at the cost of increased analgesia consumption, chest drainage and hospital stay. Finally, three studies reported the results of the comparison of intrapleural injections of SN, talc or tetracycline in inducing pleurodesis in rabbits. SN was equally effective with tetracycline and superior to talc at producing pleurodesis, with lower concentrations of SN (0.1%) resulting in significantly attenuated systemic inflammatory response when compared with either higher SN concentrations (0.5%) or talc. Although not commonly used, available evidence suggests that SN is an effective agent in inducing pleurodesis in patients with either MPE or PSP. Compared with universally employed talc, it seems to result in at least similar short-term recurrence rates for MPE, with a demonstrably good side-effect profile; the longer-term efficacy is, as yet, undetermined. In cases of PSP, evidence suggests that thoracoscopic SN instillation is at least as effective as talc, with potentially fewer systemic side effects.

Aspiration and Sclerotherapy: a Nonsurgical Treatment Option for Hydroceles

We demonstrated that hydrocele aspiration and sclerotherapy with doxycycline is an effective and safe nonsurgical treatment option for hydrocele correction. The medical records of patients who underwent hydrocele aspiration and sclerotherapy were analyzed in a retrospective cohort study for success rates as well as improvement in scrotal size and discomfort after a single hydrocele aspiration and sclerotherapy treatment. Patients who reported decreased scrotal size, improved physical symptoms and satisfaction with the procedure were considered as having success with hydrocele aspiration and sclerotherapy. A total of 29 patients (mean age 52.8 years) presenting with 32 nonseptated hydroceles underwent hydrocele aspiration and sclerotherapy with doxycycline between 2005 and 2012. Of the hydroceles 27 (84%) were successfully treated with a single aspiration and sclerotherapy procedure. Overall mean followup was 20.8 months. Three patients reported moderate pain which resolved in 2 to 3 days. Of those patients in whom hydrocele aspiration and sclerotherapy failed, 1 had hydrocele successfully resolved with a second aspiration and sclerotherapy treatment, 3 did not have success with a second procedure and underwent hydrocelectomy, and 1 wanted immediate surgical correction. Hydrocele aspiration and sclerotherapy was successful in correcting 84% of simple nonseptated hydroceles with a single treatment. This result is an increase from previously reported success rates involving a single hydrocele aspiration and sclerotherapy procedure with tetracycline (75%). The success rate of a single hydrocele aspiration and sclerotherapy procedure is similar to the reported success rates involving hydrocelectomy while avoiding the hospital expense and many other complications. We conclude that the hydrocele aspiration and sclerotherapy procedure is a reasonable, nonsurgical and underused treatment option for nonseptated simple hydroceles.

A comparison of the efficacies of heterologous blood, rifamycin, and talc as pleural sclerosants in rabbits: An experimental study

Background: In this study, we aimed to investigate the efficacy of rifamycin pleurodesis in rabbits. Methods: A total of 21 male New Zealand-type albino rabbits with an average weight of 3433 grams, were used in the study. One rabbit was used for blood supply. The other 20 rabbits were divided into four groups, including the control group, the heterologous blood group, the rifamycin group, and the talc group. Distilled water, heterologous fresh blood, rifamycin, and sterile liquid talc were administered through the catheter to the left hemithorax of rabbits. The rabbits were sacrificed using high-dose anesthesia on day 28. The pleural spaces were grossly assessed for evidence of pleurodesis and microscopic thickness of the pleura, and evidence of inflammation and fibrosis were examined. The degree of pleurodesis was rated on a scale of 0 to 4. Results: No statistically significant differences were observed between the control and heterologous blood groups at the macroscopic and microscopic level (p>0.05). The degree of pleurodesis in the talc and rifamycin groups was higher than in the control and heterologous blood group (p=0.04). No significant difference was observed between the talc and rifamycin groups in terms of macroscopic and microscopic examination (p>0.05). The median values of fibrosis thickness of the control, heterologous blood, rifamycin, and talc groups were 10 (10-29), 26 (10-71), 312 (264-351) and 304 (238-331) μm, respectively. Conclusion: The efficacy of rifamycin pleurodesis in rabbits was microscopically and macroscopically similar to the talc group and superior to the control and heterologous blood group.

Efficacy of Tigecycline Pleurodesis: A Comparative Experimental Study

We investigated whether tigecycline (TIGE) is more effective than talc in inducing pleurodesis in rabbits. Fifty-six New Zealand rabbits were utilized in a two-phase study: Effects at 14 d (phase I) and at 28 d (phase II) were assessed. Saline solution (SAL n = 3), talc slurry (TALC 200 mg/kg, n = 5), and TIGE at different concentrations (mg/kg): TIGE0.5 (n= 5); TIGE1 (n = 5); TIGE3 (n = 5); TIGE25 (n = 5); TIGE50 (n = 5) were randomly injected, for each phase, through a right chest drainage. TIGE0.5 and TIGE1 were ineffective during phase I and were thus excluded from further investigation. At post mortem examination, pleurodesis was graded grossly and microscopically by three observers blinded to treatment groups. Phase I: pleurodesis was more effective in TIGE25 and TIGE50 (P < 0.001); TALC was better than TIGE0.5 (P < 0.001), and TIGE1 (P = 0.49), macroscopically. Pleural thickness was significantly higher in TIGE25 compared with SAL, TALC, TIGE0.5, TIGE1, and TIGE3 (P < 0.01). No significant differences were evident between TALC and TIGE3, both macroscopically (P = 0.90) and microscopically (inflammation P = 0.99, fibrosis P = 0.96, pleural thickness P = 0.99). Phase II: better effectiveness of TIGE50 compared with all other groups (P < 0.001) except TIGE 25 (P = 0.29); results similar to phase I for TALC and TIGE3 (P = 0.99), macroscopically. Microscopically greater inflammation in TALC compared with TIGE3 (P < 0.05) and in TIGE50 to TIGE3 (P = 0.05). Significant complications occurred in all TIGE50 group. One of TIGE25 and one of TIGE50 died of respiratory distress and of right hemothorax+ascites, respectively. Intrapleural TIGE3 mg/kg is as effective as talc in inducing pleurodesis in rabbits. The intrapleural TIGE toxicity threshold was reached at TIGE25 mg/kg concentration.

Iodopovidone is as effective as doxycycline in producing pleurodesis in rabbits

The mechanism by which iodopovidone achieves pleurodesis is unknown. This study investigated whether iodopovidone is as effective as doxycycline in producing pleurodesis and whether systemic corticosteroids diminish its efficacy. Four groups of seven New Zealand rabbits were assigned to the following intrapleural treatment groups: 2 mL of 2% iodopovidone, 2 mL of 4% iodopovidone, 2 mL of 4% iodopovidone plus 0.8 mg/kg triamcinolone intramuscularly weekly and 10 mL/kg doxycycline in 2 mL. Pleural fluid was collected 24, 48 and 72 h after intrapleural injections and analysed for WCC, protein and LDH levels. The rabbits were killed 2 weeks after the injections. Pleurodesis was graded macroscopically on a scale from 1 to 8. The degree of microscopic pleural fibrosis and pleural inflammation was graded from the HE stain slides. The mean volume of pleural fluid as well as the mean total WCC was significantly lower in the steroid-treated group than in the other groups. The degree of the resulting pleurodesis was similar in the 2% iodopovidone (7.00 +/- 1.29), 4% iodopovidone (7.71 +/- 0.76) and doxycycline (7.14 +/- 0.90) groups (P > 0.05) whereas the pleurodesis score of the steroid group (3.71 +/- 1.98) was significantly lower than all other groups (P < 0.05). The degree of microscopic pleural fibrosis and pleural inflammation was significantly lower in the steroid group than in the 2% iodopovidone or 4% iodopovidone group. Both 2% and 4% iodopovidone can induce pleurodesis as efficaciously as doxycycline in rabbits. Systemic corticosteroids significantly decrease the efficacy of iodopovidone in producing pleurodesis.

SINGLE-CHAIN UROKINASE IN EMPYEMA INDUCED BY PASTURELLA MULTOCIDA

Intrapleural fibrin deposition and subsequent fibrosis characterize evolving empyema and contribute to the morbidity associated with this condition. Single-chain urokinase (scuPA) is proenzyme form of the urokinase plasminogen activator, which has recently been shown to effectively clear intrapleural loculation in tetracycline-induced pleurodesis in rabbits. The authors therefore hypothesized that scuPA could likewise improve intrapleural injury associated with empyema. The authors used a rabbit model of empyema induced by intrapleural administration of Pasturella multocida to test this hypothesis and determined the effects of intrapleural scuPA on pleural fluids indices of inflammation and intrapleural fibrosis. The authors found that intrapleural administration of scuPA was well tolerated, generated readily detectable fibrinolytic activity in the empyema fluids and did not induce intrapleural or systemic bleeding. Pleural fluid volume, intrapleural protein, and D-dimer concentrations were increased at 24 and 48 hours (P < .01, respectively) after induction of empyema. Intrapleural loculation did not occur in the scuPA- or vehicle control–treated animals and there was no significant change in the pleural empyema or thickening scores. These findings confirm that intrapleural scuPA generates fibrinolysis in empyema fluids but does not alter fibrotic repair at the pleural surface or the intensity of intrapleural inflammation in this empyema model.

Low doses of silver nitrate induce pleurodesis with a limited systemic response

Both talc and 0.5% silver nitrate have been shown to induce effective pleurodesis. However, acute adverse systemic inflammatory effects have been described with both agents. The aim of this study was to assess in rabbits the systemic effects associated with a new technique of pleurodesis using repeated low doses of 0.1% silver nitrate. Rabbits were injected intrapleurally through a chest tube with 0.1% silver nitrate at 0, 24 and 48 h. Other groups received a single injection of 0.5% silver nitrate or 400 mg/kg of talc. Blood samples were collected at 24, 48 and 72 h, and at 7 days, and cytological and biochemical measurements were performed. After 28 days, the presence of macroscopic pleural adhesions and microscopic pleural fibrosis in the pleural cavity were evaluated. Both talc and 0.5% silver nitrate caused significant increases in blood neutrophils, serum LDH, IL-8, transforming growth factor-beta and CRP in comparison with control at almost all time points, whereas sequential doses of 0.1% silver nitrate only increased LDH and CRP in the first 24 h and transforming growth factor-beta at all time points. All groups showed efficient pleurodesis, with no differences in pleural adhesions or fibrosis. Sequential doses of 0.1% silver nitrate produced efficient pleurodesis in rabbits, with a low systemic inflammatory response in comparison with 400 mg/kg of talc or 0.5% silver nitrate.

INTRAPLEURAL TIGECYCLIN INDUCES PLEURODESIS IN RABBITS

PURPOSE: We investigated whether tigecycline (TG) is more effective than talc, commonly used in human clinical practice, to induce pleurodesis in rabbits.

Patterns, Effects, and Thoracic Volume Changes of Thoracoscopic Pleurodesis in Rabbits

The ideal thoracoscopic pleurodesis method for preventing recurrence of spontaneous pneumothorax remains controversial. This study was conducted to compare the patterns, effects, and thoracic volume changes achieved using a variety of thoracoscopic procedures in rabbits. Thirty-six New Zealand White rabbits were randomly assigned to undergo the following thoracoscopic procedures in the left hemithorax: (a) parietal pleural abrasion; (b) minocycline instillation; (c) combination of abrasion and minocycline; or (d) examination alone. The rabbits were euthanatized 30 days after the operation to determine pleurodesis score, area of greatest adhesion, thoracic volume change, and histopathological findings. Grossly, pleural abrasion produced moderate localized apical pleural symphysis with no obvious thoracic volume change. Minocycline instillation induced moderate generalized pleurodesis with a significant decrease in thoracic volume. The combination of abrasion and minocycline instillation produced the greatest generalized pleurodesis as well as a significant decrease in thoracic volume. On microscopic examination, the combination procedure produced the greatest inflammation and fibrosis of the visceral and parietal pleura. Increased intensity of pleurodesis score as well as pleural inflammation and fibrosis is associated with decreased thoracic volume. Thoracoscopic pleurodesis achieved using pleural abrasion and minocycline instillation induced different patterns of pleurodesis, and a combination of each method generated a synergy and produced a better pleurodesis. However, as the generalization and intensity of the pleurodesis were inversely associated with thoracic volume, the optimal method should be determined on an individual basis according to the clinical situation.

Pleurodesis: A novel experimental model

The experimental model of pleurodesis in rabbits has been useful in understanding the pathophysiology of the pleural inflammatory injury induced by several sclerosing agents. However, restrictions on the use of rabbits in laboratory investigation are making this model less accessible. The aim of this study was to present a new experimental model of pleurodesis in mice using talc or silver nitrate. Four groups of 10 C57BL/6 mice received talc 2 or 4 mg/g in 0.5 mL saline, or 0.025% or 0.05% silver nitrate in 0.5 mL H(2)O. After 28 days the animals were sacrificed, and the pleural cavity was opened and evaluated for evidence of macroscopic pleural adhesions and haemothorax (scores 0-4), atelectasis (scores 0-2), and microscopic pleural and alveolar inflammation and fibrosis (scores 0-4). Statistical analysis used ANOVA. Silver nitrate 0.05% produced a more effective pleurodesis in mice than did 0.025% silver nitrate or talc 4 mg/g, with significant higher scores for pleural adhesions, microscopic pleural inflammation and fibrosis. Haemothorax, atelectasis, and microscopic alveolar inflammation and fibrosis were negligible in both groups. Both talc 4 mg/g and 0.05% silver nitrate produced an efficient pleurodesis in this experimental model in mice. This new model may overcome the restrictions on the use of large- and medium-sized animals in laboratory investigation and may open new fields of investigation with knockout mice.

Combination Therapy With Intrapleural Doxycycline and Talc in Reduced Doses Is Effective in Producing Pleurodesis in Rabbits

It has been suggested that talc and doxycycline might be acting through different pathways in creating pleurodesis. We hypothesized that combining doxycycline and talc in half the usual doses would be synergistic in inducing pleurodesis. Thirty-two rabbits were equally allocated into four groups: group 1, half-dose combination (5 mg/kg of doxycycline and 200 mg/kg of talc slurry); group 2, quarter-dose combination (2.5 mg/kg of doxycycline and 100 mg/kg of talc slurry); group 3, half-dose doxycycline (5 mg/kg of doxycycline); and group 4, half-dose talc (100 mg/kg of talc slurry). The pleurodesis scores from historical groups that received a full dose of talc (400 mg/kg) or doxycycline (10 mg/kg) were also compared to those obtained in the current study. Pleural fluid lactate dehydrogenase and protein levels were measured 24 h after the injection. Pleurodesis was graded from 1 (none) to 8 (> 50% symphysis) by two observers blinded to treatment groups. All rabbits underwent an ultrasonic examination on each side of their chest for the evaluation of pleurodesis. The mean pleurodesis score in the half-dose combination group was significantly higher than that in the half-dose talc group, half-dose doxycycline group, and the historical full-dose talc group (p = 0.009, p = 0.01, and p < 0.05, respectively). The quarter-dose combination group also had a significantly higher mean pleurodesis score compared to the half-dose talc group (p = 0.013). The difference between the historical full-dose doxycycline and the half-dose combination or quarter-dose combination groups was not significant (p > 0.05). A significantly positive correlation existed between the pleurodesis score and the ultrasound scores (r = 0.876, p = 0.000000005). This study demonstrates that the combination of half doses of talc and doxycycline is more effective than the half dose of either drug alone or the full dose of talc in producing pleurodesis in rabbits. In addition, ultrasound is an accurate imaging modality for the evaluation of pleurodesis, in that the absence of pleural gliding on ultrasound correlates well with the presence of a pleurodesis in rabbits.

Oral Forms of Tetracycline and Doxycycline Are Effective in Producing Pleurodesis

We investigated whether oral tetracyclines could produce an efficient and safe pleurodesis as does parenteral doxycycline, which is currently unavailable in many countries. Parenteral doxycycline (10 mg/kg), oral tetracycline (35 mg/kg), or doxycycline (10 mg/kg) was injected intrapleurally through a right chest tube in rabbits. The oral forms were dissolved in saline solution and passed through a sterile membrane filter. When daily aspirated pleural fluid was < 5 mL/24 h, the chest tube was removed. Fluid WBC, lactate dehydrogenase (LDH), and protein levels were measured 24 h after the injection. After the death of the animals on day 14, pleurodesis was graded from 1 (none) to 8 (> 50% symphysis) by two observers blinded to treatment groups. The right pleurodesis score of the combined oral groups (median, 7.0; interquartile range [IQR], 4.0; n = 26) did not differ significantly (p = 0.349) from that of the parenteral group (median, 7.5; IQR, 6.0; n = 10). Oral tetracycline (capsule or tablet, n = 6 in each group) and doxycycline (capsule or tablet, n = 7 in each group) were as effective as parenteral doxycycline in producing pleurodesis: tetracycline capsule (median, 7.50; IQR, 6.00); tetracycline tablet (median, 6.50; IQR, 6.00); doxycycline capsule (median, 4.00; IQR, 1.00); doxycycline tablet (median, 8.00; IQR, 5.00), and parenteral doxycycline (median, 7.50; IQR, 6.00) [p = 0.235]. The left pleurodesis scores were 1.00 in all 36 rabbits. Fluid total volume, WBC, LDH, and protein levels were comparable between each oral and parenteral group, excluding WBCs in the tetracycline tablet group (p = 0.047). The complications were nonfatal (right hemothorax: tetracycline capsule [n = 3]/tetracycline tablet [n = 2], doxycycline tablet [n = 2], parenteral doxycycline [n = 2]; left hemothorax: tetracycline capsule [n = 1]; ascites: parenteral doxycycline [n = 1]). There was no growth on all filtrate cultures. Oral forms cost less than parenteral doxycycline (<1 US dollar vs 4.72 US dollars per rabbit). Filtering costs were 1.12 US dollars per rabbit. Oral tetracycline or doxycycline is as effective and safe as parenteral doxycycline in producing pleurodesis in rabbits; thus, they may also be used in humans.

Pleurodesis Is Inhibited by Anti-Vascular Endothelial Growth Factor Antibody

The intrapleural injection of transforming growth factor (TGF)-beta2 produces pleurodesis in rabbits associated with large pleural effusions. This study investigated whether anti-vascular endothelial growth factor (VEGF) antibody has any effect on the fluid production or the pleurodesis induced by TGF-beta2. Three groups of seven New Zealand white rabbits were administered TGF-beta2 5.0 microg intrapleurally. Two groups received anti-VEGF antibody (10 mg/kg and 25 mg/kg) IV 24 h before TGF-beta2 injection, and the third group received no antibody. The rabbits were killed at 2 weeks, and the macroscopic pleurodesis score was determined. The degree of pleural angiogenesis was assessed by immunohistochemical staining for factor VIII. The administration of anti-VEGF antibodies had no significant effect on the pleural fluid volume or the characteristics of the fluid. The mean pleurodesis score of the seven rabbits in the control group (7.71 +/- 0.76) was significantly (p < 0.05) higher than that for seven rabbits in the low-dose treatment group (4.43 +/- 2.37) and the seven rabbits in the high-dose treatment group (4.57 +/- 2.36) [+/- ]. The percentage of pleural tissue demonstrating angiogenesis in the control group (4.87 +/- 0.43%) was significantly (p < 0.05) higher than that for the low-dose (2.94 +/- 0.68%) or high-dose (2.67 +/- 0.64%) antibody groups. When all rabbits were considered, there was a highly significant correlation between the pleural vascular density scores and the pleurodesis scores (r = 0.84, p < 0.01). VEGF and angiogenesis appear to play a pivotal role in the production of a pleurodesis.

Efficacy of Ultrasound in the Diagnosis of Pleurodesis in Rabbits

Efficacy of Ultrasound in the Diagnosis of Pleurodesis in Rabbits

Effect of Diclofenac on Experimental Pleurodesis Induced by Tetracycline in Rabbits

Background and ObjectivePleurodesis is a frequently preferred procedure in thoracic surgery, and many factors may affect the process. We aimed to determine whether the administration of systemic diclofenac sodium diminishes...

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The aim of this study was to examined whether transforming growth factor (TGF)-beta(3) induces pleurodesis in rabbits and collagen production by human pleural mesothelial cells in vitro. A combined animal and in vitro study. TGF-beta(3) was injected intrapleurally in rabbits at the following doses: 0.167 mug, 0.5 mug, 1.67 mug, and 5 mug (five rabbits per group). The rabbits were killed 14 days following injection, and pleurodesis was graded from 1 (none) to 8 (complete symphysis). Pleural mesothelial cell cultures were established from benign pleural effusions and treated with TGF-beta(3) for 48 h at the following doses: 0 (control), 5 ng/mL, 1.5 ng/mL, 5 ng/mL, and 15 ng/mL and 50 ng/mL (two independent experiments). Collagen I messenger RNA (mRNA) expression was quantified using real-time polymerase chain reaction. The median pleurodesis score was 5 (interquartile range [IQR], 4.5) in the 0.167-mug group, 6 (IQR, 5) in the 0.5-mug group, 8 (IQR, 1) in the 1.67-mug group, and 8 (IQR, 0.5) in the 5-mug group (p = 0.012). Higher TGF-beta(3) doses induced the production of significantly more pleural fluid than the lower doses (p = 0.005). The pleural fluid induced by higher doses contained significantly lower numbers of nucleated cells (p = 0.014) and lactate dehydrogenase levels (p = 0.013) than the pleural fluid induced by lower doses of the agent. TGF-beta(3) markedly enhanced collagen I mRNA expression by the human pleural mesothelial cells. This effect peaked at 5 ng/mL TGF-beta(3). With this dose of TGF-beta(3), the collagen I mRNA expression was increased 16-fold over control levels. TGF-beta(3) causes a dose-dependent pleurodesis when administered intrapleurally in rabbits, and induces collagen messenger RNA synthesis from human pleural mesothelial cells.

Transforming Growth Factor-β3 Induces Pleurodesis in Rabbits and Collagen Production of Human Mesothelial Cells

Study objective The aim of this study was to examined whether transforming growth factor (TGF)-β 3 induces pleurodesis in rabbits and collagen production by human pleural mesothelial cells in vitro Design A combined animal and in vitro study Methods TGF-β 3 was injected intrapleurally in rabbits at the following doses: 0.167 μg, 0.5 μg, 1.67 μg, and 5 μg (five rabbits per group). The rabbits were killed 14 days following injection, and pleurodesis was graded from 1 (none) to 8 (complete symphysis). Pleural mesothelial cell cultures were established from benign pleural effusions and treated with TGF-β 3 for 48 h at the following doses: 0 (control), 5 ng/mL, 1.5 ng/mL, 5 ng/mL, and 15 ng/mL and 50 ng/mL (two independent experiments). Collagen I messenger RNA (mRNA) expression was quantified using real-time polymerase chain reaction Results The median pleurodesis score was 5 (interquartile range [IQR], 4.5) in the 0.167-μg group, 6 (IQR, 5) in the 0.5-μg group, 8 (IQR, 1) in the 1.67-μg group, and 8 (IQR, 0.5) in the 5-μg group (p = 0.012). Higher TGF-β 3 doses induced the production of significantly more pleural fluid than the lower doses (p = 0.005). The pleural fluid induced by higher doses contained significantly lower numbers of nucleated cells (p = 0.014) and lactate dehydrogenase levels (p = 0.013) than the pleural fluid induced by lower doses of the agent. TGF-β 3 markedly enhanced collagen I mRNA expression by the human pleural mesothelial cells. This effect peaked at 5 ng/mL TGF-β 3 . With this dose of TGF-β 3 , the collagen I mRNA expression was increased 16-fold over control levels Conclusion TGF-β 3 causes a dose-dependent pleurodesis when administered intrapleurally in rabbits, and induces collagen messenger RNA synthesis from human pleural mesothelial cells

Efficacy of Ultrasound in the Diagnosis of Pleurodesis in Rabbits

PURPOSE: The treatment of recurrent pleural effusion or recurrent pneumothorax frequently involves the creation of a pleurodesis. Advances in the technology have greatly improved the imaging capabilities of ultrasound (US). Ultrasound is an efficient imaging modality for the evaluation of a wide variety of chest diseases. The purposes of this study are: (1)To investigate whether US can be used for the diagnosis of pleurodesis. (2)To confirm which US image is the most important feature to diagnosis pleurodesis.