Thorax 2001;56:643-648 ( August )

Transforming growth factor ₂ induced pleurodesis is not inhibited by corticosteroids

Y C G Lee^{a b}, C J Devin^a, L R Teixeira^c, J T Rogers^a, P J Thompson^b, K B Lane^a, R W Light^a

^a Departments of Pulmonary Medicine, St Thomas Hospital and Vanderbilt University, Nashville, Tennessee, USA, ^b Department of Medicine, University of Western Australia, Perth, Australia, ^c Division of Respiratory Diseases, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

Correspondence to: Dr Y C G Lee , Department of Pulmonary Medicine, St Thomas Hospital, 4220 Harding Road, Nashville, TN 37202, USA ycgarylee{at}hotmail.com

Received 6 September 2000; Returned to authors 18 December 2000; Revised version received 24 January 2001; Accepted for publication 9 May 2001

BACKGROUNDTalc and tetracyclines induce pleurodesis by directly injuring the pleura. The injury results in intense inflammation which subsequently leads to fibrosis. Corticosteroids can inhibit talc pleurodesis by reducing the inflammatory process. We hypothesised that transforming growth factor ₂ (TGF₂), a fibrogenic cytokine with immunomodulatory functions, could induce effective pleurodesis without generating significant pleural inflammation and therefore remain effective despite co-administration of corticosteroids.
METHODSThirty rabbits were divided into two groups. Rabbits in the steroid group received weekly intramuscular injections of triamcinolone diacetate (0.8 mg/kg). Ten rabbits in each group were given 5.0 µg TGF₂ intrapleurally via a chest tube while the remaining five received 1.7 µg TGF₂. Pleurodesis was graded macroscopically after 14 days from 1 (none) to 8 (>50% symphysis).
RESULTSTGF₂ produced excellent pleurodesis at both 5.0 µg and 1.7 µg doses. The pleural effusions produced after the injection were low in all inflammatory markers. No significant differences were seen between the steroid group and controls in macroscopic pleurodesis scores (7.2 (1.3) v 7.1 (1.2)), levels of inflammatory markers in the pleural fluids (leucocyte 1107 (387)/mm³ v 1376 (581)/mm³; protein 3.1 (0.3) mg/dl v 2.9 (0.3) mg/dl, and LDH 478 (232) IU/l v 502 (123) IU/l), and the degree of microscopic pleural fibrosis and pleural inflammation.
CONCLUSIONSTGF₂ can induce effective pleurodesis and remains effective in the presence of high dose parenteral corticosteroids.


Keywords: transforming growth factor ; pleurodesis; corticosteroids; pleural effusion

---

© 2001 by Thorax
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Decologne, N., Kolb, M., Margetts, P. J., Menetrier, F., Artur, Y., Garrido, C., Gauldie, J., Camus, P., Bonniaud, P. (2007). TGF-beta1 Induces Progressive Pleural Scarring and Subpleural Fibrosis. J. Immunol. 179: 6043-6051 [Abstract] [Full Text]  
• Teixeira, L. R., Vargas, F. S., Acencio, M. M. P., Paz, P. F. S., Antonangelo, L., Vaz, M. A. C., Marchi, E. (2005). Influence of Antiinflammatory Drugs (Methylprednisolone and Diclofenac Sodium) on Experimental Pleurodesis Induced by Silver Nitrate or Talc. Chest 128: 4041-4045 [Abstract] [Full Text]  
• Dikensoy, O., Zhu, Z., Donnelly, E., Stathopoulos, G. T., Lane, K. B., Light, R. W. (2005). Combination Therapy With Intrapleural Doxycycline and Talc in Reduced Doses Is Effective in Producing Pleurodesis in Rabbits. Chest 128: 3735-3742 [Abstract] [Full Text]  
• Guo, Y. B., Kalomenidis, I., Hawthorne, M., Parman, K. S., Lane, K. B., Light, R. W. (2005). Pleurodesis Is Inhibited by Anti-Vascular Endothelial Growth Factor Antibody. Chest 128: 1790-1797 [Abstract] [Full Text]  
• Allen, S. S., Cassone, L., Lasco, T. M., McMurray, D. N. (2004). Effect of Neutralizing Transforming Growth Factor {beta}1 on the Immune Response against Mycobacterium tuberculosis in Guinea Pigs. Infect. Immun. 72: 1358-1363 [Abstract] [Full Text]  
• Lee, Y.C.G., Lane, K.B., Zoia, O., Thompson, P.J., Light, R.W., Blackwell, T.S. (2003). Transforming growth factor-{beta} induces collagen synthesis without inducing IL-8 production in mesothelial cells. Eur Respir J 22: 197-202 [Abstract] [Full Text]  
• LEE, Y. C. G., MELKERNEKER, D., THOMPSON, P. J., LIGHT, R. W., LANE, K. B. (2002). Transforming Growth Factor beta Induces Vascular Endothelial Growth Factor Elaboration from Pleural Mesothelial Cells in Vivo and in Vitro. Am. J. Respir. Crit. Care Med. 165: 88-94 [Abstract] [Full Text]