Can pharmacologic agents speed the rate of resorption of pleural fluid?

Abstract

In conclusion, the available experimental data indicate that certain pharmacological agents may impact fluid resorption, thus affecting pleural fluid accumulation and the rate of pleural effusion resolution.

Pleural effusions induced by human herpesviruses in the immunocompetent host

“…These two channels are the main regulators of the balance of the periciliary fluid in the bronchi and the alveolar lining fluid in the alveoli and their influenzainduced functional disruption leads to pulmonary oedema. In terms of pleural fluid physiological turnover, ENaC is the main mediator of sodium transport (and osmotically water) in the pleural mesothelial cells and disruption of its function could potentially lead to fluid accumulation [63]. Outwardly rectifying chloride channels have also been identified in pleural mesothelial cells that mediate chloride exit of the cell along with water exit (osmotically driven) [64,65].…”

Benign Pleural Mesothelial Cells Have Higher Osmotic Water Permeability than Malignant Pleural Mesothelioma Cells and Differentially Respond to Hyperosmolality

“…Pleural mesothelial cells are specialized epithelial cells of mesodermal origin lining the lungs (visceral pleura) and the thoracic wall (parietal pleura) and between which the pleural cavity is formed [1]. Under physiological conditions, a small amount of pleural fluid is present in the cavity, produced by plasma ultrafiltration from the parietal pleura capillaries [2,3]. It is re-absorbed by the parietal pleura lymphatic stomata, by Starling forces across the visceral pleura and by mesothelial cell-mediated solute coupled liquid absorption and endocytosis [2,3].…”

“…pneumonia, lung cancer, malignant pleural mesothelioma (MPM), pulmonary embolism] pleural effusions occur (excess accumulation of pleural fluid in the pleural cavity) [4]. Depending on the underlying pathology, protein, glucose, lactate dehydrogenase and pH pleural fluid levels vary; as is the case for cytokines and growth factors that are produced locally either by pleural mesothelial cells or by leucocytes [2][3][4][5][6][7][8]. Thus, the pleural mesothelial cells in pathophysiological conditions can encounter various biochemical environments that may influence their functions e.g.…”

“…Due to the role of pleural mesothelial cells in pleural fluid absorption, it is important to study their plasma membrane water permeability. Several studies have shown that pleural mesothelial cells express aquaporin-1 (AQP1) that plays a role in the equilibration of the osmotic gradient between the pleural cavity and the pleural capillaries in pleural effusions [3,10,14]. Moreover, in MPM patients the high tumor expression of AQP1 has been described as a favorable prognostic factor regarding survival [15,16].…”

Editorial: Mesothelial Physiology and Pathophysiology

“…Thus, the most active area is pleural research followed by peritoneal and lastly pericardial. Pleural effusions are a common entity that involves the abnormal accumulation of pleural fluid in the pleural cavity due to abnormal turnover, and the underlying diseases stem from congestive heart failure to infectious lung diseases and several intra- and extra- thoracic malignancies (Zarogiannis and Kalomenidis, 2015 ). It is therefore easily conceived that the water and solute transport systems of the pleural membrane comprising the transcellular and paracellular mesothelial permeability can be altered in pathophysiological conditions.…”