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         Comprehensive approach on asbestos-related diseases (sponsored by SCFPST)

Comprehensive approach on asbestos-related diseases (sponsored by SCFPST)

  • Takemi Otsuki (E-mail: takemi@med.kawasaki-m.ac.jp);
    Department of Hygiene, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan

Brief overview of the research project "Comprehensive approach on asbestos-related diseases (sponsored by SCFPST)" and immunological effects of asbestos

Head, Project supported by the Special Coordination Funds for Promoting Science and Technology (SCFPST) (H18-1-3-3-1)

It is well-known that asbestos exposure causes asbestos-related diseases such as asbestosis, lung cancer and malignant mesothelioma (MM) not only in workers who have handled asbestos in the work environment, but also in residents living near factories that handle asbestos. Asbestos-related illnesses have been an enormous medical and social problem in Japan since the summer of 2005. Several patients with MM living in Amagasaki, Hyogo Prefecture, Japan have been featured in news reports. These patients resided 1 km from an asbestos factory and had no identifiable occupational exposure to asbestos. Given that MM is an incurable disease with a currently poor prognosis, and considering the absence of effective government legislation concerning the use of asbestos, people in Japan have become concerned about the social and medical issues related to asbestos. Given this milieu, the project entitled “Comprehensive approach on asbestos-related diseases” was adopted in 2006 by the Special Coordination Funds for Promoting Science and Technology (H18-1-3-3-1) and will continue until March, 2011. This project includes four parts; (1) MM case registration, (2) the development of procedures for early diagnosis of MM, (3) the commencement of clinical investigations including multimodal approaches, and (4) basic research including investigations concerning the (i) cellular and molecular characterization of mesothelioma cells, (ii) immunological effects of asbestos, and (iii) the elucidation of asbestos-induced carcinogenesis using animal models. During these 2.5 years, individual parts have proceeded with tremendous enthusiasm. The case registration system and multimodal clinical investigations have commenced. Serum SMRP (soluble mesothelin-related protein) levels have proved to be a good biomarker for MM, and thoracoscopy combined with autofluorescence imaging (AFI) and narrow band imaging (NBI) have become novel tools for the diagnosis of MM. Regarding basic research, the importance of Nf2/merlin, a tumor suppressor, and related signaling pathways has been elucidated and animal models have revealed the same molecular alterations found in human-derived mesothelioma cells. Analyses of the immunological effects of asbestos have demonstrated reduced natural killer cell activity, modification of apoptosis-related molecules and immune-suppressive cytokines. As a result of this project, the actual status of Japanese MM patients should become clearer, and early diagnosis methods and the clinical usefulness of multimodal therapy should be developed. Additionally, the basis for the future development of preventive, diagnostic and therapeutic molecular targets will be ensured. Here, a brief overview of the proceedings of these projects and the immunological effects of asbestos will be presented.