**4. Biomarkers**

Because the expression of GAGs and their fine structure are markedly altered in disease, these features could have an essential clinical implementation. Malignant pleural mesothelioma (MPM) is a highly aggressive and therapy-resistant pleural malignancy with poor prognoses and short patient survival. When patients' pleural infusion was analyzed by a Luminex multiplex assay, syndecan-1 (SDC-1) and MMP-7 levels were significantly lower, whereas mesothelin and galectin-1 levels were significantly higher in malignant mesothelioma effusions compared to in adenocarcinoma. Javadi et al. [15] suggest that MMP-7, shed SDC-1, mesothelin, and galectin-1 can be diagnostic and that VEGF and SDC-1 are prognostic markers in MPM patients. Indeed, this study confirms the vital role of ECM components in malignant disease progression.
