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Intrapleural low-dose silver nitrate elicits more pleural inflammation and less systemic inflammation than low-dose talc.

Author(s): Marchi E, Vargas FS, Teixeira LR, Acencio MM, Antonangelo L, Light RW

Affiliation(s): Pleura Laboratory, Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Brazil, Rua Lucia B. Passarin, 590, Ap.42, Jundiai, Sao Paulo, Brazil. evmarchi@uol.com.br

Publication date & source: 2005-09, Chest., 128(3):1798-804.

Publication type: Comparative Study ; Evaluation Studies; Research Support, Non-U.S. Gov't

STUDY OBJECTIVES: Several systemic effects have been described after talc pleurodesis. The aim of this study was to assess the systemic response induced by low, nonpleurodesis-inducing doses of talc and silver nitrate in an experimental model in rabbits. DESIGN: Groups of six rabbits were injected intrapleurally with talc, 100 mg/kg or 400 mg/kg, and silver nitrate, 0.1% or 0.5%. After 6, 24, or 48 h, samples of blood and pleural fluid were collected and assayed for leukocytes, percentage of neutrophils, lactate dehydrogenase, interleukin-8, and vascular endothelial growth factor (VEGF) levels. Preinjection blood samples were used as normal blood controls. MEASUREMENTS AND RESULTS: Silver nitrate 0.1% induced a more intense pleural inflammation than that produced by talc 100 mg/kg. In contrast, talc 100 mg/kg induced a more pronounced acute systemic response with higher values of WBCs and neutrophils, whereas silver nitrate 0.1% produced no significant increases in leukocytes or neutrophils. The serum interleukin-8 and VEGF levels increased in all groups, and decreased with time only in the silver nitrate 0.1% group. The highest serum VEGF levels were observed in the talc 100 mg/kg group. CONCLUSIONS: In conclusion, 0.1% silver nitrate produced an intense pleural inflammatory response with a less evident systemic response in comparison to 0.5% silver nitrate and talc 100 mg/kg or 400 mg/kg.

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