{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T18:09:18Z","timestamp":1760551758242,"version":"build-2065373602"},"reference-count":115,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Surgery, University of Pretoria, the South African Medical Research Council (SAMRC)","award":["23108","138139"],"award-info":[{"award-number":["23108","138139"]}]},{"name":"National Research Foundation (NRF)","award":["23108","138139"],"award-info":[{"award-number":["23108","138139"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Malignant mesotheliomas (MM) are hard to treat malignancies with poor prognosis and high mortality rates. This cancer is highly misdiagnosed in Sub-Saharan African countries. According to literature, the incidence of MM is likely to increase particularly in low-middle-income countries (LMICs). The burden of asbestos-induced diseases was estimated to be about 231,000 per annum. Lack of awareness and implementation of regulatory frameworks to control exposure to asbestos fibers contributes to the expected increase. Exposure to asbestos fibers can lead to cancer initiation by several mechanisms. Asbestos-induced epigenetic modifications of gene expression machinery and non-coding RNAs promote cancer initiation and progression. Furthermore, microbiome\u2013epigenetic interactions control the innate and adaptive immunity causing exacerbation of cancer progression and therapeutic resistance. This review discusses epigenetic mechanisms with more focus on miRNAs and their interaction with the microbiome. The potential use of epigenetic alterations and microbiota as specific biomarkers to aid in the early detection and\/or development of therapeutic targets is explored. The advancement of combinatorial therapies to prolong overall patient survival or possible eradication of MM especially if it is detected early is discussed.<\/jats:p>","DOI":"10.3390\/ijms23168991","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T01:47:21Z","timestamp":1660528041000},"page":"8991","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Microbiomes, Epigenomics, Immune Response, and Splicing Signatures Interplay: Potential Use of Combination of Regulatory Pathways as Targets for Malignant Mesothelioma"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-5572","authenticated-orcid":false,"given":"Botle Precious","family":"Setlai","sequence":"first","affiliation":[{"name":"Department of Surgery, Level 7, Bridge E, Steve Biko Academic Hospital, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Pretoria 0007, South Africa"},{"name":"Department of Medical Microbiology, School of Laboratory Medicine & Medical Sciences, Medical School Campus, College of Health Sciences, University of KwaZulu-Natal-Natal, Durban 4041, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0373-9973","authenticated-orcid":false,"given":"Zilungile Lynette","family":"Mkhize-Kwitshana","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Laboratory Medicine & Medical Sciences, Medical School Campus, College of Health Sciences, University of KwaZulu-Natal-Natal, Durban 4041, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"India Cancer Research Consortium (ICMR-DHR), Department of Health Research, Red Cross Road, New Delhi 110001, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4071-3905","authenticated-orcid":false,"given":"Thanyani Victor","family":"Mulaudzi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Level 7, Bridge E, Steve Biko Academic Hospital, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Pretoria 0007, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8012-3646","authenticated-orcid":false,"given":"Zodwa","family":"Dlamini","sequence":"additional","affiliation":[{"name":"SAMRC Precision Oncology Research Unit (PORU), DSI\/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Hatfield 0028, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12940-019-0512-4","article-title":"Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: A systematic review and the experience of the Apulia (southern Italy) mesothelioma register","volume":"18","author":"Vimercati","year":"2019","journal-title":"Environ. 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