Mesothelial Cells Hold Potential for Use in Tissue Repair, New Research Suggests

Researchers at the University of Western Australia have been trying to unlock the secrets of mesothelial cells and their multi-potency.

In an article prepared for the Journal of Cellular and Molecular Medicine, the researchers report that cells in the mesothelium,—the layer of tissue that lines the body’s chest and abdominal cavities, heart and many internal organs— may hold great potential for use in repairing and possibly regenerating tissue elsewhere in the body.

The mesothelium gives its name to mesothelioma, a cancer linked to asbestos exposure that produces tumors in the lining of the lung, abdomen or heart. There are different types of mesothelioma. If the asbestos-related cancer originates in the lining of the lung, it is known as malignant pleural mesothelioma. If it starts in the abdomen, the disease is known as peritoneal mesothelioma.

It’s quite rare, but sometimes mesothelioma tumors may contain tissue similar to that found in cartilage or bone. In medical literature, there are more than 20 reported cases of malignant mesothelioma with tissue bone or cartilage formation. Why that occurs is a puzzle that researchers have been trying to understand.

The Australian researchers set out to see if they could coax mesothelial cells from humans and rats to transform in the lab into different types of cells that store fat and develop into connective tissue. They collected human mesothelial cells from patients undergoing heart surgery. They exposed the mesothelial cells to certain naturally occurring substances released by cells that stimulate other cells to grow and divide.

Over a period of several weeks, they reported observing small changes in the cells consistent with the formation of bone, also known as osteoblasts. In a separate set of experiments, they observed mesothelial cells undergoing changes consistent with development of cells that store fat.

The researchers said their research provides strong evidence that mesothelial cells retain the potential to develop into different types of cells. The research also shows a mechanism by which bone is formed in malignant mesothelioma tumors.

Scientists already have used mesothelial cells in certain engineering applications including the development of blood vessels and replacements for peripheral nerves. The multi-potency of mesothelial cells suggests greater application for the cells to be used to repair and replace tissue and possibly regenerate damaged and defective tissue.

Approximately, 2,500 to 3,000 new cases of mesothelioma are diagnosed in the United States each year. The majority are malignant pleural mesothelioma. Mesothelioma symptoms typically occur decades after exposure to asbestos. Often the cancer has reached an advanced stage before doctors diagnose the condition as mesothelioma.

Mesothelioma Treatment Requires More Than Cancer Targeting Drugs

Mesothelioma is a serious, asbestos-caused cancer of the membranes that surround many of the body’s vital organs. The most common form is pleural mesothelioma, where cancer attacks the tissue surrounding the lungs. There is no known cure for mesothelioma. However, with an early diagnosis and appropriate care, patients may get some relief from their symptoms.

Treatment for mesothelioma is complex and, depending on the stage of the disease, typically involves a multi-modal approach including surgery, radiation and chemotherapy. While these treatment options are vital for fighting the disease, they can come with pain and side effects and may deplete the body of much needed nutrients. As a result, additional medications must be added to the cancer-fighting arsenal to help the patient fight off infection and fatigue and keep them as comfortable as possible during the difficult treatment regimen.

Anti-Nausea Drugs

The most common side-effects of chemotherapy treatment are nausea, vomiting and diarrhea. Fortunately, there are many drugs that a doctor can prescribe to prevent, lessen, or relieve the GI discomfort. The drugs can be given in pill form, through an IV, a patch, under the tongue, or even in a shot. In some cases the medicine is given via IV prior to receiving the chemotherapy treatment. Some common anti-nausea medicines include:

aprepitant (Emend®)
dolasetron (Anzemet®)
granisetron (Kytril®)
ondansetron (Zofran®)
proclorperazine (Compazine®)
lorazepam (Ativan®)
metoclopramide (Reglan®)
famotidine (Pepcid®)
ranitidine (Zantac®)

The Multi-Uses of Steroids

Cortisol-type steroids are used to treat many conditions and symptoms that arise from cancer and the associated treatments. Prednisone is one of the most common steroids prescribed and can be used for any or all of the following:

Shrink tumors and fight the cancer in addition to the chemotherapy;
Relieve inflammation and reduce swelling;
Reduce allergic reactions from chemotherapy and other infusions – often given via IV prior to the primary drug infusion;
Reduce nausea associated with chemotherapy and radiation;
Increase appetite and stimulate weight gain;
Induce sleep.

Pain Medications

Mesothelioma is a painful cancer and the pain associated with the disease varies from patient to patient and depends on the type of mesothelioma. Over half of the pleural mesothelioma patients suffer pain in the lower, back and sides of the chest. Sufferers of peritoneal mesothelioma may experience pain in the abdominal area, whereas pericardial mesothelioma patients experience the most pain with symptoms including chest pain, heart palpitations, shortness of breath, and constant and acute coughing.

Pain treatment varies depending on the severity.

Mild pain is typically treated with over-the-counter drugs containing ibuprofen, aspirin, naproxen or acetaminophen.
Moderate pain often involves the use of opioid medications that are sometimes used in combination with NSAIDs. Opioid products are hydrocodone, codeine, methadone or oxycodone.
Severe pain is often experienced following surgery and is typically managed through “patient-controlled analgesia” where the patient can manage the dosage of the painkiller. Most often this is a morphine drip. Higher doses of the moderate pain relievers may be used or other drugs can be prescribed including morphine, fentanyl and hydromorphone.

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Researchers Test Gastric Cancer Drug for Treatment of Pleural Mesothelioma

Malignant pleural mesothelioma is an aggressive respiratory cancer and remains difficult to control. Researchers keep searching for new treatment options to help mesothelioma patients live longer with the disease.

In a recent article in the medical journal Cancer, Chemotherapy and Pharmacology, Japanese researchers explore the effectiveness of a new anti-tumor drug known as S-1 for treating malignant pleural mesothelioma, which is closely associated with breathing asbestos.

The incidence of malignant mesothelioma is increasing worldwide with an expected peak in 2030 to 2040 in Asia and sooner in the U.S. and Europe. Complicating the treatment of mesothelioma is the fact that symptoms of asbestos-related cancer such as coughing, fluid around the lungs and chest pain are common to other conditions and mesothelioma often isn’t diagnosed until the disease has reached an advanced stage. In addition, mesothelioma patients are typically older and in weaker health. The standard treatment for advanced mesothelioma is a one-two punch of the chemotherapy drugs, pemetrexed and cisplatin. Yet, the overall prognosis for mesothelioma patients remains poor.

S-1, a chemotherapy drug that is taken orally, was developed by the Japanese drug manufacturer, Taiho Pharmaceutical Co. and is sold under the brand name Teysuno. It is used to treat patients with gastric cancer in Japan, Korea, China and other Asian countries. It was recently recommended for approval as a first line treatment for gastric cancer in Europe, but is not yet available in the U.S.

S-1 is designed to prevent the growth of cancer cells and also to enhance the effectiveness of another anti-cancer medication, 5-FU. To test the drug’s effectiveness on mesothelioma, researchers at the University of Tokushima implanted malignant mesothelioma cells into the chest cavities of mice. Their intent was to see whether S-1 would reduce the growth of cancerous tumors and the occurrence of bloody pleural fluid caused by mesothelioma.

The researchers reported that treatment with S-1 significantly reduced tumor growth in mice with certain lines of mesothelioma cells and prolonged their survival. One of the key compounds in S-1 is CDPH, which enhances the antitumor activity of 5-FU as well. Since human patients are typically diagnosed in the later stages of mesothelioma, the researchers delayed treating the mice until their tumors were advanced. They still responded to the chemotherapy and it prolonged their survival, suggesting that S-1 may be applicable for treatment of human mesothelioma patients in a clinical setting.

The research suggests that S-1 may be an effective therapy for controlling malignant pleural mesothelioma.

9/11 Health Care Bill Reopens Victims’ Compensation Fund

New York mesothelioma attorney Joseph W. Belluck said the signing of the 9/11 Health Care bill underscores the nation’s ongoing support for the rescue workers and NY residents who have suffered respiratory health problems related to breathing the toxic dust cloud after World Trade Center terrorist attacks.

“America has lived up to its moral duty to the brave responders who served selflessly on 9/11 and the days afterward,” said Belluck, a partner in Belluck & Fox, a personal injury law firm that represents victims of mesothelioma, a respiratory disease caused by breathing asbestos.

On Sunday, President Obama signed into law the James Zadroga 9/11 Health and Compensation Act that provides medical care and compensation to rescue workers and others harmed by the toxic dust after the 2001 terrorist attacks. The bill was named to honor a New York police detective who some consider to be the first responder to die from breathing the dust at Ground Zero. Zadroga died in 2006. In the closing days of 2010, Democrats and Republicans reached a compromise to pass the bill after years of wrangling about the cost.

The $4.3 billion measure provides $1.8 billion to establish a monitoring and treatment program to measure the ongoing health effects suffered by 9/11 first responders and New Yorkers of breathing the dust. It provides $2.5 billion to re-open the September 11 Victims’ Compensation Fund for five years to provide fair compensation for asbestos exposure, economic losses, and harm.

“Many New Yorkers’ lungs bear the damage from the toxic dust breathed after the 9/11 attacks,” Belluck said in a press release.. “Some firefighters still have abnormal lung function years later, and certainly respiratory diseases such as mesothelioma takes decades to appear.”

Mesothelioma, a cancer of the lining of the lung or abdomen, is linked to breathing asbestos. The microscopic asbestos particles lodge in the lung and may cause malignant tumors to appear 20 to 40 years later. Mesothelioma claims the lives of 2,500 to 3,000 Americans a year, most of whom were exposed to asbestos in a workplace many years earlier.

Amino Acids Diet Could Slow Mesothelioma Tumors

Mesothelioma Patient Survives More than Seven Years After Diagnosis with Rare Tumor

Mesothelioma, a cancer associated with inhaling asbestos, typically appears as malignant tumors in the lining of the lung or the lining of the abdomen. The cancer also can appear in the lining of the heart, though it’s uncommon. This form is called pericardial mesothelioma and accounts for only 1 percent of mesothelioma cases.

In the medical journal Rare Tumors, doctors at the University of Virginia report on the case of a 59-year-old man who has survived more than seven years since being diagnosed with pericardial mesothelioma. The man appeared at the hospital in 2003 after experiencing symptoms of periodic chest pain and fatigue after exertion. An x-ray of his heart revealed a large mass in the lining of the heart attached to the right ventricle.

Doctors performed surgery and removed much of the mass, but couldn’t remove all of it because of its involvement with the heart muscle. Lab tests confirmed it to be malignant mesothelioma. Typically, malignant tumors in the lining of heart are the advance guard of a cancer spreading from the lung, breast or elsewhere. Mesothelioma tumors originating in the lining of the heart are rare.

The patient received chemotherapy for three years, but his disease continued to advance. The initial chemotherapy consisted of eight cycles of gemcitabine and cisplatin. The combination of gemcitabine and cisplatin is one of the most common chemotherapy treatments for mesothelioma patients. After doctors observed the malignant mass growing again in January 2005, the patient received an additional six cycles of chemotherapy consisting of gemcitabine and carboplatin. Doctors observed that the mesothelioma was spreading again in November 2005; an MRI revealed that the mass had increased in size.

The patient received high-dose radiation treatment and tolerated the treatments well. The mass shrank in size after radiation. The patient has survived 50 months since the completion of radiation with no evidence of the mesothelioma returning. It has been 86 months since the initial diagnosis.

While the doctors acknowledge the outcomes are often less striking than this case, the doctors recommend high dose radiation for patients with inoperable or recurring pericardial mesothelioma.

About 2,500 to 3,000 Americans are diagnosed with mesothelioma each year, many of them workers who were exposed to asbestos decades ago in the workplace. The most common form of mesothelioma, accounting for about 60-70 percent of cases, is pleural mesothelioma, a cancer of the lining of the lung. Most of the remaining cases involve the abdominal cavity and are known as peritoneal mesothelioma.

Author: Nancy Meredith