How do inflammation and asbestos exposure interact in developing pleural mesothelioma?

Pleural mesothelioma (PM) is a cancer of the lining of the lung caused by exposure to asbestos. On average, there’s a 10% chance of survival three years after diagnosis.  

Although asbestos has been banned in the UK since 1999, it’s still present in many public buildings and PM typically develops 20-50 years after exposure. This means many people could still be at risk.  

However, there’s no way of predicting who will develop PM. There’s also no routine surveillance of people who have been exposed to asbestos. 

It’s possible that lung inflammation triggers cells to undergo changes that lead to PM. One of these triggers could be pleural injury. This can be caused by traumatic injury to the lungs, medical procedures involving the pleural membrane or infection. The COVID-19 pandemic led to a wave of pleural injury.  

The ’inflammatory trigger’ theory fits with what we’ve seen in clinical practice. We suspect pleural injury causes inflammation that interacts with asbestos exposure, increasing the risk of developing PM.  

Project aims

We want to understand whether a pleural injury increases the risk of developing PM. 

We’ll look at how common pleural injury is in PM cases, compared to other patients who haven’t been exposed to asbestos. We’ll also investigate whether severe COVID-19 increases the risk of pleural injury.  

What we hope to achieve

This work will lead to further research into risk factors for developing PM. Ultimately, we want to improve outcomes for people with PM.