Figure 1.

Asbestos and other mineral fibers cause necrotic death of mesothelial cells with the consequent release of HMGB1 in the microenvironment. HMGB1 binds to its receptor RAGE (Receptor for Advanced Glycation End products) of surviving mesothelial cells and macrophages, where it induces Nalp3 inflammasome. As a result, mesothelial cells and macrophages release pro-inflammatory cytokines including TNF-α and IL-1β that cause chronic inflammation, followed by malignant transformation in presence of asbestos-induced DNA damage, and signaling dysregulation.