Evidence that mesothelial cells regulate the acute inflammatory response in talc pleurodesis

¹ Pleura Laboratory - Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, Brazil

^* To whom correspondence should be addressed. E-mail: evmarchi{at}uol.com.br.

	Abstract

Intrapleural instillation of talc is used to produce pleurodesis in cases of recurrent malignant pleural effusions. The mechanisms by which pleurodesis is produced remain unknown but may involve either injury or activation of the mesothelium. The aim of this study was to assess inflammatory response of the space to talc in an experimental model in rabbits. A group of ten rabbits were injected intrapleurally with talc (200 mg·kg^-1) and undiluted pleural fluid was collected after 6, 24 or 48 h for measurement of IL-8, VEGF and TGF1. Samples of pleura were studied to assess the inflammatory infiltrate and mesothelial cell viability. Results: The pleural fluid IL-8 concentration peaked at 6 h, whereas VEGF and TGF1 concentration increased steadily over 48 h. WBC and neutrophil percent correlated with pleural IL-8 levels. Immunohistochemistry for cytokeratin showed a preserved layer of mesothelial cells despite the intense inflammatory pleural reaction. Thus, we propose that the mesothelial cell, although injured by the talc, may actively mediate the primary inflammatory pleural response in talc-induced pleurodesis.

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