MicroRNAs diagnostic and prognostic value as predictive markers for malignant mesothelioma

Our plain-English summary of MicroRNAs diagnostic and prognostic value as predictive markers for malignant mesothelioma, by E. Sturchio, M.G. Berardinelli, P. Boccia, et al (Archives of Environmental & Occupational Health, 2020).

The study

• Authors: E. Sturchio, M.G. Berardinelli, P. Boccia, M. Zanellato, S. Gioiosa
• Journal: Archives of Environmental & Occupational Health
• Published: 2020;75(8):471-482
• Type of article: Review
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is an aggressive tumor resistant to current therapies with a latency period ranging between 20 and 60 years, caused by inhalation of asbestos fibers, that continues to represent a social and healthcare issue. The high percentage of people exposed to asbestos for professional or environmental reasons is associated with the high biopersistence of its fibers and with its widespread use in the last century. Approximately 20-40% of men report an occupational history that might have caused the workplace exposure (criteria Helsinki, 1997). Some authors are evaluating the possible use of bioindicators as a screening and early diagnosis tool. In this regard, the use of microRNAs has been proposed as powerful diagnostic and prognostic biomarkers for many tumors and human diseases. This review focuses on the current state of knowledge on the key role of microRNAs expression as new malignant mesothelioma biomarkers, in early clinical diagnostic applications.

In plain English

This article was a narrative review. It summarized published research on microRNAs, small molecules that help control genes, as possible markers for diagnosing malignant mesothelioma and predicting its outcome. The authors described this cancer as caused by inhaling asbestos fibers. The review reported no new data and did not explain how studies were chosen. It covered studies of tumor tissue and of blood. In one study it described, miR-132-3p told apart 21 mesothelioma patients from 21 asbestos-exposed controls with 81% sensitivity (patients correctly flagged) and 61% specificity (non-patients correctly cleared). Combined with miR-126, these rose to 89% and 95%. Another study, of 43 patients and 52 asbestos-exposed people, reported 86% sensitivity and 85% specificity for miR-103a-3p combined with mesothelin. A third study tested three microRNAs in blood collected a median 8.9 months before diagnosis and found 0% sensitivity at a set specificity of 98%. The authors concluded that the data support a possible use of microRNAs as diagnostic and prognostic markers. They said a large multicenter clinical trial is needed before routine clinical use.

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 of published studies. No new data were collected, and no method for searching or selecting studies is described.
• Who was studied: Published laboratory and clinical studies of microRNAs in malignant mesothelioma, using tumor tissue, blood and plasma samples, cell lines and mice. The review does not state how many studies were included or how they were selected.
• Exposure: Asbestos exposure in general, both occupational and environmental. Many of the cited studies used asbestos-exposed people without mesothelioma as comparison groups. Specific fiber types appear only in individual cited studies: crocidolite in rat mesothelial cells, and chrysotile-treated human mesothelial cells.
• Main results:
  • In a cited study by Weber and collaborators, miR-132-3p was lower in 21 mesothelioma patients than in 21 asbestos-exposed controls. Sensitivity was 81% and specificity 61%. Combined with miR-126, sensitivity rose to 89% and specificity to 95%.
  • In a cited study of 43 mesothelioma patients and 52 healthy asbestos-exposed subjects, combining miR-103a-3p with plasma mesothelin gave 86% sensitivity and 85% specificity. Mesothelin alone had 58% sensitivity in diagnostic studies.
  • In a cited study using blood samples collected a median of 8.9 months before clinical diagnosis, miR-132-3p, miR-126-3p and miR-103a-3p showed 0% sensitivity at a defined specificity of 98%. The review states that these microRNAs failed for early detection.
  • In a cited study by Kirschner and colleagues, plasma from 15 mesothelioma patients and 14 controls was tested. miR-625-3p was about four times higher in patients, with 73.3% sensitivity and 78.5% specificity.
  • According to a cited source, miR-484 distinguished malignant pleural mesothelioma from benign asbestos pleural diseases with 100% sensitivity and specificity. No sample size is given in this review.
  • In a cited 2011 study by Santarelli and collaborators, blood levels of miR-126 in asbestos-exposed subjects without mesothelioma were not changed by asbestos exposure.
• The authors' conclusion: The authors concluded that the available data support a possible role of microRNAs in malignant mesothelioma and their possible use as diagnostic or prognostic markers. They added that a large multicenter clinical trial is needed to validate them before routine clinical use.
• Limitations the authors state:
  • The authors state that, despite many candidate markers, results are still far from use in clinical practice for mesothelioma diagnosis and prognosis.
  • The authors state that animal studies of microRNA-based treatment have so far used only mice.

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: Malignant Mesothelioma, Latency, biopersistence, Occupational History, Biomarker.

Related studies

• MicroRNA signature of malignant mesothelioma with potential diagnostic and prognostic implications — S. Busacca, S. Germano, et al. (2010)
• Diagnostic value of microRNAs in asbestos exposure and malignant mesothelioma: systematic review and qualitative meta-analysis — L. Micolucci, M.M. Akhtar, et al. (2016)
• Progress of research on microRNAs with diagnostic value in asbestos exposure: A call for method standardization — L. Micolucci, M.R. Rippo, et al. (2017)
• Midkine is a potential novel marker for malignant mesothelioma with different prognostic and diagnostic values from mesothelin — G. Ak, Y. Tada, et al. (2017)
• Prognostic and Therapeutic Implications of MicroRNA in Malignant Pleural Mesothelioma — A. Truini, S. Coco, et al. (2016)
• Diagnostic and Prognostic Value of Three microRNAs in Environmental Asbestiform Fibers-Associated Malignant Mesothelioma — V. Filetti, C. Loreto, et al. (2021)

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