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Zupanc C, Franko A, Strbac D, Kovac V, Dolzan V, Goricar K. The association of genetic factors with serum calretinin levels in asbestos-related diseases. Radiol Oncol 2023; 57:473-486. [PMID: 38038422 PMCID: PMC10690752 DOI: 10.2478/raon-2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Asbestos exposure is associated with different asbestos-related diseases, including malignant mesothelioma (MM). MM diagnosis is confirmed with immunohistochemical analysis of several markers, including calretinin. Increased circulating calretinin was also observed in MM. The aim of the study was to determine if CALB2 polymorphisms or polymorphisms in genes that can regulate calretinin expression are associated with serum calretinin levels or MM susceptibility. SUBJECTS AND METHODS The study included 288 MM patients and 616 occupationally asbestos-exposed subjects without MM (153 with asbestosis, 380 with pleural plaques and 83 without asbestos-related disease). Subjects were genotyped for seven polymorphisms in CALB2, E2F2, MIR335, NRF1 and SEPTIN7 genes using competitive allele-specific polymerase chain reaction (PCR). Serum calretinin was determined with ELISA in 545 subjects. Nonparametric tests, logistic regression and receiver operating characteristic (ROC) curve analysis were used for statistical analysis. RESULTS Carriers of at least one polymorphic CALB2 rs889704 allele had lower calretinin levels (P = 0.036). Carriers of two polymorphic MIR335 rs3807348 alleles had higher calretinin (P = 0.027), while carriers of at least one polymorphic NRF1 rs13241028 allele had lower calretinin levels (P = 0.034) in subjects without MM. Carriers of two polymorphic E2F2 rs2075995 alleles were less likely to develop MM (odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.43-0.96, P = 0.032), but the association was no longer significant after adjustment for age (P = 0.093). Optimal serum calretinin cut-off values differentiating MM patients from other subjects differed according to CALB2, NRF1, E2F2, and MIR335 genotypes. CONCLUSIONS The results of presented study suggest that genetic variability could influence serum calretinin levels. These findings could contribute to a better understanding of calretinin regulation and potentially to earlier MM diagnosis.
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Affiliation(s)
- Cita Zupanc
- Military Medical Unit-Slovenian Army, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - Alenka Franko
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
- University Medical Centre Ljubljana, Clinical Institute of Occupational Medicine, Ljubljana, Slovenia
| | - Danijela Strbac
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Viljem Kovac
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Vita Dolzan
- University of Ljubljana, Faculty of Medicine, Institute of Biochemistry and Molecular Genetics, Pharmacogenetics Laboratory, Ljubljana, Slovenia
| | - Katja Goricar
- University of Ljubljana, Faculty of Medicine, Institute of Biochemistry and Molecular Genetics, Pharmacogenetics Laboratory, Ljubljana, Slovenia
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Serum Calretinin as a Biomarker in Malignant Mesothelioma. J Clin Med 2021; 10:jcm10214875. [PMID: 34768395 PMCID: PMC8585060 DOI: 10.3390/jcm10214875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
The early diagnosis of malignant mesothelioma (MM) could improve the prognosis of MM patients. To confirm an MM diagnosis, an immunohistochemical analysis of several tumor tissue markers, including calretinin, is currently required. Our aim is to evaluate serum calretinin as a potential biomarker in asbestos-related diseases, especially in MM. Our study includes 549 subjects: 164 MM patients, 117 subjects with asbestosis, 195 subjects with pleural plaques and 73 occupationally asbestos-exposed subjects without asbestos-related diseases. The serum calretinin concentration was determined with a commercially available enzyme immunoassay. Data on the soluble mesothelin-related peptides (SMRP) concentration are available from previous studies. MM patients had a significantly higher calretinin concentration than subjects without disease, subjects with pleural plaques or subjects with asbestosis (all p < 0.001). The histological type was significantly associated with serum calretinin: patients with sarcomatoid MM had lower calretinin than patients with the epithelioid type (p = 0.001). In a ROC curve analysis, the area under the curve for calretinin concentration predicting MM was 0.826 (95% CI = 0.782-0.869; p < 0.001). At the cutoff value of 0.32 ng/mL, sensitivity was 0.683, while specificity was 0.886. The combination of calretinin and SMRP had the highest predictive value. Calretinin is a useful biomarker that can distinguish MM from other asbestos-related diseases and could, therefore, contribute to an earlier non-invasive diagnosis of MM.
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Goričar K, Holcar M, Mavec N, Kovač V, Lenassi M, Dolžan V. Extracellular Vesicle Enriched miR-625-3p Is Associated with Survival of Malignant Mesothelioma Patients. J Pers Med 2021; 11:jpm11101014. [PMID: 34683154 PMCID: PMC8538530 DOI: 10.3390/jpm11101014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 12/29/2022] Open
Abstract
Malignant mesothelioma (MM) is characterized by poor prognosis and short survival. Extracellular vesicles (EVs) are membrane-bound particles released from cells into various body fluids, and their molecular composition reflects the characteristics of the origin cell. Blood EVs or their miRNA cargo might serve as new minimally invasive biomarkers that would enable earlier detection of MM or treatment outcome prediction. Our aim was to evaluate miRNAs enriched in serum EVs as potential prognostic biomarkers in MM patients in a pilot longitudinal study. EVs were isolated from serum samples obtained before and after treatment using ultracentrifugation on 20% sucrose cushion. Serum EV-enriched miR-103-3p, miR-126-3p and miR-625-3p were quantified using qPCR. After treatment, expression of miR-625-3p and miR-126-3p significantly increased in MM patients with poor treatment outcome (p = 0.012 and p = 0.036, respectively). A relative increase in miR-625-3p expression after treatment for more than 3.2% was associated with shorter progression-free survival (7.5 vs. 19.4 months, HR = 3.92, 95% CI = 1.20-12.80, p = 0.024) and overall survival (12.5 vs. 49.1 months, HR = 5.45, 95% CI = 1.06-28.11, p = 0.043) of MM patients. Bioinformatic analysis showed enrichment of 33 miR-625-3p targets in eight biological pathways. Serum EV-enriched miR-625-3p could therefore serve as a prognostic biomarker in MM and could contribute to a more personalized treatment.
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Affiliation(s)
- Katja Goričar
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia; (K.G.); (M.H.); (N.M.); (M.L.)
| | - Marija Holcar
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia; (K.G.); (M.H.); (N.M.); (M.L.)
| | - Nina Mavec
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia; (K.G.); (M.H.); (N.M.); (M.L.)
| | - Viljem Kovač
- Institute of Oncology Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Metka Lenassi
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia; (K.G.); (M.H.); (N.M.); (M.L.)
| | - Vita Dolžan
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia; (K.G.); (M.H.); (N.M.); (M.L.)
- Correspondence: ; Tel.: +386-1-543-76
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The influence of genetic variability in IL1B and MIR146A on the risk of pleural plaques and malignant mesothelioma. Radiol Oncol 2020; 54:429-436. [PMID: 33085641 PMCID: PMC7585336 DOI: 10.2478/raon-2020-0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023] Open
Abstract
Background Asbestos exposure is associated with the development of pleural plaques as well as malignant mesothelioma (MM). Asbestos fibres activate macrophages, leading to the release of inflammatory mediators including interleukin 1 beta (IL-1β). The expression of IL-1β may be influenced by genetic variability of IL1B gene or regulatory microRNAs (miRNAs). This study investigated the effect of polymorphisms in IL1B and MIR146A genes on the risk of developing pleural plaques and MM. Subjects and methods In total, 394 patients with pleural plaques, 277 patients with MM, and 175 healthy control subjects were genotyped for IL1B and MIR146A polymorphisms. Logistic regression was used in statistical analysis. Results We found no association between MIR146A and IL1B genotypes, and the risk of pleural plaques. MIR146A rs2910164 was significantly associated with a decreased risk of MM (OR = 0.31, 95% CI = 0.13–0.73, p = 0.008). Carriers of two polymorphic alleles had a lower risk of developing MM, even after adjustment for gender and age (OR = 0.34, 95% CI = 0.14–0.85, p = 0.020). Among patients with known asbestos exposure, carriers of at least one polymorphic IL1B rs1143623 allele also had a lower risk of MM in multivariable analysis (OR = 0.50, 95% CI = 0.28–0.92, p = 0.025). The interaction between IL1B rs1143623 and IL1B rs1071676 was significantly associated with an increased risk of MM (p = 0.050). Conclusions Our findings suggest that genetic variability of inflammatory mediator IL-1β could contribute to the risk of developing MM, but not pleural plaques.
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Evaluation of soluble mesothelin-related peptides and MSLN genetic variability in asbestos-related diseases. Radiol Oncol 2020; 54:86-95. [PMID: 32187018 PMCID: PMC7087423 DOI: 10.2478/raon-2020-0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Asbestos exposure is associated with increased risk of several diseases, including malignant mesothelioma (MM). Cell surface glycoprotein mesothelin is overexpressed in MM and serum soluble mesothelin-related peptides (SMRP) were already proposed as a diagnostic or prognostic biomarker in MM. However, interindividual variability in serum SMRP levels limits the clinical usefulness. Our primary objective was to investigate the influence of MSLN rs1057147 on serum SMRP levels in asbestos-exposed subjects and patients with asbestos-related diseases as well as on survival in MM. Subjects and methods Among 782 asbestos-exposed subjects and patients with asbestos-related diseases, 154 had MM. Serum SMRP levels were determined using sandwich enzyme-linked immunosorbent assay. All subjects were genotyped for MSLN rs1057147 polymorphism using competitive allele-specific polymerase chain reaction. Nonparametric tests, logistic and Cox regression were used in statistical analysis to compare different subject groups. Results MM patients had significantly higher SMRP levels than all other subjects (p < 0.001). Compared to wild-type MSLN rs1057147 genotype, both heterozygotes and carriers of two polymorphic alleles had significantly higher SMRP levels among subjects without MM (p < 0.001), but not in MM patients (p = 0.424). If genotype information was included, specificity of SMRP increased from 88.5% to 92.7% for the optimal cutoff value. Overall survival was significantly shorter in MM patients carrying at least one polymorphic rs1057147 allele (HR = 1.72, 95% CI = 1.15-2.55, p = 0.008). Conclusions MSLN genetic variability affects serum SMRP levels and was associated with shorter survival of MM patients. Combination of genetic and serum factors could therefore serve as a better diagnostic or prognostic biomarker in MM patients.
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NLRP3 and CARD8 polymorphisms influence risk for asbestos-related diseases. J Med Biochem 2020; 39:91-99. [PMID: 32549782 DOI: 10.2478/jomb-2019-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 04/26/2019] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to investigate the association between NLRP3 rs35829419 and CARD8 rs2043211 polymorphisms and the risk of developing pleural plaques, asbestosis, and malignant mesothelioma (MM), and to study the influence of the interactions between polymorphisms and asbestos exposure on the risk of developing these diseases. Methods The case-control study included 416 subjects with pleural plaques, 160 patients with asbestosis, 154 subjects with MM and 149 subjects with no asbestos disease. The NLRP3 rs35829419 and CARD8 rs2043211 polymorphisms were determined using real-time PCR-based methods. In the statistical analysis, standard descriptive statistics was followed by univariate and multivariate logistic regression modelling. Results Asbestos exposure (medium and high vs low) was associated with the risk for each studied asbestos-related disease. An increased risk of pleural plaques was found for CARD8 rs2043211 at + TT genotypes (OR = 1.48, 95% CI 1.01-2.16, p = 0.042). When the analysis was performed for MM patients as cases, and pleural plaques patients as controls, a decreased MM risk was observed for carriers of CARD8 rs2043211 TT genotype (OR = 0.52, 95% CI 0.27-1.00, p = 0.049). The interactions between NLRP3 rs35829419 and CARD8 rs2043211 genotypes did not influence the risk of any asbestos-related disease. However, when testing interactions with asbestos exposure, a decreased risk of asbestosis was found for NLRP3 CA+AA genotypes (OR = 0.09, 95% CI 0.01-0.60, p = 0.014). Conclusions The results of our study suggest that NLRP3 and CARD8 polymorphisms could affect the risk of asbestos-related diseases.
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Kuempel ED, Jaurand MC, Møller P, Morimoto Y, Kobayashi N, Pinkerton KE, Sargent LM, Vermeulen RCH, Fubini B, Kane AB. Evaluating the mechanistic evidence and key data gaps in assessing the potential carcinogenicity of carbon nanotubes and nanofibers in humans. Crit Rev Toxicol 2017; 47:1-58. [PMID: 27537422 PMCID: PMC5555643 DOI: 10.1080/10408444.2016.1206061] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/22/2016] [Indexed: 12/31/2022]
Abstract
In an evaluation of carbon nanotubes (CNTs) for the IARC Monograph 111, the Mechanisms Subgroup was tasked with assessing the strength of evidence on the potential carcinogenicity of CNTs in humans. The mechanistic evidence was considered to be not strong enough to alter the evaluations based on the animal data. In this paper, we provide an extended, in-depth examination of the in vivo and in vitro experimental studies according to current hypotheses on the carcinogenicity of inhaled particles and fibers. We cite additional studies of CNTs that were not available at the time of the IARC meeting in October 2014, and extend our evaluation to include carbon nanofibers (CNFs). Finally, we identify key data gaps and suggest research needs to reduce uncertainty. The focus of this review is on the cancer risk to workers exposed to airborne CNT or CNF during the production and use of these materials. The findings of this review, in general, affirm those of the original evaluation on the inadequate or limited evidence of carcinogenicity for most types of CNTs and CNFs at this time, and possible carcinogenicity of one type of CNT (MWCNT-7). The key evidence gaps to be filled by research include: investigation of possible associations between in vitro and early-stage in vivo events that may be predictive of lung cancer or mesothelioma, and systematic analysis of dose-response relationships across materials, including evaluation of the influence of physico-chemical properties and experimental factors on the observation of nonmalignant and malignant endpoints.
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Affiliation(s)
- Eileen D Kuempel
- a National Institute for Occupational Safety and Health , Cincinnati , OH , USA
| | - Marie-Claude Jaurand
- b Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche , UMR 1162 , Paris , France
- c Labex Immuno-Oncology, Sorbonne Paris Cité, University of Paris Descartes , Paris , France
- d University Institute of Hematology, Sorbonne Paris Cité, University of Paris Diderot , Paris , France
- e University of Paris 13, Sorbonne Paris Cité , Saint-Denis , France
| | - Peter Møller
- f Department of Public Health , University of Copenhagen , Copenhagen , Denmark
| | - Yasuo Morimoto
- g Department of Occupational Pneumology , University of Occupational and Environmental Health , Kitakyushu City , Japan
| | | | - Kent E Pinkerton
- i Center for Health and the Environment, University of California , Davis , California , USA
| | - Linda M Sargent
- j National Institute for Occupational Safety and Health , Morgantown , West Virginia , USA
| | - Roel C H Vermeulen
- k Institute for Risk Assessment Sciences, Utrecht University , Utrecht , The Netherlands
| | - Bice Fubini
- l Department of Chemistry and "G.Scansetti" Interdepartmental Center , Università degli Studi di Torino , Torino , Italy
| | - Agnes B Kane
- m Department of Pathology and Laboratory Medicine , Brown University , Providence , RI , USA
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Maxim LD, Niebo R, Utell MJ. Are pleural plaques an appropriate endpoint for risk analyses? Inhal Toxicol 2015; 27:321-34. [DOI: 10.3109/08958378.2015.1051640] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Leong SL, Zainudin R, Kazan-Allen L, Robinson BW. Asbestos in Asia. Respirology 2015; 20:548-55. [PMID: 25819225 DOI: 10.1111/resp.12517] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/04/2014] [Accepted: 02/03/2015] [Indexed: 11/26/2022]
Abstract
Asbestos is a global killer. Despite lessons learned in the developed world on the use of asbestos and its hazardous pulmonary consequences, its use continues to increase in Asia. Although some countries such as Japan, Korea and Singapore have curtailed the use of this mineral, there are numerous countries in Asia that continue to mine, import and use this fibre, particularly China, which is one of the largest consumers in the world. Numerous factors ranging from political and economic to the lack of understanding of asbestos and the management of asbestos-related lung disease are keys to this observed trend. Awareness of these factors combined with early intervention may prevent the predicted Asian 'tsunami' of asbestos diseases.
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Affiliation(s)
- Su Lyn Leong
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia; National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Western Australia, Australia
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Lee HJ, Park EK, Wilson D, Tutkun E, Oak C. Awareness of Asbestos and Action Plans for Its Exposure can Help Lives Exposed to Asbestos. Saf Health Work 2013; 4:84-6. [PMID: 23961330 PMCID: PMC3732141 DOI: 10.1016/j.shaw.2013.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 03/12/2013] [Accepted: 03/13/2013] [Indexed: 02/01/2023] Open
Abstract
Despite the fact that asbestos is a known carcinogen to humans, it is still used in industrialized countries, especially Asian countries. The global incidence of asbestos-related diseases (ARDs) due to the past use of asbestos, continues to increase, although many countries have adopted a total ban on asbestos use. The implementation of effective strategies to eliminate ARDs is therefore an important challenge in Asia, where asbestos is still mined and consumed. Collaborative efforts and strategies at the local and international levels are vital, in the pursuit toward the elimination of ARDs in this region.
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Affiliation(s)
- Hu-Jang Lee
- Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University, Jinju, Korea
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Prazakova S, Thomas PS, Sandrini A, Yates DH. Asbestos and the lung in the 21st century: an update. CLINICAL RESPIRATORY JOURNAL 2013; 8:1-10. [PMID: 23711077 DOI: 10.1111/crj.12028] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 04/17/2013] [Accepted: 05/20/2013] [Indexed: 01/16/2023]
Abstract
The asbestos-related disorders (ARDs) are currently of significant occupational and public health concern. Asbestos usage has been banned in most developed countries, but asbestos is still used in many developing countries and the number of cases of ARDs worldwide is rising. Many countries are now experiencing an epidemic of ARDs that is the legacy of occupational exposure in the 1960s-1980s because of the long latency period between asbestos exposure and manifestation of disease. It is likely that asbestos-related mortality and morbidity will continue to increase. Although the most feared complications of asbestos inhalation are the malignant conditions such as mesothelioma and lung cancer, asbestos inhalation more frequently results in benign conditions such as pleural plaques, diffuse pleural thickening, and asbestosis (pulmonary fibrosis due to asbestos exposure). Over recent years, there have been changes in the epidemiology of mesothelioma, in clinical management of ARDs and developments in new techniques for early detection of malignancy. This review provides an update on the respiratory manifestations of asbestos exposure and also considers advances in screening methods that may affect future management in the workplace.
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Affiliation(s)
- Silvie Prazakova
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Respiratory Medicine Department, Prince of Wales Hospital, Sydney, NSW, Australia
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Lazarus A, Massoumi A, Hostler J, Hostler DC. Asbestos-related pleuropulmonary diseases: benign and malignant. Postgrad Med 2012; 124:116-30. [PMID: 22691906 DOI: 10.3810/pgm.2012.05.2555] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Asbestos is known for its desirable properties of thermal and heat resistance along with excellent strength and durability. It was widely used in many industries since the late 19th century, until its adverse effects on health were recognized. The occurrence of pleuropulmonary changes from exposure to asbestos often has a latency period of 20 to 30 years. The use of asbestos has been banned, regulated, and minimized in many countries, but in several developing countries, the use of asbestos in industries is still a common practice. In this article, the benign and malignant clinical manifestations of asbestos exposure are discussed.
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Affiliation(s)
- Angeline Lazarus
- Pulmonary Division, Walter Reed National Military Medical Center, Bethesda, MD 20889-5600, USA.
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Allen RKA, Cramond T, Lennon D, Waterhouse M. A Retrospective Study of Chest Pain in Benign Asbestos Pleural Disease. PAIN MEDICINE 2011; 12:1303-8. [DOI: 10.1111/j.1526-4637.2011.01209.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yang HY, Wang JD, Chen PC, Lee JJ. Pleural plaque related to asbestos mining in Taiwan. J Formos Med Assoc 2011; 109:928-33. [PMID: 21195893 DOI: 10.1016/s0929-6646(10)60142-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Revised: 09/25/2008] [Accepted: 10/31/2008] [Indexed: 12/12/2022] Open
Abstract
A 78-year-old woman complained of twisting-like pain in her left lower chest. During physical examination, friction rubbing was noted in both lungs. Chest radiography showed extensive bilateral pleural calcification. High-resolution computed tomography confirmed the presence of bilateral calcified pleural plaques. The patient had worked at a Japanese asbestos factory in Taiwan for 1 year when she was 16 years old. Her job involved picking out asbestos fibers from crushed asbestos minerals, but no protective equipment was used at that time. This is believed to be the first reported case of asbestos-related disease in Taiwan that resulted from asbestos mining. We also summarize the history of domestic asbestos mining, importation of asbestos, and trends in asbestos use in Taiwan.
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Affiliation(s)
- Hsiao-Yu Yang
- Department of Occupational Medicine, Buddhist Tzu Chi General Hospital, Taipei, Taiwan
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McGrath EE, Anderson PB. Diagnosis of pleural effusion: a systematic approach. Am J Crit Care 2011; 20:119-27; quiz 128. [PMID: 21362716 DOI: 10.4037/ajcc2011685] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
In most diseases related to pleural effusion, the fluid analysis yields important diagnostic information, and in certain cases, fluid analysis alone is enough for diagnosis. The many important characteristics of pleural fluid are described, as are other complementary investigations that can assist with the diagnosis of common and rare pleural effusions. For a systematic review of pleural effusion, a literature search for articles on the practical investigation and diagnosis of pleural effusion was done. Articles included guidelines, expert opinion, experimental and nonexperimental studies, literature reviews, and systematic reviews published from May 2003 through June 2009. The search yielded 1 guideline, 2 meta-analyses, 9 literature reviews, 1 randomized control trial, and 9 clinical studies. On the basis of class IIa or class I evidence from these articles, a step by step approach is recommended for investigating a pleural effusion, beginning with assessment of the medical history, clinical examination, radiology, pleural fluid evaluation, and finally, if no diagnosis is forthcoming, a pleural biopsy under image guidance or thoracoscopy.
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Affiliation(s)
- Emmet E. McGrath
- Emmet E. McGrath was a clinical lecturer in respiratory medicine and Paul B. Anderson was a consultant respiratory physician in the Department of Respiratory Medicine, Northern General Hospital, Sheffield, England at the time this article was written
| | - Paul B. Anderson
- Emmet E. McGrath was a clinical lecturer in respiratory medicine and Paul B. Anderson was a consultant respiratory physician in the Department of Respiratory Medicine, Northern General Hospital, Sheffield, England at the time this article was written
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Broaddus VC, Everitt JI, Black B, Kane AB. Non-neoplastic and neoplastic pleural endpoints following fiber exposure. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2011; 14:153-78. [PMID: 21534088 PMCID: PMC3118521 DOI: 10.1080/10937404.2011.556049] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Exposure to asbestos fibers is associated with non-neoplastic pleural diseases including plaques, fibrosis, and benign effusions, as well as with diffuse malignant pleural mesothelioma. Translocation and retention of fibers are fundamental processes in understanding the interactions between the dose and dimensions of fibers retained at this anatomic site and the subsequent pathological reactions. The initial interaction of fibers with target cells in the pleura has been studied in cellular models in vitro and in experimental studies in vivo. The proposed biological mechanisms responsible for non-neoplastic and neoplastic pleural diseases and the physical and chemical properties of asbestos fibers relevant to these mechanisms are critically reviewed. Understanding mechanisms of asbestos fiber toxicity may help us anticipate the problems from future exposures both to asbestos and to novel fibrous materials such as nanotubes. Gaps in our understanding have been outlined as guides for future research.
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Affiliation(s)
| | | | - Brad Black
- Center for Asbestos Related Disease, Libby, Montana
| | - Agnes B. Kane
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, USA
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Huang SXL, Jaurand MC, Kamp DW, Whysner J, Hei TK. Role of mutagenicity in asbestos fiber-induced carcinogenicity and other diseases. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2011; 14:179-245. [PMID: 21534089 PMCID: PMC3118525 DOI: 10.1080/10937404.2011.556051] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The cellular and molecular mechanisms of how asbestos fibers induce cancers and other diseases are not well understood. Both serpentine and amphibole asbestos fibers have been shown to induce oxidative stress, inflammatory responses, cellular toxicity and tissue injuries, genetic changes, and epigenetic alterations in target cells in vitro and tissues in vivo. Most of these mechanisms are believe to be shared by both fiber-induced cancers and noncancerous diseases. This article summarizes the findings from existing literature with a focus on genetic changes, specifically, mutagenicity of asbestos fibers. Thus far, experimental evidence suggesting the involvement of mutagenesis in asbestos carcinogenicity is more convincing than asbestos-induced fibrotic diseases. The potential contributions of mutagenicity to asbestos-induced diseases, with an emphasis on carcinogenicity, are reviewed from five aspects: (1) whether there is a mutagenic mode of action (MOA) in fiber-induced carcinogenesis; (2) mutagenicity/carcinogenicity at low dose; (3) biological activities that contribute to mutagenicity and impact of target tissue/cell type; (4) health endpoints with or without mutagenicity as a key event; and finally, (5) determinant factors of toxicity in mutagenicity. At the end of this review, a consensus statement of what is known, what is believed to be factual but requires confirmation, and existing data gaps, as well as future research needs and directions, is provided.
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Affiliation(s)
- Sarah X. L. Huang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Marie-Claude Jaurand
- INSERM (Institut National de la Santé et de la Recherche Médicale), Paris, France
| | - David W. Kamp
- Pulmonary & Critical Care Medicine, Northwestern University Feinberg School of Medicine, Jesse Brown VA Medical Center, Chicago, Illinois, USA
| | - John Whysner
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Tom K. Hei
- Address correspondence to Tom K. Hei, Center for Radiological Research, College of Physicians and Surgeons, Columbia University. 630 West 168th Street, New York, NY 10032, USA. E-mail:
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Creaney J, Olsen NJ, Brims F, Dick IM, Musk AW, de Klerk NH, Skates SJ, Robinson BW. Serum Mesothelin for Early Detection of Asbestos-Induced Cancer Malignant Mesothelioma. Cancer Epidemiol Biomarkers Prev 2010; 19:2238-46. [DOI: 10.1158/1055-9965.epi-10-0346] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ates G, Yildiz T, Akyildiz L, Topcu F, Erturk B. Environmental asbestos-related pleural plaque in southeast of Turkey. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2010; 65:34-37. [PMID: 20147001 DOI: 10.1080/19338240903390321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
It is known that many malignant and benign pleural diseases occur due to environmental exposure to mineral fibers. Calcified pleural plaque (CPP) is an important sign of asbestos exposure on chest radiographic examination. To study the possible change in the prevalence of CPP and diffuse pleural thickening 3 decades after cessation of asbestos exposure. CPP were detected in 29.9% of the villagers; 4.7% had diffuse pleural thickening and 0.7% had asbestosis. The significant variable for CPP and diffuse pleural thickening was age. The youngest villager with CPP was 33 years of age and the prevalence of CPP increased with an increase in age. The reason for our cases with CPP being of advanced age is the discontinuation of asbestos exposure. This finding enables us to suggest that environmental asbestos-related disease will gradually decrease in future decades.
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Affiliation(s)
- Gungor Ates
- Department of Pulmonology, Dicle University Medical School, Diyarbakir, Turkey.
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Beaver LM, Stemmy EJ, Schwartz AM, Damsker JM, Constant SL, Ceryak SM, Patierno SR. Lung inflammation, injury, and proliferative response after repetitive particulate hexavalent chromium exposure. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1896-902. [PMID: 20049209 PMCID: PMC2799464 DOI: 10.1289/ehp.0900715] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 08/19/2009] [Indexed: 05/13/2023]
Abstract
BACKGROUND Chronic inflammation is implicated in the development of several human cancers, including lung cancer. Certain particulate hexavalent chromium [Cr(VI)] compounds are well-documented human respiratory carcinogens that release genotoxic soluble chromate and are associated with fibrosis, fibrosarcomas, adenocarcinomas, and squamous cell carcinomas of the lung. Despite this, little is known about the pathologic injury and immune responses after repetitive exposure to particulate chromates. OBJECTIVES In this study we investigated the lung injury, inflammation, proliferation, and survival signaling responses after repetitive exposure to particulate chromate. METHODS BALB/c mice were repetitively treated with particulate basic zinc chromate or saline using an intranasal exposure regimen. We assessed lungs for Cr(VI)-induced changes by bronchoalveolar lavage, histologic examination, and immunohistochemistry. RESULTS Single exposure to Cr(VI) resulted in inflammation of lung tissue that persists for up to 21 days. Repetitive Cr(VI) exposure induced a neutrophilic inflammatory airway response 24 hr after each treatment. Neutrophils were subsequently replaced by increasing numbers of macrophages by 5 days after treatment. Repetitive Cr(VI) exposure induced chronic peribronchial inflammation with alveolar and interstitial pneumonitis dominated by lymphocytes and macrophages. Moreover, chronic toxic mucosal injury was observed and accompanied by increased airway pro-matrix metalloprotease-9. Injury and inflammation correlated with airways becoming immunoreactive for phosphorylation of the survival signaling protein Akt and the proliferation marker Ki-67. We observed a reactive proliferative response in epithelial cells lining airways of chromate-exposed animals. CONCLUSIONS These data illustrate that repetitive exposure to particulate chromate induces chronic injury and an inflammatory microenvironment that may promote Cr(VI) carcinogenesis.
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Affiliation(s)
- Laura M. Beaver
- Department of Pharmacology and Physiology
- Institute of Biomedical Sciences
| | - Erik J. Stemmy
- Institute of Biomedical Sciences
- Department of Microbiology, Immunology, and Tropical Medicine
| | | | - Jesse M. Damsker
- Institute of Biomedical Sciences
- Department of Microbiology, Immunology, and Tropical Medicine
| | - Stephanie L. Constant
- Institute of Biomedical Sciences
- Department of Microbiology, Immunology, and Tropical Medicine
| | - Susan M. Ceryak
- Department of Pharmacology and Physiology
- Institute of Biomedical Sciences
- Department of Medicine and
- GW Cancer Institute, George Washington University Medical Center, Washington, DC, USA
| | - Steven R. Patierno
- Department of Pharmacology and Physiology
- Institute of Biomedical Sciences
- GW Cancer Institute, George Washington University Medical Center, Washington, DC, USA
- Address correspondence to S.R. Patierno, Department of Pharmacology and Physiology, George Washington University Medical Center, 2300 I St. NW, Washington, DC 20037 USA. Telephone: (202) 994-3286. Fax: (202) 994-2870. E-mail:
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Screening for Malignant Pleural Mesothelioma and Lung Cancer in Individuals with a History of Asbestos Exposure. J Thorac Oncol 2009; 4:620-8. [DOI: 10.1097/jto.0b013e31819f2e0e] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Beaver LM, Stemmy EJ, Constant SL, Schwartz A, Little LG, Gigley JP, Chun G, Sugden KD, Ceryak SM, Patierno SR. Lung injury, inflammation and Akt signaling following inhalation of particulate hexavalent chromium. Toxicol Appl Pharmacol 2009; 235:47-56. [PMID: 19109987 PMCID: PMC3640501 DOI: 10.1016/j.taap.2008.11.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 10/30/2008] [Accepted: 11/17/2008] [Indexed: 12/18/2022]
Abstract
Certain particulate hexavalent chromium [Cr(VI)] compounds are human respiratory carcinogens that release genotoxic soluble chromate, and are associated with fibrosis, fibrosarcomas, adenocarcinomas and squamous cell carcinomas of the lung. We postulate that inflammatory processes and mediators may contribute to the etiology of Cr(VI) carcinogenesis, however the immediate (0-24 h) pathologic injury and immune responses after exposure to particulate chromates have not been adequately investigated. Our aim was to determine the nature of the lung injury, inflammatory response, and survival signaling responses following intranasal exposure of BALB/c mice to particulate basic zinc chromate. Factors associated with lung injury, inflammation and survival signaling were measured in airway lavage fluid and in lung tissue. A single chromate exposure induced an acute immune response in the lung, characterized by a rapid and significant increase in IL-6 and GRO-alpha levels, an influx of neutrophils, and a decline in macrophages in lung airways. Histological examination of lung tissue in animals challenged with a single chromate exposure revealed an increase in bronchiolar cell apoptosis and mucosal injury. Furthermore, chromate exposure induced injury and inflammation that progressed to alveolar and interstitial pneumonitis. Finally, a single Cr(VI) challenge resulted in a rapid and persistent increase in the number of airways immunoreactive for phosphorylation of the survival signaling protein Akt, on serine 473. These data illustrate that chromate induces both survival signaling and an inflammatory response in the lung, which we postulate may contribute to early oncogenesis.
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Affiliation(s)
- Laura M. Beaver
- Department of Pharmacology and Physiology, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Institute of Biomedical Sciences, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Erik J. Stemmy
- Institute of Biomedical Sciences, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Stephanie L. Constant
- Institute of Biomedical Sciences, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Arnold Schwartz
- Department of Pathology, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Laura G. Little
- The University of Montana, Department of Chemistry, 32 Campus Drive, Missoula, MT 59812
| | - Jason P. Gigley
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Gina Chun
- Department of Pharmacology and Physiology, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Institute of Biomedical Sciences, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Kent D. Sugden
- The University of Montana, Department of Chemistry, 32 Campus Drive, Missoula, MT 59812
| | - Susan M. Ceryak
- Department of Pharmacology and Physiology, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Institute of Biomedical Sciences, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Department of Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- GW Cancer Institute, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
| | - Steven R. Patierno
- Department of Pharmacology and Physiology, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Institute of Biomedical Sciences, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- Department of Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
- GW Cancer Institute, The George Washington University Medical Center, 2300 I Street NW, Washington, DC 20037
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Peretz A, Van Hee VC, Kramer MR, Pitlik S, Keifer MC. Pleural plaques related to "take-home" exposure to asbestos: An international case series. Int J Gen Med 2008; 1:15-20. [PMID: 20428401 PMCID: PMC2840547 DOI: 10.2147/ijgm.s3715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Context: While a large number of studies indicate the risks of high-level exposures to asbestos in the workplace setting, a relatively small number of studies describe the risk of pleural disease related to “take-home” asbestos brought into the household by workers exposed to asbestos. Consequently, the risk of pleural disease in family members of asbestos-exposed workers is likely underappreciated. Case presentations: Two families of siblings, one in Israel and one in the US, were evaluated because of their significant exposures to asbestos brought into the home by family members with heavy occupational exposures. Two of the four children of an asbestos cement debagger in Petach Tikvah, Israel and two children of a pipe lagger in a naval shipyard near Seattle, Washington, manifested benign pleural disease without parenchymal disease, despite having no occupational exposure to asbestos. Discussion: These cases illustrate that “take-home” asbestos exposure may lead to pleural disease at higher rates than commonly realized. Relevance to clinical practice: Providers should recognize that due to the potential for “take-home” exposures, asbestos-related disease in a patient may be a marker for disease in household contacts. Patients with family members heavily exposed to asbestos should be strongly encouraged to quit smoking in an effort to reduce any further carcinogenic exposures. Additionally, workplace control and regulation of asbestos use should be emphasized to protect both workers and their families.
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Affiliation(s)
- Alon Peretz
- Occupational Medicine Clinic, General Health Services, Kfar Saba, Israel
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Paris C, Martin A, Letourneux M, Wild P. Modelling prevalence and incidence of fibrosis and pleural plaques in asbestos-exposed populations for screening and follow-up: a cross-sectional study. Environ Health 2008; 7:30. [PMID: 18570653 PMCID: PMC2441611 DOI: 10.1186/1476-069x-7-30] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 06/20/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND CT-Scan is currently under assessment for the screening of asbestos-related diseases. However, to date no consensus exists as to how to select high-risk asbestos-exposed populations suitable for such screening programs. The objective of this study is to select the most relevant exposure variables for the prediction of pleural plaques and asbestosis in order to guide clinicians in their use of CT-Scan. METHODS A screening program of non malignant asbestos-related diseases by CT-scan was conducted among asbestos-exposed volunteers in France. Precise assessments of asbestos exposure were obtained by occupational hygiene measurements and a job-exposure matrix. Several parameters were calculated (time since first exposure, duration, intensity and cumulative exposure to asbestos). Predictive parameters of prevalence and incidence were then estimated by standard logistic and a complementary log-log regression models. RESULTS 1011 subjects were recruited in this screening program among them 474 (46.9%) presented with pleural plaques and 61 (6.0%) with interstitial changes compatible with asbestosis on CT-scan. Time since first exposure (p < 0.0001) and either cumulative or mean exposure (p < 0.0001) showed independent associations with both pleural plaques and asbestosis prevalence and pleural plaques incidence. Modelling incidence of pleural plaques showed a 0.8% to 2.4% yearly increase for a mean exposure of 1 f/ml. CONCLUSION Our findings confirmed the role played by time since first exposure and dose but not duration in asbestos-related diseases. We recommend to include these parameters in high-risk populations suitable for screening of these diseases. Short-periodicity of survey of pleural plaques by CT-Scan seemed not to be warranted.
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Affiliation(s)
- Christophe Paris
- Inserm ERI-11, Assessment and prevention of occupational and environmental risks Medical School, 9 av de la Forêt de Haye – BP 184, 54505 Vandoeuvre-les-Nancy Cedex, France
- Nancy-University, 1 rue Lyautey, 54000 Nancy, France
| | - Aurélie Martin
- Inserm ERI-11, Assessment and prevention of occupational and environmental risks Medical School, 9 av de la Forêt de Haye – BP 184, 54505 Vandoeuvre-les-Nancy Cedex, France
| | - Marc Letourneux
- Occupational Diseases Department, University Hospital, Avenue de la cote de Nacre, 14000 CAEN, France
| | - Pascal Wild
- Département Epidémiologie en Entreprises, Rue du Morvan, CS 60027,54519 Vandoeuvre Les Nancy Cedex, France
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Computed tomography for diagnosis and grading of dust-induced occupational lung disease. Curr Opin Pulm Med 2008; 14:135-40. [DOI: 10.1097/mcp.0b013e3282f5248e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
This chapter consists of a review of the literature regarding radiographic and tomographic characteristics of the principal occupational respiratory diseases (silicosis and asbestosis). Special attention is given to the practical relevance of high-resolution computed tomography, which is the most sensitive and specific method of identifying and quantifying the extent of pleural and parenchymal lesions related to such diseases.
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Sichletidis L, Chloros D, Chatzidimitriou N, Tsiotsios I, Spyratos D, Patakas D. Diachronic study of pleural plaques in rural population with environmental exposure to asbestos. Am J Ind Med 2006; 49:634-41. [PMID: 16732558 DOI: 10.1002/ajim.20334] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The progress of pleural plaques in persons exposed to environmental asbestos in Almopia, Greece were studied prospectively. METHODS During a 15-year period, 198 individuals, in whom pleural plaques had been observed during the period 1988-1990 were followed. Respiratory function was initially evaluated in 23. All were inhabitants of seven villages of Northern Greece, where rocks with high concentration in asbestos fibers were used for whitewashing until 1935. RESULTS Out of this population, 126 survived and underwent chest X-ray in 2003 while respiratory function was retested in 18. New radiological findings were compared to previous ones using digital technology. Furthermore, the cause of death of the remaining 72 was recorded. Deterioration of X-ray findings was observed in all survivors. Not only did the surface area of previous plaques increase (8.66 +/- 12.6 cm2, mean value +/- SD) but new ones also appeared. Total lung capacity decreased from 95.6 +/- 14.8 in 1998 to 76.5 +/- 9.3% predicted in 2003. It was found that out of 72 deaths, 11 people died of malignant lung neoplasm, and 4 of mesothelioma. CONCLUSIONS Radiological appearance of pleural plaques and respiratory function of people previously exposed to asbestos environmental pollution worsens over the years. Prevalence of mesothelioma was found to be higher than expected.
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Affiliation(s)
- L Sichletidis
- Pulmonary Clinic, Laboratory for the Investigation of Environmental Diseases, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Abstract
Malignant mesothelioma is increasing in incidence globally and has no known cure. Its unique clinical feature of local infiltration along tissue planes makes it a difficult neoplasm to manage. There have been few randomized controlled trials regarding treatment options, although these have increased in recent years, and results are eagerly awaited. This article summarizes important advances in the management of mesothelioma, especially diagnostic and therapeutic aspects.
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Affiliation(s)
- Sophie D West
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
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Creaney J, Robinson BWS. Detection of Malignant Mesothelioma in Asbestos-Exposed Individuals: The Potential Role of Soluble Mesothelin-Related Protein. Hematol Oncol Clin North Am 2005; 19:1025-40, v. [PMID: 16325121 DOI: 10.1016/j.hoc.2005.09.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Malignant mesothelioma (MM) is strongly associated with asbestos exposure. Measurement of soluble mesothelin-related protein (SMRP) levels in the serum may prove valuable as an adjunct to current tests for the diagnosis of MM and for monitoring MM patients for the early detection of disease recurrence. SMRP measures also may be useful in an overall screening program for MM because early results show that some individuals have elevated levels 1 to 4 years before symptom development. Although individuals with occupational and nonoccupational asbestos exposure are justifiably concerned about their risk of developing MM, consideration must be given to the complex issues surrounding screening for this disease, and a more substantial evaluation of the SMRP marker must be undertaken before deciding to promote a screening program.
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Affiliation(s)
- Jenette Creaney
- School of Medicine and Pharmacology, University of Western Australia, 4th Floor, G-Block, Sir Charles Gairdner Hospital, Nedlands 6009, Western Australia, Australia.
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Abstract
Malignant mesothelioma is an aggressive, treatment-resistant tumour, which is increasing in frequency throughout the world. Although the main risk factor is asbestos exposure, a virus, simian virus 40 (SV40), could have a role. Mesothelioma has an unusual molecular pathology with loss of tumour suppressor genes being the predominant pattern of lesions, especially the P16INK4A, and P14ARF, and NF2 genes, rather than the more common p53 and Rb tumour suppressor genes. Cytopathology of mesothelioma effusions or fine-needle aspirations are often sufficient to establish a diagnosis, but histopathology is also often required. Patients typically present with breathlessness and chest pain with pleural effusions. Median survival is now 12 months from diagnosis. Palliative chemotherapy is beneficial for mesothelioma patients with high performance status. The role of aggressive surgery remains controversial and growth factor receptor blockade is still unproven. Gene therapy and immunotherapy are used on an experimental basis only. Patterns identified from microarray studies could be useful for diagnosis as well as prognostication.
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Affiliation(s)
- Bruce W S Robinson
- Tumour Immunology Group, School of Medicine and Pharmacology, University of Western Australia, Australia.
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Danson S, Blackhall F, Hulse P, Ranson M. Interstitial lung disease in lung cancer: separating disease progression from treatment effects. Drug Saf 2005; 28:103-13. [PMID: 15691221 DOI: 10.2165/00002018-200528020-00002] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Lung cancer often develops in individuals with pre-existing pulmonary and cardiac pathology. Many of these individuals with pre-existing pathology are also at risk of occupational lung disease. New and worsening symptoms can be secondary to pre-existing pathology, progressive cancer or treatment. Pulmonary toxicity, including interstitial lung disease, following radiotherapy and conventional cytotoxic chemotherapy (e.g. cyclophosphamide, bleomycin), has been recognised for many years. Pulmonary toxicity also occurs with the newer classes of cytotoxic agents, including the deoxycytidine analogue gemcitabine. A small percentage (0.88%) of patients treated with the epidermal growth factor receptor tyrosine kinase inhibitor gefitinib have developed interstitial lung disease. This complication has been reported at a higher frequency in Japanese patients than in US patients (1.9% vs 0.34%, respectively) and in those with pre-existing pulmonary fibrosis. This review discusses the difficulties in both recognition and treatment of gefitinib-associated interstitial lung disease. Symptoms are vague, such as dyspnoea, cough and fever and can be difficult to differentiate from progressive disease, co-existing morbidity and new pulmonary pathology. Diagnosis is, therefore, by rigorous investigation to exclude all other differential diagnoses. Treatment, at present, is supportive and includes discontinuation of gefitinib, oxygen supplementation, high-dose corticosteroids and antibacterials.
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Affiliation(s)
- Sarah Danson
- Department of Medical Oncology, Christie Hospital NHS Trust, Withington, Manchester M20 4BX, UK.
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Isidro ontes I, Abu Shams K, Alday E, Carretero Sastre J, Ferrer Sancho J, Freixa Blanxart A, Monsó Molas E, Pascal Martínez I, Rodríguez Becerra E, Rodríguez Panadero F. Normativa sobre el asbesto y sus enfermedades pleuropulmonares. Arch Bronconeumol 2005. [DOI: 10.1157/13071586] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Isidro Montes I, Abu Shams K, Alday E, Carretero Sastre JL, Ferrer Sancho J, Freixa Blanxart A, Monsó Molas E, Pascal Martínez I, Rodríguez Becerra E, Rodríguez Panadero F. Guidelines on Asbestos-Related Pleuropulmonary Disease. ACTA ACUST UNITED AC 2005; 41:153-68. [PMID: 15766468 DOI: 10.1016/s1579-2129(06)60416-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- I Isidro Montes
- Servicio de Neumología Ocupacional, Instituto Nacional de Silicosis, Hospital Central de Asturias, Oviedo, Asturias, España.
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Lee YCG, Knight DA, Lane KB, Cheng DS, Koay MA, Teixeira LR, Nesbitt JC, Chambers RC, Thompson PJ, Light RW. Activation of proteinase-activated receptor-2 in mesothelial cells induces pleural inflammation. Am J Physiol Lung Cell Mol Physiol 2004; 288:L734-40. [PMID: 15591415 DOI: 10.1152/ajplung.00173.2004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pleural inflammation underlies many pleural diseases, but its pathogenesis remains unclear. Proteinase-activated receptor-2 (PAR(2)) is a novel seven-transmembrane receptor with immunoregulatory roles. We hypothesized that PAR(2) is present on mesothelial cells and can induce pleural inflammation. PAR(2) was detected by immunohistochemistry in all (19 parietal and 11 visceral) human pleural biopsies examined. In cultured murine mesothelial cells, a specific PAR(2)-activating peptide (SLIGRL-NH(2)) at 10, 100, and 1,000 muM stimulated a 3-, 42-, and 1,330-fold increase of macrophage inflammatory protein (MIP)-2 release relative to medium control, respectively (P < 0.05 all) and a 2-, 32-, and 75-fold rise over the control peptide (LSIGRL-NH(2), P < 0.05 all). A similar pattern was seen for TNF-alpha release. Known physiological activators of PAR(2), tryptase, trypsin, and coagulation factor Xa, also stimulated dose-dependent MIP-2 release from mesothelial cells in vitro. Dexamethasone inhibited the PAR(2)-mediated MIP-2 release in a dose-dependent manner. In vivo, pleural fluid MIP-2 levels in C57BL/6 mice injected intrapleurally with SLIGRL-NH(2) (10 mg/kg) were significantly higher than in mice injected with LSIGRL-NH(2) or PBS (2,710 +/- 165 vs. 880 +/- 357 vs. 88 +/- 46 pg/ml, respectively; P < 0.001). Pleural fluid neutrophil counts were higher in SLIGRL-NH(2) group than in the LSIGRL-NH(2) and PBS groups (by 40- and 26-fold, respectively; P < 0.05). This study establishes that activation of mesothelial cell PAR(2) potently induces the release of inflammatory cytokines in vitro and neutrophil recruitment into the pleural cavity in vivo.
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Affiliation(s)
- Y C Gary Lee
- Centre for Respiratory Research, Rayne Institute, University College London, 5 University St., London WC1E 6JJ, UK.
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