PT  - JOURNAL ARTICLE
AU  - N. Najmunnisa
AU  - K. A. Mohammed
AU  - S. Brown
AU  - Y. Su
AU  - P. S. Sriram
AU  - B. Moudgil
AU  - R. Loddenkemper
AU  - V. B. Antony
TI  - Talc mediates angiostasis in malignant pleural effusions <em>via</em> endostatin induction
AID  - 10.1183/09031936.00061606
DP  - 2007 Apr 01
TA  - European Respiratory Journal
PG  - 761--769
VI  - 29
IP  - 4
4099  - http://erj.ersjournals.com/content/29/4/761.short
4100  - http://erj.ersjournals.com/content/29/4/761.full
SO  - Eur Respir J2007 Apr 01; 29
AB  - Talc remains the most effective sclerosing agent for pleurodesis. However, its mechanism of action in resolving pleural malignant disease remains unclear. The present study evaluated the angiogenic balance in the pleural space in patients with malignant pleural effusions (MPE) following talc insufflation. Patient pleural fluid samples were collected both before and after talc insufflation. The ability of pleural mesothelial cells (PMC) and malignant mesothelioma cells (MMC) to produce endostatin in vitro was compared. The biological effects of pleural fluids and conditioned media from talc-activated PMC on endothelial cells were evaluated by performing proliferation, invasion, tube formation and apoptosis assays. Pleural fluids from patients with MPE who received thoracoscopic talc insufflation contained significantly higher levels of endostatin (median 16.75 ng·mL−1) compared with pre-talc instillation (1.06 ng·mL−1). Talc-activated PMC released significantly greater amounts of endostatin (mean±sem 1052.39±38.66 pg·mL−1) when compared with a MMC line (134.73±8.72 pg·mL−1). In conlusion, talc alters the angiogenic balance in the pleural space from a biologically active and angiogenic environment to an angiostatic milieu. Functional improvement following talc poudrage in patients with malignant pleural effusions may, in part, reflect these alterations in the pleural space.