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Filetti V, Vitale E, Broggi G, Hagnäs MP, Candido S, Spina A, Lombardo C. Update of in vitro, in vivo and ex vivo fluoro-edenite effects on malignant mesothelioma: A systematic review (Review). Biomed Rep 2020; 13:60. [PMID: 33149905 PMCID: PMC7605121 DOI: 10.3892/br.2020.1367] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/07/2020] [Indexed: 12/13/2022] Open
Abstract
Fluoro-edenite (FE), asbestiform fiber found in Biancavilla (Sicily, Italy), presents various characteristics similar to the asbestos group, in particular two fibrous phases tremolite and actinolite. Indeed, epidemiological studies have shown that FE fibers have similar effects to those of asbestos fibers. Such studies have reported a high incidence of malignant mesothelioma (MM), an aggressive neoplasm of the serosal membranes lining the pleural cavity, in individuals residing there due to FE exposure in Biancavilla related to environmental contamination. Evidence has led to the classification of FE as a Group 1 human carcinogen by the International Agency for Research on Cancer (IARC). The aim of this systematic review is to compare the results achieved in in vitro, in vivo and ex vivo experimental studies involving FE in order to update the current knowledge on the pathogenesis and molecular mechanisms responsible for FE-mediated MM development as well as the availability of effective biomarkers for MM prevention and diagnosis. This review is focused on the pathophysiological mechanisms mediated by inflammation induced by FE fiber exposure and which are responsible for MM development. This review also discusses the discovery of new diagnostic and prognostic biomarkers for the management of this pathology. It is known that the risk of cancer development increases with chronic inflammation, arising from enhanced reactive oxygen species (ROS) and NO• production stimulated by the body to remove exogenous agents, causing DNA damage and enhanced signal transduction that may lead to activation of oncogenes. Studies concerning MM biomarker discovery indicate that several biomarkers have been proposed for MM, but mesothelin is the only Food and Drug Administration (FDA)-approved biomarker for MM, with limitations. In recent studies, in silico analysis to identify selected miRNAs highly deregulated in cancer samples when compared with normal control have been developed. This in silico approach could represent an effort in the field of biomarker discovery for MM.
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Affiliation(s)
- Veronica Filetti
- Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
| | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Giuseppe Broggi
- Pathologic Anatomy, Department 'G.F. Ingrassia', University of Catania, I-95123 Catania, Italy
| | - Maria P Hagnäs
- Rovaniemi Health Centre, 96200 Rovaniemi, Finland.,Center for Life Course Health Research, University of Oulu, 90150 Oulu, Finland
| | - Saverio Candido
- Oncologic, Clinic and General Pathology Section, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy.,Research Center for Prevention, Diagnosis and Treatment of Cancer (PreDiCT), University of Catania, I-95123 Catania, Italy
| | - Anna Spina
- INPS Italian National Social Security Institution, I-95129 Catania, Italy
| | - Claudia Lombardo
- Pathologic Anatomy, Department 'G.F. Ingrassia', University of Catania, I-95123 Catania, Italy
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Filetti V, Falzone L, Rapisarda V, Caltabiano R, Eleonora Graziano AC, Ledda C, Loreto C. Modulation of microRNA expression levels after naturally occurring asbestiform fibers exposure as a diagnostic biomarker of mesothelial neoplastic transformation. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 198:110640. [PMID: 32330788 DOI: 10.1016/j.ecoenv.2020.110640] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/11/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Fluoro-edenite (FE) is a silicate mineral identified in the lava products of Monte Calvario from stone quarries located in the southeast of Biancavilla, a small city of the Etnean volcanic complex (Sicily, Italy). Inhalation of FE fibers has been associated with a higher incidence of Malignant Mesothelioma (MM), a highly aggressive neoplasm of the serosal membranes lining the pleural cavity. Only 5% of MM patients are diagnosed at an early stage and the median survival is approximate 6-12 months. Many diagnostic biomarkers have been proposed for MM. Several studies demonstrated that microRNAs (miRNAs) may be used as good non-invasive diagnostics, as well as prognostic biomarkers for various human diseases, including cancer. On these bases, the aim of the present study was to identify a set of miRNAs involved in the development and progression of MM and potentially used as diagnostic biomarkers. For these purposes, in silico analyses were performed on healthy/exposed to asbestos fibers subjects vs. patients with MM. These analyses revealed a set of miRNAs strictly involved in MM by merging the lists of miRNAs found differentially expressed in the three miRNA expression datasets analyzed. The result of these computational evaluations allowed the execution of functional in vitro experiments performed on normal pleural mesothelial cell line (MeT-5A) and MM cell line (JU77) in order to test the carcinogenetic effects and epigenetic modulation induced by FE exposure. The in vitro results showed that the expression levels of hsa-miR-323a-3p vary significantly in both supernatant- and cell-derived miRNAs derived from treated and untreated cells. Secreted and cellular hsa-miR-101-3p in MeT-5A treated with FE fibers and JU77 cells showed different trends of expression. As regard hsa-miR-20b-5p, there was no differential expression between secreted and cellular hsa-miR-20b-5p. This miRNA has been shown a significant up-regulation in JU77 cells vs. control and treated MeT-5A. As a future plan, translational analyses will be performed on a subset of patients chronically exposed to FE fibers to further verify the clinical role of such miRNAs in high-risk individuals and their possible use as biomarkers of FE exposure or MM early onset.
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Affiliation(s)
- Veronica Filetti
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, 95123, Catania, Italy.
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori "Fondazione G. Pascale", 80131, Naples, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy
| | - Rosario Caltabiano
- Section of Anatomic Pathology, Department Gian Filippo Ingrassia, University of Catania, 95123, Catania, Italy
| | | | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, 95123, Catania, Italy; Research Center for Prevention, Diagnosis and Treatment of Cancer (PreDiCT), University of Catania, 95123, Catania, Italy
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Comparison of serum biochemical markers in patients with mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 27:374-380. [PMID: 32082887 DOI: 10.5606/tgkdc.dergisi.2019.17557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 05/02/2019] [Indexed: 02/06/2023]
Abstract
Background In this study, we aimed to compare serum biochemical markers in patients with malignant pleural mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos. Methods Between September 01, 2010 and March 31, 2011, a total of 540 participants (354 males, 186 females; mean age 61.4 years; range, 35 to 89 years) were included in the study. The participants were divided into four groups as follows: (1) patients with pleural plaques (n=277); (2) healthy individuals with normal chest X-rays who were exposed to environmental asbestos (n=121); (3) healthy individuals with normal chest X-rays who were not exposed to environmental asbestos (n=118); and (4) patients with malignant pleural mesothelioma (n=24). Serum levels of carcinoembryonic antigen, cancer antigen 125, 15-3, 19-9, free T3, free T4, thyroidstimulating hormone, vitamin B12, folate, and ferritin were measured. Results Serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels were higher with lower free T3 levels in Group 4 than the other groups. The areas under the curve for cancer antigen 125 and 15-3 were 0.78 and 0.67, respectively in the differential diagnosis of mesothelioma from other pathologies (p<0.001 for both). Optimal limits of these biomarkers were 13.63 and 18.43 ng/mL, respectively with 83% and 75% sensitivity and 69% and 48% specificity, respectively. Conclusion The combination or individual use of serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels may be helpful for early diagnosis and treatment of malignant pleural mesothelioma.
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Campopiano A, Olori A, Spadafora A, Rosaria Bruno M, Angelosanto F, Iannò A, Casciardi S, Giardino R, Conte M, Oranges T, Iavicoli S. Asbestiform minerals in ophiolitic rocks of Calabria (southern Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:134-146. [PMID: 29564927 DOI: 10.1080/09603123.2018.1453051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/15/2018] [Indexed: 06/08/2023]
Abstract
Ophiolitic rocks cropping on Calabria territory, southern Italy, can hold asbestiform minerals potentially harmful for human health. The aim of this work was to detect the fibrous phases of ophiolites along the Coastal Chain of northern Calabria and southern part of the Sila massif. Above 220 massive samples were collected in the study areas and analyzed using optical and electron microscopy, X-ray diffractometry, and Fourier transform infra-red spectrometry. The main fibrous constituent belonged to tremolite-actinolite series followed by fibrous antigorite that becomes more abundant in the samples collected in Reventino Mount surroundings. Results highlighted that serpentinites samples mainly consisted of antigorite and minor chrysotile. Samples collected along the coastal chain of northern Calabria did not hold fibrous materials. The results will be useful for Italian natural occurrences of asbestos (NOA) mapping in order to avoid an unintentional exposition by human activity or weathering processes.
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Affiliation(s)
- Antonella Campopiano
- a Department of Medicine, Epidemiology, Occupational and Environmental Hygiene , National Institute for Insurance against Accidents at Work (INAIL) , Rome , Italy
| | - Angelo Olori
- a Department of Medicine, Epidemiology, Occupational and Environmental Hygiene , National Institute for Insurance against Accidents at Work (INAIL) , Rome , Italy
| | - Alessandra Spadafora
- b ARPACAL, Asbestos Regional Center of Calabria , Castrolibero (Cosenza) , Italy
| | - Maria Rosaria Bruno
- c National Institute for Insurance against Accidents at Work (INAIL) , Lamezia Terme (Catanzaro) , Italy
| | - Federica Angelosanto
- a Department of Medicine, Epidemiology, Occupational and Environmental Hygiene , National Institute for Insurance against Accidents at Work (INAIL) , Rome , Italy
| | - Antonino Iannò
- a Department of Medicine, Epidemiology, Occupational and Environmental Hygiene , National Institute for Insurance against Accidents at Work (INAIL) , Rome , Italy
| | - Stefano Casciardi
- a Department of Medicine, Epidemiology, Occupational and Environmental Hygiene , National Institute for Insurance against Accidents at Work (INAIL) , Rome , Italy
| | - Renato Giardino
- d ASP-SPISAL, Local Health Authority, region of Calabria , Catanzaro , Italy
| | - Maurizio Conte
- d ASP-SPISAL, Local Health Authority, region of Calabria , Catanzaro , Italy
| | - Teresa Oranges
- b ARPACAL, Asbestos Regional Center of Calabria , Castrolibero (Cosenza) , Italy
| | - Sergio Iavicoli
- a Department of Medicine, Epidemiology, Occupational and Environmental Hygiene , National Institute for Insurance against Accidents at Work (INAIL) , Rome , Italy
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Liu B, van Gerwen M, Bonassi S, Taioli E. Epidemiology of Environmental Exposure and Malignant Mesothelioma. J Thorac Oncol 2017; 12:1031-1045. [DOI: 10.1016/j.jtho.2017.04.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 03/21/2017] [Accepted: 04/01/2017] [Indexed: 01/11/2023]
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Beghè D, Dall’Asta L, Garavelli C, Pastorelli AA, Muscarella M, Saccani G, Aiello M, Crisafulli E, Corradi M, Stacchini P, Chetta A, Bertorelli G. Sarcoidosis in an Italian province. Prevalence and environmental risk factors. PLoS One 2017; 12:e0176859. [PMID: 28475583 PMCID: PMC5419555 DOI: 10.1371/journal.pone.0176859] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 04/18/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIM Sarcoidosis is a systemic granulomatous inflammatory disease whose causes are still unknown and for which epidemiological data are often discordant. The aim of our study is to investigate prevalence and spatial distribution of cases, and identify environmental exposures associated with sarcoidosis in an Italian province. METHODS After georeferentiation of cases, the area under study was subdivided with respect to Municipality and Health Districts and to the altitude in order to identify zonal differences in prevalence. The bioaccumulation levels of 12 metals in lichen tissues were analyzed, in order to determine sources of air pollution. Finally, the analysis of the correlation between metals and between pickup stations was performed. RESULTS 223 patients were identified (58.3% female and 41.7% male of total) and the mean age was 50.6±15.4 years (53.5±15.5 years for the females and 46.5±14.4 for the males). The mean prevalence was 49 per 100.000 individuals. However, we observed very heterogeneous prevalence in the area under study. The correlations among metals revealed different deposition patterns in lowland area respect to hilly and mountain areas. CONCLUSIONS The study highlights a high prevalence of sarcoidosis cases, characterized by a very inhomogeneous and patchy distribution with phenomena of local aggregation. Moreover, the bioaccumulation analysis was an effective method to identify the mineral particles that mostly contribute to air pollution in the different areas, but it was not sufficient to establish a clear correlation between the onset of sarcoidosis and environmental risk factors.
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Affiliation(s)
- Deborah Beghè
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Luca Dall’Asta
- Department of Applied Science and Technology, Polytechnic University of Turin, Turin, Italy
- Collegio Carlo Alberto, Moncalieri, Turin, Italy
| | - Claudia Garavelli
- Department of Medicine and Surgery, Occupational Medicine Unit, University of Parma, Parma, Italy
| | - Augusto Alberto Pastorelli
- National Reference Laboratory for Heavy Metals in Food, Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marilena Muscarella
- Istituto Zooprofilattico Sperimentale della Puglia e Basilicata, Foggia, Italy
| | - Gloria Saccani
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marina Aiello
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Ernesto Crisafulli
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Massimo Corradi
- Department of Medicine and Surgery, Occupational Medicine Unit, University of Parma, Parma, Italy
| | - Paolo Stacchini
- National Reference Laboratory for Heavy Metals in Food, Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Alfredo Chetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Giuseppina Bertorelli
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
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Ledda C, Pomara C, Bracci M, Mangano D, Ricceri V, Musumeci A, Ferrante M, Musumeci G, Loreto C, Fenga C, Santarelli L, Rapisarda V. Natural carcinogenic fiber and pleural plaques assessment in a general population: A cross-sectional study. ENVIRONMENTAL RESEARCH 2016; 150:23-29. [PMID: 27236568 DOI: 10.1016/j.envres.2016.05.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 05/09/2016] [Accepted: 05/17/2016] [Indexed: 06/05/2023]
Abstract
Natural carcinogenic fibers are asbestos and asbestiform fibers present as a natural component of soils or rocks. These fibers are released into the environment resulting in exposure of the general population. Environmental contamination by fibers are those cases occurred in: rural regions of Turkey, in Mediterranean countries and in other sites of the world, including northern Europe, USA and China. Fluoro-edenite(FE) is a natural mineral species first isolated in Biancavilla, Sicily. The fibers are similar in size and morphology to some amphibolic asbestos fibers, whose inhalation can cause chronic inflammation and cancer. The aim of the current study is to assess the presence and features of pleural plaques (PPs) in Biancavilla's general population exposed to FE through a retrospective cross-sectional study. All High-Resolution Computed Tomography (HRCT) chest scans carried out between June 2009 and June 2015 in Biancavilla municipality hospital site (exposed subjects) were reviewed. The exposed groups were 1:1 subjects, matched according to age and sex distributions, with unexposed subjects (n.1.240) randomly selected among HRCT chest scans carried out in a Hospital 30km away from Biancavilla. Subjects from Biancavilla with PPs were significantly more numerous than the control group ones (218 vs 38). Average age of either group was >60 years; the age of exposed subjects was significantly (p=0.0312) lesser than the unexposed group. In exposed subjects, in most PPs thickness ranged between 2 and 4.9cm(38%, n=83); while in unexposed ones PPs thickness was less than 2cm (55%, n=21). As to the size of PPs in exposed subjects, in most cases it ranged between 1cm and 24% of chest wall (53%, n=116); while in unexposed ones the size of PPs was lesser than 1cm (23%, n=58). Among exposed subjects, 36 cases (17%) PPs were detected with calcification, whereas in unexposed ones only three (8%) presented calcification. 137 lung parenchymal abnormalities were observed in exposed group; whereas, 12 lung parenchymal involvement were registered in unexposed subjects. The RR for PPs is 6,74 CI 95% (4,47-9,58) p<0,0001 in the exposed population. These findings, suggested the urge to extend the screening on the possible involvement of the respiratory tract to all Biancavilla's population, particularly in those aged more than 30. Besides, it seems essential to start indoor monitoring Biancavilla's municipality.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
| | - Cristoforo Pomara
- Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; Department of Anatomy, School of Medicine, University of Malta, Msida, Malta
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Dario Mangano
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Vincenzo Ricceri
- Division of Radiology - Hospital of Biancavilla "Maria SS. Addolorata", ASP Catania, Biancavilla, Italy
| | - Andrea Musumeci
- Division of Radiology - University Hospital "Policlinico - Vittorio Emanuele", University of Catania, Catania, Italy
| | - Margherita Ferrante
- Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Giuseppe Musumeci
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Concettina Fenga
- Occupational Medicine, Department of the Environment, Safety, Territory, Food and Health Sciences, University of Messina, Messina, Italy
| | - Lory Santarelli
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Ledda C, Loreto C, Bracci M, Mangano D, Migliore M, Ricceri V, Musumeci A, Costa C, Pomara C, Rapisarda V. High risk of pleural plaques and parenchymal abnormalities in women living in Biancavilla (Italy). Future Oncol 2016; 12:63-65. [PMID: 27624550 DOI: 10.2217/fon-2016-0337] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Fluoro-edenite is a natural mineral species first isolated in Biancavilla, Sicily, used for construction of houses and roads, with health effects allegedly the same as those of asbestos. The aim of the current study was to evaluate the risks of pleural plaques and parenchymal abnormalities in women living in Biancavilla through a retrospective cross-sectional study. The evaluation pointed out a relative risk of pleural plaques of 39.67 (95% CI: 11.33-138.82) and 27.67 (95% CI: 5.43-141.00) for parenchymal abnormalities as well. These findings have prompted urge to extend the screening on the possible abnormalities of the respiratory tract to all Biancavilla's population, particularly in those aged more than 30 years.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy
| | - Carla Loreto
- Human Anatomy & Histology, Department of Bio-Medical Sciences, University of Catania, Catania, Italy
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical & Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Dario Mangano
- Occupational Medicine, Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy
| | - Marcello Migliore
- Academic Thoracic Surgery, Department of Surgery & Medical Specialties, University of Catania, Catania, Italy
| | - Vincenzo Ricceri
- Division of Radiology, Hospital of Biancavilla 'Maria SS Addolorata', ASP Catania, Biancavilla, Italy
| | - Andrea Musumeci
- Division of Radiology, University Hospital 'Policlinico - Vittorio Emanuele', University of Catania, Catania, Italy
| | - Chiara Costa
- Occupational Medicine, Department of the Environment, Safety, Territory, Food & Health Sciences, University of Messina, Messina, Italy
| | - Cristoforo Pomara
- Legal Medicine, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy.,Department of Anatomy, School of Medicine, University of Malta, Msida, Malta
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy
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High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos. Environ Health Prev Med 2015; 21:82-90. [PMID: 26692324 DOI: 10.1007/s12199-015-0501-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 11/27/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Very few studies have investigated the incidence and risk of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure, especially exposure to naturally occurring asbestos (NOA). METHODS Subjects were MM, lung, and breast cancer patients who were diagnosed and followed in Diyarbakir Province between 2008 and 2013. The birthplaces of patients were displayed on a geologic map. Geological and meteorological effects on MM were analyzed by logistic regression. RESULTS A total of 180 MM, 368 breast, and 406 lung cancer patients were included. The median distance from birthplace to ophiolites was 6.26 km for MM, 31.06 km for lung, and 34.31 km for breast cancer (p < 0.001). The majority of MM cases were seen within 20 km from NOA areas. The MM incidence inside of NOA was 1059/100.000, and out of NOA was 397/100.000; this difference was significant (p = 0.014). The largest concentration of MM residential areas was within ± 30° (34 residential areas 36.6%) of the dominant wind direction. Most MM patients were found in or near the dominant wind direction, especially in the acute angle defined by the dominant wind direction. MM incidence was directly proportional to {[area of NOA (km(2))] * [cosine α of wind direction angle]} and was inversely proportional to the square of the distance (R = 0.291, p = 0.023). CONCLUSIONS MM was higher near NOA and in the downwind direction. MM incidence and risk were affected by geological and meteorological factors.
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Kart L, Akkoyunlu ME, Bayram M, Yakar F, Kutbay Özçelik H, Karaköse F, Sezer M. COPD: an underdiagnosed disease at hospital environment. Wien Klin Wochenschr 2013; 126:73-8. [PMID: 24249327 DOI: 10.1007/s00508-013-0458-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 10/22/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Chronic obstructive pulmonary disease (COPD) is a serious disease with morbidity and mortality due to delayed diagnosis until significant symptoms arise. We aimed to assess the utility of spirometry and COPD Assessment Test (CAT) in detecting undiagnosed COPD patients in a localized area. MATERIAL AND METHODS People who came to the hospital for patient visit or examination with a smoking history of > 10 pack-years (> 40 years old), and with no known chest disease were invited to study. The participants completed a questionnaire and performed spirometry. Spirometry was performed according to ATS/ERS Task Force on spirometry. COPD was defined as according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. RESULTS There were 800 subjects screened, and 648, capable of performing spirometry, were included to the study. The mean age was 48.3 ± 9.0 and 38 % of the study population was male. Post-bronchodilator FEV1/FVC ratio was lower than 0.70 in 17 % of the subjects. Median (25-75 percentiles) total CAT scores and among the questions of CAT; cough, phlegm, chest tightness and breathlessness scores for COPD and non-COPD subjects were; 15(9-22) vs 12(6-18) (p = .004), 2(1-3) vs 1(0-2) (p < .001), 2(0-3) vs 1(0-3) (p = .004), 3(1-4) vs 2(0-3) (p > .001), 4(3-5) vs 3(2-4) (p = .001), respectively. Symptom prevalence was as follows: exertional dyspnea 91 %, dyspnea 80.9 %, cough 56.3 % and phlegm 58.3 % in COPD. CONCLUSION Our study showed that spirometric screening together with the CAT questionnaire may improve the awareness of disease and may determine undiagnosed patients.
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Affiliation(s)
- Levent Kart
- Department of Pulmonary Medicine, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
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Bayram M, Dongel I, Akbaş A, Benli I, Akkoyunlu ME, Bakan ND. Serum biomarkers in patients with mesothelioma and pleural plaques and healthy subjects exposed to naturally occurring asbestos. Lung 2013; 192:197-203. [PMID: 24170217 DOI: 10.1007/s00408-013-9526-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/09/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE This study investigated the diagnostic accuracy of the serum biomarkers osteopontin and mesothelin in discriminating mesothelioma patients from those with other, benign conditions and whether levels of the biomarkers differed in subjects who had inhaled naturally occurring asbestos compared with a non-exposed control group. METHODS This cross-sectional study studied 24 subjects with mesothelioma, 279 subjects with pleural plaques, 123 "healthy exposed," and 120 control subjects. The Kruskal-Wallis test was performed to compare mesothelin and osteopontin levels of the groups, and receiver operating characteristics curves were generated to determine diagnostic yields of both biomarkers. Multiple linear regression analyses were used to identify associated covariates with osteopontin and mesothelin levels. RESULTS Serum osteopontin and mesothelin levels were higher in mesothelioma than in benign asbestos-related diseases and healthy exposed subjects. Both biomarker levels were independently associated with mesothelioma, age and smoking pack years. Mesothelin levels were also associated with body mass index. The sensitivity and specificity of osteopontin in distinguishing mesothelioma from the three other groups were 75 and 86 %, respectively; those of mesothelin were 58 and 83 %, respectively. The sensitivity and specificity to discriminate mesothelioma from pleural plaques and healthy subjects were 93 and 73 %, respectively, if osteopontin and mesothelin levels were higher than their optimal cut off levels. CONCLUSIONS The combination of serum osteopontin and mesothelin levels can help to distinguish mesothelioma from benign asbestos-related diseases and asbestos-exposed subjects.
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Affiliation(s)
- Mehmet Bayram
- Department of Pulmonology, Bezmialem Vakif University, Istanbul, Turkey,
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