PURPOSE: Vascular Endothelial Growth Factor (VEGF) is a cytokine known to increase vascular permeability and related to pleural effusion production. It plays along with Transforming Growth Factor Beta (TGF-β), an important role in pleural fibrosis. Bevacizumab (BZ), a recombinant antibody that prevents VEGF receptor binding and inhibits angiogenesis could interfere in the pleurodesis efficacy. The aim of this study was to evaluate the effect of Bevacizumab on pleural pleurodesis induced by talc (TL) or silver nitrate (SN).
METHODS: Sixty New Zealand rabbits divided in 4 groups received 2 ml of 400 mg/kg of talc or 0.5% SN intrapleurally. Half of animals received intravenous Bevacizumab (5mg/kg) 30 minutes previously to TL or SN intrapleural injection. Pleural fluid was collected at 24, 48, 72, 96 hours and cytokines VEGF, IL-8 and TGF were measured. Animals were killed after 7, 14 and 28 days and pleural adhesion were evaluated by scores from 0 to 4. Statiscal analyses: t-test.
RESULTS: The systemic injection of BZ tended to diminish the pleural adhesion in the TL group; however its action was strongly noted in the SN group with significant reduction of the pleural adhesions (p<0.05) during all studied time. In the acute phase of pleurodesis, BZ diminished the VEGF and IL-8 levels in the pleural effusion after TL and SN (p<0.05). Interestingly to note that this antibody did not affect the TGF levels in both sclerosing agents.
CONCLUSION: The systemic injection of anti-VEGF interfered in the IL-8 and VEGF production and in the pleural adhesions formation no matter of pleural sclerosing agent used.
CLINICAL IMPLICATIONS: This study suggests that the systemic administration of anti-VEGF prior to the intrapleural injection of talc or silver nitrate may interfere in the pleurodesis satisfactory efficacy.
DISCLOSURE: Lisete Teixeira, No Financial Disclosure Information; No Product/Research Disclosure Information