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Furue M, Ishii Y, Tsukimori K, Tsuji G. Aryl Hydrocarbon Receptor and Dioxin-Related Health Hazards-Lessons from Yusho. Int J Mol Sci 2021; 22:ijms22020708. [PMID: 33445793 PMCID: PMC7828254 DOI: 10.3390/ijms22020708] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 12/15/2022] Open
Abstract
Poisoning by high concentrations of dioxin and its related compounds manifests variable toxic symptoms such as general malaise, chloracne, hyperpigmentation, sputum and cough, paresthesia or numbness of the extremities, hypertriglyceridemia, perinatal abnormalities, and elevated risks of cancer-related mortality. Such health hazards are observed in patients with Yusho (oil disease in Japanese) who had consumed rice bran oil highly contaminated with 2,3,4,7,8-pentachlorodibenzofuran, polychlorinated biphenyls, and polychlorinated quaterphenyls in 1968. The blood concentrations of these congeners in patients with Yusho remain extremely elevated 50 years after onset. Dioxins exert their toxicity via aryl hydrocarbon receptor (AHR) through the generation of reactive oxygen species (ROS). In this review article, we discuss the pathogenic implication of AHR in dioxin-induced health hazards. We also mention the potential therapeutic use of herbal drugs targeting AHR and ROS in patients with Yusho.
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Affiliation(s)
- Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka 812-8582, Japan;
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Correspondence: ; Tel.: +81-92-642-5581; Fax: +81-92-642-5600
| | - Yuji Ishii
- Division of Pharmaceutical Cell Biology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Kiyomi Tsukimori
- Department of Obstetrics, Perinatal Center, Fukuoka Children’s Hospital, Fukuoka 813-0017, Japan;
| | - Gaku Tsuji
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka 812-8582, Japan;
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Parrado C, Mercado-Saenz S, Perez-Davo A, Gilaberte Y, Gonzalez S, Juarranz A. Environmental Stressors on Skin Aging. Mechanistic Insights. Front Pharmacol 2019; 10:759. [PMID: 31354480 PMCID: PMC6629960 DOI: 10.3389/fphar.2019.00759] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022] Open
Abstract
The skin is the main barrier that protects us against environmental stressors (physical, chemical, and biological). These stressors, combined with internal factors, are responsible for cutaneous aging. Furthermore, they negatively affect the skin and increase the risk of cutaneous diseases, particularly skin cancer. This review addresses the impact of environmental stressors on skin aging, especially those related to general and specific external factors (lifestyle, occupation, pollutants, and light exposure). More specifically, we have evaluated ambient air pollution, household air pollutants from non-combustion sources, and exposure to light (ultraviolet radiation and blue and red light). We approach the molecular pathways involved in skin aging and pathology as a result of exposure to these external environmental stressors. Finally, we reflect on how components of environmental stress can interact with ultraviolet radiation to cause cell damage and the critical importance of knowing the mechanisms to develop new therapies to maintain the skin without damage in old age and to repair its diseases.
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Affiliation(s)
- Concepcion Parrado
- Department of Histology and Pathology, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Sivia Mercado-Saenz
- Department of Histology and Pathology, Faculty of Medicine, University of Málaga, Málaga, Spain
| | | | | | - Salvador Gonzalez
- Medicine and Medical Specialties Department, Alcala University, Madrid, Spain
| | - Angeles Juarranz
- Biology Department, Sciences School, Autonoma University, Madrid, Spain
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Therapeutic Agents with AHR Inhibiting and NRF2 Activating Activity for Managing Chloracne. Antioxidants (Basel) 2018; 7:antiox7070090. [PMID: 30011787 PMCID: PMC6071176 DOI: 10.3390/antiox7070090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/02/2018] [Accepted: 07/11/2018] [Indexed: 12/13/2022] Open
Abstract
Chloracne is the major skin symptom caused by dioxin intoxication. Dioxin activates the aryl hydrocarbon receptor (AHR)–cytochrome p450 1A1 (CYP1A1) system, generates oxidative stress, and induces hyperkeratinization of keratinocytes and sebocytes leading to chloracne. Nuclear factor-erythroid 2-related factor-2 (NRF2) is a master switch that induces the expression of various antioxidative enzymes, such as heme oxygenase-1. Cinnamaldehyde is an antioxidant phytochemical that inhibits AHR–CYP1A1 signaling and activates the NRF2–antioxidative axis. The cinnamaldehyde-containing Kampo herbal medicine Keishibukuryogan is capable of improving chloracne in Yusho patients who are highly contaminated with dioxin. Agents with dual functions in promoting AHR–CYP1A1 inhibition and NRF2 activation may be useful for managing dioxin-related health hazards.
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Mitoma C, Uchi H, Tsukimori K, Todaka T, Kajiwara J, Shimose T, Akahane M, Imamura T, Furue M. Current state of yusho and prospects for therapeutic strategies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:16472-16480. [PMID: 29197056 DOI: 10.1007/s11356-017-0833-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/23/2017] [Indexed: 05/20/2023]
Abstract
The mass food poisoning incident yusho occurred in Japan in 1968. It was caused by the ingestion of rice bran oil contaminated with polychlorinated biphenyls and various dioxins and dioxin-like compounds including polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDFs). Notably, PCDFs were found to contribute to approximately 65% of the total toxicity equivalent in the blood of yusho patients. Lipophilic dioxins are retained in the body for a longer period than previously estimated. Victims suffered from characteristic skin manifestations associated with non-specific systemic symptoms, neurological symptoms, and respiratory symptoms. The severe symptoms seen in the initial phase subsequently faded, but recently, improvements have scarcely been observed. The Yusho Group has been researching treatments for this condition. Several clinical trials with chelating agents or dietary fibers aimed at accelerating the excretion of compounds. While some treatments increased dioxin excretion, none provided satisfactory symptom relief. Concurrently, various phytochemicals and herbal extracts have been found to possess biological activities that suppress dioxin-induced toxicity via aryl hydrocarbon receptor or activate the antioxidant nuclear factor-erythroid 2-related factor-2 (NRF2) signal pathway, making them promising therapeutic candidates. Here, we summarize the current status of yusho and findings of clinical trials for yusho patients and discuss the treatment prospects.
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Affiliation(s)
- Chikage Mitoma
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Kiyomi Tsukimori
- Department of Obstetrics, Fukuoka Children's Hospital, Fukuoka, 813-0017, Japan
| | - Takashi Todaka
- Kitakyushu Life Science Center, Public Interest Incorporated Foundation, Fukuoka, 804-0003, Japan
| | - Jumboku Kajiwara
- Fukuoka Institute of Health and Environmental Sciences, Fukuoka, 818-0135, Japan
| | - Takayuki Shimose
- Clinical Research Support Center Kyushu, Fukuoka, 812-8582, Japan
| | - Manabu Akahane
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Nara, 634-8521, Japan
| | - Tomoaki Imamura
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Nara, 634-8521, Japan
| | - Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
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Mitoma C, Mine Y, Utani A, Imafuku S, Muto M, Akimoto T, Kanekura T, Furue M, Uchi H. Current skin symptoms of Yusho patients exposed to high levels of 2,3,4,7,8-pentachlorinated dibenzofuran and polychlorinated biphenyls in 1968. CHEMOSPHERE 2015; 137:45-51. [PMID: 25985428 DOI: 10.1016/j.chemosphere.2015.03.070] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 03/05/2015] [Accepted: 03/13/2015] [Indexed: 06/04/2023]
Abstract
Yusho was a mass food poisoning event due to the ingestion of rice oil contaminated with polychlorinated biphenyls (PCBs) and various dioxins and dioxin-like compounds. At its outbreak in 1968, Yusho patients suffered severe skin symptoms. Although the blood concentrations of PCBs and dioxins, especially highly toxic 2,3,4,7,8-pentachlorinated dibenzofuran (2,3,4,7,8-PeCDF) remain high in these patients, extensive analysis has not been performed on their current skin symptoms. We categorized and evaluated the specific skin symptoms in Yusho in 2012 by grading their severity using an arbitrary scoring system, and analyzed their correlations with the blood concentrations of 2,3,4,7,8-PeCDF and PCBs. A total of 352 Yusho patients underwent annual dermatological check-ups, in which five skin symptoms: black comedones, acneiform eruptions, scar formation, pigmentation and nail deformity, were evaluated for their distribution and severity. Approximately one-third of Yusho patients still presented with black comedones, acneiform eruptions and scar formation; the distributions of these symptoms were similar to those at the time of the Yusho outbreak. The mean blood concentrations of 2,3,4,7,8-PeCDF and total PCBs in Yusho patients were still higher than those in controls. The prevalence and severity of black comedones were correlated with age. Severity scores of black comedones and scar formation were positively correlated with 2,3,4,7,8-PeCDF blood level, and those of black comedones, scar formation, and pigmentation were positively correlated with total PCBs blood level. This study suggests that 2,3,4,7,8-PeCDF and PCBs remaining in Yusho patients still play crucial roles in the development of skin symptoms in Yusho.
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Affiliation(s)
- Chikage Mitoma
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan.
| | - Yoshiko Mine
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan
| | - Atsushi Utani
- Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shinichi Imafuku
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masahiko Muto
- Department of Dermatology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | | | - Takuro Kanekura
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan; Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Matsumoto S, Akahane M, Kanagawa Y, Kajiwara J, Mitoma C, Uchi H, Furue M, Imamura T. Unexpectedly long half-lives of blood 2,3,4,7,8-pentachlorodibenzofuran (PeCDF) levels in Yusho patients. Environ Health 2015; 14:76. [PMID: 26384313 PMCID: PMC4574225 DOI: 10.1186/s12940-015-0059-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/31/2015] [Indexed: 05/10/2023]
Abstract
BACKGROUND Dioxins and dioxin-like compounds have half-lives typically between 7.2 years and 15 years. Our previous study of patients poisoned by extremely high concentrations of 2,3,4,7,8-pentachlorodibenzofuran (PeCDF) in the 'Yusho incident' in 1968 found that in some the half-life of blood 2,3,4,7,8-PeCDF tended towards infinity. This suggests that there are two groups of Yusho patients, those with 2,3,4,7,8-PeCDF half-lives around 10 years, and those with half-lives near infinity. We sought to establish the proportions of each in a cohort of 395 Yusho patients, and whether the proportions were changing over time. METHODS We undertook longitudinal measurement of the blood concentration of 2,3,4,7,8-PeCDF in our cohort between 2002 and 2010. We estimated the change in concentration for each patient using linear regression for measured 2,3,4,7,8-PeCDF concentration, then compared the distribution of changes in concentrations with our previous study. RESULTS In patients in whom the blood concentration of 2,3,4,7,8-PeCDF exceeded 50 pg/g lipid, the proportion 8.0% of patients exhibiting half-lives less than 13.3 years fell compared with our previous study (28.2%), while the proportion with near infinity half-lives increased. CONCLUSION The prolongation of the half-lives was likely a consequence of age-related factors.
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Affiliation(s)
- Shinya Matsumoto
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, Japan.
| | - Manabu Akahane
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, Japan.
| | - Yoshiyuki Kanagawa
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, Japan.
| | - Jumboku Kajiwara
- Fukuoka Institute of Health and Environmental Sciences, 39 Mukaizano, Dazaifu, Fukuoka, Japan.
| | - Chikage Mitoma
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.
| | - Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.
| | - Tomoaki Imamura
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, Japan.
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Mitoma C, Uchi H, Tsukimori K, Yamada H, Akahane M, Imamura T, Utani A, Furue M. Yusho and its latest findings-A review in studies conducted by the Yusho Group. ENVIRONMENT INTERNATIONAL 2015; 82:41-8. [PMID: 26010306 DOI: 10.1016/j.envint.2015.05.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 05/10/2015] [Accepted: 05/14/2015] [Indexed: 05/20/2023]
Abstract
The Yusho incident is an unprecedented mass food poisoning that occurred in Japan in 1968. It was caused by the ingestion of rice bran oil contaminated with polychlorinated biphenyls (PCBs) and various dioxins and dioxin-like compounds, such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). The victims of Yusho have suffered from characteristic skin manifestations associated with systemic, ophthalmological, and mucosal symptoms for a long period of time. The Study Group of Yusho (the Yusho Group) has been conducting annual medical check-ups on Yusho victims for more than 45years. Since 2002, when concentrations of dioxins in the blood of Yusho patients started to be measured, the pharmacokinetics of dioxins, relationship between blood levels of dioxins and symptoms/signs in patients directly exposed to dioxins, and the adverse effects on the next generation have become dramatically clear. Herein we review recent findings of studies conducted by the Yusho Group to evaluate chronic dioxin-induced toxicity to the next generation as well as Yusho patients in comparison with a similar food mass poisoning, the Yucheng incident. Additionally, we summarized basic studies carried out by the Yusho Group to re-evaluate the mechanisms of dioxin toxicities in experimental models and various functions of the aryl hydrocarbon receptor (AhR), known as the dioxin receptor, pathway.
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Affiliation(s)
- Chikage Mitoma
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan.
| | - Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kiyomi Tsukimori
- Department of Obstetrics, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Hideyuki Yamada
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Manabu Akahane
- Health Management and Policy, Department of Public Health, School of Medicine, Nara Medical University, Nara, Japan
| | - Tomoaki Imamura
- Health Management and Policy, Department of Public Health, School of Medicine, Nara Medical University, Nara, Japan
| | - Atsushi Utani
- Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan; Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Role of AhR/ARNT system in skin homeostasis. Arch Dermatol Res 2014; 306:769-79. [PMID: 24966027 PMCID: PMC4220966 DOI: 10.1007/s00403-014-1481-7] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 04/27/2014] [Accepted: 05/22/2014] [Indexed: 11/04/2022]
Abstract
Aryl hydrocarbon receptor (AhR) is a ligand-dependent transcription factor that binds to structurally diverse synthetic and naturally occurring chemicals including dioxins, flavonoids, tryptophan photoproducts, and Malassezia metabolites. Upon binding to its ligands, cytoplasmic AhR translocates to the nucleus, heterodimerizes with aryl hydrocarbon receptor nuclear translocator (ARNT), and mediates numerous biological and toxicological effects by inducing the transcription of various AhR-responsive genes. AhR ligation controls oxidation/antioxidation, epidermal barrier function, photo-induced response, melanogenesis, and innate immunity. This review summarizes recent advances in the understanding of the regulatory mechanisms of skin homeostasis mediated by the AhR/ARNT system.
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