Randomized Trials Describing Lung Inflammation after Pleurodesis with Talc of Varying Particle Size

Maskell, Nick A; Lee, Y. C.; Gleeson, Fergus; Hedley, Emma; Pengelly, Gerry; Davies, Robert J. O.

doi:10.1164/rccm.200311-1579oc

Cited by 222 publications

(108 citation statements)

References 19 publications

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“…Current treatment options, including needle aspiration, pleurodesis (chemical-induced pleural fibrosis), or indwelling pleural catheters, are aimed at draining or eliminating the pleural space. These treatments are nonspecific, often ineffective, associated with morbidity and mortality, and do not benefit a significant number of patients (9)(10)(11). Improved understanding of MPE formation and development of new treatments targeting this pathobiology may yield safer and more effective therapeutic options (12).…”

mentioning

confidence: 99%

Host-derived Interleukin-5 Promotes Adenocarcinoma-induced Malignant Pleural Effusion

Stathopoulos¹,

Sherrill²,

Karabela³

et al. 2010

Am J Respir Crit Care Med

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Rationale: IL-5 is a T helper 2 cytokine important in the trafficking and survival of eosinophils. Because eosinophils can be found in malignant pleural effusions (MPE) from mice and humans, we asked whether IL-5 is involved in the pathogenesis of MPE. Objectives: To determine the role of IL-5 in MPE formation. Methods: The effects of IL-5 on experimental MPE induced in C57BL/6 mice by intrapleural injection of syngeneic lung (Lewis lung cancer [LLC]) or colon (MC38) adenocarcinoma cells were determined using wild-type (il5 1/1 ) and IL-5-deficient (il5 2/2 ) mice, exogenous administration of recombinant mouse (rm) IL-5, and in vivo antibody-mediated neutralization of endogenous IL-5. The direct effects of rmIL-5 on LLC cell proliferation and gene expression in vitro were determined by substrate reduction and microarray. Measurements and Main Results: Eosinophils and IL-5 were present in human and mouse MPE, but the cytokine was not detected in mouse (LLC) or human (A549) lung and mouse colon (MC38) adenocarcinoma-conditioned medium, suggesting production by host cells in MPE. Compared with il5 1/1 mice, il5 2/2 mice showed markedly diminished MPE formation in response to both LLC and MC38 cells. Exogenous IL-5 promoted MPE formation in il5 1/1 and il5 2/2 mice, whereas anti-IL-5 antibody treatment limited experimental MPE in il5 1/1 mice. Exogenous IL-5 had no effects on LLC cell proliferation and gene expression; however, IL-5 was found to be responsible for recruitment of eosinophils and tumor-promoting myeloid suppressor cells to MPE in vivo. Conclusions: Host-derived IL-5 promotes experimental MPE and may be involved in the pathogenesis of human MPE.

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mentioning

confidence: 99%

Host-derived Interleukin-5 Promotes Adenocarcinoma-induced Malignant Pleural Effusion

Stathopoulos¹,

Sherrill²,

Karabela³

et al. 2010

Am J Respir Crit Care Med

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“…The former keeps the talc the talc slurry in pleural space while allowing air to escape in case of tension pneumothorax [9].…”

Section: Discussionmentioning

confidence: 99%

Beware of Simultaneous Bilateral Spontaneous Pneumothorax: Case Reports and Literature Review

Ho¹,

Tai²,

Cheong³

et al. 2015

UCMS

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INTRODUCTION: SBSP (Simultaneous Bilateral Spontaneous Pneumothorax) means concurrent or coincident bilateral pneumothorax. Usually, chest drains insertion is followed by pleurodesis to prevent recurrence. METHOD: There are a few cases of SBSP each year in Wong Tai Sin Hospital of Hong Kong. It consists of two groups clinically. One group is easily tackled by bilateral chest drain insertion followed by pleurodesis and the other group is difficult to achieve full lung expansion despite the application of negative suction via the chest drains. Pleurodesis cannot be achieved in the latter as the visceral and parietal pleura are not in touched. RESULTS: By considering the pressure difference between the different intrapulmonary compartments, the underlying cause can be identified. The following two cases demonstrated the basic principle-the success of chest drain relies on an enclosed pleural space. DISCUSSION AND CONCLUSION: Literature review of the SBSP will be followed by the proposed treatment.

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“…However, the use of contemporary French-graded talc allows these risks to be mitigated [62]. Pleurodesis with ungraded talc with small particles (<10 µM) has been shown to be associated with significantly greater levels of systemic inflammation and poorer gas exchange than graded talc in which these small particles are removed [63].…”

Section: Pleurodesismentioning

confidence: 99%

The management of benign non-infective pleural effusions

et al. 2016

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The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting. Pleural fluid analysis forms an important basis of the diagnostic evaluation, and more specific assays and imaging modalities are helpful in specific subpopulations.Options for management beyond treatment of the underlying disorder, whenever possible, include therapeutically aspirating the fluid, talc pleurodesis and insertion of an indwelling pleural catheter. Randomised trials will inform clinicians in the future as to the risks and benefits of these options providing a guide as to how best to manage patient symptoms in this challenging clinical setting. @ERSpublications Benign pleural effusion management is challenging and based on limited evidence. Treatment options are discussed http://ow.ly/10EOSN

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Randomized Trials Describing Lung Inflammation after Pleurodesis with Talc of Varying Particle Size

Cited by 222 publications

References 19 publications

Host-derived Interleukin-5 Promotes Adenocarcinoma-induced Malignant Pleural Effusion

Host-derived Interleukin-5 Promotes Adenocarcinoma-induced Malignant Pleural Effusion

Beware of Simultaneous Bilateral Spontaneous Pneumothorax: Case Reports and Literature Review

The management of benign non-infective pleural effusions

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