Matrix metalloproteinases production in malignant pleural effusions after talc pleurodesis

Abstract

In this study we have evaluated the modifications of matrix metalloproteinases (MMPs) in malignant pleural fluids taken from patients suffering from lung cancer and treated with intrapleural talc instillation to induce pleurodesis. Furthermore, we have analysed the variations of some inflammatory mediators (C-reactive protein, alpha-1 antitrypsin) and of a protein (plasminogen) involved in MMP activation. In all patients the clinical improvement after talc pleurodesis was followed by a reduction in MMP-1, TIMP-1, C-reactive protein, alpha-1 antitrypsin and plasminogen activity. Furthermore, MMP-9 levels were variable; in fact, in some patients they were high at the beginning of treatment, in others they increased a few days after pleurodesis induction. These inhibitory effects of talc on MMP-1 and inflammatory mediators associated with the reduction of pleural effusion could constitute an effective means to evaluate the evolution of the treatment.

Fig. 1

Levels of pro-MMP-1 in pleural effusions. pro-MMP-1 concentration was evaluated using ELISA at different times after talc pleurodesis. Each column indicates the different time of pleural fluid harvesting following the treatment. The white column shows the value of pro-MMP-1 before intrapleural talc instillation, the black column the last withdrawal and shaded and hatched columns intermediate points. Data are expressed as means of three determinations in three different aliquots of each sample; the mean variations were less than 10% per patient. Time scale: every 3 days.

Fig. 2

Levels of CRP in pleural effusions. CRP concentrations were determined by nephelometric analysis at different times after talc pleurodesis. Each column indicates the different time of pleural fluid harvesting following the treatment. The white column shows the value of CRP before intrapleural talc instillation, the black column the last withdrawal and shaded and hatched columns intermediate points. Data are expressed as means of three determinations in three different aliquots of each sample; the mean variations were less than 10% per patient. Time scale: every 3 days.