A new study published by the National Academy of Sciences may have uncovered an answer to the question of how asbestos causes the formation of cancerous mesothelioma in healthy cells.

When asbestos fibers are inhaled or ingested, they can become permanently lodged in the mesothelium, the lining that surrounds the body’s internal organs. These fibers may cause the death of mesothelial cells with which they come into contact. Since dead cells cannot form tumors, experts were puzzled as to how malignant mesothelioma cancer cells could form after asbestos exposure.

Researchers from the University of Hawaii found that when healthy mesothelial cells are exposed to asbestos fibers, they undergo a process called “programmed cell necrosis.” This process causes dying cells to release a protein called “high mobility group box 1” (HMGB1). The release of HMGB1 causes the nearby cells to release a second protein, TNF-α, which triggers inflammation and increases the risk of mutation into the malignant cancer cells that cause mesothelioma.

The study found that individuals who are exposed to asbestos develop elevated levels of the HMGB1 protein well before the first symptoms of mesothelioma appear. By testing for elevated levels of the protein in patients who have been exposed to asbestos, doctors may be able to identify those who are at risk of mesothelioma and begin treatment before the first signs of the disease even appear.

Scientists are planning further research to test anti-inflammatory medications that may be able to slow the HMGB1 process. If successful, these tests may help to delay or fully prevent malignant mesothelioma for those who have been exposed to asbestos.

The University of Hawaii study is welcome news for those engaged in the fight against mesothelioma, as well as workers and other individuals who have been exposed to asbestos. According to a report from the Centers for Disease Control and Prevention, approximately 2,500 people in the United States die each year from mesothelioma.

While scientists are still a long way from being able to cure mesothelioma, this new understanding of the role that asbestos plays in its development represents a significant step forward in the search for a cure to this deadly disease.