Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Pulmonology Reports
Published in: Current Pulmonology Reports 2/2013

01-06-2013 | Pleural Diseases and Mesothelioma (YCG Lee, Section Editor)

New agents for pleurodesis

Author: Richard W. Light

Published in: Current Pulmonology Reports | Issue 2/2013

Login to get access

Abstract

At times when patients have a malignant pleural effusion or a pneumothorax, one wishes to eliminate the pleural space by pleurodesis. This article describes results from attempting pleurodesis with silver nitrate, iodopovidone (betadine), transforming growth factor beta (TGFβ), OK432, and lipoteichoic acid-T. The two most promising agents seem to be silver nitrate and iodopovidone. Both agents induce pleurodesis that is at least comparable with that produced by talc, and neither induced the acute respiratory distress syndrome that sometimes occurs after intrapleural administration of talc.
Literature
1.
Lee YC, Baumann MH, Maskell NA, et al. Pleurodesis practice for malignant pleural effusions in five English-speaking countries: survey of pulmonologists. Chest. 2003;124:2229–38.PubMedCrossRef
2.
Light RW. Pleural diseases. 5th ed. Baltimore: Lippincott, Williams and Wilkins; 2007.
3.
Vargas FS, Wang N-S, Lee HM, et al. Effectiveness of bleomycin in comparison to tetracycline as pleural sclerosing agent in rabbits. Chest. 1993;104:1582–4.PubMedCrossRef
4.
Vargas FS, Teixeira LR, Silva LMMF, et al. Comparison of silver nitrate and tetracycline as pleural sclerosing agents in rabbits. Chest. 1995;108:1080–3.PubMedCrossRef
5.
Vargas FS, Teixeira LR, Vaz MAC, et al. Silver nitrate is superior to talc slurry in producing pleurodesis in rabbits. Chest. 2000;118:808–13.PubMedCrossRef
6.
Vargas FS, Teixeira LR, Antonangelo L, et al. Experimental pleurodesis in rabbits induced by silver nitrate or talc: 1-year follow-up. Chest. 2001;119:1516–20.PubMedCrossRef
7.
Marchi E, Vargas FS, Acencio MM, et al. Talc and silver nitrate induce systemic inflammatory effects during the acute phase of experimental pleurodesis in rabbits. Chest. 2004;125:2268–77.PubMedCrossRef
8.
Marchi E, Vargas FS, Acencio MM, et al. Low doses of silver nitrate induce pleurodesis with a limited systemic response. Respirology. 2009;14:885–9.PubMedCrossRef
9.
Tremblay A, Stather D, Kelly M. Effect of repeated administration of low-dose silver nitrate for pleurodesis in a rabbit model. Respirology. 2011;16:1070–5.PubMedCrossRef
10.
• Tremblay A, Dumitriu S, Stather DR, et al. Use of a drug eluting pleural catheter for pleurodesis. Exp Lung Res. 2012;38:475–82. This study demonstrates that silver nitrate-eluting indwelling catheters in both rabbits and lambs result in good pleurodesis over a 14-day period.PubMedCrossRef
11.
Vargas FS, Carmo AO, Teixeira LR. A new look at old agents for pleurodesis. Nitrogen mustard, sodium hydroxide and silver nitrate. Curr Opin Pulm Med. 2000;6:281–6.PubMedCrossRef
12.
Paschoalini M, da Silva AA, Vargas FS, et al. Prospective randomized trial of silver nitrate vs talc slurry in pleurodesis for symptomatic malignant pleural effusions. Chest. 2005;128:684–9.CrossRef
13.
•• Terra RM, Kim SY, Pego-Fernandes PM, et al. Is silver nitrate pleurodesis for patients with malignant pleural effusion feasible and safe when performed in an outpatient setting? Ann Surg Oncol. 2011;18:1145–50. This study demonstrates that outpatient pleurodesis with silver nitrate is safe and effective.PubMedCrossRef
14.
Marcheix B, Brouchet L, Renaud C, Lamarche Y, Mugniot A, Benouaich V, et al. Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion? Eur J Cardiothorac Surg. 2007;31:1106–9.PubMedCrossRef
15.
Guo Y, Tang K, Bilaceroglu S, et al. Iodopovidone is as effective as doxycycline in producing pleurodesis in rabbits. Respirology. 2010;15:119–25.PubMedCrossRef
16.
Olivares-Torres CA, Laniado-Laborin R, Chavez-Garcia C, et al. Iodopovidone pleurodesis for recurrent pleural effusion. Chest. 2002;122:581–3.PubMedCrossRef
17.
Agarwal R, Aggarwal AN, Gupta D. Efficacy and safety of iodopovidone pleurodesis through tube thoracostomy. Respirology. 2006;11:105–8.PubMedCrossRef
18.
Neto JD, de Oliveira SF, Vianna SP, et al. Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions. Respirology. 2010;15:115–8.PubMedCrossRef
19.
• Mohsen TA, Zeid AA, Meshref M, et al. Local iodine pleurodesis versus thoracoscopic talc insufflation in recurrent malignant pleural effusion: a prospective randomized control trial. Eur J Cardiothorac Surg. 2011;40:282–6. This randomized study demonstrated that patients who received iodopovidone for pleurodesis required fewer analgesics for severe chest pain than did patients who received talc insufflation. Recurrence was similar at a mean follow-up of 22.6 months.PubMed
20.
•• Agarwal R, Khan A, Aggarwal AN, Gupta D. Efficacy & safety of iodopovidone pleurodesis: a systematic review and meta-analysis. Indian J Med Res. 2012;135:297–304. This meta-analysis shows that iodopovidone was a very effective pleurodesing agent for 499 patients whether administered via thoracoscopy or chest tube.PubMed
21.
Wagenfeld L, Zeitz O, Richard G. Visual loss after povidone–iodine pleurodesis. N Engl J Med. 2007;357:1264–5.PubMedCrossRef
22.
Grande JP. Role of transforming growth factor-β in tissue injury and repair. Proc Soc Exp Biol Med. 1997;214:27–40.PubMed
23.
Sime PJ, Xing Z, Graham FL, et al. Adenovector-mediated gene transfer of active transforming growth factor-β1 induces prolonged severe fibrosis in rat lung. J Clin Invest. 1997;100:768–76.PubMedCrossRef
24.
25.
Idell S, Zwieb C, Kumar A, et al. Pathways of fibrin turnover of human pleural mesothelial cells in vitro. Am J Respir Cell Mol Biol. 1992;7:414–26.PubMedCrossRef
26.
Rodriguez-Panadero F, Segado A, Martin Juan J, et al. Failure of talc pleurodesis is associated with increased pleural fibrinolysis. Am J Respir Crit Care Med. 1995;151:785–90.PubMedCrossRef
27.
Light RW, Cheng D-S, Lee YC, et al. A single intrapleural injection of transforming growth factor-2 produces excellent pleurodesis in rabbits. Am J Respir Crit Care Med. 2000;162:98–104.PubMedCrossRef
28.
Lee YCG, Lane KB, Parker RE, et al. Transforming growth factor (TGF)-β2 produces effective pleurodesis in sheep with no systemic complications. Thorax. 2000;55:1058–62.PubMedCrossRef
29.
Lee YCG, Yasay JR, Johnson JE, et al. Comparing transforming growth factor-β2, talc and bleomycin as pleurodesing agents in sheep. Respirology. 2002;7:209–16.PubMedCrossRef
30.
Lee YCG, Teixeira LR, Devin CJ, et al. Transforming growth factor-beta(2) induces pleurodesis significantly faster than talc. Am J Respir Crit Care Med. 2001;163:640–4.CrossRef
31.
Lee YCG, Devin CJ, Teixeira LR, et al. Transforming growth factor β2 induced pleurodesis is not inhibited by corticosteroids. Thorax. 2001;56:643–8.PubMedCrossRef
32.
Luh KT, Yang PC, Kuo SH, et al. Comparison of OK-432 and mitomycin C pleurodesis for malignant pleural effusion caused by lung cancer. A randomized study. Cancer. 1992;69:674–9.PubMedCrossRef
33.
Muta F, Takamon S, Matsuo T, et al. Changes in the pleural cavity by pleurodesis using talc or OK-432: an experimental study. Surg Today. 2011;41:111–4.PubMedCrossRef
34.
Kataoka M, Morishita R, Hiramatsu J, et al. OK-432 induces production of neutrophil chemotactic factors in malignant pleural effusion. Intern Med. 1995;34:352–6.PubMedCrossRef
35.
Kishi K, Homma S, Sakamoto S, et al. Efficacious pleurodesis with OK-432 and doxorubicin against malignant pleural effusions. Eur Respir J. 2004;24:263–6.PubMedCrossRef
36.
Ishida A, Miyazawa T, Miyazu Y, et al. Intrapleural cisplatin and OK432 therapy for malignant pleural effusion caused by non-small cell lung cancer. Respirology. 2006;11:90–7.PubMedCrossRef
37.
Mutsubara N, Itoh K, Mudai H, Nagai S. Long-term outcome of pleurodesis with OK-432 in metastatic breast cancer: a new risk model for success from an analysis of 75 cases. Int J Clin Oncol. 2012;17:470–6.CrossRef
38.
Pai AB, Patel H, Prokopienko AJ, et al. Lipoteichoic acid from Staphylococcus aureus induces lung endothelial cell barrier dysfunction: Role of reactive oxygen and nitrogen species. PLoS One. 2012;7:e49209.PubMedCrossRef
39.
Rahman NM, Davies HE, Salzberg M, et al. Use of lipoteichoic acid-T for pleurodesis in malignant pleural effusion: a phase I toxicity and dose-escalation study. 2008; 9:946–952.
40.
Daddi N, Vannucci J, Maggio C, et al. Efficacy of tigecycline pleurodesis: a comparative experimental study. J Surg Res. 2011;169:e109–18.PubMedCrossRef
Metadata
Title
New agents for pleurodesis
Author
Richard W. Light
Publication date
01-06-2013
Publisher
Current Science Inc.
Published in
Current Pulmonology Reports / Issue 2/2013
Electronic ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-013-0043-3

Other articles of this Issue 2/2013

Current Pulmonology Reports 2/2013 Go to the issue

Pleural Diseases and Mesothelioma (YCG Lee, Section Editor)

Management options for the complicated pleural space

Pleural Diseases and Mesothelioma (YCG Lee, Section Editor)

Prognostic factors for malignant pleural mesothelioma

Pleural Diseases and Mesothelioma (YCG Lee, Section Editor)

EGFR mutations in malignant pleural effusions from lung cancer

Sleep Medicine (V Castronovo, Section Editor)

Sleep-disordered breathing in pregnancy

Hot Topic

Targeting angiogenesis in advanced non-small-cell lung cancer: are biomarkers needed?

Pleural Diseases and Mesothelioma (YCG Lee, Section Editor)

Advantages of indwelling pleural catheters for management of malignant pleural effusions
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits