Oncotarget recently published “Evaluation of cellular alterations and inflammatory profile of mesothelial cells and/or neoplastic cells exposed to talc used for pleurodesis” which reported that in this study, PMC cultures, human lung and breast adenocarcinoma cells were divided in 5 groups: 100% PMC, 100% NC, 25% PMC 75% NC, 50% of each type and 75% PMC 25% NC. High IL-6, IL-1β and TNFRI levels were found in PMC and NC exposed to talc. In pure cultures TNFRI was higher in A549 followed by PMC and MCF7. LDH was higher in A549 than PMC. Apoptotic cells exposed to talc were higher in pure cultures of NC than in PMC. Mixed cultures of PMC and A549 showed lower levels of apoptosis in cultures with more NC.
Dr. Milena Marques Pagliarelli Acencio from the University of de São Paulo said, “Metastatic neoplasms are the most common type of pleural neoplastic disease and the principal primary sites are lung, breast, stomach and ovary.“
The Oncotarget authors described that in an experimental model of pleurodesis acute inflammatory reaction to talc was observed with an increase in pleural fluid concentrations of IL-8, VEGF and TGF-β detected after intrapleural injection of talc and noted that the mesothelial cell layer was preserved.
Thus, mesothelial cells appear to participate in the response to talc and contribute to the acute inflammatory response.
Some authors discuss the importance of cell death caused mainly by apoptosis in mesothelial cells and/or neoplastic cells leading to the success or failure of pleurodesis, or even acting to decrease the tumor.
They explain that in preliminary experimental studies it has also been suggested that talc can induce apoptosis in tumor cells and inhibit angiogenesis, thus contributing to a better control of malignant pleural effusion.
The ultimate hypothesis of the Oncotarget study is to determine the role of mesothelial and/or neoplastic cells in the initiation and regulation of the acute inflammatory response following the instillation of talc in the pleural space, evaluating cellular aspects such as apoptosis and inflammatory mediators.
“The ultimate hypothesis of the Oncotarget study is to determine the role of mesothelial and/or neoplastic cells in the initiation and regulation of the acute inflammatory response.”
The Acencio Research Team concluded in their Oncotarget Research Paper that these results permit them to infer that the normal mesothelium in contact with the talc particles is the main stimulus in the genesis of the inflammatory process.
From the mesothelial activation the production of molecular mediators occurs, and that probably contributes to the dynamics of the local inflammatory process and subsequent production of pleural fibrosis; these mechanisms are necessary to induce effective pleurodesis.
These data also allow them to observe that talc has an action in the neoplastic cells inducing higher rates of apoptosis than observed in normal mesothelial cells; this may even contribute in a modest way to tumoral decrease.
Also that different types of tumor cells may respond differently to exposure to talc.
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Correspondence to – Milena Marques Pagliarelli Acencio – firstname.lastname@example.org
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