FBLN-3 as a biomarker of pleural plaques in workers occupationally exposed to carcinogenic fibers: a pilot study

Our plain-English summary of FBLN-3 as a biomarker of pleural plaques in workers occupationally exposed to carcinogenic fibers: a pilot study, by V. Rapisarda, C. Ledda, M. Migliore, et al (Future Oncology, 2015).

The study

• Authors: V. Rapisarda, C. Ledda, M. Migliore, R. Salemi, A. Musumeci, M. Bracci, A. Marconi, C. Loreto, M. Libra
• Journal: Future Oncology
• Published: 2015;11(24 Suppl):35-7
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

FBLN-3 has recently been proposed as a biomarker for malignant mesothelioma. A significantly increased standardized mortality rate from malignant mesothelioma has been reported in Biancavilla, Italy. Its cause has been identified in environmental exposure to fluoro-edenite. The aim of this study was to seek a correlation between plasma FBLN-3 concentration and pleural plaques in subjects exposed to fluoro-edenite and in a nonexposed control group. Pleural plaques was never detected in the control group, whereas it was found in 52% of exposed subjects. Median FBLN-3 concentrations were 12.96 and 5.29 ng/ml in the exposed and the control group, respectively (p < 0.001). FBLN-3 plasma levels exhibited a high predictive value for the presence of pleural plaques.

In plain English

This pilot study from Italy asked whether blood levels of a protein called FBLN-3 were related to pleural plaques in workers exposed to fluoro-edenite. The article describes fluoro-edenite as a natural asbestiform fiber found in building material around Biancavilla, Sicily. The subjects were male cleaners: 30 working in the Biancavilla area and 30 controls working in other towns. Three Biancavilla-area workers were excluded because of past asbestos exposure, leaving 27 exposed workers. All had breathing tests, blood tests and high-resolution chest CT scans. No one had respiratory symptoms. CT showed pleural plaques in 14 (52%) of the exposed workers, all of whom lived and worked in Biancavilla, and in none of the controls. Median FBLN-3 was 12.96 ng/ml in the exposed group and 5.29 ng/ml in the controls (p less than 0.001). A cut-off of 35.76 ng/ml identified plaques with a reported sensitivity of 93.7% and specificity of 91.9%. The authors concluded that FBLN-3 is a promising screening tool for people exposed to fluoro-edenite. They also stated that larger studies are needed.

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: Pilot study comparing exposed workers with a nonexposed control group (cross-sectional comparison of blood FBLN-3 levels and CT findings)
• Who was studied: Male cleaners in Sicily, Italy. Thirty worked in the Biancavilla area: 3 were excluded for a history of asbestos exposure, leaving 27, of whom 17 (63%) lived and worked in Biancavilla. Thirty worked in other municipalities and served as controls. The exposed workers had a mean age of 45.4 plus or minus 8.9 years and 20.7 plus or minus 3.6 mean working years. Study dates are not given.
• Exposure: Fluoro-edenite, which the article describes as a natural asbestiform fiber, through working (and, for some, living) in Biancavilla. The article says these subjects were not exposed to asbestos. No fiber measurements or doses are reported.
• Main results:
  • Pleural plaques were seen on CT in 14 (52%) of the 27 exposed workers, all of whom lived and worked in Biancavilla. No plaques were seen in any control subject.
  • Median plasma FBLN-3 was 12.96 ng/ml (range 0.29 to 69.64) in the exposed group and 5.29 ng/ml (range 1.98 to 12.60) in the control group (p less than 0.001).
  • In the ROC curve analysis of FBLN-3 against the presence of pleural plaques, a cut-off of 35.76 ng/ml gave a sensitivity of 93.7% and a specificity of 91.9%. Table 1 also lists a positive predictive value of 92.0%, a negative predictive value of 91.1% and an accuracy of 91.7%.
  • Breathing test results were within the normal range in both groups, and no participant had respiratory symptoms.
  • FBLN-3 levels were not influenced by the duration of fluoro-edenite exposure in these participants.
• The authors' conclusion: The authors concluded that FBLN-3 is a promising screening tool for people exposed to fluoro-edenite and may allow earlier detection of pleural plaques. They also suggested that a population screening program is needed.
• Limitations the authors state:
  • The authors stated that larger groups of exposed people must be studied to assess the value of FBLN-3 as a biomarker.
  • The authors stated that further studies, including malignant mesothelioma patients, are needed to clarify the role of FBLN-3 as a screening tool.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Biomarker, Pleural Plaques, Carcinogenic, Malignant Mesothelioma, Biancavilla, Environmental Exposure, fluoro-edenite.

Related studies

• Fibulin-3 immunoexpression in malignant mesothelioma due to fluoro-edenite: a preliminary report — R. Caltabiano, C. Loreto, et al. (2018)
• Fibulin-3 as biomarker of malignant mesothelioma — C. Ledda, R. Caltabiano, et al. (2019)
• Analysis of fibulin-3 after exposure to asbestos-like fibers — V. Rapisarda, R. Caltabiano, et al. (2017)
• Fibulin-3 as a blood and effusion biomarker for pleural mesothelioma — H.I. Pass, S.M. Levin, et al. (2012)
• Plasma Fibulin-3 as a Potential Biomarker for Patients with Asbestos-Related Diseases in the Han Population — Z. Jiang, S. Ying, et al. (2017)
• HMGB1 and Its Hyperacetylated Isoform are Sensitive and Specific Serum Biomarkers to Detect Asbestos Exposure and to Identify Mesothelioma Patients — A. Napolitano, D.J. Antoine, et al. (2016)

Browse more research in Future Oncology, or return to medical research.