Pleural disorders chemokines

In the present review, the role of chemokines in pleural disorders such as particulate-induced pleural disease, infectious disease, and malignant disease will be described. Besides pleural mesothelial cells, several other cells in the pleural space produce chemokines. Their role will be delineated. During treatment of diseases such as malignancy, pleurodesis agents such as talc are often instilled into the pleural space. Chemokine production during talc insufflation will be described. Importantly, chemokines have been identified to have multiple other immunologic and physiologic roles. In the pleural space, chemokines and chemokine receptors play an important role in repair of the denuded mesothelium. 

It is abundantly clear that chemokines and chemokine receptors play a critical role in the pathogenesis of pleural disease. They are not only important in the development of pleural pathology, but play a role in normal homeostatic mechanisms as well as pleural repair processes. Chemokines are not only present in pleural fluids, but are expressed by multiple cell types present in the pleural space. Depending on the pleural disorder, they include pleural mesothelial cells, inflammatory cells including neutrophils and mononuclear cells, malignant cells that invade the pleural surface, and submesothellal cells such as pleural fibroblasts. That chemokines play a pivotal role in the process of development of pleural disease has been weU confirmed. Key pleural responses in diseases such as metastases or infection are mediated via chemokines. It remains to be seen if manipulation of local chemokine expression can modulate disease processes. 

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