Malignant mesotheliomas (MM) are neoplasms arising from mesothelial cells that line the body cavities, most commonly the pleural and peritoneal cavities. Although traditionally recognized as associated with occupational asbestos exposures, MMs can appear in individuals with no documented exposures to asbestos fibers, and emerging data suggest that genetic susceptibility and simian virus 40 (SV40) infections also facilitate the development of MMs. Both asbestos exposure and transfection of human mesothelial cells with SV40 large and small antigens (Tag, tag) cause genetic modifications and cell signaling events, most notably the induction of cell survival pathways and activation of receptors, and other proteins that favor the growth and establishment of MMs as well as their resistance to chemotherapy. Recent advances in high-throughput technologies documenting gene and protein expression in patients and animal models of MMs can now be validated in human MM tissue arrays. These have revealed expression profiles that allow more accurate diagnosis and prognosis of MMs. More importantly, serum proteomics has revealed two new candidates (osteopontin and serum mesothelin-related protein or SMRP) potentially useful in screening individuals for MMs. These mechanistic approaches offer new hope for early detection and treatment of these devastating tumors.
Keywords asbestos; mesothelioma; cancer; SV40Mesothelial cells are unusual in that they possess features of both mesenchymal and epithelial cells, and normally facilitate lubrication and movement of serosal surfaces [Mutsaers, 2004]. The processes involved in the initiation and development of malignant mesothelioma (MM), an aggressive tumor derived from mesothelial cells, are under intense investigation. The interest in this peculiar, phenotypically diverse cancer arises from the fact that its incidence is increasing worldwide, and patients generally die less than a year from initial diagnosis [Mossman and Gee, 1989;. Thus, MM represents a great challenge to clinicians and cancer researchers due to its poor prognosis and marked resistance to current therapies. MM is presently a worldwide problem [Bocchetta et al., 2001]. Although MM is a rare disease with an annual incidence in the USA of 2,000 to 3,000 cases, a steady rise in cases has been reported [Grondin and Sugarbaker, 1999] that may have recently plateaued [Weill et al., 2004]. In Europe, the incidence of MM has risen for decades and is expected to peak between the years 2010 and 2020 [Boutin et al., 1998]. Understanding the mechanisms of MM development and invasiveness, and elucidating potential biomarkers are intrinsic to prevention, screening, and effective therapies for MM. Here, we present recent data on the etiology and molecular pathogenesis of this tumor.
FACTORS CAUSING MALIGNANT MESOTHELIOMAIn the US the most important causal factor for the development of human mesothelioma is occupational exposure to asbestos, primarily the amphiboles, crocidolite, and amosite [Mossman and Gee, 1989;Mossman et a...