PURPOSE: Vascular Endothelial Growth Factor (VEGF) an angiogenic cytokine related to pleural effusion production plays along with Transforming Growth Factor Beta (TGF-β), an important role in pleural fibrosis.The aim of this study was to evaluate the effect of an anti-VEGF antibody (Bevacizumab) on pleural inflammation and fibrosis after intrapleural instillation of talc (TL).
METHODS: Two groups of twenty-five New Zealand rabbits received 2 ml of 400 mg/kg of talc intrapleurally. One group received intravenous Bevacizumab (5mg/kg) 30 minutes previously to TL injection, and the second group did not receive the anti-VEGF antibody. After 1, 2, 3, 4 or 7 days, five animals in each group were killed and macro and microscopic analyses were performed using scores from 0 to 4. Statiscal analyses: t-test.
RESULTS: The systemic injection of the anti-VEGF (Bevacizumab) reduced the gross adhesions from the 3rd day, however the microscopic pleural fibrosis decreased only after the 7th day. No changes in microscopic pleural inflammation were observed (Figure).
CONCLUSION: The intravenous administration of anti-VEGF reduces significantly the pleural adhesions in the initial phase of talc pleurodesis.
CLINICAL IMPLICATIONS: This study suggests that the administration of anti-VEGF prior to the intrapleural instillation of talc may interfere in the effectiveness of pleurodesis.
DISCLOSURE: Leila Antonangelo, No Financial Disclosure Information; No Product/Research Disclosure Information