Fig. 4
From: Chemical pleurodesis – a review of mechanisms involved in pleural space obliteration
The role of angiogenesis and angiostasis in pleurodesis. In brief, pleurodesis produces not only a repair scar, but a well-vascularized and innervated connective tissue that creates a continuity between visceral and parietal pleura. The role of VEGF is ambiguous – it activates endothelial cells stimulating the formation of new vessels and induce adhesion formation but at the same time it is one of the most potent cytokines that increase vascular permeability and induce pleural fluid formation. It seems possible, that the angiogenesis-angiostasis equilibrium changes over time of the process; see text for details. Solid lines represent stimulation, dashed lines represent inhibition. **** - bidirectional and dose dependent effect on endostatin production was observed – see explanations in the text. Please, note that this is a simplified diagram. The mechanisms of angiogenesis and angiostasis involved in chemical pleurodesis are probably more complex