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Rotbeh A, Kazeminia M, Kalantari M, Rajati F. Global prevalence of oral pigmentation and its related factors: a systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e411-e424. [PMID: 35066171 DOI: 10.1016/j.jormas.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Oral pigmentation is due to the accumulation of one or more pigments in tissues, causing changes in the color of the oral mucosal surfaces. Understanding the exact global prevalence of oral pigmentation and its associated factors helps researchers make the proper interventions at the right time; in this respect, the objective of the present systematic review and meta-analysis was to determine the global prevalence of oral pigmentation and its related factors. METHOD A systematic review and meta- analysis were conducted using the following databases: Magiran, SID, Scopus, Embase, PubMed, Web of Science (WoS), and Google Scholar. The search was run to retrieve articles published from inception until July 2021, and the following keywords were applied in the search strategy: "Epidemiolo*", "Prevalen*", "Factor*", "Pigment*", "Mouth", and "Oral". The I2 index was used to assess the heterogeneity of the studies, and Egger's test was used to examine the publication bias. RESULTS Sixty-nine articles, with a sample size of 70,668 people, meeting the inclusion criteria were included in the study. The pooled of prevalence of oral pigmentation was estimated to be 20.8% (95% confidence interval: 17.1-1.25%). The prevalence of oral pigmentation raised significantly towards the end of the timespan covered by the study (P˂ 0.001). The majority of the examined studies reported that the prevalence of oral pigmentation is significantly higher in men, smokers or those exposed to secondhand smoke, people with fair skin, and who were affected by Yusho patients. CONCLUSION The results of the present study show that the prevalence of oral pigmentation is high, with higher prevalence in men, smokers or those exposed to cigarette smoke, people with fair skin, and Yusho patients compared to other groups. It is recommended that. these findings be used in policy makers' decisions to deliver better health care.
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Affiliation(s)
- Ali Rotbeh
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Kalantari
- Oral and Dental Diseases Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Onozuka D, Nakamura Y, Tsuji G, Furue M. Cancer- and noncancer-specific cumulative incidence of death after exposure to polychlorinated biphenyls and dioxins: A competing risk analysis among Yusho patients. ENVIRONMENT INTERNATIONAL 2021; 147:106320. [PMID: 33321390 DOI: 10.1016/j.envint.2020.106320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/15/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND In competing risks settings, the cause-specific cumulative incidence function is of great interest since it quantifies cumulative risk in the presence of other causes. To date, however, long-term cancer- and noncancer-specific mortality in Yusho patients exposed to polychlorinated biphenyls (PCBs) and dioxin-related compounds has not been estimated. METHODS We identified vital status and cause of death for Yusho patients between 1968 and 2017. Risk of cancer- and noncancer-specific mortality was estimated using a flexible hazards-based regression model, with accounting for competing events. RESULTS In total, 1664 Yusho patients with 63,566 person-years of follow-up were included in the analysis. 50-year cumulative incidence of cancer mortality was 12.4% (95% confidence interval [CI], 10.5-14.7) in males and 4.7% (95% CI, 3.5-6.4) in females (difference, 7.7 percentage points [95% CI, 5.2-10.2]; adjusted hazard ratio for males, 2.61 [95% CI, 1.93-3.52]). For noncancer, the 50-year cumulative incidence of mortality was 35.4% (95% CI, 32.8-38.3) in males and 35.6% (95% CI, 33.3-38.1) in females (difference, -0.2 percentage points [95% CI, -3.5 to 3.1]; adjusted hazard ratio for males, 1.51 [95% CI, 1.26-1.82]). CONCLUSIONS These findings confirm that male Yusho patients have a significantly higher risk of cumulative incidence of cancer-specific mortality than female Yusho patients. Our findings might be useful in providing Yusho patients with more accurate information on cancer prognosis and survivorship and help determine more appropriate disease management.
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Affiliation(s)
- Daisuke Onozuka
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan; Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yuko Nakamura
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan
| | - Gaku Tsuji
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan; Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan; Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Furue M, Ishii Y, Tsukimori K, Tsuji G. Aryl Hydrocarbon Receptor and Dioxin-Related Health Hazards-Lessons from Yusho. Int J Mol Sci 2021; 22:ijms22020708. [PMID: 33445793 PMCID: PMC7828254 DOI: 10.3390/ijms22020708] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 12/15/2022] Open
Abstract
Poisoning by high concentrations of dioxin and its related compounds manifests variable toxic symptoms such as general malaise, chloracne, hyperpigmentation, sputum and cough, paresthesia or numbness of the extremities, hypertriglyceridemia, perinatal abnormalities, and elevated risks of cancer-related mortality. Such health hazards are observed in patients with Yusho (oil disease in Japanese) who had consumed rice bran oil highly contaminated with 2,3,4,7,8-pentachlorodibenzofuran, polychlorinated biphenyls, and polychlorinated quaterphenyls in 1968. The blood concentrations of these congeners in patients with Yusho remain extremely elevated 50 years after onset. Dioxins exert their toxicity via aryl hydrocarbon receptor (AHR) through the generation of reactive oxygen species (ROS). In this review article, we discuss the pathogenic implication of AHR in dioxin-induced health hazards. We also mention the potential therapeutic use of herbal drugs targeting AHR and ROS in patients with Yusho.
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Affiliation(s)
- Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka 812-8582, Japan;
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Correspondence: ; Tel.: +81-92-642-5581; Fax: +81-92-642-5600
| | - Yuji Ishii
- Division of Pharmaceutical Cell Biology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Kiyomi Tsukimori
- Department of Obstetrics, Perinatal Center, Fukuoka Children’s Hospital, Fukuoka 813-0017, Japan;
| | - Gaku Tsuji
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka 812-8582, Japan;
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Onozuka D, Nakamura Y, Tsuji G, Furue M. Mortality in Yusho patients exposed to polychlorinated biphenyls and polychlorinated dibenzofurans: a 50-year retrospective cohort study. Environ Health 2020; 19:119. [PMID: 33228703 PMCID: PMC7685647 DOI: 10.1186/s12940-020-00680-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/17/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND In 1968, the Yusho incident resulted in accidental exposure to polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and related compounds in Japan. This study updated the risk of mortality in Yusho patients. METHODS We obtained updated cohort data for all Yusho patients for the period 1968-2017. We calculated standardized mortality ratios (SMRs) for all-cause and cause-specific mortality over a 50-year follow-up period compared with the general population in Japan. RESULTS A total of 1664 Yusho patients with 63,566 person-years of follow up were included in the analysis. Among males, excess mortality was observed for all cancers (SMR: 1.22, 95% confidence interval [CI]: 1.02 to 1.45) and lung cancer (SMR: 1.59, 95% CI: 1.12 to 2.19). Among females, increased mortality was observed for liver cancer (SMR: 2.05, 95% CI: 1.02 to 3.67). No significant increase was seen in non-cancer-related mortality compared with the general population. CONCLUSIONS Carcinogenic risk in humans after exposure to PCBs and PCDFs remains higher among Yusho patients. Our findings suggest the importance of care engagement and optimum management to deal with the burden of Yusho disease.
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Affiliation(s)
- Daisuke Onozuka
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibeshin-machi, Suita, Osaka, 564-8565 Japan
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuko Nakamura
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan
| | - Gaku Tsuji
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Furue M. Regulation of Filaggrin, Loricrin, and Involucrin by IL-4, IL-13, IL-17A, IL-22, AHR, and NRF2: Pathogenic Implications in Atopic Dermatitis. Int J Mol Sci 2020; 21:E5382. [PMID: 32751111 PMCID: PMC7432778 DOI: 10.3390/ijms21155382] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022] Open
Abstract
Atopic dermatitis (AD) is an eczematous, pruritic skin disorder with extensive barrier dysfunction and elevated interleukin (IL)-4 and IL-13 signatures. The barrier dysfunction correlates with the downregulation of barrier-related molecules such as filaggrin (FLG), loricrin (LOR), and involucrin (IVL). IL-4 and IL-13 potently inhibit the expression of these molecules by activating signal transducer and activator of transcription (STAT)6 and STAT3. In addition to IL-4 and IL-13, IL-22 and IL-17A are probably involved in the barrier dysfunction by inhibiting the expression of these barrier-related molecules. In contrast, natural or medicinal ligands for aryl hydrocarbon receptor (AHR) are potent upregulators of FLG, LOR, and IVL expression. As IL-4, IL-13, IL-22, and IL-17A are all capable of inducing oxidative stress, antioxidative AHR agonists such as coal tar, glyteer, and tapinarof exert particular therapeutic efficacy for AD. These antioxidative AHR ligands are known to activate an antioxidative transcription factor, nuclear factor E2-related factor 2 (NRF2). This article focuses on the mechanisms by which FLG, LOR, and IVL expression is regulated by IL-4, IL-13, IL-22, and IL-17A. The author also summarizes how AHR and NRF2 dual activators exert their beneficial effects in the treatment of AD.
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Affiliation(s)
- Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan; ; Tel.: +81-92-642-5581; Fax: +81-92-642-5600
- Research and Clinical Center for Yusho and Dioxin, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan
- Division of Skin Surface Sensing, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan
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Furue M, Tsuji G. Chloracne and Hyperpigmentation Caused by Exposure to Hazardous Aryl Hydrocarbon Receptor Ligands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234864. [PMID: 31816860 PMCID: PMC6926551 DOI: 10.3390/ijerph16234864] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
Dioxins and dioxin-like compounds are environmental pollutants that are hazardous to human skin. They can be present in contaminated soil, water, and air particles (such as ambient PM2.5). Exposure to a high concentration of dioxins induces chloracne and hyperpigmentation. These chemicals exert their toxic effects by activating the aryl hydrocarbon receptor (AHR) which is abundantly expressed in skin cells, such as keratinocytes, sebocytes, and melanocytes. Ligation of AHR by dioxins induces exaggerated acceleration of epidermal terminal differentiation (keratinization) and converts sebocytes toward keratinocyte differentiation, which results in chloracne formation. AHR activation potently upregulates melanogenesis in melanocytes by upregulating the expression of melanogenic enzymes, which results in hyperpigmentation. Because AHR-mediated oxidative stress contributes to these hazardous effects, antioxidative agents may be potentially therapeutic for chloracne and hyperpigmentation.
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Affiliation(s)
- Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan;
- Research and Clinical Center for Yusho and Dioxin, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan
- Division of Skin Surface Sensing, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan
- Correspondence: ; Tel.: +81-92-642-5581; Fax: +81-92-642-5600
| | - Gaku Tsuji
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan;
- Research and Clinical Center for Yusho and Dioxin, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka 812-8582, Japan
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Tanaka Y, Uchi H, Furue M. Antioxidant cinnamaldehyde attenuates UVB-induced photoaging. J Dermatol Sci 2019; 96:151-158. [PMID: 31735467 DOI: 10.1016/j.jdermsci.2019.11.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/07/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Ultraviolet (UV) irradiation disrupts skin through several deleterious actions, such as induction of reactive oxygen species (ROS), DNA damage, and collagen degradation. Cinnamaldehyde (CIN) is a major constituent of the cinnamon and it possesses potent antioxidative activity; however, it is unclear whether CIN is capable of inhibiting the adverse effects of UVB. OBJECTIVE To investigate protective effects of CIN against UVB-induced photodamage. METHODS HaCaT keratinocytes were pretreated with CIN, irradiated with UVB, and assessed for the ROS production by flow cytometry and for the DNA damage by ELISA. As in vivo mouse model, Hos:HR-1 hairless mice were treated with ointments containing DMSO or CIN and irradiated multiple times with UVB. After 10 weeks of irradiation, wrinkle formation, epidermal thickness, infiltrating cell number, malondialdehyde amount, collagen amount, MAP kinase signaling, and related gene expressions (Hmox1, Col1a1, Mmp1a, and Mmp13) were analyzed. RESULTS CIN significantly reduced the ROS production and accelerated the repair of DNA damage pyrimidine(6-4)pyrimidone photoproducts in UVB-irradiated human keratinocytes in vitro. In the mouse model, topical application of CIN significantly inhibited wrinkle formation, epidermal hyperplasia, and dermal inflammatory cell infiltration. The antioxidative process was significantly promoted in the CIN-applied site, as evidenced by upregulation of the antioxidative enzyme Hmox1 as well as the reduced accumulation of malondialdehyde. In addition, topical application of CIN normalized the UVB-induced collagen/Col1a1 downregulation and the UVB-induced Mmp13 upregulation, implying the prevention of UVB-induced collagen degradation. CONCLUSIONS CIN and CIN-containing herbal agents may exert potent protective effects against UVB exposure on skin.
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Affiliation(s)
- Yuka Tanaka
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Uchi
- Department of Dermatology, National Hospital organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan; Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Peng F, Tsuji G, Zhang JZ, Chen Z, Furue M. Potential role of PM 2.5 in melanogenesis. ENVIRONMENT INTERNATIONAL 2019; 132:105063. [PMID: 31394397 DOI: 10.1016/j.envint.2019.105063] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/04/2019] [Accepted: 07/25/2019] [Indexed: 06/10/2023]
Abstract
Ambient particulate matter 2.5 (PM2.5) is one of the main components of air pollutants, which can absorb many polycyclic aromatic hydrocarbons and metals. The effect of PM2.5 on human skin and its biological significance in skin homeostasis remain incompletely understood. Previous studies demonstrated that PM2.5 can activate aryl hydrocarbon receptor (AhR), generate reactive oxygen species, and induce skin inflammation. These processes may be involved in melanocyte homeostasis and melanogenesis. We hypothesize that AhR signaling may be responsible for PM2.5-related hyperpigmentation.
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Affiliation(s)
- Fen Peng
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
| | - Gaku Tsuji
- Department of Dermatology, Graduate School of Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka 812-8582, Japan.
| | - Jian-Zhong Zhang
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
| | - Zhou Chen
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka 812-8582, Japan; Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
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Parrado C, Mercado-Saenz S, Perez-Davo A, Gilaberte Y, Gonzalez S, Juarranz A. Environmental Stressors on Skin Aging. Mechanistic Insights. Front Pharmacol 2019; 10:759. [PMID: 31354480 PMCID: PMC6629960 DOI: 10.3389/fphar.2019.00759] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022] Open
Abstract
The skin is the main barrier that protects us against environmental stressors (physical, chemical, and biological). These stressors, combined with internal factors, are responsible for cutaneous aging. Furthermore, they negatively affect the skin and increase the risk of cutaneous diseases, particularly skin cancer. This review addresses the impact of environmental stressors on skin aging, especially those related to general and specific external factors (lifestyle, occupation, pollutants, and light exposure). More specifically, we have evaluated ambient air pollution, household air pollutants from non-combustion sources, and exposure to light (ultraviolet radiation and blue and red light). We approach the molecular pathways involved in skin aging and pathology as a result of exposure to these external environmental stressors. Finally, we reflect on how components of environmental stress can interact with ultraviolet radiation to cause cell damage and the critical importance of knowing the mechanisms to develop new therapies to maintain the skin without damage in old age and to repair its diseases.
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Affiliation(s)
- Concepcion Parrado
- Department of Histology and Pathology, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Sivia Mercado-Saenz
- Department of Histology and Pathology, Faculty of Medicine, University of Málaga, Málaga, Spain
| | | | | | - Salvador Gonzalez
- Medicine and Medical Specialties Department, Alcala University, Madrid, Spain
| | - Angeles Juarranz
- Biology Department, Sciences School, Autonoma University, Madrid, Spain
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Therapeutic Agents with AHR Inhibiting and NRF2 Activating Activity for Managing Chloracne. Antioxidants (Basel) 2018; 7:antiox7070090. [PMID: 30011787 PMCID: PMC6071176 DOI: 10.3390/antiox7070090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/02/2018] [Accepted: 07/11/2018] [Indexed: 12/13/2022] Open
Abstract
Chloracne is the major skin symptom caused by dioxin intoxication. Dioxin activates the aryl hydrocarbon receptor (AHR)–cytochrome p450 1A1 (CYP1A1) system, generates oxidative stress, and induces hyperkeratinization of keratinocytes and sebocytes leading to chloracne. Nuclear factor-erythroid 2-related factor-2 (NRF2) is a master switch that induces the expression of various antioxidative enzymes, such as heme oxygenase-1. Cinnamaldehyde is an antioxidant phytochemical that inhibits AHR–CYP1A1 signaling and activates the NRF2–antioxidative axis. The cinnamaldehyde-containing Kampo herbal medicine Keishibukuryogan is capable of improving chloracne in Yusho patients who are highly contaminated with dioxin. Agents with dual functions in promoting AHR–CYP1A1 inhibition and NRF2 activation may be useful for managing dioxin-related health hazards.
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Mitoma C, Uchi H, Tsukimori K, Todaka T, Kajiwara J, Shimose T, Akahane M, Imamura T, Furue M. Current state of yusho and prospects for therapeutic strategies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:16472-16480. [PMID: 29197056 DOI: 10.1007/s11356-017-0833-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/23/2017] [Indexed: 05/20/2023]
Abstract
The mass food poisoning incident yusho occurred in Japan in 1968. It was caused by the ingestion of rice bran oil contaminated with polychlorinated biphenyls and various dioxins and dioxin-like compounds including polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDFs). Notably, PCDFs were found to contribute to approximately 65% of the total toxicity equivalent in the blood of yusho patients. Lipophilic dioxins are retained in the body for a longer period than previously estimated. Victims suffered from characteristic skin manifestations associated with non-specific systemic symptoms, neurological symptoms, and respiratory symptoms. The severe symptoms seen in the initial phase subsequently faded, but recently, improvements have scarcely been observed. The Yusho Group has been researching treatments for this condition. Several clinical trials with chelating agents or dietary fibers aimed at accelerating the excretion of compounds. While some treatments increased dioxin excretion, none provided satisfactory symptom relief. Concurrently, various phytochemicals and herbal extracts have been found to possess biological activities that suppress dioxin-induced toxicity via aryl hydrocarbon receptor or activate the antioxidant nuclear factor-erythroid 2-related factor-2 (NRF2) signal pathway, making them promising therapeutic candidates. Here, we summarize the current status of yusho and findings of clinical trials for yusho patients and discuss the treatment prospects.
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Affiliation(s)
- Chikage Mitoma
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Kiyomi Tsukimori
- Department of Obstetrics, Fukuoka Children's Hospital, Fukuoka, 813-0017, Japan
| | - Takashi Todaka
- Kitakyushu Life Science Center, Public Interest Incorporated Foundation, Fukuoka, 804-0003, Japan
| | - Jumboku Kajiwara
- Fukuoka Institute of Health and Environmental Sciences, Fukuoka, 818-0135, Japan
| | - Takayuki Shimose
- Clinical Research Support Center Kyushu, Fukuoka, 812-8582, Japan
| | - Manabu Akahane
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Nara, 634-8521, Japan
| | - Tomoaki Imamura
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Nara, 634-8521, Japan
| | - Masutaka Furue
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
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