Mesothelium and Malignant Mesothelioma

Our plain-English summary of Mesothelium and Malignant Mesothelioma, by E. Hiriart, R. Deepe, A. Wessels (Journal of Developmental Biology, 2019).

The study

• Authors: E. Hiriart, R. Deepe, A. Wessels
• Journal: Journal of Developmental Biology
• Published: 2019;7(2)
• Type of article: Review
• Cited by: 48 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The mesothelium is an epithelial structure derived from the embryonic mesoderm. It plays an important role in the development of a number of different organs, including the heart, lungs, and intestines. In this publication, we discuss aspects of the development of the mesothelium, where mesothelial structures can be found, and review molecular and cellular characteristics associated with the mesothelium. Furthermore, we discuss the involvement of the mesothelium in a number of disease conditions, in particular in the pathogenesis of mesotheliomas with an emphasis on malignant pleural mesothelioma (MPM)-a primary cancer developing in the pleural cavity.

In plain English

This article was a narrative review, not an original study, by authors at the Medical University of South Carolina. It described how the mesothelium, the thin lining of the chest, heart and abdominal cavities, forms in the embryo, the genes and signaling pathways involved, and markers used to identify mesothelial cells. It then discussed diseases of this lining, with emphasis on malignant pleural mesothelioma. Drawing on other published studies, the authors wrote that asbestos exposure is implicated in about 80% of malignant pleural mesothelioma cases. They wrote that risk appears highest with amphibole fibers, especially crocidolite, and that long fibers are retained in the pleura while short fibers such as chrysotile can be cleared. They described a cited pooled analysis of eight cohort studies that reported a median latency of about 39 years. They also reviewed erionite, carbon nanotubes, simian virus 40 (whose role they called controversial), radiation, and genetic changes such as deletions at 9p21 and 22q12. The authors concluded that genes found in mesothelial tissue, such as cytokeratin and WT1, are valuable markers for telling mesothelioma apart from adenocarcinoma.

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 literature (no original data)
• Who was studied: No study population; the review covered published research on mesothelium development (largely animal and cell studies) and on mesothelioma, especially malignant pleural mesothelioma (MPM)
• Exposure: Reviewed causes of MPM: asbestos (serpentine and amphibole groups, including crocidolite and chrysotile), asbestos-like materials (erionite, carbon nanotubes, silicon carbide whiskers, fluoro-edenite), simian virus 40 (SV40), and ionizing radiation
• Main results:
  • Citing other studies, the review stated that asbestos exposure is implicated in about 80% of MPM cases, and that in the remaining 20% there is no indication of asbestos exposure
  • Citing other studies, the review stated that MPM risk appears highest with amphibole exposure, and that amphibole fibers, especially crocidolite, have a clearly established carcinogenic role
  • The review described the proposed mechanism: short fibers such as chrysotile can be cleared from the pleural space, while long asbestos fibers cannot pass through the stomata and accumulate in the parietal pleura
  • Citing a pooled analysis of eight cohort studies, the review reported a median latency of approximately 39 years from asbestos exposure to MPM diagnosis, with women tending to have longer latency than men
  • Citing other studies, the review stated that no direct association between human exposure to carbon nanotubes and MPM has been reported, although animal studies showed asbestos-like effects
  • The review described the role of SV40 in mesothelioma as controversial
  • Citing a study by Ordonez of 60 epithelioid mesotheliomas and 50 lung carcinomas, the review reported that 93% of the mesotheliomas were positive for WT1 and none of the carcinomas were
• The authors' conclusion: The authors concluded that genes characteristic of developing and established mesothelial structures are very valuable as diagnostic markers for mesothelioma, allowing malignant mesotheliomas to be distinguished from, for example, adenocarcinomas (e.g., cytokeratin and WT1)
• Limitations the authors state:
  • The authors stated that the review did not discuss all markers and their usefulness in detail, and that many more markers could be added to their list

Topics

Medical terms in this study, explained in our Lexicon: Mesothelium, Mesothelioma, Mesoderm, Pleural Mesothelioma, Pleural Cavity.

Related studies

• Asbestos, carbon nanotubes and the pleural mesothelium: a review of the hypothesis regarding the role of long fibre retention in the parietal pleura, inflammation and mesothelioma — K. Donaldson, F.A. Murphy, et al. (2010)
• Value of the mesothelium-associated antibodies thrombomodulin, cytokeratin 5/6, calretinin, and CD44H in distinguishing epithelioid pleural mesothelioma from adenocarcinoma metastatic to the pleura — P.M. Cury, D.N. Butcher, et al. (2000)
• Use of antibodies to carcinoembryonic antigen and human milk fat globule to distinguish carcinoma, mesothelioma, and reactive mesothelium — R.J. Marshall, A. Herbert, et al. (1984)
• The mesothelium and its reactions: a review — D. Whitaker, J.M. Papadimitriou, et al. (1982)
• Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies — A.K. Ghosh, K.C. Gatter, et al. (1987)
• Immunocytochemistry of CD146 is useful to discriminate between malignant pleural mesothelioma and reactive mesothelium — A. Sato, I. Torii, et al. (2010)

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