Biomarkers of Response to Asbestos Exposure

Abstract

Asbestos-related diseases (ARDs) resulting from exposure to asbestos include lung cancer and malignant mesothelioma (MM). This has significant health and economic implications that have been well documented. The 20–40-year latency periods of ARDs and their low incidence rates in the general population make preventative strategies and early treatment extremely challenging. The availability of well-validated diagnostic biomarkers of asbestos exposure would greatly facilitate both prevention and early treatment strategies. In this chapter, we have summarized the state of knowledge on biomarkers of response to asbestos exposure and highlighted recent advances, including the discovery of new specific biomarker based on the posttranslational modifications of the high mobility group box 1 (HMGB1) protein. Asbestos is inhaled and trapped primarily in lung tissue and so can only be detected in bronchoalveolar lavage fluid. This makes direct exposure assessments very difficult. In contrast, biomarkers of response, which reflect a change in biologic function in response to asbestos exposure, have proved to be more useful. MM is the major biological response to asbestos that can be readily monitored, and numerous studies have used this disease as confirmation of a prior asbestos exposure. There is some new evidence that an increase in serum nonacetylated HMGB1 can serve as a biological response biomarker of asbestos exposure; whereas acetylated serum HMGB1 is associated with progression to MM. Finally, we discuss the potential merit of combined use of a multiplexed serum lipid biomarker panel with serum protein biomarkers.