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Trovato E, Fiorani D, Cartocci A, Cinotti E, Rubegni P. IGF1 synthesis after CO 2 fractional laser resurfacing (FLR): New insights in the treatment of scalp actinic keratoses. Lasers Surg Med 2023; 55:642-652. [PMID: 37222180 DOI: 10.1002/lsm.23680] [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: 02/21/2023] [Revised: 05/06/2023] [Accepted: 05/12/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Actinic keratosis have a high risk of progression to a squamous cell carcinoma. Insulin-like growth factor 1 and its receptor play a relevant role in restoring repair of ultraviolet-induced cell damage. This pathway is reduced in patients older than 65 years. Ablative fractional laser resurfacing could normalize insulin-like growth factor 1 (IGF-1) secretion in elderly by recruiting new fibroblasts. The aim of the study is to evaluate restoration of IGF1 values by PCR in senescent fibroblasts after ablative fractional laser resurfacing. METHODS We enrolled 30 male patients with multiple actinic keratosis on the scalp, equally divided into two mirror areas of up to 50 cm2 , treating only the right one. We performed one skin biopsy for each area 30 days after treatment. Real-time PCR in fibroblasts was performed to assess the change in IGF1. At baseline and after 6 months, in vivo reflectance confocal microscopy examination was performed in all patients. RESULTS IGF1 values were increased in the treated side by about 60%. The right areas had fairly complete resolution of actinic keratosis at the last follow-up visit after 6 months with no appearance of new lesions. The mean number of actinic keratosis in the right area was reduced by more than 75% at four- and six-follow-up visits compared to the left area. The improvement in the right area was also evidenced by lower values of the mean AKASI (actinic keratosis area and severity index) score. Reflectance confocal microscopy showed a reduction of keratinocytic disarray and scales after treatment. DISCUSSION Taken together, all the clinical, laboratory, and in vivo results of our study allowed us to confirm that ablative fractional laser resurfacing is a valuable tool for the treatment of actinic keratosis and cancerization field, both for the management of clinically evident lesions and for preventing the occurrence of squamous cell carcinoma.
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Affiliation(s)
- Emanuele Trovato
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Diletta Fiorani
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | | | - Elisa Cinotti
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
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Sullivan DA, da Costa AX, Del Duca E, Doll T, Grupcheva CN, Lazreg S, Liu SH, McGee SR, Murthy R, Narang P, Ng A, Nistico S, O'Dell L, Roos J, Shen J, Markoulli M. TFOS Lifestyle: Impact of cosmetics on the ocular surface. Ocul Surf 2023; 29:77-130. [PMID: 37061220 PMCID: PMC11246752 DOI: 10.1016/j.jtos.2023.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
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Affiliation(s)
| | | | - Ester Del Duca
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | | | - Sihem Lazreg
- Lazreg Cornea and Ocular Surface Center, Blida, Algeria
| | - Su-Hsun Liu
- University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | - Alison Ng
- Centre for Ocular Research & Education, School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Steven Nistico
- Department of Dermatology, University Magna Graecia, Catanzaro, Italy
| | | | | | - Joanne Shen
- Department of Ophthalmology, Mayo Clinic in Arizona, Scottsdale, AZ, USA
| | - Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
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Frommeyer TC, Rohan CA, Spandau DF, Kemp MG, Wanner MA, Tanzi E, Travers JB. Wounding Therapies for Prevention of Photocarcinogenesis. Front Oncol 2022; 11:813132. [PMID: 35071017 PMCID: PMC8776632 DOI: 10.3389/fonc.2021.813132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 01/01/2023] Open
Abstract
The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is linked to diminished insulin-like growth factor-1 (IGF-1) signaling from senescent dermal fibroblasts in geriatric skin. Consequently, keratinocyte IGF-1 receptor (IGF-1R) remains inactive, resulting in failure to induce appropriate protective responses including DNA repair and cell cycle checkpoint signaling. This allows UVB-induced DNA damage to proliferate unchecked, which increases the likelihood of malignant transformation. NMSC is estimated to occur in 3.3 million individuals annually. The rising incidence results in increased morbidity and significant healthcare costs, which necessitate identification of effective treatment modalities. In this review, we highlight the pathogenesis of NMSC and discuss the potential of novel preventative therapies. In particular, wounding therapies such as dermabrasion, microneedling, chemical peeling, and fractionated laser resurfacing have been shown to restore IGF-1/IGF-1R signaling in geriatric skin and suppress the propagation of UVB-damaged keratinocytes. This wounding response effectively rejuvenates geriatric skin and decreases the incidence of age-associated NMSC.
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Affiliation(s)
- Timothy C. Frommeyer
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
| | - Craig A. Rohan
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dayton Veterans Administration Medical Center, Dayton, OH, United States
| | - Dan F. Spandau
- Departments of Dermatology and Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
- Richard A. Roudebush Veterans Administration (VA) Medical Center, Indianapolis, IN, United States
| | - Michael G. Kemp
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dayton Veterans Administration Medical Center, Dayton, OH, United States
| | - Molly A. Wanner
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States
| | | | - Jeffrey B. Travers
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dayton Veterans Administration Medical Center, Dayton, OH, United States
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Spandau DF, Chen R, Wargo JJ, Rohan CA, Southern D, Zhang A, Loesch M, Weyerbacher J, Tholpady SS, Lewis DA, Kuhar M, Tsai KY, Castellanos AJ, Kemp MG, Markey M, Cates E, Williams AR, Knisely C, Bashir S, Gabbard R, Hoopes R, Travers JB. Randomized controlled trial of fractionated laser resurfacing on aged skin as prophylaxis against actinic neoplasia. J Clin Invest 2021; 131:e150972. [PMID: 34428179 PMCID: PMC8483749 DOI: 10.1172/jci150972] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/18/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUNDThe loss of insulin-like growth factor 1 (IGF-1) expression in senescent dermal fibroblasts during aging is associated with an increased risk of nonmelanoma skin cancer (NMSC). We tested how IGF-1 signaling can influence photocarcinogenesis during chronic UVB exposure to determine if fractionated laser resurfacing (FLR) of aged skin, which upregulates dermal IGF-1 levels, can prevent the occurrence of actinic keratosis (AK) and NMSC.METHODSA human skin/immunodeficient mouse xenografting model was used to test the effects of a small molecule inhibitor of the IGF-1 receptor on chronic UVB radiation. Subsequently, the durability of FLR treatment was tested on a cohort of human participants aged 65 years and older. Finally, 48 individuals aged 60 years and older with considerable actinic damage were enrolled in a prospective randomized clinical trial in which they underwent a single unilateral FLR treatment of one lower arm. Numbers of AKs/NMSCs were recorded on both extremities for up to 36 months in blinded fashion.RESULTSXenografting studies revealed that chronic UVB treatment with a topical IGF-1R inhibitor resulted in a procarcinogenic response. A single FLR treatment was durable in restoring appropriate UVB response in geriatric skin for at least 2 years. FLR resulted in sustained reduction in numbers of AKs and decreased numbers of NMSCs in the treated arm (2 NMSCs) versus the untreated arm (24 NMSCs).CONCLUSIONThe elimination of senescent fibroblasts via FLR reduced the procarcinogenic UVB response of aged skin. Thus, wounding therapies are a potentially effective prophylaxis for managing high-risk populations.TRIAL REGISTRATIONClinicalTrials.gov (NCT03906253).FUNDINGNational Institutes of Health, Veterans Administration.
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Affiliation(s)
- Dan F. Spandau
- Department of Biochemistry and Molecular Biology and
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Roy Chen
- Department of Pharmacology & Toxicology and
| | - Jeffrey J. Wargo
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, Ohio, USA
| | - Craig A. Rohan
- Department of Pharmacology & Toxicology and
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, Ohio, USA
| | - David Southern
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Angela Zhang
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mathew Loesch
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jonathan Weyerbacher
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sunil S. Tholpady
- Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
- Department of Surgery and
| | - Davina A. Lewis
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Matthew Kuhar
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kenneth Y. Tsai
- Departments of Anatomic Pathology and Tumor Biology, Moffit Cancer Center, Tampa, Florida, USA
| | | | | | - Michael Markey
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, Ohio, USA
| | | | | | | | | | | | | | - Jeffrey B. Travers
- Department of Pharmacology & Toxicology and
- Department of Biochemistry and Molecular Biology, Boonshoft School of Medicine at Wright State University, Dayton, Ohio, USA
- Dayton Veterans Administration Medical Center, Dayton, Ohio, USA
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Tai F, Shah M, Pon K, Alavi A. Laser Resurfacing Monotherapy for the Treatment of Actinic Keratosis. J Cutan Med Surg 2021; 25:634-642. [PMID: 34213956 DOI: 10.1177/12034754211027515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Treating actinic keratosis (AK) and photodamaged skin is critical to reduce the risk of progression to skin cancer. Laser resurfacing for AK treatment is available as either lesion-directed or field therapy. Laser resurfacing removes the superficial epidermis and dermis containing actinic damage, promoting re-epithelialization of healthy skin. Although laser resurfacing has been explored as a modality for AK treatment in the literature, studies summarizing its efficacy in the treatment of AK are lacking. This review summarizes existing research on laser resurfacing as a monotherapy for AK treatment, highlighting the various laser resurfacing modalities available for AK treatment as well as their complications and efficacy in comparison to other therapies. Despite longer healing time, fully ablative laser resurfacing, including carbon dioxide and erbium-doped yttrium aluminum garnet were found to be more effective for AK treatment than fractional ablative techniques. Although some studies suggest laser resurfacing monotherapy as less efficacious than photodynamic therapy, and equally effective to 5-fluorouracil and 30% trichloroacetic acid, clinical trials of larger sample size are required to establish stronger evidence-based conclusions. Moreover, laser resurfacing used as lesion-directed therapy, as opposed to the usual field-therapy, requires further investigation.
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Affiliation(s)
- Felicia Tai
- 793812366 Temerty Faculty of Medicine, University of Toronto, ON, Canada
| | - Monica Shah
- 793812366 Temerty Faculty of Medicine, University of Toronto, ON, Canada
| | - Kucy Pon
- 71545 Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine, University of Toronto, ON, Canada
| | - Afsaneh Alavi
- Department of Medicine, University of Toronto, ON, Canada.,Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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Alkawar AMM, Castellanos AJ, Carpenter MA, Hutcherson RJ, Madkhali MAO, Johnson RM, Bottomley M, Kemp MG. Insulin-like Growth Factor-1 Impacts p53 Target Gene Induction in UVB-irradiated Keratinocytes and Human Skin. Photochem Photobiol 2020; 96:1332-1341. [PMID: 32416609 DOI: 10.1111/php.13279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/05/2020] [Indexed: 12/19/2022]
Abstract
The tumor suppressor protein p53 limits mutagenesis in response to ultraviolet-B (UVB) light exposure by activating the transcription of genes that mitigate the damaging effects of UVB radiation on DNA. Because most nonmelanoma skin cancers (NMSCs) occur in older individuals, it is important to understand the process of mutagenesis in the geriatric skin microenvironment. Based on previous studies demonstrating that geriatric skin expresses lower levels of the growth factor insulin-like growth factor-1 (IGF-1) than young adult skin, a role for IGF-1 in the regulation of p53 target genes was investigated in both human keratinocytes in vitro and human skin explants ex vivo. The products of the p53 target genes p21 and DNA polymerase eta (pol η) were found to be increased by UVB exposure in both experimental systems, and this induction was observed to be partially abrogated by depriving keratinocytes of IGF-1 in vitro or by the treatment of keratinocytes in vitro and human skin explants with an IGF-1 receptor antagonist. Because p21 and pol η function to limit mutagenic DNA replication following UVB exposure, these results suggest that NMSC risk in geriatric populations may be due to age-dependent decreases in IGF-1 signaling that disrupt p53 function in the skin.
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Affiliation(s)
- Abdulrahman M M Alkawar
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | - Amber J Castellanos
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | - Mae Alexandra Carpenter
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | - Rebekah J Hutcherson
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | - Mariyyah A O Madkhali
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | - Ron Michael Johnson
- Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | | | - Michael G Kemp
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH
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