Mesothelioma Types
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Respirology. 2005 Jan;10(1):2-8. Related Articles, LinksPathogenesis of malignant pleural mesothelioma.Jaurand MC, Fleury-Feith J. INSERM E0337, Faculty of Medicine, University Paris XII, Creteil Cedex, France. Malignant pleural mesothelioma (MPM) results from neoplastic transformation
of mesothelial cells. Past asbestos exposure represents the major risk
factor for MPM, as the link between asbestos fibres and MPM has been largely
proved by epidemiological and experimental studies. Asbestos fibres induce
DNA and chromosome damage linked to oxidative stress following phagocytosis.
Recently, simian virus 40 (SV40) has been implicated in the aetiology
of MPM. The origin of human infection has been associated with SV40-contaminated
polio vaccines, although to date, no epidemiological data supports this
hypothesis. SV40 may act as a coactivator of asbestos in mesothelial oncogenesis.
The transforming potency of SV40 results from the activity of two viral
proteins, large T and small t antigens. SV40 infection stimulates production
of growth factors elsewhere implicated in autocrine growth of mesothelioma
cells and inactivates RASSF1, a gene silenced in MPM. Roles for ionising
radiation, chemicals or genetic factors have also been suggested from
the observation of sporadic MPM cases or animal studies. Genetic alterations
in the tumour suppressor genes, P16/CDKN2A and neurofibromatosis 2 (NF2),
are found both in human MPM and in asbestos-exposed Nf2-deficient mice.
MPM is still of great international concern. Despite a ban on asbestos
use in Western countries, the incidence of MPM is increasing, due to the
long delay between asbestos exposure and diagnosis. Moreover, asbestos
is still used in developing countries. The implication of other risk factors,
especially SV40, supports a need for further research into MPM.
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