Oxidized regenerated cellulose induces pleural thickening in patients with pneumothorax: possible involvement of the mesothelial-mesenchymal transition.

Abstract:

PURPOSE:The pleural covering technique, i.e., wrapping a part of or the entire surface of the lung with oxidized regenerative cellulose (ORC), reinforces visceral pleura through pleural thickening for patients with pneumothorax and cystic lung diseases. However, it remains undetermined how ORC induces pleural thickening. METHODS:A histopathological examination was performed for lung specimens from patients who had recurrent pneumothoraces after pleural covering and re-operation (n = 5). To evaluate the influence of ORC on the pleura in vitro, we used MeT-5A cells (a human pleural mesothelial cell line). RESULTS:Pleural thickening was confirmed in all lung specimens examined. Three months after covering, the thickened pleura showed inflammatory cell infiltration, proliferation of myofibroblasts, and expression of fibronectin and TGF-β. However, after 1 year, those findings virtually disappeared, and the thickened pleura was composed mainly of abundant collagen. When MeT-5A cells were cultured in ORC-immersed medium, their morphology changed from a cobblestone to spindle-shaped appearance. The expression of E-cadherin decreased, whereas that of N-cadherin, α-smooth muscle actin, and fibronectin increased, suggesting mesothelial-mesenchymal transition (Meso-MT). CONCLUSIONS:Our results suggest that Meso-MT may be involved as a mechanism of pleural thickening induced by pleural covering with ORC.

journal_name

Surg Today

journal_title

Surgery today

authors

Ebana H,Hayashi T,Mitani K,Kobayashi E,Kumasaka T,Mizobuchi T,Kurihara M,Takahashi F,Takahashi K,Seyama K

doi

10.1007/s00595-017-1597-4

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

462-472

issue

4

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-017-1597-4

journal_volume

48

pub_type

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