Changes in cell population and tumor necrosis factor, interleukin-6, and interleukin-8 in malignant pleural effusions after treatment with intrapleural tetracycline.
To evaluate the changes in cellular components and cytokine levels (tumor necrosis factor, interleukin-6 and IL-8) before and after intrapleural tetracycline (TC) injection, we evaluated 10 patients with malignant pleural effusion. Differential cell counts in the pleural fluid were obtained using cytocentrifuge preparations. Mononuclear cells from pleural fluid, collected before intrapleural injection of TC, on Day 4, and Days 10 to 14 after TC injection, were stimulated either with phytohemagglutinin (PHA) or PHA plus phorbol myristic acetate. The production of tumor necrosis factor (TNF) and IL-8 was measured. In addition, IL-6, IL-8, and TNF from serial collections of pleural fluid in these patients were measured by RIA or ELISA. The main inflammatory cells in pleural effusions before therapy were lymphocytes and mononuclear cells, but neutrophils predominated after TC injection. IL-6, IL-8, and TNF were markedly increased on Day 4 after TC intrapleural injection and then decreased to baseline levels on Day 14. The results suggest that TC intrapleural injection induces the release of cytokines (IL-6 and TNF), which are markers of an inflammatory response, and releases IL-8, which attracts neutrophils into the pleural space, which may be the mechanism of the sclerosing effect of TC.
Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
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D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007267:Injections; D015850:Interleukin-6 / Q000032:analysis*; D016209:Interleukin-8 / Q000032:analysis*; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000737:chemistry* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D013752:Tetracycline / Q000008:administration & dosage*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis* / Q000187:drug effects
D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D013752:Tetracycline