Malignant mesothelioma (MM) is a
neoplasm arising from mesothelial cells lining the pleural, peritoneal, and pericardial cavities. Over 20 million people in the US are at risk of developing MM due to
asbestos exposure. MM mortality rates are estimated to increase by 5-10% per year in most industrialized countries until about 2020. The incidence of MM in men has continued to rise during the past 50 years, while the incidence in women appears largely unchanged. It is estimated that about 50-80% of pleural MM in men and 20-30% in women developed in individuals whose history indicates
asbestos exposure(s) above that expected from most background settings. While rare for women, about 30% of peritoneal
mesothelioma in men has been associated with exposure to
asbestos.
Erionite is a potent carcinogenic
mineral fiber capable of causing both pleural and peritoneal MM. Since
erionite is considerably less widespread than
asbestos, the number of MM cases associated with
erionite exposure is smaller.
Asbestos induces
DNA alterations mostly by inducing mesothelial cells and reactive macrophages to secrete mutagenic
oxygen and
nitrogen species. In addition,
asbestos carcinogenesis is linked to the chronic inflammatory process caused by the deposition of a sufficient number of
asbestos fibers and the consequent release of pro-inflammatory molecules, especially HMGB-1, the master switch that starts the inflammatory process, and
TNF-alpha by macrophages and mesothelial cells.
Genetic predisposition, radiation exposure and
viral infection are co-factors that can alone or together with
asbestos and
erionite cause MM. J. Cell. Physiol. 227: 44-58, 2012. © 2011 Wiley Periodicals, Inc.