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Bettuzzi T, Sanchez-Pena P, Lebrun-Vignes B. Cutaneous adverse drug reactions. Therapie 2024; 79:239-270. [PMID: 37980248 DOI: 10.1016/j.therap.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/14/2023] [Indexed: 11/20/2023]
Abstract
Cutaneous adverse drug reactions (ADRs) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality. Maculopapular exanthema and urticaria are the most common types of cutaneous ADR. Serious cutaneous ADRs, which may cause permanent sequelae or have fatal outcome, may represent 2% of all cutaneous ADR and must be quickly identified to guide their management. These serious reactions include bullous manifestations (epidermal necrolysis i.e. Stevens-Johnson syndrome and toxic epidermal necrolysis), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP). Some risk factors for developing cutaneous ADRs have been identified, including immunosuppression, autoimmunity or genetic variants. All drugs can cause cutaneous ADRs, the most commonly implicated being antibiotics (especially aminopenicillins and sulfonamides), anticonvulsants, allopurinol, antineoplastic drugs, non-steroidal anti-inflammatory drugs and iodinated contrast media. Pathophysiology is related to immediate or delayed "idiosyncratic" immunologic mechanisms, i.e., usually not related to dose, and pharmacologic/toxic mechanisms, commonly dose-dependent and/or time-dependent. If an immuno-allergic mechanism is suspected, allergological explorations (including epicutaneous patch testing and/or intradermal test) are often possible to clarify drug causality, however these have a variable sensitivity according to the drug and to the ADR type. No in vivo or in vitro test can consistently confirm the drug causality. To determine the origin of a rash, a logical approach based on clinical characteristics, chronologic factors and elimination of differential diagnosis (especially infectious etiologies) is required, completed with a literature search. Reporting to pharmacovigilance system is therefore essential both to analyze drug causality at individual level, and to contribute to knowledge of the drug at population level, especially for serious cutaneous ADRs or in cases involving newly marketed drugs.
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Affiliation(s)
- Thomas Bettuzzi
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France; EpiDermE, université Paris Est Créteil Val-de-Marne, 94000 Créteil, France
| | - Paola Sanchez-Pena
- Service de pharmacologie médicale, centre régional de pharmacovigilance de Bordeaux, CHU de Bordeaux, 33000 Bordeaux, France; Groupe FISARD de la Société française de dermatologie, France
| | - Bénédicte Lebrun-Vignes
- EpiDermE, université Paris Est Créteil Val-de-Marne, 94000 Créteil, France; Groupe FISARD de la Société française de dermatologie, France; Service de pharmacologie médicale, centre régional de pharmacovigilance Pitié-Saint-Antoine, groupe hospitalier AP-HP-Sorbonne université, 75013 Paris, France.
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2
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Steinbach P, Pastille E, Kaumanns L, Adamczyk A, Sutter K, Hansen W, Dittmer U, Buer J, Westendorf AM, Knuschke T. Influenza virus infection enhances tumour-specific CD8+ T-cell immunity, facilitating tumour control. PLoS Pathog 2024; 20:e1011982. [PMID: 38271469 PMCID: PMC10846710 DOI: 10.1371/journal.ppat.1011982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/06/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Influenza A virus (IAV) can cause severe respiratory infection leading to significant global morbidity and mortality through seasonal epidemics. Likewise, the constantly increasing number of cancer diseases is a growing problem. Nevertheless, the understanding of the mutual interactions of the immune responses between cancer and infection is still very vague. Therefore, it is important to understand the immunological cross talk between cancer and IAV infection. In several preclinical mouse models of cancer, including melanoma and colorectal cancer, we observed that IAV infection in the lung significantly decreased the tumour burden. Concomitantly, tumour-specific CD8+ T-cells are strongly activated upon infection, both in the tumour tissue and in the lung. CD8+ T-cell depletion during infection reverses the reduced tumour growth. Interestingly, IAV infection orchestrated the migration of tumour-specific CD8+ T-cells from the tumour into the infected lung. Blocking the migration of CD8+ T-cells prevented the anti-tumoural effect. Thus, our findings show that viral respiratory infection has significant impact on the anti-tumour CD8+ T-cell response, which will significantly improve our understanding of the immunological cross talk between cancer and infection.
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Affiliation(s)
- Philine Steinbach
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eva Pastille
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lara Kaumanns
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexandra Adamczyk
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kathrin Sutter
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Wiebke Hansen
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Astrid M. Westendorf
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Torben Knuschke
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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3
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Krzysztofik M, Brzewski P, Cuber P, Kacprzyk A, Kulbat A, Richter K, Wojewoda T, Wysocki WM. Risk of Melanoma and Non-Melanoma Skin Cancer in Patients with Psoriasis and Psoriatic Arthritis Treated with Targeted Therapies: A Systematic Review and Meta-Analysis. Pharmaceuticals (Basel) 2023; 17:14. [PMID: 38276003 PMCID: PMC10820691 DOI: 10.3390/ph17010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Targeted therapies represent major advancements in the treatment of chronic skin conditions such as psoriasis. While previous studies have shown an increased risk of melanoma and non-melanoma skin cancer (NMSC) in patients receiving TNF-α inhibitors, the risks associated with newer biologics (IL-12/23 inhibitors, IL-23 inhibitors, IL-17 inhibitors) and Janus kinase (JAK) inhibitors remain less known. Using a systematic and meta-analytical approach, we aimed to summarize the currently available literature concerning skin cancer risk in patients treated with targeted therapies. The MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to find studies reporting the incidence rates (IR) of melanoma and NMSC in patients with psoriasis and psoriatic arthritis treated with biologics or JAK inhibitors. Nineteen studies were included in the analysis with a total of 13,739 patients. The overall IR of melanoma was 0.08 (95% CI, 0.05-0.15) events per 100 PYs and the overall IR of NMSC was 0.45 (95% CI, 0.33-0.61) events per 100 PYs. The IRs of melanoma were comparable across patients treated with IL-17 inhibitors, IL-23 inhibitors, and JAK inhibitors, while the IRs of NMSC were higher in patients treated with JAK inhibitors than in those treated with biologics. Prospective, long-term cohort studies are required to reliably assess the risks associated with novel targeted therapies.
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Affiliation(s)
- Marta Krzysztofik
- Department of Dermatology and Venereology, Stefan Zeromski Municipal Hospital, 31-913 Krakow, Poland
| | - Paweł Brzewski
- Department of Dermatology and Venereology, Stefan Zeromski Municipal Hospital, 31-913 Krakow, Poland
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland (W.M.W.)
| | - Przemysław Cuber
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland (W.M.W.)
- Department of Oncological Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Krakow, Poland
| | - Artur Kacprzyk
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-530 Krakow, Poland
| | - Aleksandra Kulbat
- Department of Oncological Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Krakow, Poland
| | - Karolina Richter
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland (W.M.W.)
| | - Tomasz Wojewoda
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland (W.M.W.)
- Department of Oncological Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Krakow, Poland
| | - Wojciech M. Wysocki
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland (W.M.W.)
- Department of Oncological Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Krakow, Poland
- National Institute of Oncology, Maria Skłodowska-Curie Memorial, 02-781 Warsaw, Poland
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4
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Tavares TS, da Costa AAS, da Mata Camargos F, Gomez RS, Nonaka CFW, Alves PM, Mendonça EF, Sousa-Neto SS, Vasconcelos ACU, Tarquínio SBC, Caldeira PC. Oral melanoacanthoma: Clinicopathological and immunohistochemical features of a case series and a scoping review. J Oral Pathol Med 2023; 52:1013-1020. [PMID: 37852303 DOI: 10.1111/jop.13495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND This study presents a case series and scoping review of oral melanoacanthoma to examine its clinical, histopathological, and immunohistochemical characteristics. METHODS Nine cases of oral melanoacanthoma were included in the case series. Clinical data were collected from biopsy charts. Hematoxylin-eosin and immunohistochemistry for TRP2, CD3, and CD20 were done. For the scoping review, MEDLINE/PubMed, Web of Science, EMBASE, and Scopus were searched. RESULTS Case series: The mean age was 46.8 years (female-to-male ratio 2:1). Lesion's mean size was 11.0 mm (±9.3). Lesions were mainly macular (77.8%) with brown or black coloration (88.9%) and often affected multiple sites (44.4%). The evolution time ranged from 15 days to 96 months. Lesions commonly showed epithelial acanthosis (66.7%), spongiosis (55.6%), exocytosis (77.8%), melanin incontinence (88.9%), and inflammatory infiltrate in the lamina propria (77.8%), from which all showed lymphocytes. TRP2-positive melanocytes were identified in the basal and spinous layer of all cases, and in the superficial layer of three cases. CD3-positive cells predominate over the CD20-positive. Scoping review: 85 cases of oral melanoacanthoma were retrieved from 55 studies. Patients were primarily female (female-to-male ratio 2.2:1), black-skinned (64.1%), with a mean age of 36.13 (± 17.24). Lesions were flat (81.9%), often brown (62.4%). Buccal mucosa was the preferred site (32.9%), followed by multiple sites (28.2%). CONCLUSION Oral melanoacanthoma mainly affects women across a wide age range, with lesions commonly appearing as brown/black macules, particularly on the buccal mucosa. TRP2-positive melanocytes and T-lymphocytes were consistently found and could participate in oral melanoacanthoma pathogenesis.
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Affiliation(s)
- Thalita Soares Tavares
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Felipe da Mata Camargos
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Pollianna Muniz Alves
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | | | | | | | | | - Patrícia Carlos Caldeira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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5
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Wang Y, Liu Y, Peng J, Wang H. Regulation mechanisms underlying tail resorption in Bufo gargarizans metamorphosis. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. PART D, GENOMICS & PROTEOMICS 2023; 47:101113. [PMID: 37517282 DOI: 10.1016/j.cbd.2023.101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/01/2023]
Abstract
Anurans have been excellent organisms for studying amphibian metamorphosis. Tail resorption is a remarkable event that occurs during amphibian metamorphosis. Although tail resorption has been previously studied in other anurans like Xenopus laevis and Rana chensinensis, there is no report on Bufo gargarizans. This paper thus explored the mechanism of tail resorption during metamorphosis in Bufo gargarizans tadpoles through some biological research methods. Histological results showed that the tail tissues of tadpoles gradually degraded as metamorphosis progressed. RNA sequencing analysis was performed to examine the expression level and functional enrichment of differentially expressed genes in the tail. In addition, we analyzed the mRNA expression levels of genes related to tail resorption by quantitative real-time polymerase chain reaction. We also speculated on three pathways that participate in the regulation of tail resorption based on the above results. The present study might provide a theoretical basis and novel insights for further research of complex molecular mechanisms of tail resorption in amphibians.
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Affiliation(s)
- Yaxi Wang
- College of Life Science, Shaanxi Normal University, Xi'an 710119, People's Republic of China
| | - Ying Liu
- College of Life Science, Shaanxi Normal University, Xi'an 710119, People's Republic of China
| | - Jufang Peng
- Basic Experimental Teaching Center, Shaanxi Normal University, Xi'an 710119, People's Republic of China
| | - Hongyuan Wang
- College of Life Science, Shaanxi Normal University, Xi'an 710119, People's Republic of China.
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6
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Phadnis P, Rathoriya S, Singhal R, Choudhary V. Eruptive lentiginosis in a young healthy woman—Revisiting causal associations. TURKISH JOURNAL OF DERMATOLOGY 2023. [DOI: 10.4103/tjd.tjd_123_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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7
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Chousakos E, Kose K, Kurtansky NR, Dusza SW, Halpern AC, Marghoob AA. Analyzing the Spatial Randomness in the Distribution of Acquired Melanocytic Neoplasms. J Invest Dermatol 2022; 142:3274-3281. [PMID: 35841946 PMCID: PMC10475172 DOI: 10.1016/j.jid.2022.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 01/05/2023]
Abstract
On the basis of the clinical impression and current knowledge, acquired melanocytic nevi and melanomas may not occur in random localizations. The goal of this study was to identify whether their distribution on the back is random and whether the location of melanoma correlates with its adjacent lesions. Therefore, patient-level and lesion-level spatial analyses were performed using the Clark‒Evans test for complete spatial randomness. A total of 311 patients with three-dimensional total body photography (average age of 40.08 [30‒49] years; male/female ratio: 128/183) with 5,108 eligible lesions in total were included in the study (mean sum of eligible lesions per patient of 16.42 [3‒199]). The patient-level analysis revealed that the distributions of acquired melanocytic neoplasms were more likely to deviate toward clustering than dispersion (average z-score of ‒0.55 [95% confidence interval = ‒0.69 to ‒0.41; P < 0.001]). The lesion-level analysis indicated a higher portion of melanomas (n = 57 of 72, 79.2% [95% confidence interval = 69.4‒88.9%]) appearing in proximity to neighboring melanocytic neoplasms than to nevi (n = 2,281 of 5,036, 45.3% [95% confidence interval = 43.9‒46.7%]). In conclusion, the nevi and melanomas' distribution on the back tends toward clustering as opposed to dispersion. Furthermore, melanomas are more likely to appear proximally to their neighboring neoplasms than to nevi. These findings may justify various oncogenic theories and improve diagnostic methodology.
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Affiliation(s)
- Emmanouil Chousakos
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; 1(st) Department of Pathology, Medical School, National & Kapodistrian University of Athens, Athens, Greece.
| | - Kivanc Kose
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nicholas R Kurtansky
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephen W Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Allan C Halpern
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ashfaq A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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8
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Thornton J, Chhabra G, Singh CK, Guzmán-Pérez G, Shirley CA, Ahmad N. Mechanisms of Immunotherapy Resistance in Cutaneous Melanoma: Recognizing a Shapeshifter. Front Oncol 2022; 12:880876. [PMID: 35515106 PMCID: PMC9066268 DOI: 10.3389/fonc.2022.880876] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/18/2022] [Indexed: 12/21/2022] Open
Abstract
Melanoma is one of the seven most common cancers in the United States, and its incidence is still increasing. Since 2011, developments in targeted therapies and immunotherapies have been essential for significantly improving overall survival rates. Prior to the advent of targeted and immunotherapies, metastatic melanoma was considered a death sentence, with less than 5% of patients surviving more than 5 years. With the implementation of immunotherapies, approximately half of patients with metastatic melanoma now survive more than 5 years. Unfortunately, this also means that half of the patients with melanoma do not respond to current therapies and live less than 5 years after diagnosis. One major factor that contributes to lower response in this population is acquired or primary resistance to immunotherapies via tumor immune evasion. To improve the overall survival of melanoma patients new treatment strategies must be designed to minimize the risk of acquired resistance and overcome existing primary resistance. In recent years, many advances have been made in identifying and understanding the pathways that contribute to tumor immune evasion throughout the course of immunotherapy treatment. In addition, results from clinical trials focusing on treating patients with immunotherapy-resistant melanoma have reported some initial findings. In this review, we summarize important mechanisms that drive resistance to immunotherapies in patients with cutaneous melanoma. We have focused on tumor intrinsic characteristics of resistance, altered immune function, and systemic factors that contribute to immunotherapy resistance in melanoma. Exploring these pathways will hopefully yield novel strategies to prevent acquired resistance and overcome existing resistance to immunotherapy treatment in patients with cutaneous melanoma.
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Affiliation(s)
- Jessica Thornton
- Department of Dermatology, University of Wisconsin, Madison, WI, United States
| | - Gagan Chhabra
- Department of Dermatology, University of Wisconsin, Madison, WI, United States
| | - Chandra K Singh
- Department of Dermatology, University of Wisconsin, Madison, WI, United States
| | | | - Carl A Shirley
- Department of Dermatology, University of Wisconsin, Madison, WI, United States
| | - Nihal Ahmad
- Department of Dermatology, University of Wisconsin, Madison, WI, United States.,William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
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Acharya M, Kim T, Li C. Broad-Spectrum Antibiotic Use and Disease Progression in Early-Stage Melanoma Patients: A Retrospective Cohort Study. Cancers (Basel) 2021; 13:4367. [PMID: 34503177 PMCID: PMC8431240 DOI: 10.3390/cancers13174367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Animal studies and a few clinical studies have reported mixed findings on the association between antibiotics and cancer incidence. Antibiotics may inhibit tumor cell growth, but could also alter the gut-microbiome-modulated immune system and increase the risk of cancer. Studies that assess how antibiotics affect the progression of cancer are limited. We evaluated the association between broad-spectrum antibiotic use and melanoma progression. We conducted a retrospective cohort study using IQVIA PharMetrics® Plus data (2008-2018). We identified patients with malignant melanoma who underwent wide local excision or Mohs micrographic surgery within 90 days of first diagnosis. Surgery date was the index date. Patients were excluded if they had any other cancer diagnosis or autoimmune disorders in 1 year before the index date ("baseline"). Exposure to broad-spectrum antibiotics was identified in three time windows using three cohorts: 3 months prior to the index date, 1 month after the index date, and 3 months after the index date. The covariates were patients' demographic and clinical characteristics identified in the 1-year baseline period. The patients were followed from the index date until cancer progression, loss of enrollment, or the end of 2 years after the index date. Progression was defined as: (i) any hospice care after surgery, (ii) a new round of treatment for melanoma (surgery, chemotherapy, immunotherapy, targeted therapy, or radiotherapy) 180 days after prior treatment, or (iii) a metastasis diagnosis or a diagnosis of a new nonmelanoma primary cancer at least 180 days after first melanoma diagnosis or prior treatment. A high-dimensional propensity score approach with inverse weighting was used to adjust for the patients' baseline differences. Cox proportional hazard regression was used for estimating the association. The final samples included 3930, 3831, and 3587 patients (mean age: 56 years). Exposure to antibiotics was 16% in the prior-3-months, 22% in the post-1-month, and 22% in the post-3-months. In the pre-3-months analysis, 9% of the exposed group and 9% of the unexposed group had progressed. Antibiotic use was not associated with melanoma progression (HR: 0.81; 95% CI: 0.57-1.14). However, antibiotic use in subsequent 1 month and subsequent 3 months was associated with 31% reduction (HR: 0.69; 95% CI: 0.51-0.92) and 32% reduction (HR: 0.68; 95% CI: 0.51-0.91) in progression, respectively. In this cohort of patients with likely early-stage melanoma cancer, antibiotic use in 1 month and 3 months after melanoma surgery was associated with a lower risk of melanoma progression. Future studies are warranted to validate the findings.
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Affiliation(s)
- Mahip Acharya
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR 72205, USA;
| | - Thomas Kim
- Department of Radiation Oncology, Rush University Medical College, Chicago, IL 60612, USA;
| | - Chenghui Li
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR 72205, USA;
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10
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Clinicopathological Analysis of Acquired Melanocytic Nevi and a Preliminary Study on the Possible Origin of Nevus Cells. Am J Dermatopathol 2021; 42:414-422. [PMID: 31880593 DOI: 10.1097/dad.0000000000001599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The pathogenesis of acquired melanocytic nevi (AMN) is still unclear, and the origin of nevus cells has not been clarified. OBJECTIVE To analyze the clinical features and pathological types of AMN and identify the possible origin of nevus cells. METHODS A retrospective study of 2929 cases of AMN was conducted, and 96 specimens of intradermal and junctional nevi were selected. Immunohistochemical assays were performed to detect the expression of basement membrane component receptor DDR-1 and the molecular markers on epidermal melanocytes, dermal stem cells (DSCs), and hair follicle stem cells. RESULTS Junctional nevi and compound nevi were prone to occur on glabrous skin, such as the palms, soles, and vulva, and on the extremities in children, whereas intradermal nevi tended to develop on the trunk, head, and face of adults. The immunohistochemical data revealed that both junctional nevi and intradermal nevi expressed the epidermal melanocyte surface markers E-cadherin, DDR-1, and integrin α6 and the DSC molecular markers NGFRp-75 and nestin. CD34 was expressed only in junctional nevi, whereas K19 was not expressed in any type of melanocytic nevi. There was no significant difference in molecular expression at different sites or in different ages of onset. Nestin expression was markedly stronger in the intradermal nevi than in the junctional nevi, but there was no difference between the superficial and deep nevus cell nests of intradermal nevi. CONCLUSION AMN may have a multicellular origin that commonly follows the mode of Abtropfung. Furthermore, DSCs may partly or independently participate in the formation of nevus cells.
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11
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Bryson BL, Tamagno I, Taylor SE, Parameswaran N, Chernosky NM, Balasubramaniam N, Jackson MW. Aberrant Induction of a Mesenchymal/Stem Cell Program Engages Senescence in Normal Mammary Epithelial Cells. Mol Cancer Res 2020; 19:651-666. [PMID: 33443106 DOI: 10.1158/1541-7786.mcr-19-1181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 10/23/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022]
Abstract
Although frequently associated with tumor progression, inflammatory cytokines initially restrain transformation by inducing senescence, a key tumor-suppressive barrier. Here, we demonstrate that the inflammatory cytokine, oncostatin M, activates a mesenchymal/stem cell (SC) program that engages cytokine-induced senescence (CIS) in normal human epithelial cells. CIS is driven by Snail induction and requires cooperation between STAT3 and the TGFβ effector, SMAD3. Importantly, as cells escape CIS, they retain the mesenchymal/SC program and are thereby bestowed with a set of cancer SC (CSC) traits. Of therapeutic importance, cells that escape CIS can be induced back into senescence by CDK4/6 inhibition, confirming that the mechanisms allowing cells to escape senescence are targetable and reversible. Moreover, by combining CDK4/6 inhibition with a senolytic therapy, mesenchymal/CSCs can be efficiently killed. Our studies provide insight into how the CIS barriers that prevent tumorigenesis can be exploited as potential therapies for highly aggressive cancers. IMPLICATIONS: These studies reveal how a normal cell's arduous escape from senescence can bestow aggressive features early in the transformation process, and how this persistent mesenchymal/SC program can create a novel potential targetability following tumor development.
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Affiliation(s)
- Benjamin L Bryson
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Ilaria Tamagno
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Sarah E Taylor
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Neetha Parameswaran
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Noah M Chernosky
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Nikhila Balasubramaniam
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Mark W Jackson
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio. .,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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Bogach J, Wright FC, Austin J, Cheng SY, Diong C, Sutradhar R, Baxter NN, Look Hong NJ. Medical Immunosuppression and Outcomes in Cutaneous Melanoma: A Population-Based Cohort Study. Ann Surg Oncol 2020; 28:3302-3311. [PMID: 33067747 DOI: 10.1245/s10434-020-09224-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Melanoma and the immune system are intimately related. However, the association of immunosuppressive medications (ISMs) with survival in melanoma is not well understood. The study evaluated this at a population level. METHODS A cohort of patients with a diagnosis of invasive cutaneous melanoma (2007-2015) was identified from the Ontario Cancer Registry and linked to identify demographics, stage at diagnosis, prescription of immunosuppressive medications (both before and after diagnosis), and outcomes. The demographics of patients with and without prescriptions for ISM were compared. Patients eligible for Ontario's Drug Benefit Plan were included to ensure accurate prescription data. The primary outcome was overall survival. Cox Proportional Hazards Regression models identified factors associated with mortality, including use of ISM as a time-varying covariate. RESULTS Of the 4954 patients with a diagnosis of cutaneous melanoma, 1601 had a prescription for ISM. The median age of the patients was 74 years. Overall, 58.4% of the patients were men (60.5% of those without ISM and 54% of those using ISM; p < 0.001). The use of oral immunosuppression was associated with an increased hazard of death (hazard ratio, 5.84; 95% confidence interval, 5.11-6.67; p < 0.0001) when control was used for age, disease stage at diagnosis, anatomic site, comorbidity, and treatment. Other factors associated with death were increasing age, male sex, increased disease stage, truncal location of primary melanoma, and inadequate treatment. In sensitivity analysis with steroid-only ISM use excluded, survival did not differ significantly (p = 0.355). CONCLUSIONS The use of immunosuppressive steroids for melanoma is associated with worse overall survival. Use of steroids should be limited when possible.
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Affiliation(s)
- Jessica Bogach
- Department of Surgery, University of Toronto, Toronto, ON, Canada.
| | - Frances C Wright
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Janice Austin
- Department of Surgery, Joseph Brant Hospital, McMaster University, Hamilton, ON, Canada
| | | | | | - Rinku Sutradhar
- ICES, Toronto, ON, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Nancy N Baxter
- Cancer Research Program, ICES, Toronto, ON, Canada.,Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Nicole J Look Hong
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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13
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Meneguzzo A, Lazzarotto A, Alaibac M. Eruptive Melanocytic Nevi Secondary to Encorafenib for BRAF Mutant Metastatic Colorectal Cancer. In Vivo 2020; 34:441-445. [PMID: 31882511 DOI: 10.21873/invivo.11793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 01/02/2023]
Abstract
A 59-year-old woman, undergoing treatment with encorafenib for metastatic BRAF mutated colorectal cancer, developed during the first two months of therapy multiple eruptive nevi and changes in pre-existing nevi. Development of eruptive nevi has increasingly been reported in association with medications, most frequently conventional immunosuppressants and biologics. Some drugs are associated with eruptive nevi through an indirect effect of their mechanism of action, whereas other drugs are directly implicated in melanocyte proliferation. In this regard, BRAF inhibitors have been demonstrated to activate the MAPK pathway, and to promote cellular proliferation and survival, therefore leading to the development of new melanocytic nevi and to an increase in the size and hyperpigmentation of pre-existing nevi. A dermatological assessment and follow-up should be recommended in all patients presenting with eruptive nevi, regardless of the pathogenesis, because a high number of acquired melanocytic nevi may represent an adjunctive risk factor for melanoma.
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Affiliation(s)
| | | | - Mauro Alaibac
- Unit of Dermatology, University of Padua, Padua, Italy
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14
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Austin J, Wright FC, Cheng SY, Sutradhar R, Baxter NN, Look Hong NJ. Outcomes of Immunosuppressed Patients Who Develop Melanoma: A Population-Based Propensity-Matched Cohort Study. Ann Surg Oncol 2020; 27:2927-2948. [PMID: 32248374 DOI: 10.1245/s10434-020-08265-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Few studies have examined outcomes in immunosuppressed patients who develop melanoma. The purpose of this study is to compare survival in immunosuppressed patients who developed melanoma with that in patients with melanoma who are not immunosuppressed. METHODS Immunosuppressed patients were defined as having solid organ transplant, lymphoma, leukemia, or human immunodeficiency virus prior to diagnosis of melanoma. Patients with cutaneous melanoma with and without immunosuppression were identified retrospectively from the Ontario Cancer Registry (2007-2015) and linked with administrative databases to identify demographics, treatment, and outcomes. Immunosuppressed patients were matched with non-immunosuppressed patients based on age at diagnosis, sex, birth year, stage at diagnosis, and propensity score. The primary outcome was overall survival. Multivariable Cox proportional hazard regression was used to identify factors associated with survival. RESULTS Baseline characteristics were well balanced in 218 immunosuppressed patients matched to 436 controls. Of the patients, 186 (28.4%) were female, and median age at melanoma diagnosis was 69 (interquartile range, IQR 59-78) years. Three-year overall survival (OS) was 65% for immunosuppressed patients and 79% for non-immunosuppressed patients. Melanoma was the leading cause of death for both groups. On multivariable analysis, immunosuppression was associated with increased mortality [hazard ratio (HR) 1.70, 95% confidence interval (CI) 1.30-2.23]. Adequate treatment (HR 0.36, 95% CI 0.22-0.58) and dermatologist visits either before (HR 0.52, 95% CI 0.36-0.73) or after (HR 0.61, 95% CI 0.41-0.90) melanoma diagnosis were associated with improved OS. CONCLUSIONS Immunosuppressed patients who develop melanoma have worse outcomes when matched to non-immunosuppressed patients. This decrease in survival appears related to the underlying condition rather than diagnosis of melanoma.
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Affiliation(s)
- Janice Austin
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Frances C Wright
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | | | - Nancy N Baxter
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of General Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Nicole J Look Hong
- Department of Surgery, University of Toronto, Toronto, ON, Canada. .,Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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15
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Melanoma and Vitiligo: In Good Company. Int J Mol Sci 2019; 20:ijms20225731. [PMID: 31731645 PMCID: PMC6888090 DOI: 10.3390/ijms20225731] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
Cutaneous melanoma represents the most aggressive form of skin cancer, whereas vitiligo is an autoimmune disorder that leads to progressive destruction of skin melanocytes. However, vitiligo has been associated with cutaneous melanoma since the 1970s. Most of the antigens recognized by the immune system are expressed by both melanoma cells and normal melanocytes, explaining why the autoimmune response against melanocytes that led to vitiligo could be also present in melanoma patients. Leukoderma has been also observed as a side effect of melanoma immunotherapy and has always been associated with a favorable prognosis. In this review, we discuss several characteristics of the immune system responses shared by melanoma and vitiligo patients, as well as the significance of occurrence of leukoderma during immunotherapy, with special attention to check-point inhibitors.
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16
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Turk T, Saad AM, Al-Husseini MJ, Gad MM. The risk of melanoma in patients with chronic lymphocytic leukemia; a population-based study. Curr Probl Cancer 2019; 44:100511. [PMID: 32115255 DOI: 10.1016/j.currproblcancer.2019.100511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/10/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Melanoma is a highly malignant tumor that has been repeatedly reported in chronic lymphocytic leukemia (CLL) patients. We aim to assess the epidemiologic characteristics of this association and emphasize the importance of carefully approaching such cases. METHODS Patients who were diagnosed with CLL between 2000 and 2015 and registered in the Surveillance, Epidemiology and End Results (SEER) database of the US National Cancer Institute were identified using the SEER*stat software (version 8.3.5). The Multiple Primary Standardized Incidence Ratios session of the SEER*stat software (version 8.3.5) was used to calculate the observed/expected (O/E) ratios of melanoma. RESULTS 48,876 CLL cases were reviewed, of which 474 developed a second primary melanoma of the skin. O/E ratio was 2.07 (95% CI 1.89-2.27), and excess risk was 9.7 per 10,000. The increase in melanoma risk was higher within the first 5 years following CLL diagnosis; O/E = 2.22 (95% CI 1.56-2.14) and excess risk was 10.43 per 10,000. It was higher in males compared to females O/E was 2.10 (95% CI 1.89-2.33) and 1.98 (95% CI 1.62-2.40) in males and females, respectively, and in people aged 45-64; O/E = 2.30 (95% CI 1.95-2.70). Out of 7827 CLL patients receiving chemotherapy, 70 later developed melanoma with a significant O/E of 2.28 (95% CI 1.77-2.88) and an excess risk of 10.66 per 10,000. CONCLUSION CLL increases the risk of developing melanoma, especially within 5 years of the diagnosis, and in white males aged between 45-64 years. It is crucial to keep rigorous screening, high-suspicion and close follow-up for recurrence in consideration while managing these patients.
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Affiliation(s)
- Tarek Turk
- Department of Dermatology and Venereology, General Commission of the Red Crescent Hospital, Ministry of Health, Damascus, Syria.
| | - Anas M Saad
- Cleveland Clinic Foundation, Cleveland, Ohio; Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mohamed M Gad
- Cleveland Clinic Foundation, Cleveland, Ohio; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Damento GM, Pulido JS, Abbott BA, Hodge DO, Dalvin LA. TNF-Alpha Inhibition and Other Immunosuppressants in the Development of Uveal and Cutaneous Melanoma. Mayo Clin Proc 2019; 94:1287-1295. [PMID: 31272570 DOI: 10.1016/j.mayocp.2018.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/21/2018] [Accepted: 11/28/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate an association between tumor necrosis factors-alpha (TNFα) inhibitors or other immunosuppressants and the development of uveal and cutaneous melanoma. PATIENTS AND METHODS We performed a retrospective incidence and case-control analysis of patients in Olmsted County, MN, who were diagnosed with uveal or cutaneous melanoma from January 1, 2000, to December 31, 2014. Incidence was adjusted by age and gender to the 2010 US white population. Controls were matched by sex and age to cases at time of diagnosis of melanoma. RESULTS There were 1221 cases of melanoma (33 uveal, 1188 cutaneous). Combined incidence of uveal and cutaneous melanoma per 100,000 person-years varied by gender (male > female), age (older > younger), and time period: 2010 to 2014 (77.9, 95% confidence interval [CI], 71.1-84.7) ≈ 2005 to 2009 (78.0, 95% CI, 70.9-85.0) > 2000 to 2004 (42.5, 95% CI, 36.9-48.1, P<.001). TNFa inhibitor prescription was not associated with significantly increased risk of melanoma vs controls (1.06% vs 0.41%, P=.06). Immunosuppressive agents, high-dose corticosteroids, and topical immunosuppressants were associated with melanoma (odds ratio [OR] 1.42 CI, 1.03-1.95, 3.30 CI, 2.44-4.48, and 1.87 CI, 1.06-3.28, respectively). An increased number of patients with uveal melanoma received immune modulating agents vs controls, but this was not statistically significant (P=.36). Autoimmune disease itself was not correlated with melanoma (P=.73). CONCLUSION Exposure to immunosuppressive agents is associated with melanoma. TNFa inhibition and autoimmune disease alone do not significantly increase risk of melanoma. In patients receiving immunosuppressive treatments, physicians should consider monitoring with dilated ophthalmic and full-body skin examinations. Further studies are needed to assess the impact of TNFa inhibitors on development of melanoma, particularly in uveal melanoma.
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Affiliation(s)
- Gena M Damento
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Jose S Pulido
- Department of Ophthalmology, Mayo Clinic, Rochester, MN; Department of Ophthalmology, Molecular Medicine, Mayo Clinic, Rochester, MN
| | | | - David O Hodge
- Department of Health Sciences Research/Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL
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18
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Melanom. MEDIKAMENTÖSE TUMORTHERAPIE IN DER DERMATO-ONKOLOGIE 2019. [PMCID: PMC7121576 DOI: 10.1007/978-3-662-58012-7_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Das Melanom ist der gefährlichste Hautkrebs mit der höchsten Sterblichkeitsrate, der schon bei jungen Menschen auftreten kann und seit Jahrzehnten steigende Inzidenz verzeichnet (Jemal et al. 2007; Little et al. 2012). Jährlich erkranken weltweit etwa 137.000 Menschen am Melanom und 37.000 versterben an der Erkrankung (Boyle et al. 2004). Die Inzidenz liegt weltweit jährlich bei 2,3–2,6/100.000 Einwohner (Pisani et al. 2002). In Deutschland beträgt die Inzidenz 19,2/100.000 Einwohner und es verstarben 2711 Betroffene im Jahre 2010 (Statistisches Bundesamt).
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19
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Yang Z, Qi Y, Lai N, Zhang J, Chen Z, Liu M, Zhang W, Luo R, Kang S. Notch1 signaling in melanoma cells promoted tumor-induced immunosuppression via upregulation of TGF-β1. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2018; 37:1. [PMID: 29301578 PMCID: PMC5755139 DOI: 10.1186/s13046-017-0664-4] [Citation(s) in RCA: 198] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/11/2017] [Indexed: 01/05/2023]
Abstract
Background The receptors of Notch family play an important role in controlling the development, differentiation, and function of multiple cell types. The aim of this study is to investigate the role of Notch1 signaling upon immune suppression induced by melanoma cells. Methods Melanoma cell line B16 cells were transfected by lentivirus containing mouse Notch1 gene or Notch1 shRNA to generate B16 cell line that highly or lowly expressed Notch1. Notch1 in anti-tumor immune response was comprehensively appraised in murine B16 melanoma tumor model in immunocompetent and immunodeficient mice. The ratios of CD3+CD8+ cytotoxic T cells, CD49b+NK cells, CD4+CD25+FoxP3+ Tregs and Gr1+CD11b+ MDSCs in tumor-DLN or spleen were examined by flow cytometry. After the co-culture of B16 cells and CD8+ T cells, the effects of Notch1 on the proliferation and activation of T cells were assessed by CCK8 assay, CFSE dilution and Chromium-release test. The mRNA expression and supernatant secretion of immunosuppressive cytokines, TGF-β1, VEGF, IL-10 and IFN-γ were measured by RT-PCR and ELISA, respectively. Results Downregulation or overexpression of Notch1 in B16 melanoma cells inhibited or promoted tumor growth in immunocompetent mice, respectively. Notch1 expression in B16 melanoma cells inhibited the infiltration of CD8+ cytotoxic T lymphocytes and NK cells and reduced IFN-γ release in tumor tissue. It could also enhance B16 cell-mediated inhibition of T cell proliferation and activation, and upregulate PD-1 expression on CD4+ and CD8+ T cells. The percentage of CD4+CD25+FoxP3+ Tregs and Gr1+CD11b+MDSCs were significantly increased in tumor microenvironment, and all these were attributed to the upregulation of TGF-β1. Conclusion These findings suggested that Notch1 signaling in B16 melanoma cells might inhibit antitumor immunity by upregulation of TGF-β1.
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Affiliation(s)
- Zike Yang
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China
| | - Yanxia Qi
- Cancer Center, The First People's Hospital of Huaihua City, Huaihua, 418000, Hunan Province, People's Republic of China
| | - Nan Lai
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China
| | - Jiahe Zhang
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China
| | - Zehong Chen
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China
| | - Mingyu Liu
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China
| | - Wan Zhang
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China
| | - Rongcheng Luo
- Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shiliugang Road, Haizhu District, Guangzhou, 510315, Guangdong Province, People's Republic of China.
| | - Shijun Kang
- Oncology Department, Nanfang Hospital, Southern Medical University, No.1838, North of Guangzhou Avenue, Baiyun District, Guangzhou, Guangdong Province, 510515, People's Republic of China.
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RF - Drug-Induced Eruptive Melanocytic Nevi. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2016.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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García-Montero P, Millán-Cayetano JF, García-Harana C, Del Boz J. Drug-Induced Eruptive Melanocytic Nevi. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:775-776. [PMID: 28504086 DOI: 10.1016/j.ad.2016.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 12/31/2016] [Indexed: 11/18/2022] Open
Affiliation(s)
- P García-Montero
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España.
| | - J F Millán-Cayetano
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - C García-Harana
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - J Del Boz
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
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22
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Katoulis AC, Sgouros D, Argenziano G, Rallis E, Panayiotides I, Rigopoulos D. Surgical suturing-induced melanocytic nevi. A new type of eruptive melanocytic nevi? J Dermatol Case Rep 2016; 10:49-52. [PMID: 28400894 DOI: 10.3315/jdcr.2016.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/04/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Nevogenesis is a complex process involving several pathogenetic mechanisms, including genetic factors, hormonal influences and UV-radiation. Trauma has been described as a triggering factor for an alternative pathway of nevogenesis. Eruptive melanocytic nevi (EMN), related either to immunosuppression or to blistering disorders, represent a special type of nevi probably induced by the disruption of the dermo-epidermal junction and consequent proliferation of quiescent pigment cells during re-epithelization. MAIN OBSERVATIONS We report two patients with three melanocytic nevi that developed de novo along the direction of surgical suturing, following surgical operation for other reason. The lesions exhibited special dermoscopic characteristics and histology revealed features of acquired melanocytic nevi. CONCLUSIONS Such cases may represent a new type of eruptive nevus, the surgical suturing-induced nevus, which should be included in the differential diagnosis of new pigmentation developing within a scar.
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Affiliation(s)
- Alexander C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Giuseppe Argenziano
- Dermatology Unit, 2nd University of Naples, 43 Antonio Vivaldi str, 81100, Caserta CE, Naples, Italy
| | - Efstathios Rallis
- Department of Dermatology, Veterans Administration Hospital, 10 Monis Petraki str, 11521, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Dimitrios Rigopoulos
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
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Perry BM, Nguyen A, Desmond BL, Blattner CM, Thomas RS, Young RJ. Eruptive nevi associated with medications (ENAMs). J Am Acad Dermatol 2016; 75:1045-1052. [DOI: 10.1016/j.jaad.2016.04.064] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 04/21/2016] [Accepted: 04/24/2016] [Indexed: 10/21/2022]
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Vena GA, Fargnoli MC, Cassano N, Argenziano G. Drug-induced eruptive melanocytic nevi. Expert Opin Drug Metab Toxicol 2016; 13:293-300. [PMID: 27759434 DOI: 10.1080/17425255.2017.1247155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The sudden eruption of melanocytic nevi has been associated with a number of conditions, such as bullous skin diseases, immunodeficiency and immunosuppression. The exact mechanisms leading to the development of eruptive melanocytic nevi are unknown. Areas covered: The aim of this article is to review the literature concerning eruptive melanocytic nevi following the administration of immunosuppressive drugs and other medications. Expert opinion: The literature regarding the development of eruptive nevi in association with pharmacological therapies includes a relatively low number of reports. Prevalence of this phenomenon is likely to be underestimated, thus reporting should be encouraged in order to better define the actual significance and related clinical implications. The development of multiple melanocytic nevi during immunosuppressive treatments highlights the importance of immune system integrity in the regulation of nevi growth. The observation of eruptive nevi as an unexpected effect of targeted therapies for specific types of cancer, including melanoma, provided intriguing hints to understand the mechanisms underlying this paradoxical event. The synergistic role of additional triggers in the occurrence of drug-induced eruptive nevi has not been explored and may be an interesting area of research.
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Affiliation(s)
- Gino A Vena
- a Dermatology and Venereology Private Practice , Bari and Barletta , Italy
| | | | - Nicoletta Cassano
- a Dermatology and Venereology Private Practice , Bari and Barletta , Italy
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25
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Coati I, Miotto S, Zanetti I, Alaibac M. Toll-like receptors and cutaneous melanoma. Oncol Lett 2016; 12:3655-3661. [PMID: 27900049 DOI: 10.3892/ol.2016.5166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 06/07/2016] [Indexed: 12/31/2022] Open
Abstract
Innate immune cells recognize highly conserved pathogen-associated molecular patterns (PAMPs) via pattern recognition receptors (PRRs). Previous studies have demonstrated that PRRs also recognize endogenous molecules, termed damage-associated molecular patterns (DAMPs) that are derived from damaged cells. PRRs include Toll-like receptors (TLRs), scavenger receptors, C-type lectin receptors and nucleotide oligomerization domain-like receptors. To date, 10 TLRs have been identified in humans and each receptor responds to a different ligand. The recognition of PAMPS or DAMPs by TLRs leads to the activation of signaling pathways and cellular responses with subsequent pro-inflammatory cytokine release, phagocytosis and antigen presentation. In the human skin, TLRs are expressed by keratinocytes and melanocytes: The main cells from which skin cancers arise. TLRs 1-6 and 9 are expressed in keratinocytes, while TLRs 2-5, 7, 9 and 10 have been identified in melanocytes. It is hypothesized that TLRs may present a target for melanoma therapies. In this review, the involvement of TLRs in the pathogenesis and treatment of melanoma was discussed.
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Affiliation(s)
- Ilaria Coati
- Department of Medicine, Unit of Dermatology, University of Padua, Padua 35128, Italy
| | - Serena Miotto
- Department of Medicine, Unit of Dermatology, University of Padua, Padua 35128, Italy
| | - Irene Zanetti
- Department of Medicine, Unit of Dermatology, University of Padua, Padua 35128, Italy
| | - Mauro Alaibac
- Department of Medicine, Unit of Dermatology, University of Padua, Padua 35128, Italy
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Kibbi N, Ariyan S, Slogoff F, Lazova R, Choi JN. Eruptive melanocytic nevi heralding the diagnosis of metastatic malignant melanoma: A case report. JAAD Case Rep 2016; 1:74-6. [PMID: 27051688 PMCID: PMC4802567 DOI: 10.1016/j.jdcr.2015.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Nour Kibbi
- Department of Dermatology, Yale University School of Medicine, New York
| | - Stephan Ariyan
- Department of Surgery, Yale University School of Medicine, New York
| | - Frederick Slogoff
- Department of Medicine, New York Presbyterian/Columbia University Medical Center, New York
| | - Rossitza Lazova
- Department of Dermatology, Yale University School of Medicine, New York
| | - Jennifer Nam Choi
- Department of Dermatology, Yale University School of Medicine, New York
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Lee JH, Kang JH, Cho BK, Park HJ. Dysplastic Nevus with Eruptive Melanocytic Lesions That Developed during Nilotinib Therapy for Chronic Myeloid Leukemia. Ann Dermatol 2016; 27:782-4. [PMID: 26719659 PMCID: PMC4695442 DOI: 10.5021/ad.2015.27.6.782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 02/16/2015] [Accepted: 02/25/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Joo Hyun Lee
- Department of Dermatology, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jin Hee Kang
- Department of Dermatology, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Baik Kee Cho
- Department of Dermatology, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Hyun Jeong Park
- Department of Dermatology, The Catholic University of Korea, College of Medicine, Seoul, Korea
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Koseoglu G, Akay BN, Kucuksahin O, Erdem C. Dermoscopic changes in melanocytic nevi in patients receiving immunosuppressive and biologic treatments: Results of a prospective case-control study. J Am Acad Dermatol 2015; 73:623-9. [DOI: 10.1016/j.jaad.2015.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 11/26/2022]
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Krynitz B, Rozell BL, Lyth J, Smedby KE, Lindelöf B. Cutaneous malignant melanoma in the Swedish organ transplantation cohort: A study of clinicopathological characteristics and mortality. J Am Acad Dermatol 2015; 73:106-113.e2. [PMID: 25929720 DOI: 10.1016/j.jaad.2015.03.045] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 03/02/2015] [Accepted: 03/21/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Risk of cutaneous melanoma is increased among organ transplant recipients (OTRs) but outcome has rarely been evaluated. OBJECTIVE We sought to assess melanoma characteristics and prognosis among OTRs versus the general population. METHODS Using Swedish health care registers, we identified melanomas in OTRs (n = 49) and in the general population (n = 22,496), given a diagnosis between 1984 and 2008 and followed up through December 31, 2012. Tumor slides of posttransplantation melanomas were reviewed. Odds ratios for comparison of histopathological characteristics and hazard ratios of melanoma-specific death were calculated. RESULTS Among OTRs the trunk was the most common anatomic melanoma site (50% among female vs 51% among male) and 73% (n = 36) of all melanomas were histologically associated with a melanocytic nevus, 63% (n = 31) atypical/dysplastic. Compared with population melanomas, posttransplantation melanomas were more advanced at diagnosis (Clark level III-V: odds ratio 2.2 [95% confidence interval 1.01-4.7, P = .03], clinical stages III-IV: odds ratio 4.2 [1.6-10.8, P = .003]). Risk of melanoma-specific death was increased among OTRs: adjusted hazard ratio 3.0 (1.7-5.3, P = .0002). LIMITATIONS Only posttransplantation melanoma slides were reviewed. CONCLUSIONS Melanomas were more advanced at diagnosis and melanoma-specific survival was poorer in OTRs than in the general population. Prophylactic excision of truncal nevi among OTRs may be advised.
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Affiliation(s)
- Britta Krynitz
- Department of Pathology and Cytology, Karolinska University Laboratories, Stockholm, Sweden; Unit of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
| | - Barbro Lundh Rozell
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Clinical Pathology and Clinical Genetics, Linköping University, Linköping, Sweden
| | - Johan Lyth
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Regional Cancer Center Southeast, University Hospital, Linköping, Sweden
| | - Karin E Smedby
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Bernt Lindelöf
- Unit of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
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Bulman A, Neagu M, Constantin C. Immunomics in Skin Cancer - Improvement in Diagnosis, Prognosis and Therapy Monitoring. CURR PROTEOMICS 2013; 10:202-217. [PMID: 24228023 PMCID: PMC3821382 DOI: 10.2174/1570164611310030003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/10/2013] [Accepted: 06/11/2013] [Indexed: 11/30/2022]
Abstract
This review will focus on the elements of the skin’s immune system, immune cells and/or non-immune cells that support immune mechanisms, molecules with immune origin and/or immune functions that are involved in skin
carcinogenesis. All these immune elements are compulsory in the development of skin tumors and/or sustainability of the neoplastic process. In this light, recent data gathered in this review will acknowledge all immune elements that contribute to skin tumorigenesis; moreover, they can serve as immune biomarkers. These immune markers can contribute to the
diagnostic improvement, prognosis forecast, therapy monitoring, and even personalized therapeutical approach in skin cancer. Immune processes that sustain tumorigenesis in non-melanoma and melanoma skin cancers are described in the framework of recent data.
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Abstract
While being treated with azathioprine and dexamethasone, a 21-year old man with myasthenia gravis suddenly developed rapidly progressing brown macules, predominantly on the trunk, palms and soles. We made a diagnosis of eruptive melanocytic nevi (EMN). This rare entity can appear after blistering skin diseases, in immunocompromised patients, and, in particular, during immunosuppressive therapy for autoimmune diseases. Since therapeutic regimens including azathioprine have been frequently reported in association with EMN, we recommended to our patient a treatment switch to mycophenolic acid to prevent the development of more nevi.
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Zalaudek I, Moscarella E, Sturm RA, Argenziano G, Longo C, Misciali C, Patrizi A, Neri I. 'Eruptive' amelanotic compound nevi in children with facial freckles and pale skin colour: more than an occasion? J Eur Acad Dermatol Venereol 2013; 27:1583-5. [PMID: 23398024 DOI: 10.1111/jdv.12110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 01/10/2013] [Indexed: 11/26/2022]
Affiliation(s)
- I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria; Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Instituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy
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Kubica AW, Brewer JD. Melanoma in immunosuppressed patients. Mayo Clin Proc 2012; 87:991-1003. [PMID: 23036673 PMCID: PMC3538393 DOI: 10.1016/j.mayocp.2012.04.018] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 04/04/2012] [Accepted: 04/30/2012] [Indexed: 12/17/2022]
Abstract
The immunogenic characteristics of malignant melanoma are intriguing. To date, multiple studies exist regarding the immunogenicity of melanoma. In this article, we summarize data in the literature on the role of immunosuppression in melanoma and discuss several immunocompromised patient populations in detail. A comprehensive PubMed search was conducted with no date limitation. The following search terms were used: melanoma in combination with immunosuppression, immunocompromised, genetics, antigen processing, UV radiation, organ transplantation, organ transplant recipients, lymphoproliferative disease, lymphoma, CLL, NHL, radiation, and HIV/AIDS. Although no formal criteria were used for inclusion of studies, most pertinent studies on the topic were reviewed, with the exception of smaller case reports and case series. The included studies were generally large (≥ 1000 patients in organ transplant recipient studies; ≥ 500 patients in lymphoma studies), with a focus on institutional experiences, or population-based national or international epidemiologic studies. Melanoma-induced immunosuppression, the role of UV radiation in melanoma development, and the epidemiology, clinical course, and prognosis of melanoma in immunocompromised patients are highlighted. Organ transplant recipients, patients with lymphoproliferative disorders, patients with iatrogenic immunosuppression, and patients with human immunodeficiency virus infection/AIDS are also highlighted. Recommendations are proposed for the care and monitoring of immunosuppressed patients with melanoma. With better understanding of the molecular microenvironment and clinical course of melanoma in immunosuppressed patients, novel therapies could be developed and outcomes potentially affected in these patients.
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Affiliation(s)
| | - Jerry D. Brewer
- Department of Dermatology, Mayo Clinic, Rochester, MN
- Correspondence: Address to Jerry D. Brewer, MD, Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905
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Abstract
This chapter describes how skin immune system (SIS) is specifically involved in the development of cutaneous melanoma. Local immune surveillance is presented as a complex process that comprises markers to be monitored in disease's evolution and in therapy. The ranking of tissue or soluble immune markers in a future panel of diagnostic/prognostic panel are evaluated. Taking into account the difficulties of cutaneous melanoma patients' management, this chapter shows the immune surveillance at the skin level, the conditions that favor the tumor escape from the immunological arm, the immune pattern of skin melanoma with diagnostic/prognostic relevance, the circulatory immune markers, and, last but not least, how immune markers are used in immune-therapy monitoring. The chapter cannot be exhaustive but will give the reader a glimpse of the complex immune network that lies within tumor escape and where to search for immune-therapeutical targets in skin melanoma.
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Affiliation(s)
- Monica Neagu
- Immunobiology Laboratory, "Victor Babes" National Institute of Pathology, Bucharest, Romania.
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McCourt C, Feighery C, McIntyre G, Walsh M, Hoey S. Eruptive nevi in prostate cancer: is this a paraneoplastic phenomenon? Int J Dermatol 2012; 52:212-3. [PMID: 22928954 DOI: 10.1111/j.1365-4632.2011.05253.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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O'Reilly Zwald F, Brown M. Skin cancer in solid organ transplant recipients: advances in therapy and management: part I. Epidemiology of skin cancer in solid organ transplant recipients. J Am Acad Dermatol 2011; 65:253-261. [PMID: 21763561 DOI: 10.1016/j.jaad.2010.11.062] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 11/04/2010] [Accepted: 11/06/2010] [Indexed: 12/25/2022]
Abstract
Skin cancer is the most frequent malignancy in organ transplant recipients, 95% of which are nonmelanoma skin cancer, especially squamous cell and basal cell carcinomas. This paper also discusses the incidence of other tumors (eg, melanoma, Merkel cell carcinoma, and Kaposi sarcoma) that are also increased in organ transplant patients compared to the general population. Part I of this two-part series describes the latest data concerning the epidemiologic and pathogenic aspects of nonmelanoma skin cancer development in solid organ transplant recipients. This review also highlights the concept of "field cancerization," represented by extensive areas of actinic damage and epidermal dysplasia, which accounts for increased risk of aggressive skin cancer development in susceptible patients.
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Affiliation(s)
- Fiona O'Reilly Zwald
- Department of Dermatology and Division of Transplantation, Department of Surgery, Emory University, Atlanta, Georgia.
| | - Marc Brown
- Department of Dermatology and Oncology, University of Rochester, Rochester, New York
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Neagu M, Constantin C, Tanase C. Immune-related biomarkers for diagnosis/prognosis and therapy monitoring of cutaneous melanoma. Expert Rev Mol Diagn 2011; 10:897-919. [PMID: 20964610 DOI: 10.1586/erm.10.81] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Skin melanoma, a life-threatening disease, has a recently reported worldwide increase in incidence, despite primary prevention. Skin melanoma statistics emphasize the need for finding markers related to the immune response of the host. The mechanisms that are able to over-power the local immune surveillance comprise molecules that can be valuable markers for diagnosis and prognosis. This article summarizes the immune markers that can monitor the disease stage and evaluate the efficacy of therapeutic interventions. Recent data regarding immunotherapy are presented in the context of tumor escape from immune surveillance and the immune molecules that are both targets and a means of monitoring. Perspectives for developing immune interventions for skin melanoma management and the position of tissue or soluble immune markers as a diagnostic/prognostic panel are evaluated. State-of-the-art technology is emphasized for developing immune molecular signatures for a complex characterization of the patient's immunological status.
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Affiliation(s)
- Monica Neagu
- Victor Babes' National Institute of Pathology, 99-101 Splaiul Independentei, 050096 Bucharest, Romania.
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Han J, Qureshi AA, Nan H, Zhang J, Song Y, Guo Q, Hunter DJ. A germline variant in the interferon regulatory factor 4 gene as a novel skin cancer risk locus. Cancer Res 2011; 71:1533-9. [PMID: 21270109 DOI: 10.1158/0008-5472.can-10-1818] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Genome-wide association studies on pigmentary phenotypes provide a pool of candidate genetic markers for skin cancer risk. The SNPs identified from a genome-wide association study of natural hair color were assessed for associations with the risk of three types of skin cancer simultaneously in a nested case-control study within the Nurses' Health Study [218 melanoma, 285 squamous cell carcinoma (SCC), and 300 basal cell carcinoma (BCC) cases, and 870 common controls]. Along with two known pigmentation loci, MC1R and OCA2, the IRF4 rs12203592 T allele was associated with an increased risk of each type of skin cancer (P value, 6.6 × 10(-4) for melanoma, 7.0 × 10(-7) for SCC, and 0.04 for BCC). This association was further replicated in additional samples (190 melanoma, 252 SCC, and 634 common controls). The P value in the replication set was 0.03 for melanoma and 4.2 × 10(-3) for SCC. The risk of BCC was replicated in an independent set of 213 cases and 718 controls (P value, 0.02). The combined results showed that the association with SCC reached the genome-wide significance level [odds ratio (OR) for additive model = 1.61, 95%CI, 1.36-1.91, P = 3.2 × 10(-8)]. The OR was 1.49 for melanoma (95%CI, 1.23-1.80; P = 4.5 × 10(-5)), and 1.32 for BCC (95%CI, 1.11-1.57; P = 1.6 × 10(-3)). Given that the T allele was shown previously to be associated with increased expression of IRF4 locus, further studies are warranted to elucidate the role of the IRF4 gene in human pigmentation and skin cancer development.
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Affiliation(s)
- Jiali Han
- Clinical Research Program, Department of Dermatology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.
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Sekulic A, Colgan MB, Davis MDP, DiCaudo DJ, Pittelkow MR. Activating BRAF mutations in eruptive melanocytic naevi. Br J Dermatol 2011; 163:1095-8. [PMID: 20716222 DOI: 10.1111/j.1365-2133.2010.09989.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Eruptive melanocytic naevi (EMN) are melanocytic proliferations developing rapidly on previously unaffected skin in association with various clinical scenarios, most commonly systemic immunosuppression. However, the exact mechanism leading to development of EMN is not understood. In particular, it is not known whether EMN harbour the BRAF mutations which occur frequently in melanoma and most common naevi. OBJECTIVES To evaluate whether activating BRAF mutations may play a role in genesis of EMN. METHODS Genomic DNA was isolated from 20 EMN from a patient treated with 6-mercaptopurine (6-MP). Primary BRAF genotyping was performed by allelespecific polymerase chain reaction, followed by validation using direct sequencing. RESULTS The BRAF V600E mutation was identified in 85% of EMN examined. CONCLUSIONS Our results implicate mutational activation of the BRAF–MAPK pathway as a factor in development of EMN in the setting of 6-MP treatment. The mechanism leading to development of EMN in this, and potentially other patients, may relate to synergistic mutagenic effects of thioguanines and ultraviolet (UV) A. Together with the documented importance of BRAF mutations in melanoma development and maintenance, these findings highlight the importance of UVA protection, especially in patients treated with thiopurines such as 6-MP.
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Affiliation(s)
- A Sekulic
- Department of Dermatology, Mayo Clinic College of Medicine, Scottsdale, AZ 85259, USA.
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Speeckaert R, van Geel N, Vermaelen KV, Lambert J, Van Gele M, Speeckaert MM, Brochez L. Immune reactions in benign and malignant melanocytic lesions: lessons for immunotherapy. Pigment Cell Melanoma Res 2010; 24:334-44. [DOI: 10.1111/j.1755-148x.2010.00799.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Dillon P, Thomas N, Sharpless N, Collichio F. Regression of advanced melanoma upon withdrawal of immunosuppression: case series and literature review. Med Oncol 2009; 27:1127-32. [PMID: 19890737 DOI: 10.1007/s12032-009-9348-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 10/19/2009] [Indexed: 12/24/2022]
Abstract
We report two cases of stage IV malignant melanoma arising in patients treated with azathioprine for myasthenia gravis. In both cases, the melanoma metastases regressed upon withdrawal of immunosuppression. One patient remains melanoma free at 10 years, and the second patient experienced an 18-month disease free period. There is one prior case report in the medical literature to support full immune reconstitution for treatment in advanced immunosuppression-related melanoma, and one case series suggesting that transplant patients developing melanoma may benefit from a switch to sirolimus. Virtually, no data exist for the medical management of early stage melanoma in the immunosuppressed patients. We review the limited preclinical data in support of immune reconstitution and the data on immunosuppression as a risk factor for melanoma. We conclude that reduction or withdrawal of immunosuppression may be beneficial in patients with advanced stage melanoma and warrants further consideration in patients with early stage melanoma.
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Affiliation(s)
- P Dillon
- The Lineberger Comprehensive Cancer Center, Department of Dermatology, University of North Carolina at Chapel Hill, 130 Manning Dr, CB 7305, Chapel Hill, NC 27516, USA.
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Continuing declines in some but not all HIV-associated cancers in Australia after widespread use of antiretroviral therapy. AIDS 2009; 23:2183-90. [PMID: 19734774 DOI: 10.1097/qad.0b013e328331d384] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To describe changes in cancer incidence in people with HIV in Australia since the introduction of highly active antiretroviral therapy (HAART). DESIGN Population-based, retrospective cohort study of people with HIV (n = 20 232) using data linkage between national registers of HIV/AIDS and cancer in 1982-2004. METHODS Age-adjusted and sex-adjusted incidence rate ratios with 95% confidence intervals were calculated to compare site-specific cancer incidence during the early (1996-1999) and late (2000-2004) HAART periods with that prior to HAART (1982-1995). Five-year age-specific, sex-specific, calendar year-specific, and state-specific standardized incidence ratios with 95% confidence interval were also calculated for each period. RESULTS Incidence of Kaposi sarcoma and non-Hodgkin lymphoma declined significantly (Ptrend < 0.001). Incidence of Hodgkin lymphoma was significantly higher during the early-HAART period (incidence rate ratio 2.34, 95% confidence interval 1.19-4.63) but declined thereafter (Pdiff = 0.014). Incidence of anal cancer was unchanged (Ptrend = 0.451) and remained raised more than 30-fold. Incidence declined significantly for melanoma (Ptrend = 0.041) and prostate cancer (Ptrend = 0.026), and, during the late-HAART period, was lower than in the general population for both cancers. Incidence of colorectal cancer was consistently lower than in the general population. CONCLUSION Incidence of Kaposi sarcoma and non-Hodgkin lymphoma has continued to decline among people with HIV in Australia, though it remains very substantially elevated. Incidence of Hodgkin lymphoma may now also be declining. Incidence of anal cancer has remained stable, and it is now the third most common cancer in HIV-infected Australians. Reasons for the reduced incidence of colorectal and prostate cancer, and more recently of melanoma, are unclear.
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