Pleural mesothelial cells and extracellular matrix

Pleural mesothelial cells (PMCs) form a specialized, metabolically active monolayer that lines the pleural cavity, supported by an underlying extracellular matrix (ECM) composed of collagen, elastin, and proteoglycans (Mutsaers, 2004). These cells are essential for maintaining pleural homeostasis, facilitating the transport of fluids and cells, and producing lubricating substances like hyaluronan to reduce friction during respiration (Batra & Antony, 2015). In response to injury or asbestos exposure, PMCs can undergo mesothelial-to-mesenchymal transition (MMT), a process that contributes to pleural fibrosis and the development of malignant pleural mesothelioma (MPM) (Sanders et al., 2012). The ECM serves as a scaffold that influences PMC behavior through integrin signaling and the sequestration of growth factors like TGF-beta (Kuwahara et al., 2001). Therapeutic strategies involving this system include the use of sclerosing agents like talc to induce pleurodesis for effusions, and systemic chemotherapies such as pemetrexed and cisplatin to target malignant transformations within the mesothelial layer (Tsao et al., 2018).

Other names

Pleural mesotheliumPleural liningMesothelial cell layerPleural ECM

Drugs targeting this system act through various mechanisms, including DNA cross-linking and antimetabolite activity to inhibit malignant cell proliferation, as well as the induction of chemical pleurodesis to manage pleural effusions (Tsao et al., 2018; Batra & Antony, 2015).