Abstract
Asbestos-related diseases, such as malignancies and asbestosis, remain a significant occupational and public health concern. Asbestos is still widely used in many developing countries despite being a recognized carcinogen that has been banned over 50 countries. The prevalence and mortality from asbestos-related diseases continue to pose challenges worldwide. Many countries are now experiencing an epidemic of asbestos-related disease that is the legacy of occupational exposure during the 20th century because of the long latency period (up to 40 years) between initial asbestos exposure and exhibition of disease. However, the gastrointestinal (GI) cancers resulting from asbestos exposure are not as clearly defined. In this review, we summarize some of the recent epidemiology of asbestos-related diseases and then focus on the evidence implicating asbestos in causing GI malignancies. We also briefly review the important new pathogenic information that has emerged over the past several years that may account for asbestos-related gastrointestinal cancers. All types of asbestos fibers have been implicated in the mortality and morbidity from GI malignancies but the collective evidence to date is mixed. Although the molecular basis of GI cancers arising from asbestos exposure is unclear, there have been significant advances in our understanding of mesothelioma and asbestosis that may contribute to the pathophysiology underlying asbestos-induced GI cancers. The emerging new evidence into the pathogenesis of asbestos toxicity is providing insights into the molecular basis for developing novel therapeutic strategies for asbestos-related diseases in future management.
Highlights
Asbestos, which is a naturally occurring hydrated silicate fiber, is ideal for a variety of construction and insulation purposes
Utilization of asbestos began in the 1850s, but its harmful risks for causing pulmonary malignancies and other nonmalignant disease as well as other type of cancers were increased by the middle of the 20th century [1,2]
The strongest association between asbestos exposure and GI cancers is with stomach cancer, but even there are discordant studies
Summary
Asbestos, which is a naturally occurring hydrated silicate fiber, is ideal for a variety of construction and insulation purposes. There is more evidence linking non-occupational and environmental chrysotile asbestos exposure to GI cancers possibly resulting from contaminated drinking water as the most likely route of GI entry [22]. McConnell group showed that toxic or neoplastic lesions are not observed in gastrointestinal tract and mesothelium in Fischer 344 rat and in Syrian golden hamsters given the diet with amosite (at a concentration of 1% of pelleted diet) for their lifetime even though increasing C-cell carcinomas of the thyroid and monocyte significantly [75,76] It is well established in pulmonary fibrosis caused by asbestos that some of the important molecular mechanisms are related with asbestos-induced ROS productions inducing a fail of mitochondrial dysfunctions, such as protection of mtDNA integrity and protection of intrinsic apoptosis in patients with pulmonary fibrosis have increased oxidative stress as measured by various [5,77,78,79]. Asbestos-exposed pulmonary and gastrointestinal tract increase the levels of 8-oxo-7,8-dihydroguanine causing oxidative-damaged DNA in the lung and internal organs [84]
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