Premium
Malignant mesothelioma cells secrete natriuretic peptides: Data and diagnostic clinical implications
Author(s) -
Tsolaki Vasiliki,
Zarogiannis Sotirios,
Zygoulis Paris,
Kalomenidis Ioannis,
Jagirdar Rajesh,
Makris Demosthenes,
Daniil Zoe,
Magkouta Sofia,
Triantafyllou Ioannis,
Papanikolaou John,
Gourgoulianis Konstantinos I.,
Zakynthinos Epamidas
Publication year - 2020
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13788
Subject(s) - medicine , mesothelioma , pathology , gastroenterology , mesothelial cell , pleural disease , pleural effusion , lung , respiratory disease
Background and objective Mesothelial cells and cardiomyocytes have shared embryonic mesodermal origin. Cardiomyocytes release BNP under stretch. We searched whether malignant mesothelioma cells also secrete BNP and if so, this has a meaningful impact. Methods Part I: Prospectively, patients with pleural lesions on CT having malignant mesothelioma effusions (MME, n = 13) were compared to patients with malignant effusions with pleural lesions (MEa, n = 14). Age‐matched patients with ME without pleural lesions (MEb, n = 16) and non‐malignant effusions (NME, n = 25) were analysed. Part II: Retrospectively, samples from patients with mesothelioma ( n = 14), lung cancer ( n = 8) or heart failure ( n = 9) were used. BNP was measured in pleural fluid and blood/plasma. Part III: BNP was assessed in the culture supernatants of benign (MeT‐5A) and malignant mesothelioma cell lines (M14K‐epithelioid, MSTO‐biphasic and ZL34‐sarcomatoid) ( n = 10 per cell line in three different biological replicates). Results In vitro, BNP concentration was significantly higher in the supernatant of all malignant cell lines than benign ones ( P < 0.01), denoting BNP's production from the former. The pleural fluid to blood BNP ratio in MME was extremely high in Part I and Part II subjects (28.3 ± 12.1 and 25.9 ± 8.6, respectively) versus 1.1 ± 0.3 and 0.4 ± 0.1 in Part I ME and NME, respectively ( P < 0.0001), and 0.8 ± 0.1 and 0.4 ± 0.1 in Part II ME and NME, respectively ( P < 0.0001). BNP ratio ≥2.11 in Part I had 92% sensitivity and 94.5% specificity for MME ( P < 0.0001). Conclusion BNP is secreted from malignant mesothelial cells. In clinical practice, the pleural fluid to blood BNP ratio can help in the diagnosis of malignant mesothelioma.