Fig. 3
From: Chemical pleurodesis – a review of mechanisms involved in pleural space obliteration
The role of fibrogensis and fibrolysis in pleurodesis. In brief, fibrogenesis occurs in the late stage of pleural symphysis formation and involves the recruitment and proliferation of fibroblasts producing collagen and extracellular matrix components in order to replace delicate fibrin pleural adhesions (see also Fig. 2) by stronger, dense collagen fibers; see text for details. Solid lines represent stimulation, dashed lines represent inhibition; **- see also role of matrix metalloproteinases (MMPs) in Fig. 1; *** - there have been no studies either on the effect of pleurodesis on HGF activity or potentially profibrogenic effects of anti-HGF antibodies in the pleural cavity. It can be hypothesized that inhibition of HGF might enhance pleural fibrogenesis initiated by the sclerosing agent. This figure is a simplified diagram, while the actual mechanisms are probably more complex