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Mesothelioma Research Results Offer Potential Route to Earlier Detection

X-ray of lungs

Cancer experts have known for decades that asbestos causes mesothelioma. Yet, only 2 to 10 percent of people with prolonged asbestos exposure are diagnosed with pleural mesothelioma, the most common type of the disease.

Researchers want to know how the disease actually happens, and what this may tell us about why some people exposed to asbestos develop the disease while others do not.

The latest results from the Shukla Research Lab at the pathology and laboratory medicine department at the University of Vermont have shed light on the precise steps for how asbestos fibers lead to mesothelioma.

The newly described pathway from asbestos exposure to mesothelioma may one day be used as a way to detect the cancer earlier.

This is an exciting possibility because survival is better for people diagnosed with early-stage mesothelioma than it is for patients diagnosed with more advanced disease.

From Asbestos Fibers to Diagnosable Disease

Until this new study, there was a gap in understanding key steps for how fibers entering the lungs end up causing cancer in a different tissue.

Even though asbestos fibers enter the body through the lungs, mesothelioma cancer occurs in the mesothelium, which is also known as the lining of the chest cavity.

Asbestos fibers do appear to migrate to the chest lining. However, this doesn’t account for all of the early inflammation and damage that leads to cancer in these cells.

The University of Vermont lab, which is run by Dr. Arti Shukla, sought to uncover how asbestos-damaged lung cells may be influencing changes in cells in the mesothelium — even before asbestos fibers make their way out of the lungs.

In the laboratory study, the researchers exposed lung cells to asbestos.

The following are the results:

  • The lung cells created and confined certain proteins into a package called an exosome.

  • The package was secreted from the cell, carrying its protein cargo with it.

  • Next, the researchers exposed mesothelial cells to the exosome packages from the asbestos-treated lung cells.

  • The mesothelial cells responded to the packages by turning on and off genes known to play a role in cancer development.

According to Shukla’s website, the U.S. Department of Defense is funding her exosome research.

Importance of These Results

“At this time, there are no identified biomarkers to demarcate asbestos exposure before the presentation of disease and symptoms,” the study’s authors wrote. “And there is only limited understanding of the underlying biology that governs asbestos-induced disease.”

Only a small portion of individuals exposed to asbestos go on to develop mesothelioma. Until now, nobody had an idea for how to determine which people with known asbestos exposure develop the deadly disease.

Something that can be detected in the blood, which is called a biomarker, would be an important step forward in the mesothelioma field.

Novel Way for Possible Early Detection of Mesothelioma

Now there is a potential way to identify people most susceptible to mesothelioma. This would allow regular screening and catching the disease earlier in people with a known history of asbestos exposure.

This would be a win for the patient and a win for doctors to treat mesothelioma most effectively.

It will be a few years until we know if these packages called exosomes will be a good way to detect mesothelioma prior to disease symptoms.

More investigation will determine if the packages from asbestos-exposed lung cells can be detected in the blood.

However, researchers already are able to identify tiny amounts of genetic material from tumors in a person’s blood. That’s a sign exosomes also may be detectable.

Building on Novel Findings

Even if this does not turn out to be the best way to screen for mesothelioma, it will open entirely new avenues of research. These possibilities will further improve understanding of mesothelioma, leading to yet more research.

Each piece of the puzzle is important for anyone exposed to asbestos or living with mesothelioma.


Suzanne Dixon is a registered dietitian, epidemiologist and experienced medical writer. She has volunteered with the National Cancer Policy Forum, Oncology Nutrition Dietetic Practice Group, American Institute for Cancer Research, American Society for Clinical Oncology, The National Academies of Sciences, Engineering, and Medicine. The New York Times and Time Magazine also have reviewed her cancer patient resources.

Last Modified April 11, 2018
Sources
  1. Jasani, B., Gibbs, A. (2012). Mesothelioma Not Associated With Asbestos Exposure. Retrieved from http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2011-0039-RA
  2. Phillip P. et al. (2018, March 19). Exosomes from asbestos-exposed cells modulate gene expression in mesothelial cells. Retrieved from https://doi.org/10.1096/fj.201701291RR

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