Mesothelioma And Asbestos Lung Cancer Class Actions Explained – Relationship between ECOG-PS, mGPS, BMI/WL range and body composition and physical activity in cancer patients
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Mesothelioma And Asbestos Lung Cancer Class Actions Explained
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Metabolic Rewiring And Redox Alterations In Malignant Pleural Mesothelioma
By David Michael Abbott David Michael Abbott Scilit Preprints.org Google Scholar 1 , Chandra Bortolotto Chandra Bortolotto Scilit Preprints.org Google Scholar 2 , Silvia Benvenuti Silvia Benvenuti Scilit Preprints.org Google Scholar 3 , Andrea Lacillit Preprints.org , Andrea Riccardo Filipo Filippi Scilit Preprints.org Google Scholar 4 and Giulia Maria Stella Giulia Maria Stella Scilit Preprints.org Google Scholar 1, *
Department of Medicine and Infectious Diseases, Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy
Radiology Unit, Department of Intensive Medicine, IRCCS Policlinico San Matteo Foundation and Medical School of Pavia, 27100 Pavia, Italy
The Asbestos Fibre Burden In Human Lungs: New Insights Into The Chrysotile Debate
Radiotherapy Unit, Department of Medicine and Infectious Diseases, IRCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy
Received: 24 March 2020 / Revised: 2 May 2020 / Accepted: 4 May 2020 / Published: 7 May 2020
Mesothelioma is a malignant condition of the serosal membrane that includes the peritoneum, pleura, pericardium and tunica vaginalis of the testicles. Malignant mesothelioma (MM) is a rare disease with a worldwide incidence of about 1.15 per 100,000 inhabitants in countries such as Italy. Malignant Pleural Mesothelioma (MPM) is the most common type of mesothelioma, accounting for approximately 80% of cases. Although rare in the general population, mesothelioma is associated with exposure to industrial pollution and mineral fibers, approximately 80% of which are associated with asbestos. Due to continued exposure to asbestos in many countries, a further increase in the incidence of MPM worldwide is expected in the current and future years. The tumor grows in a loco-regional manner, extending from the diaphragm to the inner pleura and invading surrounding structures causing a clinical picture of pleural effusion, pain, and dyspnea. Distant spread and metastases are rarely seen, and most patients die from the burden of the primary cancer. Currently, there are no effective treatments for MPM, and the prognosis remains poor. Some studies usually predict about a year after diagnosis. The unique weak dynamic landscape that characterizes the MPM appears to arise from the selective pressure exerted by the environment; Therefore, inflammation and the immune response appear to be important players in driving the progression of MPM and represent protective targets. Here, we review the current knowledge of MPM, focusing on the emerging network between genetic assets and the inflammatory microenvironment that characterizes this disease as a suitable target for novel therapies.
What Is Mesothelioma? Overview Of Types, Symptoms & Treatment
Malignant Pleural Mesothelioma (MPM) is an aggressive malignant disease with a severe disease due to pathogenesis that is strongly associated with exposure to asbestos fibers. MPM was first linked to exposure to asbestos fiber in 1935 [1, 2] and is now well documented to cause at least 80% of cases from exposure to asbestos fiber [1, 3]. Because of its extreme flexibility, asbestos became popular in the 1970s and 80s in the production of cement, tiles, rope, toys, jewelry, pipe fittings, and more [3, 4]. In addition, its temperature resistant properties have made it particularly attractive for insulation and heat exchange [3, 5]. Unfortunately, these contradictory properties have made disposal of carcinogenic asbestos-containing materials almost impossible (properly, the word asbestos comes from the Greek word meaning “indestructible”), which presents difficult epidemiological challenges . MPM still has effective treatments and the median survival after diagnosis is about 13-15 months . Growing evidence shows that the damage caused by asbestos is associated with the generation of an inflammatory microenvironment that may support the development of cancer, possibly related to genetic predisposition [6, 7, 8]. Here we describe the current knowledge of MPM, focusing on the heterogeneous context and the complex interplay between genetics and the microenvironment that emerges as a driving force in cancer progression. A deeper understanding of these processes will allow the proper classification of patients and the identification of new and effective treatments.
Although mesothelioma is rare and the manufacture of asbestos-containing materials has been illegal in many states for more than 20 years—although in some states it has not been banned—incidences of MPM are still increasing. This is mainly due to the 20 to 40 year delay in the effects of asbestos in the aging, genetically vulnerable population. Since 1994, the World Health Organization (WHO) has monitored the epidemiological data of Malignant Pleural Mesothelioma (MPM) . From 1994 to 2008, the WHO mortality database identified approximately 100,000 MPM deaths in 83 countries, with approximately 5 deaths per million. In addition, men are affected more often than women and the average death rate is 70 years. Asbestos is completely safe in its primary form and is basically solid rock, but it is a serious health hazard when mined or processed as it produces carcinogenic nanometer-scale fibrous particles that become airborne. Easily absorbed from the lungs. Asbestos fibers can be divided into two main groups: serpentine and amphibole. Serpentine fibers have only one subtype, chrysotile fibers, also known as white asbestos because of its light color. These fibers are short and curled and make up about 95% of the asbestos used commercially. Amphibole fibers include crocidolite (blue asbestos) and amosite (brown asbestos), tremolite and various others. Amphibole fibers are long and straight and can be carcinogenic. However, the International Agency for Research on Cancer (IARC) classified both fibers as Group I carcinogens . There is a dose-response pattern to asbestos exposure for MM and lung cancer, but as stated by IARC and WHO, no safe lower limit has been identified. Asbestos can also cause lung cancer, with an estimated 20,000 asbestos-related lung cancers and 10,000 MM occurring annually in people in Western Europe, Scandinavia, North America, Japan, and Australia, where there are no registries. It still uses asbestos like the rest of Asia including Eastern Europe, South America, Africa and China [11, 12]. In addition, MPM has been associated with exposure to erionite, a zeolite mineral with physical properties similar to asbestos, which is widespread in Cappadocia (Turkey) and other North American cities . In comparison, a cluster of deaths from pleural mesothelioma was reported in Biancavilla (Sicily), Italy. A subsequent study showed that those cases of MPM were associated with patient exposure to fluoro-edenite, a quarry material with a morphology and mineral composition of the tremolite-actinolite series [14, 15]. Therefore, awareness of the potential danger of new man-made and biostable fibers with the same carcinogenic properties shown by carbon nanotubes should be strictly observed to avoid a new epidemic . Although asbestos is undoubtedly the largest and most well-known cause of mesothelioma, approximately 20 percent of patients were not exposed to asbestos. Although these patients may have been inadvertently exposed, genetic analysis and other studies have suspected a genetic predisposition following chronic exposure to chemicals such as nitrosamines, nitrosoureas, potassium bromate, ferric saturates, and biostable minerals and radiation therapy. ] all offenders [12, 13, 14, 15, 16, 17, 18]. Simian Virus 40 (SV40) infection was previously tested as an etiologic agent but was not found .
Such different clinical and imaging presentations require diagnosis to depend on immunohistochemical (IHC) markers: mesothelioma must be positive for at least two mesothelioma markers and negative for at least two tumor-related markers . IHC seems to be the most effective combination of markers: calretinin and cytokeratin 5/6 (or WT1) and CEA (carcinoembryonic antigen) and MOC-31, also called epithelial, are good markers.
Pleural Mesothelioma And Lung Cancer Risks In Relation To Occupational History And Asbestos Lung Burden
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