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TRANSFORMING GROWTH FACTOR-BETA 1 IN TUBERCULOUS PLEURISY

Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical Sch, Sao Paulo, Brazil

PURPOSE: Residual pleural thickening is a complication of tuberculous pleurisy. Transforming Growth Factor-ß1 (TGF-ß1) plays a key role in tissue remodeling by increasing the production or decreasing the degradation of connective tissue after injury. The objective of this study was to determine whether pleural fluid and serum levels of TGF-ß1 are correlated with the development of pleural thickening.

METHODS: A total of 58 pleural fluid and serum samples from patients with tuberculosis (n = 50) or transudates (n = 8) were evaluated. Serum and pleural fluid TGF-ß1 were quantified by ELISA and the pleural thickening before and after the specific treatment was measured in high resolution computed tomography. Pleural thickening scores were: 0: < 3mm; 1: 3 and < 10mm and 2: 10mm.

RESULTS: Pleural fluid and serum TGF-ß1 were higher in tuberculosis than in transudates (p<0.001). The mean TGF-ß1 levels in patients from score 2 (955.7 ± 491.9 pg/mL), were higher (p = 0.032) than those observed in patients from score 0 (605.8 ± 456.7 pg/mL) or score 1 (547.0 ± 442.1 pg/mL). After the specific treatment, there were no changes in the pleural thickening observed in patients from score 0 and 2. From score 1, 36% have changed to score to 2 (TGF-ß1 = 884.6 ± 471.4) and 36% have changed to score 0 (TGF-ß1 = 509.7 ± 337.1), with statistical significance between TGF levels (p = 0.026). We do not observe significant differences in serum TGF-ß1 levels when compared to the different scores (p = 0. 591).

CONCLUSION: TGF-ß1 levels in serum and in pleural fluid are higher in tuberculosis than in transudates. The pleural levels of TGF-ß1 were correlated with pleural thickening and could be a potential predictor of pleural thickening in tuberculous pleurisy.

CLINICAL IMPLICATIONS: These results may imply in a new therapeutic approach associating TGF-ß inhibitors to prevent the pleural thickening.

DISCLOSURE: Marcia Seiscento, None.