Fluoro Edenite-Associated Pathogenesis in pleural malignant mesothelioma

Aim: Malignant Pleural Mesothelioma (MPM) is a rare, but very aggressive tumour arising from pleural mesothelial cells.MPM etiology is strongly associated with exposure to asbestiform mineral fibres, which represent the principal carcinogenic factor.Inhalation of these fibres is interconnected with two pathogenic processes: chronic inflammation and carcinogenesis. Recently, anevident cluster of MPM cases was found in Biancavilla, an eastern Sicily village, where the onset of the lung tumour was associatedwith the exposure to the newly discovered asbestiform fibre, called Fluoro-Edenite (FE). This minireview focuses on the several studies,both in vitro and in vivo, that have been carried out until today, to understand the pathogenesis of MPM associated with theexposure to FE.Materials and methods: The literature search was conducted on PubMed, Scopus and Google Scholar using appropriatekeywords in relation to the pathogenesis related to Fluoro-edenite exposure.Discussion: Previous studies reported that the biological reactivity of FE fibres resembles that of asbestos ones, and the exposureto these fibres could be associated with the onset of MPM. Until today, it has been discovered that the exposure to FE fibresinduces the production of reactive oxygen and nitrogen species, which leads to cells death, chronic inflammation and aneuploidy. Thecarcinogenesis is therefore based on a close relationship between inflammatory process, DNA damage and apoptosis, which leads tothe classic honeycombing of alveolar cells and fibrosis, but the mechanisms remain to be further elucidated.Conclusion: Understanding of how pleural mesothelial cells respond to the FE fibres might be helpful to design preventiveapproaches to protect population from consequences of exposure to this airborne mineral fibre and may have important implicationsfor therapeutic strategies.