Asbestos Cell Injury Inflammation and Fibrotic Lung Disease

One interesting study is called, "Approaches tocontrasted with the unexposed population. The
prevention of asbestos-induced lung disease usingprevalence in the group with direct or indirect asbestos
polyethylene glycol (PEG)-conjugated catalase" -exposure was 5.3, 5.8, 3.5%; whereas in the
Journal of Free Radicals in Biology & Medicine -unexposed population it was 0.34%. These results
Volume 2, Issues 5-6, 1986, Pages 335-338 by Brookeindicate that asbestos is primarily responsible for pleural
T. Mossman, Joanne P. Marsh, David Hardwick,findings, but that some pleural disease may be the
Rhonda Gilbert, Scot Hill, Ann Sesko, Marie Shatos,result of the other factors, still not known. The
Jacqueline Doherty, Ann Weller and Michaelidentification of other causes is hampered by the long
Bergeron.  Here is an excerpt: "Abstract -period which need elapse from the onset of the
Asbestos-associated damage to cells of theprocess to the radiological appearance of the pleural
respiratory tract in vitro can be prevented by thechange."
simultaneous addition of scavengers of active oxygenAnother study is called, "Malignant pleural mesothelioma
species to cultures. To determine if administration ofcaused by environmental exposure to asbestos or
scavenger enzymes to animals and humans is aerionite in rural Turkey: CT findings in 84 patients" by
plausible approach to the prevention ofAA Sahin, L Coplu, ZT Selcuk, M Eryilmaz, S Emri, O
asbestos-induced lung disease, osmotic pumps wereAkhan and YI Baris Department of Chest Diseases,
filled with various concentrations of PEG-coupledHacettepe University, School of Medicine, Ankara,
catalase and implanted subcutaneously into FischerTurkey. - American Journal of Roentgenology, Vol 161,
344 rats over a 28-day period. At 3, 14, and 28 days533-537.  Here is an excerpt: "OBJECTIVE Malignant
after implantation of the pumps, the animals werepleural mesothelioma in rural Turkey frequently results
evaluated for levels of catalase in serum and lung. Infrom environmental exposure to tremolite asbestos or
addition, lung tissue and lavage fluids were examinedfibrous zeolite (erionite). The aim of this study was to
at 28 days for biochemical and morphologic indicationsdetermine the CT features of malignant pleural
of cell injury, inflammation, and fibrotic lung disease. Atmesothelioma in patients exposed to asbestos or
all time points examined, the administration oferionite. MATERIALS AND METHODS. The CT scans
PEG-catalase caused a dosage-dependent increase inof 84 patients with proved malignant pleural
serum levels of catalase. The levels of lung catalasemesothelioma were retrospectively evaluated. Twenty
were evaluated at 28 days but not at earlier timepatients (24%) had been exposed to erionite and 64
periods. In comparison to control rats, the amounts ofpatients (76%) had been exposed to asbestos. The
enzymes (lactic dehydrogenase, alkaline phosphatase),CT scans were interpreted by seven observers who
protein, and cells in lavage fluids from treated animalsdid not know the clinical or pathologic findings.
were unaltered. Moreover, the lungs showed noRESULTS. CT scans showed either unilateral pleural
evidence of inflammation or fibrotic disease asthickening or pleural nodules/masses in all patients.
determined by differential cell counts in lavage andPleural nodules were present in 25 patients (30%) and
measurement of hydroxyproline. These studiespleural masses in 44 patients (52%). Pleural effusion
suggest that administration of PEG-catalase does notwas found in 61 patients (73%), mediastinal pleural
cause injury or other alterations in lung tissue and caninvolvement in 78 (93%), pleural calcifications in 52
be pursued as a feasible approach to prevention of(62%), involvement of the interlobar fissures in 64
asbestosis."(76%), and volume contraction in 61 (73%). Reduced
Another study is called, "Prevalence of pleuralsize of the hemithorax was significantly correlated with
calcification in persons exposed to asbestos dust, andchest wall involvement. On the basis of CT findings,
in the general population in the same district" -the preassigned staging was changed in 21 patients
Environmental Research - Volume 5, Issue 2, June(25%), including 44% of the patients with disease that
1972, Pages 210-216 by M. Navrátilb, a and F.had been classified as stage I. CT findings were not
Trippéb, a – Here is an excerpt: "Abstract - It issignificantly different between the patients exposed to
of interest whether pleural calcification is primarily theerionite and those exposed to asbestos.
result of long years of exposure to asbestos dust orCONCLUSION. The most common CT findings in
whether there are factors other than exposure tocases of malignant pleural mesothelioma were
dust. We have investigated persons working for a longunilateral pleural thickening or pleural nodules/masses
period in a plant processing asbestos productswith or without effusion. CT provided valuable
(chrysotile), persons without occupational exposure toinformation on the extent of the disease, which was
dust but living in the vicinity of the plant, andimportant for staging. Although the CT features are
consanguineous relations of patients with pleuralnot pathognomonic, they provide valuable clues to the
calcifications. We have also studied a large populationdiagnosis in patients who have been exposed to
above the age of 40, in the district in which the plant ismineral fibers."
situated. Comparison of the groups disclosed that 
prevalence of pleural calcifications was closely relatedIf you found any of these excerpts interesting, please
to opportunity for exposure to asbestos dust eitherread the studies in their entirety.  We all owe a debt
occupationally or by family or neighborhood contact, asof gratitude to these fine researchers.