Biological responses to asbestos inhalation and pathogenesis of asbestos-related benign and malignant disease

Our plain-English summary of Biological responses to asbestos inhalation and pathogenesis of asbestos-related benign and malignant disease, by E. Solbes, R.W. Harper (Journal of Investigative Medicine, 2018).

The study

• Authors: E. Solbes, R.W. Harper
• Journal: Journal of Investigative Medicine
• Published: 2018;66(4):721-727
• Type of article: Review
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos comprises a group of fibrous minerals that are naturally occurring in the environment. Because of its natural properties, asbestos gained popularity for commercial applications in the late 19th century and was used throughout the majority of the 20th century, with predominant use in the construction, automotive, and shipbuilding industries. Asbestos has been linked to a spectrum of pulmonary diseases, such as pleural fibrosis and plaques, asbestosis, benign asbestos pleural effusion, small cell lung carcinoma, non-small cell lung carcinoma, and malignant mesothelioma. There are several mechanisms through which asbestos can lead to both benign and malignant disease, and they include alterations at the chromosomal level, activation of oncogenes, loss of tumor suppressor genes, alterations in cellular signal transduction pathways, generation of reactive oxygen and nitrogen species, and direct mechanical damage to cells from asbestos fibers. While known risk factors exist for the development of asbestos-related malignancies, there are currently no effective means to determine which asbestos-exposed patients will develop malignancy and which will not. There are also no established screening strategies to detect asbestos-related malignancies in patients who have a history of asbestos exposure. In this article, we present a case that highlights the different biological responses in human hosts to asbestos exposure.

© American Federation for Medical Research (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

In plain English

This article is a review of how the body responds to inhaled asbestos and how asbestos-related diseases develop, introduced with the case of one patient. She was a 54-year-old woman with mild persistent asthma who came to a lung clinic with chronic pleurisy, which is pain from the lining around the lungs. Her father worked in a shipyard with daily asbestos exposure. Her mother routinely washed his laundry, and as an infant the patient sat in a playpen beside her while she did it. Chest imaging showed densely calcified pleural plaques on both sides, with no lung fibrosis or pleural effusion. She had robotic-assisted surgery to remove the plaques, and the removed tissue showed dense fibrosis. Her father had no effects from asbestos exposure, and her mother died from mesothelioma. The authors then reviewed published research on fiber types, the range of benign and malignant asbestos-related diseases, cellular and molecular mechanisms, mesothelioma risk factors and screening. They noted that there are currently no guidelines for screening asbestos-exposed people for mesothelioma. The authors concluded that the case highlights probable genetic factors and shows variable expression of asbestos-related disease within one family.

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: Narrative review introduced by a single case report
• Who was studied: One patient: a 54-year-old woman with mild persistent asthma seen in a pulmonary clinic for chronic pleurisy. The review also covers published human, animal and cell studies.
• Exposure: Indirect (household) exposure. The patient's father worked in a shipyard with daily asbestos exposure, and her mother routinely did his laundry while the patient, as an infant, was in a playpen next to her. No fiber type is given for the case.
• Main results:
  • The patient's chest imaging showed densely calcified pleural plaques on both sides, with no pulmonary fibrosis or pleural effusion.
  • Because her pleurisy continued, the patient had robotic-assisted thoracoscopic removal of the plaques with mechanical pleurodesis. The removed plaques showed dense fibrosis.
  • Within the family, the father had no effects from asbestos exposure, and the mother died from mesothelioma.
  • In their review, the authors described the main disease pathways thought to lead to asbestos-related fibrosis or cancer as inflammation, apoptosis and oxidative stress.
  • The authors stated that there are currently no guidelines for screening asbestos-exposed people for mesothelioma.
• The authors' conclusion: The authors concluded that the case highlights probable genetic factors in the development of asbestos-related lung disease and is an example of variable expression of asbestos-related disease within the same family. They called for research on screening tests and early biomarkers.
• Limitations the authors state:
  • The authors stated that an in-depth discussion of each asbestos-related disease was beyond the scope of the article; each was reviewed only briefly.
  • The authors stated that discussion of bronchogenic carcinoma (lung cancer) was beyond the scope of the review.

Topics

Medical terms in this study, explained in our Lexicon: Fibrosis, Benign Asbestos Pleural Effusion, Carcinoma, Malignant Mesothelioma, Tumor Suppressor Gene, Asbestos Exposure.

Related studies

• Benign asbestos-related pleural disease — C. King, D. Mayes, et al. (2011)
• Inhalation and Oropharyngeal Aspiration Exposure to Rod-Like Carbon Nanotubes Induce Similar Airway Inflammation and Biological Responses in Mouse Lungs — P. Kinaret, M. Ilves, et al. (2017)
• Biological mechanisms of non-linear dose-response for respirable mineral fibers — L.A.T. Cox (2018)
• Asbestos exposure and benign asbestos diseases in 772 formerly exposed workers: dose-response relationships — G. Mastrangelo, M.N. Ballarin, et al. (2009)
• Quantification of the pathological response and fate in the lung and pleura of chrysotile in combination with fine particles compared to amosite-asbestos following short-term inhalation exposure — D.M. Bernstein, R.A. Rogers, et al. (2011)
• The pathological response and fate in the lung and pleura of chrysotile in combination with fine particles compared to amosite asbestos following short-term inhalation exposure: interim results — D.M. Bernstein, R.A. Rogers, et al. (2010)

Browse return to medical research.