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Do Different Doses of Talc Influence the Acute Systemic Inflammatory Response in Experimental Pleurodesis? FREE TO VIEW

Evaldo Marchi, MD,FCCP; F. S. Vargas, MD, FCCP; M. M. Acencio, PhD; L Antonangelo, MD; L. R. Teixeira, MD; R. W. Light, MD, FCCP
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FMUSP, Sao Paulo, Brazil


Chest. 2003;124(4_MeetingAbstracts):80S. doi:10.1378/chest.124.4_MeetingAbstracts.80S-b
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PURPOSE:  Talc used for pleurodesis may elicit systemic effects due to the migration of small talc particles into the systemic circulation or the absorption of inflammatory mediators from the pleural space. The aim of this study was to compare the acute systemic inflammatory response produced by talc in doses considered effective (400 mg/kg) and ineffective (100 mg/kg) in producing pleurodesis in rabbits.

METHODS:  Groups of six rabbits were injected intrapleurally with talc 100 or 400 mg/kg and after 6, 24 and 48 hours samples of blood were assayed for leukocytes (WBC), neutrophil percent (%N), lactic dehydrogenase (LDH) and the inflammatory cytokines interleukin-8 (IL-8) and vascular endothelial growth factor (VEGF). Pre-injection blood samples were used as controls. Statistics: ANOVA.RESULTS: 6 hours24 hours48 hoursControlTL100TL400TL100TL400TL100TL400WBC5.1 ± 1.6*7.6 ± 2.19.7 ± 3.64.7 ± 1.36.8 ± 3.17.8 ± 2.99.0 ± 3.4%N53 ± 7*74 ± 977 ± 661 ± 544 ± 1#54 ± 630 ± 9#LDH217 ± 84499 ± 170677 ± 569336 ± 160359 ± 228227 ± 135206 ± 100IL-890 ± 31*890 ± 390620 ± 3801461 ± 610880 ± 5401410 ± 8701600 ± 440VEGF< 15*65 ± 3543 ± 1066 ± 4295 ± 92121 ± 56164 ± 142

WBC: *p< 0.05 TL400 6 and 48 hours vs control.

%N: *p< 0.001 TL100 and TL400 6h vs control; #p< 0.05 TL100 24 and 48 hours vs TL400.


IL-8 and VEGF: *p< 0.05 TL100 and TL400 at all times vs control.

CONCLUSIONS: Intrapleural talc elicited an acute systemic inflammatory response of a comparable degree with doses considered either ineffective or effective in producing pleurodesis. The WBC tended to increase more in the TL400 groups while the %N tended to increase more in the TL100 group. In both treatment groups, there were significant increases in the %N, LDH, IL-8 and VEGF at most time points.

CLINICAL IMPLICATIONS:  Side-effects reported with talc pleurodesis may be related to a systemic inflammatory response that is not dependent on the dose of talc instilled into the pleural cavity.SUPPORTED BY: FAPESP, CNPq.

DISCLOSURE:  E. Marchi, None.

Monday, October 27, 2003

8:00 AM - 9:30 AM




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