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Elevated serum cytokine levels in mesothelioma patients who have undergone pleurectomy or extrapleural pneumonectomy and adjuvant intraoperative photodynamic therapy.
[systemic capillary leak syndrome]
Patients
treated
on
a
Phase-
I
clinical
trial
of
photodynamic
therapy
(
PDT
)
developed
a
systemic
capillary
leak
syndrome
that
constituted
the
dose-limiting
toxicity
.
We
examined
serum
samples
from
patients
treated
at
the
maximally
tolerated
dose
level
for
evidence
of
a
systemic
,
cytokine-mediated
inflammatory
response
.
Patients
underwent
pleurectomy
or
extrapleural
pneumonectomy
(
EPP
)
followed
by
intraoperative
PDT
of
the
thorax
using
Foscan
at
a
dose
of
0
.
1
mg
/
kg
6
days
before
surgery
and
652
nm
red
light
at
a
dose
of
10
J
/
cm
2
.
Levels
of
interferon-gamma
(
IFN-gamma
)
,
tumor
necrosis
factor
-alpha
(
TNF
-alpha
)
,
interleukin
(
IL
)
-
1
beta
,
IL
-
6
,
IL
-
8
,
IL
-
10
and
IL
-
12
were
assayed
before
Foscan
administration
;
after
anesthetic
induction
,
surgical
resection
and
light
delivery
;
in
postoperative
recovery
and
the
day
after
the
surgery
.
Of
the
analyzed
patients
,
eight
underwent
a
pleurectomy
and
one
an
EPP
followed
by
PDT
.
IFN-gamma
,
TNF
-alpha
and
IL
-
12
showed
no
elevation
,
but
IL
-
1
beta
,
IL
-
6
,
IL
-
8
and
IL
-
10
levels
were
elevated
after
surgery
and
PDT
.
IL
-
1
beta
showed
a
statistically
significant
variation
from
baseline
after
surgery
and
IL
-
6
,
after
PDT
.
The
results
suggest
a
systemically
mediated
inflammatory
response
resulting
from
thoracic
surgery
followed
by
PDT
.
Further
investigation
of
specific
mechanisms
is
warranted
.
Diseases
Validation
Diseases presenting
"red light at a dose"
symptom
systemic capillary leak syndrome
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