Mesothelioma_and_normal_pleura

Malignant pleural mesothelioma (MPM) is an aggressive tumour of the pleural lining of the lung associated with asbestos exposure that develops over a period of 40 to 50 years. Patients often present late in disease and have a prognosis of less than 12 months. Although asbestos has been banned in developed countries the incidence of MPM is still increasing in Europe and is expected to rise across developing countries. Significant progress has been made in understanding MPM tumour biology, but there are still a number of important open questions in the field regarding the pathogenesis and evolution of MPM. Recent advances in genetic and epigenetic sequencing of benign tissue can provide insight into the earliest stages of MPM and allow reconstruction of comprehensive maps of tumour evolution. We hypothesise that MPM is the result of a decades long process of pleural cell damage and regeneration resulting acquisition of genetic and epigenetic changes over time. Whole genome, RNA, and ATAC sequencing of normal pleura, early pleural thickening and plaques from asbestos exposure, and MPM will provide critical insight into this process to inform future techniques for diagnosis and treatment of MPM.