Preface

Asbestos-related issues are a major international concern, and the World Health Organization (WHO) has issued a declaration to eliminate asbestos-related diseases. However, there are still countries that export asbestos, and some countries have not banned its use. Considering that asbestos-related diseases, such as refractory and refractory malignant mesothelioma, will develop 30 to 50 years after the first exposure, the issue of asbestos-related diseases is of great importance.

Dr. Otsuki has been studying the immune effects of asbestos for 20 years. In observing the immunological effects of asbestos fibers, he, along with Associate Professor Nishimura, obtained research results that asbestos fibers bring about a reduction in antitumor immunity to various immunocompetent cells. This poses a challenge for the treatment of malignant mesothelioma using the immune checkpoint agent described in this text. Although there are biomarkers that can be used to detect asbestos exposure, there is currently only one way to detect pleural plaque and this is with radiological techniques. However, there are cases in which mesothelioma is discovered without sufficient discovery. In terms of cost, it is expensive to continuously screen members of high-risk groups of exposure (e.g., current or past workers in asbestos-handling factories, building demolition business, rubble disposal, etc.).

This book describes the immunological effects of asbestos fibers, biomarkers for malignant mesothelioma, pathology and clinical practice (especially the effects of immune checkpoints), and matrix metallopreteinases (MMPs).

This book is a useful reference for those who are involved in clinical and research studies of asbestos-induced diseases, as well as legislation and all other related areas.

> **Takemi Otsuki** Professor, Department of Hygiene, Kawasaki Medical School, Kurashiki, Japan

## **Chapter 1**
