Quoted from http://toxsci.oxfordjournals.org/content/early/2012/05/12/toxsci.kfs171.abstract?maxtoshow=&HITS=10&hits=2&RESULTFORMAT=&andorexacttitle=or&andorexacttitleabs=and&fulltext=asbestos&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct

The threshold length for fibre-induced acute pleural inflammation: shedding light on the early events in asbestos-induced mesothelioma

• Received February 10, 2012.

Abstract

Suspicion has been raised that high aspect ratio nanoparticles or nanofibres might possess asbestos-like pathogenicity. The pleural space is a specific target for disease in individuals exposed to asbestos and, by implication nanofibres. Pleural effects of fibres depends on fibre length, but the key threshold length beyond which adverse effects occur has never been identified up to now since all asbestos and vitreous fibre samples are heterogeneously distributed in their length. Nanotechnology advantageously allows for highly defined length distribution of synthetically engineered fibres which enable for in depth investigation of this threshold length. We utilised the ability to prepare silver-nanofibres of five defined length classes to demonstrate a threshold fibre length for acute pleural inflammation. Nickel-nanofibres and carbon nanotubes were then used to strengthen the relationship between fibre length and pleural inflammation. A method of intrapleural injection of nanofibres in female C57Bl/6 strain mice was used to deliver the fibre dose and we then assessed the acute pleural inflammatory response. Chestwall sections were examined by light and by scanning electron microscopy to identify areas of lesion; furthermore cell-nanowires interaction on the mesothelial surface of the parietal pleura in vivo, were investigated. Our results showed a clear threshold effect demonstrating that fibres beyond 4 µm in length are pathogenic to the pleura. The identification of the threshold length for nanofibre induced pathogenicity in the pleura has important implications for understanding the structure-toxicity relationship for asbestos-induced mesothelioma and consequent risk assessment with the aim to contribute to the engineering of synthetic nanofibres by the adoption of a benign-by-design approach.

Quoted from http://chestjournal.chestpubs.org/content/early/2012/05/08/chest.11-3204.abstract

Post Mortem Findings of Malignant Pleural Mesothelioma: A Two-Centre Study of 318 patients

Abstract

Background: Malignant pleural mesothelioma (MPM) is an incurable cancer with a rising incidence. MPM is often perceived as a locally invasive cancer and the exact cause of death is poorly understood.

Aim: This two-centre study describes the anatomical features of patients with MPM at post-mortem.

Methods: The Mesothelioma Registry of Western Australia (WA) and the Avon region (UK) Coroner’s reports were interrogated for the post-mortem records of confirmed mesothelioma cases.

Results: Post-mortem records of 318 pleural mesothelioma patients (169 from WA and 149 from Avon) were identified. Most (91.5%) patients were male (mean age 68.4±11.5) and MPM was right sided in 55.3%. Extrapleural dissemination of tumor was found in 87.7% of cases and lymph node involvement in 53.3%. Tumor dissemination in extra-thoracic sites was common (55.4% of patients) and almost all organs were involved, including liver (31.9%), spleen (10.8%), thyroid (6.9%), and the brain (3.0%). Pulmonary emboli (PE) were found in 6% of cases and considered as directly contributing to death in 13 (4.1%) patients. The precise cause of death could only be determined in 63 (19.8%) cases even after post-mortem. The body mass index was significantly lower in cases which had no identifiable anatomical cause of death at post-mortem (18.8±4.3 vs. 21.0±4.7, p=0.034).

Conclusion: In this largest post-mortem series on MPM, extra-thoracic dissemination of mesothelioma was common and often under-recognized. No anatomical cause of death was identified in the majority of patients even at autopsy, raising the possibility of physiological and metabolic causes of death.

Quoted from http://highwire.stanford.edu/cgi/medline/pmid;22544163

Mesothelioma Associated With Commercial Use of Vermiculite Containing Libby Amphibole. KK Dunning, S Adjei, L Levin, AM Rohs, T Hilbert, E Borton, V Kapil, C Rice, GK Lemasters, and JE Lockey J Occup Environ Med, April 25, 2012; .
OBJECTIVES:: To describe asbestos-related mortality among manufacturing workers who expanded and processed Libby vermiculite that contained amphibole fiber. METHODS:: Standardized mortality ratio was calculated for 465 white male workers 31 years after last Libby vermiculite exposure. RESULTS:: Two workers died from mesothelioma, resulting in a significantly increased standardized mortality ratio of 10.5 (95% confidence interval, 1.3 to 38.0). These workers were in the upper 10th percentile of cumulative fiber exposure, that is, 43.80 and 47.23 fiber-years/cm, respectively. One additional worker with cumulative fiber exposure of 5.73 fiber-years/cm developed mesothelioma but is not deceased. There were no other significantly increased standardized mortality ratios. CONCLUSIONS:: Workers expanding and processing Libby vermiculite in a manufacturing setting demonstrated an increased risk for the development of mesothelioma following exposure to the amphibole fiber contained within this vermiculite ore source.

Quoted from http://www.staradvertiser.com/news/breaking/150386255.html

UH researcher leads breakthrough on a deadly cancer

By Star-Advertiser staff

POSTED: 07:46 p.m. HST, May 06, 2012

An international team led by University of Hawaii Cancer Center researcher Haining Yang has identified a protein known as HMGB1 as a critical link in the development of malignant mesothelioma, one of the deadliest forms of cancer.

The findings were published in the current issue of the online journal “Cancer Research.”

Mesothelioma has been linked to occupational and environmental exposure to asbestos and the naturally occurring mineral fiber erionite. The average survival for those diagnosed with the disease is less than one year, in part because the cancer is highly aggressive and resistant to current treatments, and partly because it is usually diagnoses it its late states.

[Article continues at original source]

Quoted from http://annhyg.oxfordjournals.org/content/early/2012/05/04/annhyg.mes017.abstract?maxtoshow=&HITS=10&hits=6&RESULTFORMAT=&andorexacttitle=or&andorexacttitleabs=and&fulltext=asbestos&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct

Pulmonary Carcinoid Tumors and Asbestos Exposure

• Received November 10, 2011.
• Accepted February 14, 2012.

Abstract

Objectives: The hypothesis that asbestos exposure may have more specific associations with particular histological types of lung cancer remains controversial. The aim of this study was to analyze the relationships between asbestos exposure and pulmonary carcinoid tumors.

Methods: A retrospective case–control study was conducted in 28 cases undergoing surgery for pulmonary carcinoid tumors and aged >40 years and in 56 controls with lung cancer of a different histological type, matched for gender and age, from 1994 to 1999, recruited in two hospitals in the region of Paris. Asbestos exposure was assessed via expertise of a standardized occupational questionnaire and mineralogical analysis of lung tissue, with quantification of asbestos bodies (AB).

Results: Definite asbestos exposure was identified in 25% of cases and 14% of controls (ns). Cumulative asbestos exposure was significantly higher in cases than in controls (P < 0.05), and results of the quantification of AB tended to be higher in cases than in controls (24 and 9% had >1000 AB per gram dry lung tissue, respectively, P = 0.09). Mean cumulative smoking was lower in cases than in controls (P < 0.05).

Conclusions: This study argues in favor of a relationship between asbestos exposure and certain pulmonary carcinoid tumors.

Quoted from http://jco.ascopubs.org/content/30/13/1541.abstract?maxtoshow=&HITS=10&hits=1&RESULTFORMAT=&andorexacttitle=or&andorexacttitleabs=and&fulltext=asbestos&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct

Serum Mesothelin for Diagnosing Malignant Pleural Mesothelioma: An Individual Patient Data Meta-Analysis

1. Presented in part at the 10th International Congress of the International Mesothelioma Interest Group, August 31 to September 3, 2010, Kyoto, Japan.

Abstract

Purpose Mesothelin is currently considered the best available serum biomarker of malignant pleural mesothelioma. To examine the diagnostic accuracy and use of serum mesothelin in early diagnosis, we performed an individual patient data (IPD) meta-analysis.

Methods The literature search identified 16 diagnostic studies of serum mesothelin, measured with the Mesomark enzyme-linked immunosorbent assay. IPD of 4,491 individuals were collected, including several control groups and 1,026 patients with malignant pleural mesothelioma. Mesothelin levels were standardized for between-study differences and age, after which the diagnostic accuracy and the factors affecting it were examined with receiver operating characteristic (ROC) regression analysis.

Results At a common diagnostic threshold of 2.00 nmol/L, the sensitivities and specificities of mesothelin in the different studies ranged widely from 19% to 68% and 88% to 100%, respectively. This heterogeneity can be explained by differences in study population, because type of control group, mesothelioma stage, and histologic subtype significantly affected the diagnostic accuracy. The use of mesothelin in early diagnosis was evaluated by differentiating 217 patients with stage I or II epithelioid and biphasic mesothelioma from 1,612 symptomatic or high-risk controls. The resulting area under the ROC curve was 0.77 (95% CI, 0.73 to 0.81). At 95% specificity, mesothelin displayed a sensitivity of 32% (95% CI, 26% to 40%).

Conclusion In patients suspected of having mesothelioma, a positive blood test for mesothelin at a high-specificity threshold is a strong incentive to urge further diagnostic steps. However, the poor sensitivity of mesothelin clearly limits its added value to early diagnosis and emphasizes the need for further biomarker research.

Quoted from http://occmed.oxfordjournals.org/content/early/2012/04/26/occmed.kqs028.abstract?maxtoshow=&HITS=10&hits=3&RESULTFORMAT=&andorexacttitle=or&andorexacttitleabs=and&fulltext=asbestos&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct

The presentation and natural history of asbestos-induced diffuse pleural thickening

1. V. Jeebun1 and
2. S. C. Stenton2

1. ? 1Department of Respiratory Medicine, University Hospital of North Tees, Stockton on Tees, TS19 8PE, UK
2. ? 2Regional Unit for Occupational Lung Disease, Royal Victoria Infirmary, Newcastle Upon Tyne, NE1 4AP, UK.

• Received September 26, 2011.
• Revision received January 15, 2012.
• Accepted January 26, 2012.

Abstract

Background Three forms of asbestos-related benign pleural disease are recognized: discrete pleural plaques, pleural effusions and diffuse pleural fibrosis. Of these, diffuse pleural fibrosis is the most significant on account of its chronicity and associated morbidity.

Aims The objectives of this study were to determine the latency of asbestos-induced diffuse pleural fibrosis, its presenting features and its clinical course once established.

Methods We conducted a retrospective review of 75 patients with asbestos-induced diffuse pleural fibrosis referred for assessment at our institution from 1992 to 2007. Diffuse pleural fibrosis was considered to be present if there was obliteration of the costophrenic angle in continuity with at least 3-mm pleural thickening, in accordance with the International Labour Organization 2000 Classification.

Results The median latency for development of diffuse pleural fibrosis from first asbestos exposure was 34 years. Seventy-three per cent of patients had unilateral disease at presentation and 24% of these were observed to develop contralateral disease after a median of 2 years. Unilateral pleural disease was commonest on the right. Forty per cent of patients presented with pleural effusions preceding the development of diffuse pleural thickening. The median latency for development of pleural effusions from onset of exposures was 38 years. Eighty per cent of the pleural effusions were unilateral. Once established, pleural thickening was reported to have remained stable in 91% on the ipsilateral side.

Conclusions The findings of this study may help in providing further insight into the natural history of diffuse pleural fibrosis to guide the clinician in the management of this condition.

Quoted from http://highwire.stanford.edu/cgi/medline/pmid;22509441

Primary malignant pericardial mesothelioma presenting as acute pericarditis. WS Choi, MS Im, JH Kang, YG Kim, IC Hwang, JM Lee, S Lee, HS Shin, SP Lee, and GY Cho J Cardiovasc Ultrasound, March 1, 2012; 20(1): 57-9.   Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
We report on a 21-year-old man with fever, dyspnea, and pleuritic chest pain. An electrocardiography showed ST elevation in multiple lead and thoracic echocardiography revealed moderate pericardial effusion. He was initially diagnosed with acute pericarditis, and treated with nonsteroidal anti-inflammatory drugs and colchicines with clinical and laboratory improvement. After 1 month of medication, his symptoms recurred. An echocardiography showed constrictive physiology and the patient was treated with steroid on the top of current medication. The patient had been well for 7 months until dyspnea and edema developed, when an echocardiography showed marked increased pericardial thickness and constriction. Pericardial biopsy was performed and primary malignant pericardial mesothelioma was diagnosed. Malignancy should be considered in the differential diagnosis of recurrent pericarditis.

Quoted from http://highwire.stanford.edu/cgi/medline/pmid;22513792

Malignant Peritoneal Mesothelioma in a 16-Year-Old Girl: Presentation of a Rare Disease. IB Brecht, A Agaimy, M Besendorfer, R Carbon, FC Thiel, O Rompel, D Osinski, T Langer, M Metzler, and W Holter Klin Padiatr, April 18, 2012; . Pediatric Hematology and Oncology, University Hospital -Erlangen, Germany.
Malignant peritoneal mesothelioma is extremely rarely seen in young patients. A 16 year-old girl presented with appendicitis-like acute abdominal pain. Intra-operatively, multiple confluent peritoneal nodules were seen on the entire greater omentum and in the pelvis infiltrating the uterus and both ovaries. Biopsies were obtained and interpreted as serous ovarian carcinoma. Radical surgical resection and hyperthermic intraperitoneal chemotherapy -(HIPEC) with carboplatin was performed and followed by 2 cycles of carboplatin / paclitaxel. Histological reevaluation showed characteristic features of epithelioid peritoneal mesothelioma and ruled out serous ovarian cancer. Therapy was continued with 6 cycles of pemetrexed/cisplatin.3 months after end of chemotherapy vital tumor tissue was found in the recess behind the liver, which could be resected completely. The patient is currently disease-free 17 months after initial diagnosis. Malignant peritoneal mesothelioma in young female patients might be under-recognized and possibly misdiagnosed as ovarian serous carcinoma in some cases. International and interdisciplinary cooperation is necessary in order to provide evidence based guidelines for diagnosis and treatment in the future.

Quoted from http://www.medpagetoday.com/MeetingCoverage/ELCC/32298

RT May Have Role in Mesothelioma

ByCharles Bankhead, Staff Writer, MedPage Today

Published: April 22, 2012

 

GENEVA — Patients with advanced, poor-risk mesothelioma lived for as long as 7 years after treatment with high-dose, hemithoracic radiation therapy, data from a small patient series showed.

The 45 patients had a median overall survival of 12.4 months from treatment and an estimated 1-year survival of 50%. No patient had in field-only recurrent disease following treatment with conformal or intensity-modulated radiation therapy (IMRT).

The findings dispute the notion that mesothelioma is radiation insensitive, Malcolm Feigen, MD, said here at the European Lung Cancer Conference (ELCC).

“I stood before [the ELCC] 2 years ago to present the first 14 patients we had analyzed and asked whether there was a role for high-dose hemithoracic radiotherapy in unpneumonectomized mesothelioma patients,” said Feigen, of the Austin Health Radiation Oncology Center in Melbourne, Australia. “I think now that the answer to that question is ‘absolutely.’”

[Article continues at original source]