title: Pathogenesis of pleural fibrosis.
abstract: Pleural fibrosis resembles fibrosis in other tissues and can be defined as an excessive deposition of matrix components that results in the destruction of normal pleural tissue architecture and compromised function. Pleural fibrosis may be the consequence of an organised haemorrhagic effusion, tuberculous effusion, empyema or asbestos-related pleurisy and can manifest itself as discrete localised lesions (pleural plaques) or diffuse pleural thickening and fibrosis. Although the pathogenesis is unknown, it is likely that the complex interactions between resident and inflammatory cells, profibrotic mediators and coagulation, and fibrinolytic pathways are integral to pleural remodelling and fibrosis. It is generally considered that the primary target cell for pleural fibrosis is the subpleural fibroblast. However, increasing evidence suggests that mesothelial cells may also play a significant role in the pathogenesis of this condition, both by initiating inflammatory responses and producing matrix components. A greater understanding of the interactions between pleural and inflammatory cells, cytokines and growth factors, and blood derived proteins is required before adequate therapies can be developed to prevent pleural fibrosis from occurring.
authors.affiliation: Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Australia. mutsaers@aari.uwa.edu.au
authors.forename: Steven E
authors.initials: SE
authors.lastname: Mutsaers
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Prele
authors.forename: Arnold R
authors.initials: AR
authors.lastname: Brody
authors.forename: Steven
authors.initials: S
authors.lastname: Idell
mesh_terms: D001195:Asbestosis / Q000150:complications / Q000503:physiopathology; D004848:Epithelium / Q000503:physiopathology; D005342:Fibrinolysis; D005355:Fibrosis; D006801:Humans; D010982:Platelet-Derived Growth Factor / Q000378:metabolism; D010994:Pleura / Q000473:pathology; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology*; D010998:Pleurisy / Q000209:etiology / Q000503:physiopathology; D013925:Thromboplastin / Q000378:metabolism; D016212:Transforming Growth Factor beta / Q000378:metabolism
chemical_list: D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta; D013925:Thromboplastin