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Blood BNP concentration can help diagnose malignant mesothelioma

01 Oct 2020

The ratio of pleural fluid to blood B-type natriuretic peptide (BNP), which is secreted from malignant mesothelial cells, can aid in the diagnosis of malignant mesothelioma, suggests a recent study.

The study was divided into three parts. For the first part, the investigators prospectively compared patients with pleural lesions on computed tomography having malignant mesothelioma effusions (MME, n=13) to those with malignant effusions with pleural lesions (MEa, n=14). They also analysed age-matched ME patients without pleural lesions (MEb, n=16) and nonmalignant effusions (NME, n=25).

Retrospectively, the investigators used samples from patients with mesothelioma (n=14), lung cancer (n=8), or heart failure for part II of the study. They then measured BNP in all pleural fluid and blood/plasma. For part III, BNP was examined 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).

In vitro, significantly higher BNP concentration was observed in the supernatant of all malignant cell lines compared to benign ones (p<0.01), indicating the production of BNP from the former. The pleural fluid to blood BNP ratio in MME was extremely high in parts I and II patients (28.3±12.1 and 25.9±8.6, respectively) compared with part I ME and NME (1.1±0.3 and 0.4±0.1, respectively; p<0.0001) and with part II ME and NME (0.8±0.1 and 0.4±0.1, respectively; p<0.0001).

Additionally, BNP ratio ≥2.11 in part I had a sensitivity of 92 percent and specificity of 94.5 percent for detecting MME (p<0.0001).

“Mesothelial cells and cardiomyocytes have shared embryonic mesodermal origin. Cardiomyocytes release BNP under stretch,” the investigators said.

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Most Read Articles
Pearl Toh, 16 Sep 2020
Mepolizumab, a first-in-class anti-IL-5* antibody, effectively prevents asthma exacerbations in patients with severe eosinophilic asthma (SEA), according to a presentation at the ERS 2020 Congress.
Roshini Claire Anthony, 07 Oct 2020

In patients with severe eosinophilic asthma, cessation of mepolizumab may lead to increased exacerbations and reductions in asthma control, according to results of the COMET* trial.

Audrey Abella, 05 Oct 2020
Regular, low-dose, oral sustained-release morphine improved the health status of patients with moderate-to-very-severe chronic breathlessness due to chronic obstructive pulmonary disease (COPD), the MORDYC* trial has shown, validating its palliative role for chronic breathlessness.