Association of biomarker levels with severity of asbestos-related diseases

Our plain-English summary of Association of biomarker levels with severity of asbestos-related diseases, by E.K. Park, D.H. Yates, J. Creaney, et al (Safety and Health at Work, 2012).

The study

• Authors: E.K. Park, D.H. Yates, J. Creaney, P.S. Thomas, B.W. Robinson, A.R. Johnson
• Journal: Safety and Health at Work
• Published: 2012;3(1):17-21
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objectives: Asbestos-related diseases (ARDs) have increased globally over the decades, causing an economic burden and increased health care costs. It is difficult to predict the risk of development of ARDs and of respiratory disability among workers with a history of asbestos exposure. Blood based biomarkers have been reported as promising tools for the early detection of malignant mesothelioma. This study investigated whether serum soluble mesothelin-related peptide (SMRP) would reflect severity of disablement in compensable ARDs.

Methods: SMRP levels were measured in a cohort of 514 asbestos-exposed subjects. Severity of ARDs was assessed by a Medical Authority comprising four specially qualified respiratory physicians. Severity of ARDs and SMRP levels were compared.

Results: Mean (standard deviation) serum SMRP level in the population with compensable ARDs (n = 150) was 0.95 (0.65) nmol/L, and was positively associated with disability assessment (p = 0.01). Mean SMRP level in healthy asbestos-exposed subjects was significantly lower than those with pleural plaques (p < 0.0001) and in subjects with ARDs who received compensation (p < 0.01).

Conclusion: This study indicates that serum SMRP levels correlate with severity of compensable ARDs. Serum SMRP could potentially be applied to monitor progress of ARDs. Further prospective work is needed to confirm the relationship between SMRP and disability assessment in this population.

In plain English

This study measured a blood marker, serum soluble mesothelin-related peptide (SMRP), in 514 men with past asbestos exposure seen at the Workers' Compensation (Dust Diseases) Board in Sydney, Australia. It asked whether SMRP levels reflected disability from asbestos-related diseases. Of these men, 150 had compensable diseases (asbestosis, diffuse pleural thickening, or both). A panel of four respiratory physicians rated 81 of them as 10-100% disabled and 69 as 0% disabled. Among the 150, higher SMRP went with higher disability ratings (Pearson r = 0.209, p = 0.01). Mean SMRP was 0.79 nmol/L in 223 apparently healthy exposed men. This was significantly lower than in 141 men with pleural plaques (1.00 nmol/L) and in the 81 compensated men (1.06 nmol/L). The 0%-disabled group averaged 0.82 nmol/L. The authors concluded that SMRP levels correlate with severity of compensable disease and could potentially help monitor it, but that further prospective work is needed. They noted that past exposure could not be assessed, the registry favored people with symptoms, and smoking habits differed between groups.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional comparison of serum SMRP levels with disability assessments, using data from a previously described cohort of asbestos-exposed workers
• Who was studied: 514 asbestos-exposed men examined at the Workers' Compensation (Dust Diseases) Board of New South Wales, Sydney, Australia; mean age 66.9 years. They fell into five diagnostic groups: asbestosis (24), diffuse pleural thickening (113), asbestosis and diffuse pleural thickening (13), pleural plaques only (141), and apparently healthy (223). Study dates are not given.
• Exposure: Past occupational asbestos exposure in New South Wales; fiber types and doses are not reported, and the authors could not assess past exposure
• Main results:
  • Mean (SD) serum SMRP in the 150 subjects with compensable asbestos-related diseases was 0.95 (0.65) nmol/L
  • Among the 150 with compensable diseases, SMRP level was positively correlated with disability as assessed by the Medical Authority (Pearson r = 0.209, p = 0.01)
  • Apparently healthy asbestos-exposed subjects (n = 223) had mean (SD) SMRP of 0.79 (0.45) nmol/L
  • Subjects with pleural plaques (n = 141) had mean (SD) SMRP of 1.00 (0.60) nmol/L
  • Subjects with compensable diseases but 0% disability (n = 69) had mean (SD) SMRP of 0.82 (0.46) nmol/L
  • Compensated subjects with 10-100% disability (n = 81) had mean (SD) SMRP of 1.06 (0.76) nmol/L; SMRP differed across the four groups (ANOVA, p < 0.0001)
  • Mean SMRP in the healthy subjects was significantly lower than in subjects with pleural plaques (p < 0.01 in the Results text) and in compensated subjects with 10-100% disability (p < 0.01)
  • The compensated group had significantly more ex-smokers than the non-compensated group (p < 0.0001); age and body mass index did not differ between these two groups
• The authors' conclusion: The authors concluded that serum SMRP levels correlate with severity of compensable asbestos-related diseases and could potentially be used to monitor their progress, but that further prospective work is needed to confirm the relationship with disability assessment
• Limitations the authors state:
  • Past asbestos exposure could not be assessed because occupational exposure history records were incomplete
  • The population came from a compensation and screening registry and is biased toward people with symptomatic disease, so findings do not reflect the general population or people who do not apply for compensation
  • All subjects were men
  • Smoking habits differed between the groups
  • Some subjects with pleural plaques may also have had asbestosis or diffuse pleural thickening, because high resolution CT scans were not always available
  • Lung function measurements were part of the compensation assessment, which could have confounded the results

Topics

Medical terms in this study, explained in our Lexicon: Biomarker, Asbestos Exposure, Mesothelioma, Mesothelin, Soluble Mesothelin-Related Peptides (SMRP), Pleural Plaques.

Related studies

• Factors affecting soluble mesothelin related protein levels in an asbestos-exposed population — E.K. Park, P.S. Thomas, et al. (2010)
• Evaluation of ovarian cancer biomarkers in subjects with benign asbestos-related pleural diseases — E.K. Park, A.R. Johnson, et al. (2011)
• Soluble mesothelin-related protein in an asbestos-exposed population: the dust diseases board cohort study — E.K. Park, A. Sandrini, et al. (2008)
• Follow-up of Soluble Mesothelin-Related Protein Levels in Participants With Asbestos-Related Disorders — E.K. Park, A.R. Johnson, et al. (2020)
• Soluble mesothelin related peptides (SMRP) and osteopontin as protein biomarkers for malignant mesothelioma: analytical validation of ELISA based assays and characterization at mRNA and protein levels — A.J. Rai, R.M. Flores, et al. (2010)
• Serum soluble mesothelin-related protein (SMRP) and fibulin-3 levels correlate with baseline malignant pleural mesothelioma (MPM) tumor volumes but are not useful as biomarkers of response in an immunotherapy trial — S.I. Katz, L. Roshkovan, et al. (2021)

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