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Open Access Research article

Pleurodesis by erythromycin, tetracycline, Aerosil™ 200, and erythromycin plus Aerosil™ 200 in a rat model: a preliminary study

Shahryar Hashemzadeh1, Khosrow Hashemzadeh2, Kamran Mamaghani3, Elnaz Ansari3, Raheleh Aligholipour1, Samad EJ Golzari4 and Kamyar Ghabili5*

Author Affiliations

1 Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of Cardiovascular Surgery, Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

3 Department of General and Thoracic Surgery, Tabriz Branch, Islamic Azad University, Tabriz, Iran

4 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

5 Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

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DARU Journal of Pharmaceutical Sciences 2012, 20:79  doi:10.1186/2008-2231-20-79

Published: 26 November 2012

Abstract

Background

None of the current pleurodesing agents fulfil all the criteria for best pleural sclerosant. Therefore, the search for the ideal agent for chemical pleurodesis still continues. The aim of the present study was to compare the effectiveness of erythromycin, tetracycline, Aerosil™ 200 (hydrophilic fumed amorphous silica), and erythromycin plus Aerosil™ 200 in producing pleurodesis in rats. In the present study, talc was not used as a pleurodesing agent due to an unavailability of its sterile and pure form in Iran.

Methods

Overall, 75 adult male Spraque-Dawley rats were randomized to 5 treatment groups. Each group received an intrapleural injection via 5 Fr Silastic tubes of one of the following sterile agents: 35mg/kg erythromycin in 2 ml of saline, 35mg/kg tetracycline in 2 ml of saline, 35mg/kg Aerosil™ 200 in 2ml of saline, erythromycin (35mg/kg in 2 ml of saline) plus Aerosil™ 200 (35mg/kg in 2 ml of saline), or 2 ml of saline as a control. The animals were euthanized and necropsied 30 days after injection. The pleurae were assessed for macroscopic and microscopic evidence of surrounding inflammation and fibrosis.

Results

The median macroscopic score in the Aerosil™ 200 group was significantly higher than that in the erythromycin group (P < 0.005). The median microscopic score in the erythromycin group was significantly lower than that in the Aerosil™ 200 and erythromycin plus Aerosil™ 200 groups (P < 0.005). Furthermore, maximum and minimum pleural fibrosis was observed in the erythromycin plus Aerosil™ 200 and erythromycin groups, respectively (P < 0.05).

Conclusion

This study suggests that Aerosil™ 200 with or without erythromycin may be more potent pleurodesis agent than erythromycin and tetracycline.

Keywords:
Aerosil™ 200; Erythromycin; Pleurodesis; Silicon dioxide; Tetracycline