The mesothelium and its reactions: a review

Our plain-English summary of The mesothelium and its reactions: a review, by D. Whitaker, J.M. Papadimitriou, M.N. Walters (Critical Reviews in Toxicology, 1982).

The study

• Authors: D. Whitaker, J.M. Papadimitriou, M.N. Walters
• Journal: Critical Reviews in Toxicology
• Published: 1982;10(2):81-144
• Type of article: Review
• Cited by: 85 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The origins, nature, and reactions of the mesothelium have intrigued investigators for over 100 years. Recently, the use of sophisticated techniques has clarified earlier impressions of its development, structure, and function. The structure of mesothelium reflects its functional properties, its long slender microvilli entrapping a layer of glycosoaminoglycans, providing a frictionless free surface between the parietal and visceral serosa. Transport requirements are met by various surface modifications and both inter- and intra-cellular mechanisms occur. The presence of stomatal openings in the mesothelial membrane has been established, and they may have a major role to play in the movement of cells to and from the serosal cavities. In addition, mesothelial cells can respond to situations of increased functional demand and during the course of inflammation, the mesothelium's fibrinolytic properties are of major importance in preventing the formation of adhesions and the enhancement of healing. Of all the unanswered questions the most significant is the nature, localization, and potentialities of mesothelial precursors. A mesodermal origin is readily acknowledged, but the healing process of damaged mesothelium is less clear. It seems probable that "mature" mesothelium is one source of cell renewal, but mesenchymal cells located in the submesothelial serosa are also strong contenders. Neoplastic mesothelium can adopt a spectrum of histological appearances, reflecting its mesodermal origins. In fact, overacceptance of this concept has erroneously led to the classification of other neoplasms arising in the serosal area as mesotheliomas. Although the ocogenic sequence is still obscure, asbestos is recognized as the major etiologic agent in malignant mesotheliomas. In 1955, Hartwell described differing impressions of the peritoneum as seen through the eyes of an anatomist, an histologist, and a surgeon. In this review on the mesothelium we have attempted to unravel some of its complexities as viewed by embryologists, electronmicroscopists, cell biologists, pathologists, and oncologists.

In plain English

This article was a review of published research on the mesothelium, the single layer of cells lining the pleural (chest), peritoneal (abdominal) and pericardial (heart) cavities. The authors worked at a hospital and university pathology service in Western Australia. The review covered how this lining develops in the embryo, its structure, how fluid and particles cross it, how it renews and heals, how adhesions form, and tumors. It drew mainly on other studies, with some of the authors' own observations. The authors had examined material from over 70 cases of diffuse malignant mesothelioma, most associated with blue asbestos mining in the north of Western Australia from 1939 to 1966. In their necropsy series, widespread metastases occurred in 21 of 37 cases. Sections from 40 cases of diffuse malignant mesothelioma all tested negative for a carcinoembryonic antigen-like substance. In laboratory incubation, the authors saw crocidolite asbestos fibers apparently penetrating the mesothelial surface after 4 hours. The authors concluded that, although the sequence by which cancer develops was still obscure, asbestos is recognized as the major causative agent in malignant mesotheliomas.

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 the literature, with some of the authors' own observations
• Who was studied: Published human and animal studies of the mesothelium, plus the authors' own material from over 70 cases of diffuse malignant mesothelioma in Western Australia, most associated with blue asbestos mining in the north of the state from 1939 to 1966
• Exposure: Asbestos, mainly blue asbestos (crocidolite) mining among the authors' cases. The authors also exposed mesothelium to crocidolite fibers in the laboratory (in vitro). The review also covered other injuries and irritants of the mesothelium.
• Main results:
  • In the authors' necropsy series of malignant mesothelioma, widespread metastases occurred in 21 out of 37 cases.
  • Paraffin sections from 40 cases of diffuse malignant mesothelioma, tested by the authors with immunoperoxidase, were all negative for carcinoembryonic antigen (CEA)-like substance.
  • In the same test, four adenomatoid tumors were negative and three papillary tumors arising from the surface of the ovary were positive.
  • The authors judged that this test is useful for excluding a diagnosis of malignant mesothelioma when the result is positive.
• The authors' conclusion: The authors concluded that although the sequence by which cancer develops remained obscure, asbestos is recognized as the major causative agent in malignant mesotheliomas.
• Limitations the authors state:
  • The authors stated that detailed assessment of the large literature on asbestos-induced mesothelioma in laboratory animals was beyond the scope of the review.
  • The authors stated that methods for preventing serosal adhesions were not covered.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelium, Mesothelial Cells, Inflammation, Neoplasm, Mesothelioma, Malignant Mesothelioma, Peritoneum.

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