O-111 * MOBILIZATION OF GROWTH FACTORS AFTER PLEURODESIS

Abstract

Objectives: The purpose of our study was to analyze and compare growth factors (GF) mobilization in the process of chemical and mechanical pleurodesis. GF are secreted by inflammatory cells and are also released from binding sites within the pleural basal membrane. Transforming growth factor (TGF) beta1, vascular endothelial growth factor (VEGF), and fibroblast growth factors (FGF)1 and 2 are the central mediators in the fibrosis process. However, VEGF's vasodilatory effect can also trigger ARDS. Method(s): A prospective randomized study included 26 female patients with breast carcinoma and malignant pleural effusion. Twelve patients were treated by means of mechanical and 14 patients by chemical pleurodesis. Samples of pleural fluid and blood serum were analyzed for growth factors content by ELISA. The results from the two groups were compared using Mann-Whitney test. Result(s): Maximal serum VEGF level after chemical pleurodesis was 11 930 pg/ml and 2687 pg/ml after mechanical pleurodesis. Pleural levels of FGF1, 2 and TGFbeta1 were higher after performing mechanical pleurodesis compared to those after chemical pleurodesis, nevertheless the difference did not reach statistical significance. Conclusion(s): In some patients chemical pleurodesis led to an enormous increase of VEGF serum level, such significant changes were not observed after mechanical pleurodesis. Mechanical pleurodesis may launch a more favourable ratio of released GF. TGFbeta1 and, in our experience, also FGF2 remain the most interesting parameter for future research. Considering the mechanisms of growth factors action we conclude that the mechanical pleurodesis is a more efficient and safer method than chemical pleurodesis.