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Crovella S, Bianco AM, Vuch J, Zupin L, Moura RR, Trevisan E, Schneider M, Brollo A, Nicastro EM, Cosenzi A, Zabucchi G, Borelli V. Iron signature in asbestos-induced malignant pleural mesothelioma: A population-based autopsy study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2016; 79:129-141. [PMID: 26818092 DOI: 10.1080/15287394.2015.1123452] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive cancer with poor prognosis. The development of MPM is frequently linked to inhalation of asbestos fibers. A genetic component of susceptibility to this disease is suggested by the observation that some individuals develop MPM following lower doses of asbestos exposure, whereas others exposed to higher quantities do not seem to be affected. This hypothesis is supported also by frequent reports of MPM familial clustering. Despite the widely recognized role of iron (Fe) in cellular asbestos-induced pulmonary toxicity, the role of the related gene polymorphisms in the etiology of MPM has apparently not been evaluated. Eighty-six single-nucleotide polymorphisms (SNPs) of 10 Fe-metabolism genes were examined by exploiting formalin-fixed paraffin-embedded postmortem samples from 77 patients who died due to MPM (designated AEM) and compared with 48 who were exposed to asbestos but from died in old age of cause other than asbestos (designated AENM). All subjects showed objective signs of asbestos exposure. Three SNPs, localized in the ferritin heavy polypeptide, transferrin, and hephaestin genes, whose frequencies were distributed differently in AEM and AENM populations, were identified. For ferritin and transferrin the C/C and the G/G genotypes, respectively, representing intronic polymorphisms, were significantly associated with protection against MPM and need to be considered as possible genetic markers of protection. Similarly, the C/C hephaestin SNP, a missense variation of this multicopper ferroxidase encoding gene, may be related, also functionally, with protection against MPM. In conclusion, it is proposed that three Fe metabolism-associated genes, significantly associated with protection against development of MPM, may serve as protective markers for this aggressive tumor.
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Affiliation(s)
- Sergio Crovella
- a Institute for Maternal and Child Health, IRCCS Burlo Garofolo , Trieste , Italy
| | - Anna Monica Bianco
- a Institute for Maternal and Child Health, IRCCS Burlo Garofolo , Trieste , Italy
| | - Joseph Vuch
- a Institute for Maternal and Child Health, IRCCS Burlo Garofolo , Trieste , Italy
| | - Luisa Zupin
- a Institute for Maternal and Child Health, IRCCS Burlo Garofolo , Trieste , Italy
| | | | - Elisa Trevisan
- b Department of Life Science , University of Trieste , Italy
| | - Manuela Schneider
- c Laboratory of Pathological Anatomy , Hospital of Monfalcone (GO), Ass2 , Gorizia , Italy
| | - Alessandro Brollo
- c Laboratory of Pathological Anatomy , Hospital of Monfalcone (GO), Ass2 , Gorizia , Italy
| | - Enza Maria Nicastro
- c Laboratory of Pathological Anatomy , Hospital of Monfalcone (GO), Ass2 , Gorizia , Italy
| | - Alessandro Cosenzi
- d Department of Medicine , Hospital of Monfalcone (GO), Ass2 , Gorizia , Italy
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Zhang W, Wu X, Wu L, Zhang W, Zhao X. Advances in the diagnosis, treatment and prognosis of malignant pleural mesothelioma. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:182. [PMID: 26366399 DOI: 10.3978/j.issn.2305-5839.2015.07.03] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 07/03/2015] [Indexed: 12/18/2022]
Abstract
Malignant pleural mesothelioma (MPM) is a rare cancer originated from pleural mesothelial cells. MPM has been associated with long-term exposure to asbestos. The prognosis of MPM is poor due to the difficulty of making diagnosis in the early stage, the rapid progression, the high invasiveness and the lack of effective treatment. Although the incidence of MPM is low in China to date, it has a tendency to increase in the coming years. The variety of clinical features may cause the delay of diagnosis and high rate of misdiagnosis. The diagnosis of MPM is based on biopsy of the pleura and immunohistochemistry. As China has become the largest country in the consumption of asbestos, it would give rise to a new surge of MPM in the future. The current treatment of MPM is multimodality therapy including surgery, radiotherapy, chemotherapy and immunotherapy. Two surgical procedures are commonly applied: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). Three dimensional conformal radiotherapy is used to denote a spectrum of radiation planning and delivery techniques that rely on the 3D imaging to define the tumor. Cisplatin combined with pemetrexed (PEM) is the first-line chemotherapy for MPM. The principal targets in immunotherapy include T cells (Treg), CTLA-4 and PD-1. The diagnosis, treatment and prognosis still remain a major challenge for clinical research and will do so for years to come.
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Affiliation(s)
- Weiquan Zhang
- 1 Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan 250033, China ; 2 Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Xinshu Wu
- 1 Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan 250033, China ; 2 Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Licun Wu
- 1 Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan 250033, China ; 2 Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Weidong Zhang
- 1 Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan 250033, China ; 2 Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Xiaogang Zhao
- 1 Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan 250033, China ; 2 Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
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Verma M, Seminara D, Arena FJ, John C, Iwamoto K, Hartmuller V. Genetic and epigenetic biomarkers in cancer : improving diagnosis, risk assessment, and disease stratification. Mol Diagn Ther 2007; 10:1-15. [PMID: 16646573 DOI: 10.1007/bf03256438] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Gene expression patterns change during the initiation, progression, and development of cancer, as a result of both genetic and epigenetic mechanisms. Genetic changes arise due to irreversible changes in the nucleotide sequence, whereas epigenetic changes occur due to changes in chromatin conformation, histone acetylation, and methylation of the CpG islands located primarily in the promoter region of a gene. Both genetic and epigenetic markers can potentially be utilized to identify different stages of tumor development. Several such markers exhibit high sensitivity and specificity for different tumor types and can be assayed in biofluids and other specimens collected by noninvasive technologies. In spite of the availability of large numbers of diagnostic markers, only a few have been clinically validated so far. The current status and the challenges in the field of genetic and epigenetic markers in cancer diagnosis, risk assessment, and disease stratification are discussed.
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Affiliation(s)
- Mukesh Verma
- Analytic Epidemiology Research Branch, Epidemiology and Genetics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland 20852, USA.
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Musti M, Kettunen E, Dragonieri S, Lindholm P, Cavone D, Serio G, Knuutila S. Cytogenetic and molecular genetic changes in malignant mesothelioma. ACTA ACUST UNITED AC 2006; 170:9-15. [PMID: 16965949 DOI: 10.1016/j.cancergencyto.2006.04.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 03/28/2006] [Accepted: 04/04/2006] [Indexed: 11/29/2022]
Abstract
Malignant mesothelioma (MM) results from the accumulation of a number of acquired genetic events, especially deletions, which lead to the inactivation of multiple onco-suppressor genes in a multistep cascade mechanism. Past asbestos exposure represents the major risk factor for MM, and the link between asbestos fibers and MM has been largely proved by several epidemiologic and experimental studies. Asbestos fibers induce DNA and chromosomal damage. Most MM cases have shown multiple chromosomal abnormalities. Chromosomal losses are more common than gains. The most common cytogenetic abnormality in MM is a deletion in 9p21, the locus of CDKN2A, a tumor suppressor gene (TSG). The deletion of CDKN2A is a negative prognostic factor in MM. Loss of TSG CDKN2A/p14(ARF) is also common in MM and mutations in NF2 occur in approximately half of the cases. Despite the ban on asbestos use in Western countries, the incidence of MM is increasing, and asbestos is still used in developing countries. This epidemiologic situation calls for further research. Ongoing studies are already applying high-throughput genomic profiling methods in MM. Genetic alterations observed in MM may be useful in differential diagnosis between lung cancer and MM, as diagnostic markers or therapeutic targets, and as indicators of premalignancy for primary prevention and health surveillance.
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Affiliation(s)
- Marina Musti
- Preventive Medicine of Workers and Psychotechnology, Department of Internal Medicine and Public Medicine, Section of Occupational Medicine, University of Bari, and National Register of Mesothelioma, Regional Operative Centre Apulia, Bari, Italy
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Abstract
Although mesothelioma cases may have peaked in the 1990s in developed countries, it is expected that there will be over 70,000 cases diagnosed in the United States over the next 5 decades. With the industrial expansion in Southeast Asia and China and the continued use of asbestos, an epidemic of mesothelioma cases is anticipated over the next several decades. A considerable amount has been learned about the cytogenetic and molecular genetics of mesotheliomas. However, in-depth studies are needed to further define specific factors that may provide for early diagnosis, surgical treatment, oncologic management, and gene therapy. Serologic markers for surveillance of those with asbestos exposure and at risk for mesothelioma are needed. Targeted therapy using molecular markers and gene therapy may provide a means to reverse mesothelial proliferations or stabilize tumor growth and allow for surgical resection. The future holds great promise in identifying mesothelioma gene expression profiles (genomics, gene microarrays) and proteins (proteomics) that may produce the key to dealing with this dismal and devastating neoplasm.
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Affiliation(s)
- John Hicks
- Department of Pathology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas 77030-2313, USA.
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Neri M, Filiberti R, Taioli E, Garte S, Paracchini V, Bolognesi C, Canessa PA, Fontana V, Ivaldi GP, Verna A, Bonassi S, Puntoni R. Pleural malignant mesothelioma, genetic susceptibility and asbestos exposure. Mutat Res 2005; 592:36-44. [PMID: 15993904 DOI: 10.1016/j.mrfmmm.2005.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Pleural malignant mesothelioma (MM) is a rare but extremely aggressive cancer. The limited impact of standard therapeutic treatments on survival rates makes the identification of factors that increase the individual risk a leading priority. The high proportion of cases explained by exposure to asbestos has guided intervention policies to an effective ban of this compound from our environment. However, MM cannot be solely attributed to this agent, and the role of predisposing factors and their interaction with asbestos exposure is increasingly studied. The role of mEH, GSTM1, GSTT1, NAT2, and CYP1A1 genotypes in modulating susceptibility to MM was examined in a case-control study of 80 subjects with a confirmed diagnosis of MM and 255 controls. Subjects with low mEH activity showed a significantly increased risk of MM (OR, 2.51; 95% CI, 1.11-5.68). The association was stronger in the group with low asbestos exposure (OR, 7.83; 95% CI, 0.98-62.60). A significant increased risk of MM was also found in NAT2 fast acetylators (OR, 1.74; 95% CI, 1.02-2.96). The presence of synergisms between genotypes, i.e., mEH and NAT2 (LRT for heterogeneity p<0.023), mEH and GSTM1 (LRT p<0.061), and NAT2 and GSTM1 (LRT p<0.049), combined with the interaction observed with exposure to asbestos, suggests the presence of gene-environment and gene-gene interactions in the development of MM, although the size of the study group does not allow to draw clearcut conclusions. Since genetic polymorphisms can also modify the extent of genetic damage occurring in subjects exposed to carcinogens, we measured the frequency of micronuclei in peripheral blood lymphocytes of a subgroup of MM cases. The limited number of cases (28) did not allow to observe significant effects. In conclusion, these results strengthen the hypothesis that individual susceptibility to MM can be modulated by the interaction between polymorphic genes involved in the metabolism and the intensity of asbestos exposure.
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Affiliation(s)
- Monica Neri
- Unit of Epidemiology and Biostatistics, National Cancer Research Institute, Largo Rosanna Benzi 10, 16132 Genoa, Italy
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Abstract
One out of four deaths in the USA is due to cancer. Identification of populations at risk of developing cancer is important as it provides opportunities for prevention and treatment of cancer. Biomarkers are measurable indicators of exposure effects and susceptibility or disease state, and are used to understand the mechanisms of cancer progression. In recent molecular epidemiology studies genomic, proteomic, and epigenomic markers have been utilized which exhibit high sensitivity and specificity for different tumor types and can be assayed in biofluids and other specimens collected by non-invasive technologies. The current challenges and future directions in the field are discussed in this article.
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Affiliation(s)
- M Verma
- Analytical Epidemiology Research Branch, Epidemiology and Genetics, Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA.
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