In response to Sharing different perspectives to understand asbestos-induced carcinogenesis: A comment to Jiang et al. (2016) by Alessandro Francesco Gualtieri (2017)

Our plain-English summary of In response to Sharing different perspectives to understand asbestos-induced carcinogenesis: A comment to Jiang et al. (2016) by Alessandro Francesco Gualtieri (2017), by S. Toyokuni, L. Jiang (Cancer Science, 2017).

The study

• Authors: S. Toyokuni, L. Jiang
• Journal: Cancer Science
• Published: 2017;108(5):1089-1090
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this letter, the authors replied to a commentary by Alessandro Francesco Gualtieri on their 2016 paper about iron removal by desferal in asbestos-induced mesothelial carcinogenesis. They agreed that understanding asbestos-induced carcinogenesis required a multidisciplinary perspective. They noted that intraperitoneal UICC chrysotile, crocidolite and amosite generated malignant mesothelioma in almost 100% of rats, whereas other fibrous materials did not.

They answered six of the commentary's points:

• They described the proposed model as reasonable because mesothelial cells are the targets. They added that peritoneal adipocytes promote carcinogenesis with macrophages, and that the model disregards the decades-long travel of fibers from the airway to the body cavity.
• They suggested that iron on fibers may come from hemolysis and the adsorption of hemoglobin.
• They stated that catalytic Fe(II) is more important than Fe(III) because it initiates a Fenton reaction.
• They described two roles of macrophages: scavenging fibers and promoting inflammation.
• They stated that chrysotile is carcinogenic (IARC Group 1) and should be banned as soon as possible.

The authors stated their belief that local iron overload is the major mechanism. They based this on genetic alterations, local iron deposition and the preventive effects of iron chelators. They considered desferal and deferasirox not practically applicable to exposed people, because desferal requires intrapleural injection and deferasirox may have renal side-effects. They suggested that regular blood donation or phlebotomy could be the best preventive strategy, if experimentally shown to be effective. They also suggested that anti-inflammatory measures would work. Finally, they encouraged epidemiologists to collect data on iron in carcinogenesis, including asbestos-associated lung cancer.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor, not a research study, and it reports no new data. Two pathologists at Nagoya University in Japan replied to a commentary by Alessandro Francesco Gualtieri on their own 2016 paper about removing iron with desferal in asbestos-induced mesothelial cancer. Citing their own earlier work, the authors wrote that chrysotile, crocidolite and amosite injected into the abdomen produced malignant mesothelioma in almost 100% of rats. They stated that chrysotile is carcinogenic to mesothelial cells (IARC Group 1) and should be banned, and that asbestos-induced mesothelial cancer takes a few decades to develop. The authors concluded that, in their view, local iron overload is the major mechanism. They thought the iron-removing drugs desferal and deferasirox were not practical for people already substantially exposed to asbestos. They suggested that regular blood donation or phlebotomy could be the best preventive strategy, but only if experiments show that it works. They also encouraged epidemiologists to collect data on the role of iron in cancer, including asbestos-related lung cancer.

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: Letter to the editor replying to a published commentary; no new study or data
• Who was studied: Not applicable: no people, animals or samples were studied. The letter replies to a commentary by Alessandro Francesco Gualtieri on the authors' 2016 paper on iron elimination by desferal in asbestos-induced mesothelial carcinogenesis.
• Exposure: Asbestos in general, with UICC chrysotile, crocidolite and amosite named. The letter also discusses iron and the iron chelators desferal and deferasirox.
• Main results:
  • Not a new finding. Citing their earlier work, the authors stated that intraperitoneal UICC chrysotile, crocidolite and amosite generates malignant mesothelioma in almost 100% of rats.
  • The authors' stated position is that chrysotile is carcinogenic to mesothelial cells (IARC Group 1) and should be banned as soon as possible.
  • The authors stated that asbestos-induced mesothelial carcinogenesis takes a few decades.
  • The authors' view is that neither desferal nor deferasirox is practically applicable to people already substantially exposed to asbestos. The reasons given are the invasive administration of desferal (injection into the pleural space) and the potential kidney side-effects of deferasirox.
  • The authors suggested that regular blood donation or phlebotomy could be the best prevention strategy, but only if it is experimentally demonstrated to be effective.
  • The authors encouraged epidemiologists worldwide to collect data on the role of iron in carcinogenesis, including asbestos-associated lung cancer.
• The authors' conclusion: The authors believe that local iron overload is the major mechanism of asbestos-induced mesothelial carcinogenesis. They base this on earlier genetic comparisons with an iron-induced cancer rat model, observed local iron deposition, and preventive effects of iron chelators.

Topics

Medical terms in this study, explained in our Lexicon: Carcinogenesis, UICC, Chrysotile, Crocidolite, Amosite, Malignant Mesothelioma, Mesothelial Cells, Macrophage.

Related studies

• Sharing different perspectives to understand asbestos-induced carcinogenesis: A comment to Jiang et al. (2016) — A.F. Gualtieri (2017)
• Dual preventive benefits of iron elimination by desferal in asbestos-induced mesothelial carcinogenesis — L. Jiang, S.H. Chew, et al. (2016)
• Iron addiction with ferroptosis-resistance in asbestos-induced mesothelial carcinogenesis: Toward the era of mesothelioma prevention — S. Toyokuni (2019)
• Global overexpression of divalent metal transporter 1 delays crocidolite-induced mesothelial carcinogenesis in male mice — S. Funahashi, Y. Okazaki, et al. (2018)
• Decoding the molecular enigma behind asbestos and fibrous nanomaterial-induced carcinogenesis — S. Toyokuni, Y. Kong (2025)
• The origin and future of oxidative stress pathology: From the recognition of carcinogenesis as an iron addiction with ferroptosis-resistance to non-thermal plasma therapy — S. Toyokuni (2016)

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