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Introduction
Depending upon whom we represent, asbestos lawyers either eagerly
await or dread any new scientific research on SV40.
Simian virus 40 is a DNA tumor virus of, as its name suggests,
monkeys. It is believed, though has not been proven, that SV40 was first introduced
to the human population in the late 1950's to early 1960's through polio vaccines. The
polio vaccines were prepared in the kidney cells of rhesus monkeys, and apparently many of
them were contaminated with SV40 present in those cells.
On August 29, the National Academy of Sciences published a study
entitled, "Human mesothelial cells are unusually susceptible to simian virus
40-mediated transformation and asbestos cocarcinogenicity."
Anytime SV40, asbestos and mesothelioma are mentioned on the same
page, asbestos lawyers put on their reading glasses and search for language that supports
their clients interests. Based on studies that as much as 60% of human malignant
mesotheliomas contain SV40 DNA, asbestos defense attorneys in particular have been hunting
for anything that might show that SV40, and not asbestos, causes mesothelioma. Defense
lawyers may seize on statements from the study such as, "We found that human
mesothelia are uniquely susceptible to SV40," as a courtroom cause celebre?.
My view, however, is that the study will have little or no effect on
the issue of causation in mesothelioma litigation. But with some good will, good fortune,
and good science, it may lead directly or indirectly to greater treatment options for
mesothelioma patients.
Summary of the SV40-Asbestos Cocarcinogenity Study
According to the study, mesothelial cells are much more susceptible
than other human cells to transformance, i.e., the malignant process of abnormal and
continuous cell reproduction, by SV40. In non-mesothelial tissue, SV40 replicates
actively, quickly leading to cell death. But apparently, the elevated levels of the
protein p53 in mesothelial tissue as opposed to other human tissue, inhibit SV40
replication, thereby limiting cell death. As a result, since the cells are not simply
killed, transformance can occur.
Further, the study reports that SV40 appears to act synergistically
with asbestos to transform mesothelial cells, thus indicating that SV40 and asbestos may
be cocarcinogens. The reports conclusion, in its own words, is that "Malignant
mesothelioma may be a new example of cocarcinogenesis between a virus (SV40) and a
ubiquitous environmental carcinogen (asbestos)."
The article does not overturn more than 50 years of published
research proving that asbestos causes mesothelioma in humans. Beginning simply with the
premise that in tissue culture, i.e., in vitro, asbestos does not
"transform" mesothelial cells, the study seeks to explain how transformance of
mesothelial cells might occur in vitro. "The role of asbestos in causing
malignant mesothelioma has been firmly established epidemiologically; however, it has been
difficult to reconcile the epidemiological findings with the inability of asbestos to
transform mesothelial cells in tissue culture."
Arguing that science does not yet understand the precise mechanism
by which asbestos causes mesothelioma does not undermine the established proof that
asbestos fibers cause mesothelioma.
This was the same argument the tobacco lawyers made for years
"since we dont know the exact mechanism by which tobacco smoke turns healthy
lung cells into malignant cells, we cant say that smoking causes cancer." This
argument has been rejected as fallacious, both by scientists, and by juries.
To shed light on how transformance does occur in human mesothelioma,
the study examines the effects of the SV40 contaminant and asbestos on mesothelial cells
in petri dishes. It indicates that again, in vitro, SV40 is able to cause some
mesothelial cell transformance, and that tissue culture exposed to both SV40 and asbestos
results in much more transformation.
Thus, the study concludes that SV40 may be a cocarcinogen, with
asbestos, in causing mesothelioma. This does not prove that SV40 alone causes
mesothelioma.
Nor does it eliminate asbestos as a cause of malignant mesothelial
cell transformation.
On the contrary, it shows that in vitro,
asbestos combined
with SV40 does cause transformance, significantly more than does SV40 alone.
Furthermore, the study recognizes that the way asbestos operates in
isolated mesothelial cell culture in vitro does not fully describe the way it
operates on actual human tissue, in vivo.
In the human body, "asbestos induces the production of oxygen
radicals by macrophages, which may promote gene alterations and carcinogenesis. Thus it is
possible that in vivo, asbestos has stronger effects on carcinogenesis than
in
vitro."
Far from proving that asbestos does not cause mesothelioma, the
study recognizes that in the human body, asbestos may be even more carcinogenic than it is
within the simplified environment of a petri dish.
The Studys Effect in the Courtroom
While the study may be helpful in identifying one way that asbestos
might
operate with SV40 or other factors to cause mesothelioma, it does not prove that
SV40 is the only thing that causes mesothelioma, or even is essential in causing it.
Aside from SV40, there is a myriad of human DNA viruses, and one or
more of these may be similar to SV40 and act with asbestos in vivo the same way
SV40 does in vitro. Indeed, it is not yet clear that what is referred to as SV40
when found in human mesothelial tissue is actually the same as SV40 in monkeys, or is a
distinct variant.
This raises the questions: Are we even sure that SV40 in humans
originated from the polio vaccines? Could it simply have been latent in the human DNA for
many years?
In any case, the evidence is that SV40 from contaminated polio
vaccines cannot be necessary to cause mesothelioma. Many cases of mesothelioma have
been diagnosed in individuals who were not exposed to such SV40. For example, mesothelioma
occurs in Finland and Turkey, yet neither country received contaminated polio vaccines.
SV40 is not even present in mesotheliomas from Finnish or Turkish patients. I represent
several mesothelioma clients who were born several years after the last batch of
contaminated vaccine was given.
Further, researchers were reporting mesothelioma cases in the
literature as far back as the early 1900's (Robertson in 1923 and Klemperer and Rabin in
1930). And the association between asbestos and mesothelioma found its way into the
published literature in the 1940's a decade before the first infected polio
vaccines were given anywhere.
Finally, the study itself quantifies the proportion of malignant
mesothelioma containing SV40 DNA as about 60%. It therefore follows that in at least 40%
of the cases, a human who did not carry the virus nevertheless developed mesothelioma. All
these facts indicate that SV40 is not a necessary pre-condition in causing mesothelioma.
My view, therefore, is that in the courtroom the study will not
alter 50 plus years of scientific evidence that asbestos "causes" mesothelioma.
Arguing that SV40 is the cause is a slightly smelly red herring, no more.
The Studys Effect on the Search for Treatments - Possible
Hope for Mesothelioma Victims
Lawyers for plaintiffs and defendants can disagree on the cause or
causes of mesothelioma. But there is one thing we should agree on: Basic research on the
mechanism by which tumors are caused at the genetic level provides a foundation for
applied research on developing treatments for this "uncured" cancer. (I say
"uncured" because it is dishonest to call mesothelioma "incurable"
without ever truly committing to try to cure it.)
Millions of dollars have been burned up on courtroom experts. I hope
that both sides, and their lawyers, will think outside the box and support
any
research that might expand treatment options for mesothelioma patients.
The SV40-asbestos study offers hope in this regard. It suggests that
one way mesothelioma may develop is through viral antigens that act in concert with
asbestos. It may be possible for scientists to target the viral antigen with a viral
protein in the form of a vaccine.
The study shows that the SV40 virus preferentially invades healthy
mesothelial cells, and not the surrounding human tissue. It further suggests that select
proteins (p53 in the case of SV40) may actually limit the cell death that a particular
viral antigen would otherwise cause, allowing the cell in the presence of asbestos to
transform malignantly. This offers hope that genes could be engineered to act on the
mesothelioma cells DNA and "turn off" those select proteins that keep the
cancer cell alive and reproducing.
Finally, if indeed the presence of the SV40 infection "may
negatively influence prognosis" as the article posits, then at the very least, we
should be working on finding new tumor markers to test for early stage mesothelioma
or even genetic susceptibility to this cancer in those persons who have known
exposures to asbestos.
This is certainly an issue that the asbestos companies should focus
on, as part of their duty to mitigate (or prevent) damages a common law duty which
most of them have never taken seriously.
The existence of these possibilities, if it were coupled with the
collective will to fund the research necessary to develop them, would offer real hope to
mesothelioma victims.
Roger G. Worthington
** POSTED SEPTEMBER
18, 2000 **
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