A mesothelioma epidemic in Cappadocia: scientific developments and unexpected social outcomes

Abstract

In Cappadocia, Turkey, an unprecedented mesothelioma epidemic causes 50% of all deaths in three small villages. Initially linked solely to the exposure to a fibrous mineral, erionite, recent studies by scientists from Turkey and the United States have shown that erionite causes mesothelioma mostly in families that are genetically predisposed to mineral fibre carcinogenesis. This manuscript reports, through the eyes of one of the researchers, the resulting scientific advances that have come from these studies and the social improvements that were brought about by both the scientists and members of the Turkish Government.

Eighth International Mesothelioma Interest Group

“…The general conclusion was that these markers may be elevated insignificantly years before mesothelioma develops, but cannot predict for the development of mesothelioma. HI Pass presented preliminary studies conducted in Cappadocia (Carbone et al, 2007). SMRP and osteopontin enzyme-linked immunosorbent assays were performed on sera from patients who lived in some villages where the mesothelioma rate approaches 50%.…”

“…Genetics and Gene-environment interaction The opening lecture was by M Carbone, who presented the work that he is conducting in Cappadocia, Turkey, where three villages experience a very high incidence of mesothelioma (over 50% of all deaths are caused by mesothelioma). Carbone et al (2007) discovered that genetic predisposition to erionite, a type of mineral fiber similar to asbestos, is the cause of this epidemic. These researchers are now attempting to isolate the putative mesothelioma susceptibility gene that makes certain families unusually susceptible to mineral fiber carcinogenesis.…”

“…Alfacell, a company that produces Onconase -see section by A Tsao -a drug that has limited side effects and that has proven beneficial in some mesothelioma patients -is preparing a subcutaneous formula to be tested in high-risk individuals in Cappadocia (that is, individuals found to have high levels of mesothelin or osteopontin). The Turkish government will provide the support for clinical testing and follow-up of these patients (the ethical issues are discussed in Carbone et al, 2007). The results of the early detection serological trial (osteopontin and mesothelin), and of the chemopreventive trial (Onconase), are of obvious potential significance for millions of asbestos-exposed workers that are at risk for mesothelioma.…”

Programmed necrosis induced by asbestos in human mesothelial cells causes high-mobility group box 1 protein release and resultant inflammation

“…The latency of 30-50 y from the time of exposure to tumor development could potentially allow time for intervention to block the presently unclear mechanism(s) that trigger asbestos-induced carcinogenesis (1,2).…”

Effects of SiO2in Turkish Natural Stones on Cancer Development

“…Erionite mineral is found in the composition of tuff stones in this area and causes health hazards by entering in human respiratory system through air transportation. Houses were constructed on erionite soils in these villages, and erionite stones were used in the construction of houses; in addition, agricultural activities are made on erionite soils, and thus people are surrounded by erionite in all sides (Iman, 2001;Roushdy-Hammady, 2001;Carbone et al, 2007). Çermik-village in Diyarbakır, Büyüktatlı town in Afşin County and Mihallıççık county and villages in Eskişehir are some of the samples for cancer cases in Turkey caused by regional geological conditions (Baris et al, 1996).…”