Is serum thioredoxin-1 a useful clinical marker for malignant pleural mesothelioma?

Our plain-English summary of Is serum thioredoxin-1 a useful clinical marker for malignant pleural mesothelioma?, by R. Maeda, C. Tabata, R. Tabata, et al (Antioxidants & Redox Signaling, 2011).

The study

• Authors: R. Maeda, C. Tabata, R. Tabata, R. Eguchi, Y. Fujimori, T. Nakano
• Journal: Antioxidants & Redox Signaling
• Published: 2011;15(3):685-9
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma (MPM), an asbestos-related aggressive malignant tumor of mesothelial origin, shows limited response to therapy and overall survival remains very poor. Reactive oxygen species play an important role in asbestos toxicity. Here, we found that the patients with MPM had significantly higher serum levels of thioredoxin-1 (TRX) than control population. The patients with advanced-stage MPM showed higher levels of TRX than those with early-stage MPM. The difference in overall survival between the groups with lower and higher serum TRX levels was significant. Our data suggest that serum TRX concentration could be a useful clinical marker for MPM.

In plain English

This study measured a blood protein called thioredoxin-1 (TRX) to see whether it could help identify malignant pleural mesothelioma and predict its course. Serum samples came from 91 people with a history of asbestos exposure seen at Hyogo College of Medicine Hospital in Japan from 2005 to 2007: 57 with mesothelioma, 19 with pleural plaques and/or asbestosis, and 15 with no asbestos-related lesions. Average TRX was 119.1 ng/mL in the mesothelioma patients and 40.1 ng/mL in the other exposed people (p less than 0.0001). At a cutoff of 60 ng/mL, the test detected 71.9% of mesothelioma patients and had a specificity of 85.0%. Patients with stage IV disease had higher levels (139.9 ng/mL) than those with stage I to III (82.7 ng/mL). Among 56 patients followed for 1400 days, overall survival differed significantly between the 16 below and the 40 above the cutoff (p = 0.030). In a combined analysis, stage was found to be an independent predictor of survival. The authors concluded that serum TRX could be a useful clinical marker for this disease. They noted that its sensitivity was not high.

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: Clinical biomarker study (published as a 'News & Views' article): serum TRX was measured in mesothelioma patients and asbestos-exposed comparison subjects, with survival follow-up of the mesothelioma patients
• Who was studied: 91 asbestos-exposed people seen at the Department of Respiratory Medicine, Hyogo College of Medicine Hospital, Japan, 2005 to 2007: 57 with malignant pleural mesothelioma, 19 with pleural plaques and/or asbestosis, and 15 with no asbestos-related lesions. Also 5 healthy volunteers never exposed to asbestos, and 10 lung cancer patients with malignant pleuritis.
• Exposure: All subjects had a history of asbestos exposure. The article does not give fiber types, jobs or doses.
• Main results:
  • For telling the 57 mesothelioma patients apart from the 34 exposed non-mesothelioma subjects, the area under the ROC curve for serum TRX was 0.8178 (95% confidence interval 0.7482 to 0.8873)
  • At the 60 ng/mL cutoff, sensitivity for mesothelioma was 71.9% and the positive predictive value was 89.1%
  • At the 60 ng/mL cutoff, specificity was 85.0%
  • Negative predictive value of a high TRX value for mesothelioma was 64.4%
  • Mean serum TRX was 119.1 ng/mL in the mesothelioma patients and 40.1 ng/mL in the exposed subjects with asbestosis, pleural plaques or no lesions (p less than 0.0001)
  • In 5 healthy volunteers never exposed to asbestos, serum TRX was 4.8 ng/mL
  • In 10 patients with lung cancer involving malignant pleuritis, serum TRX was 61.3 ng/mL, which the authors described as significantly lower than in the mesothelioma patients (p = 0.05)
  • Mesothelioma patients with stage IV disease had higher serum TRX (139.9 ng/mL) than those with stage I to III (82.7 ng/mL)
  • Of the 57 mesothelioma patients, 56 were followed for 1400 days. Overall survival differed significantly between the 16 patients with TRX below 60 ng/mL and the 40 above it (p = 0.030).
  • In a Cox regression of 56 mesothelioma patients including age, sex, histology, stage and serum TRX, stage had an independent effect on survival (stage IV versus I to III: HR 3.15, 95% CI 1.23 to 8.04, p = 0.017). The article does not report an independent result for TRX in this analysis.
• The authors' conclusion: The authors concluded that serum TRX concentration could be a useful clinical marker for malignant pleural mesothelioma.
• Limitations the authors state:
  • The authors noted that the test's diagnostic sensitivity was not high (71.9%).

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Overall Survival, Reactive Oxygen Species (ROS).

Related studies

• Serum thioredoxin-1 as a diagnostic marker for malignant peritoneal mesothelioma — C. Tabata, T. Terada, et al. (2013)
• Clinical significance of serum vascular endothelial growth factor in malignant pleural mesothelioma — A. Yasumitsu, C. Tabata, et al. (2010)
• Sensitive and specific new enzyme-linked immunosorbent assay for N-ERC/mesothelin increases its potential as a useful serum tumor marker for mesothelioma — K. Shiomi, Y. Hagiwara, et al. (2008)
• Asbestos modulates thioredoxin-thioredoxin interacting protein interaction to regulate inflammasome activation — J.K. Thompson, C.M. Westbom, et al. (2014)
• Upregulation of 9 genes, including that for thioredoxin, during epithelial differentiation of mesothelioma cells — X. Sun, K. Dobra, et al. (2000)
• The levels of HDAC1 and thioredoxin1 are related to the death of mesothelioma cells by suberoylanilide hydroxamic acid — B.R. You, W.H. Park (2016)

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