Johns Hopkins University
Some patients that have a tunneled pleural catheter will not have the pleural fluid (water around the lung) return after some time (pleurodesis). The purpose of this study is to understand how the investigators can predict who will achieve pleurodesis and how this occurs by studying the pleural effusion.
An alternative and emerging treatment for malignant pleural effusions is the placement of a chronic indwelling pleural catheter. Tunneled pleural catheters (TPC) are ideal for treatment of malignant pleural effusion (MPE) associated with a trapped or non-expandable lung which will not have sufficient visceral and parietal pleura apposition for chemical pleurodesis. Transforming growth factor-Beta 1 (TGF-β) is a profibrotic cytokine, and a potent inducer of Plasminogen activator inhibitor-1 (PAI-1) in human pleural mesothelial cells. PAI-1 inhibits protease-dependent fibrinolytic activity and…
Inclusion criteria: * Pleural effusion (etiology fulfilling one of the following criteria): 1. Malignant effusion confirmed by cytology or pleural biopsy 2. exudative effusion in the setting of known malignancy with no other identifiable cause 3. Malignant effusion due to tumors that are historically rapidly responsive to systemic therapy (small cell lung cancer, hematological malignancies) will only be included if refractory to standard chemotherapy * 18 years of age * Symptoms such as shortness of breath, cough, or chest fullness/chest discomfort * Demonstration of symptomatic improv…
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