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Talc pleurodesis: basic fibroblast growth factor mediates pleural fibrosis
Veena B Antony1, Najmunnisa Nasreen, Kamal A Mohammed
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Florida, PO Box 100225, Gainesville, FL 32610-0225, USA. antonvb@medicine.ufl.edu
Chest
|November 13, 2004
Summary
Talc pleurodesis for malignant pleural effusions stimulates pleural mesothelial cells to release basic fibroblast growth factor (bFGF). Higher bFGF levels correlate with successful pleurodesis, especially when the mesothelium is tumor-free.
Area of Science:
- Pulmonary Medicine
- Oncology
- Cell Biology
Background:
- Recurrent malignant pleural effusions often require pleurodesis.
- Talc is a common sclerosing agent, but its mechanism is unclear.
- Basic fibroblast growth factor (bFGF) is implicated in fibrosis.
Purpose of the Study:
- To investigate if talc induces pleural mesothelial cells (PMCs) to produce bFGF.
- To determine if bFGF mediates talc-induced pleural fibrosis.
Main Methods:
- Collected pleural fluid from patients with malignant effusions and controls.
- Activated PMCs in vitro with talc and measured bFGF.
- Assessed fibroblast proliferation and bFGF mRNA expression.
Main Results:
- Successful pleurodesis correlated with higher pleural fluid bFGF levels.
- Talc-activated PMCs produced significantly more bFGF.
- bFGF neutralization inhibited talc-induced fibroblast proliferation.
Conclusions:
- Talc instillation stimulates PMCs to release active bFGF.
- Higher bFGF response in patients with less tumor involvement predicts successful pleurodesis.
- Tumor-free mesothelium enhances the success of talc pleurodesis.