Growth factors in pleural fibrosis.
OBJECTIVE
Pleural fibrosis is a double-edged sword in clinical settings. Successful induction of pleural fibrosis is the basis of therapeutic pleurodesis. On the other hand, pleural septations and fibrosis are undesirable outcomes in pleural infection and fibrothoraces. The significance of growth factors in the pathogenesis of pleural fibrosis has become increasingly apparent.


RESULTS
Recent findings have indicated that transforming growth factor beta is a key mediator of pleural fibrosis and demonstrated the therapeutic potential of both transforming growth factor beta itself and transforming growth factor beta inhibitors. Basic fibroblast growth factor has been highlighted as a key factor in successful pleurodesis, and in the formation of pleural effusions. Vascular endothelial growth factor inhibition has been shown to decrease pleural fibrosis in vivo. By contrast, hepatocyte growth factor stimulates non-fibrotic healing, while inhibition increases fibrosis.


CONCLUSIONS
The actions of the growth factors, and their inhibitors, are potentially and/or currently applicable in a clinical setting. Understanding the biology of these growth factors may allow therapeutic manipulation of these cytokines to create pleurodesis or to inhibit pleural (and peritoneal) adhesion/fibrosis.
Mutsaers
Steven E
SE
Asthma, Allergy & Respiratory Research Institute, Department of Medicine, University of Western Australia, Perth, Australia.
Kalomenidis
Ioannis
I
Wilson
Nicola A
NA
Lee
Y C Gary
YC
D016222:Fibroblast Growth Factor 2 / Q000378:metabolism*; D005355:Fibrosis; D017228:Hepatocyte Growth Factor / Q000378:metabolism*; D006801:Humans; D010995:Pleural Diseases / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D016212:Transforming Growth Factor beta / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D016212:Transforming Growth Factor beta; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2; D017228:Hepatocyte Growth Factor