**1. Introduction**

Malignant mesothelioma (MM) is a malignant tumor originating from the mesothelial layer of the pleura, peritoneum, pericardium, and vaginal tunic and traditionally related to the exposure to asbestos fibers [1]. Asbestos includes different types of minerals: serpentine (chrysotile), and fibrous amphiboles cummingtonite-grunerite (amosite asbestos), actinolite, anthophyllite, riebeckite (crocidolite asbestos), anthracite, and tremolite. Such fibers represent an environmental health problem as chronic exposure to these minerals has been associated with respiratory diseases, including cancer. Additionally, exposure to several other types of mineral particles found in the natural environment and termed "naturally occurring asbestos" (NOA) such as fibers of the minerals erionite, winchite, magnesio-riebeckite, Libby asbestos, richterite, antigorite, and fluoro-edenite (FE) have also been associated with MM [1, 2].

At present, MM is still considered a lethal cancer characterized by a considerable period of latency (≥30–60 years) and late diagnosis that determines bad prognosis and quality of life and unresponsiveness to presently available treatments [3]. To date, there are no diagnostic tools with high sensitivity and specificity that can be used to perform an early diagnosis of MM in asymptomatic people. Many biomarkers have been proposed for the screening and diagnosis of MM in exposed subjects [3–13]. Pathogenic mechanisms of lung illness were linked to the activation of different biomarkers including fibulin-3 (Fb-3) [3].
