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Kang DH, Kim M, Lew BL, Kwon SH. Metformin is not associated with decreased risk of non-melanoma skin cancer: A distributed network analysis of 14 real-world databases in Korea. J Eur Acad Dermatol Venereol 2024; 38:e880-e882. [PMID: 38545875 DOI: 10.1111/jdv.19977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/11/2024] [Indexed: 09/26/2024]
Affiliation(s)
- Da-Hyun Kang
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Myoungsuk Kim
- Healthcare Big-Data Center, Research Institute of Clinical Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Bark-Lynn Lew
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Soon-Hyo Kwon
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
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2
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Yang K, Lu HH, Zhao W, Zhao Q. Efficacy and safety of metformin in combination with chemotherapy in cancer patients without diabetes: systematic review and meta-analysis. Front Oncol 2023; 13:1176885. [PMID: 37546417 PMCID: PMC10402741 DOI: 10.3389/fonc.2023.1176885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Background The results of a meta-analysis of retrospective studies suggest that the use of metformin in cancer patients may prolong progression-free disease survival and overall survival. However, the studies included in the meta-analysis did not strictly distinguish between patients with or without type 2 diabetes mellitus. Therefore, further studies are needed to assess whether the use of adjuvant chemotherapy with metformin in cancer patients without diabetes improves prognosis. Method Systematic searches of Embase, Pubmed, and The Cochrane library were performed for the subject terms metformin and neoplasm and for free words. Data related to PFS, OS were extracted according to inclusion exclusion criteria. The data were combined and meta-analysis was performed using Review Manager 5.4 to confirm the efficacy and safety of metformin administration. Results There were 3228 publications retrieved from the database and a total of 13 publications with 955 patients were included in the meta-analysis after screening. All included studies were randomised controlled trials. Metformin combined with adjuvant chemotherapy did not improve progression-free survival (HR=1,95CI 0.79-1.25), overall survival (HR=0.91,95% CI 0.69-1.20) and did not improve objective disease response rates in patients. There was no significant difference in grade 3-4 adverse reactions compared to placebo. Conclusion In this meta-analysis of randomised controlled trial studies, we found that chemotherapy in combination with metformin in cancer patients without diabetes did not prolong progression-free survival and overall survival and improved disease control in patients, although there was no significant difference in terms of safety. More high-quality randomised controlled trials are needed in the future to confirm the in vivo anti-tumour activity and survival benefit of metformin.
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Affiliation(s)
- Kang Yang
- Department of Pharmacy, General Hospital of Northern Theater Command of PLA, Shenyang, China
- China Medical University, Shenyang, China
| | - Hao-hao Lu
- Department of Pharmacy, General Hospital of Northern Theater Command of PLA, Shenyang, China
- China Medical University, Shenyang, China
| | - Wei Zhao
- Department of Pharmacy, General Hospital of Northern Theater Command of PLA, Shenyang, China
| | - Qingchun Zhao
- Department of Pharmacy, General Hospital of Northern Theater Command of PLA, Shenyang, China
- China Medical University, Shenyang, China
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3
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Raza S, Al-Niaimi F, Ali FR. A systematic review of the uses of metformin in dermatology. Clin Exp Dermatol 2023; 48:73-79. [PMID: 36641775 DOI: 10.1093/ced/llac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 01/16/2023]
Abstract
Metformin is an established staple drug in the management of Type 2 diabetes mellitus. In this systematic review, we sought to establish the clinical utility of metformin in a range of dermatological conditions. The pathophysiology of acne vulgaris and polycystic ovarian syndrome (PCOS) is well suited to the pharmacological profile of metformin, and we found evidence for its efficacy in managing these conditions. We found some evidence for the use of metformin particularly in acne and PCOS; however, the evidence base is of mixed quality. There is scope for clinicians to consider metformin as an adjunct therapy in acne and PCOS. There is generally insufficient evidence to recommend metformin in other dermatological conditions.
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Affiliation(s)
- Sami Raza
- Department of Medicine, Walsall Healthcare NHS Trust, UK.,Faculty of Medicine, Health and Life Science, Swansea University, UK
| | | | - Faisal R Ali
- Department of Dermatology, Mid-Cheshire NHS Foundation Trust, UK.,St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Anderson JM, Moy L, Moy RL. Preventative Options and the Future of Chemoprevention for Cutaneous Tumors. Dermatol Clin 2022; 41:231-238. [DOI: 10.1016/j.det.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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5
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Monte-Serrano J, Villagrasa-Boli P, Cruañes-Monferrer J, Arbués-Espinosa P, Martínez-Cisneros S, García-Gil MF. Metformina en el tratamiento de enfermedades dermatológicas: una revisión narrativa. Aten Primaria 2022; 54:102354. [PMID: 35569426 PMCID: PMC9111182 DOI: 10.1016/j.aprim.2022.102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022] Open
Abstract
Objetivo Revisar y discutir la evidencia actual del uso de la metformina como herramienta terapéutica en enfermedades cutáneas. Diseño Artículo original. Investigación cualitativa. Revisión narrativa. Emplazamiento Aragón y Murcia, España. Participantes Médicos Internos Residentes de Dermatología Médico-Quirúrgica y Venereología y de Atención Primaria y Comunitaria. Métodos Se ha realizado una revisión narrativa utilizando la base de datos bibliográfica PubMed con fecha de búsqueda el 27 de enero de 2022. Resultados La metformina ha demostrado ser efectiva en el tratamiento de dermatosis inflamatorias tales como el acné, hidrosadenitis supurativa, psoriasis y dermatitis de contacto alérgica. También ha demostrado propiedades antitumorales frente al carcinoma basocelular, carcinoma espinocelular y melanoma. De forma adicional, se ha descrito efectos beneficiosos del tratamiento adyuvante con metformina en pacientes con carcinoma basocelular que reciben terapia fotodinámica. En pacientes con dermatosis relacionadas con endocrinopatías tales como el hirsutismo, la acantosis nigricans y los xantomas eruptivos, el tratamiento con metformina ha demostrado efectividad terapéutica. El tratamiento tópico con metformina ha demostrado ser eficaz en el tratamiento del melasma. Finalmente se ha propuesto como un fármaco con propiedades antienvejecimiento cutáneo y favorecedoras de la cicatrización. Para ninguna de las indicaciones previamente descritas se han objetivado efectos adversos graves. Conclusiones La metformina es un tratamiento efectivo y seguro en el esquema terapéutico de dermatosis inflamatorias, neoplasias cutáneas, dermatosis relacionadas con endocrinopatías, melasma, envejecimiento cutáneo y cicatrización.
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Obrador E, Salvador-Palmer R, Villaescusa JI, Gallego E, Pellicer B, Estrela JM, Montoro A. Nuclear and Radiological Emergencies: Biological Effects, Countermeasures and Biodosimetry. Antioxidants (Basel) 2022; 11:1098. [PMID: 35739995 PMCID: PMC9219873 DOI: 10.3390/antiox11061098] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
Atomic and radiological crises can be caused by accidents, military activities, terrorist assaults involving atomic installations, the explosion of nuclear devices, or the utilization of concealed radiation exposure devices. Direct damage is caused when radiation interacts directly with cellular components. Indirect effects are mainly caused by the generation of reactive oxygen species due to radiolysis of water molecules. Acute and persistent oxidative stress associates to radiation-induced biological damages. Biological impacts of atomic radiation exposure can be deterministic (in a period range a posteriori of the event and because of destructive tissue/organ harm) or stochastic (irregular, for example cell mutation related pathologies and heritable infections). Potential countermeasures according to a specific scenario require considering basic issues, e.g., the type of radiation, people directly affected and first responders, range of doses received and whether the exposure or contamination has affected the total body or is partial. This review focuses on available medical countermeasures (radioprotectors, radiomitigators, radionuclide scavengers), biodosimetry (biological and biophysical techniques that can be quantitatively correlated with the magnitude of the radiation dose received), and strategies to implement the response to an accidental radiation exposure. In the case of large-scale atomic or radiological events, the most ideal choice for triage, dose assessment and victim classification, is the utilization of global biodosimetry networks, in combination with the automation of strategies based on modular platforms.
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Affiliation(s)
- Elena Obrador
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain; (R.S.-P.); (B.P.); (J.M.E.)
| | - Rosario Salvador-Palmer
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain; (R.S.-P.); (B.P.); (J.M.E.)
| | - Juan I. Villaescusa
- Service of Radiological Protection, Clinical Area of Medical Image, La Fe University Hospital, 46026 Valencia, Spain; (J.I.V.); (A.M.)
- Biomedical Imaging Research Group GIBI230, Health Research Institute (IISLaFe), La Fe University Hospital, 46026 Valencia, Spain
| | - Eduardo Gallego
- Energy Engineering Department, School of Industrial Engineering, Polytechnic University of Madrid, 28040 Madrid, Spain;
| | - Blanca Pellicer
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain; (R.S.-P.); (B.P.); (J.M.E.)
| | - José M. Estrela
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain; (R.S.-P.); (B.P.); (J.M.E.)
| | - Alegría Montoro
- Service of Radiological Protection, Clinical Area of Medical Image, La Fe University Hospital, 46026 Valencia, Spain; (J.I.V.); (A.M.)
- Biomedical Imaging Research Group GIBI230, Health Research Institute (IISLaFe), La Fe University Hospital, 46026 Valencia, Spain
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Mousa IA, Hammady TM, Gad S, Zaitone SA, El-Sherbiny M, Sayed OM. Formulation and Characterization of Metformin-Loaded Ethosomes for Topical Application to Experimentally Induced Skin Cancer in Mice. Pharmaceuticals (Basel) 2022; 15:657. [PMID: 35745575 PMCID: PMC9227071 DOI: 10.3390/ph15060657] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023] Open
Abstract
To achieve the best treatment of skin cancer, drug penetration inside the deepest layers of the skin is an important scientific interest. We designed an ethosome formulation that serves as a carrier for metformin and measured the in vitro skin permeation. We also aimed to measure the antitumor activity of the optimal ethosomal preparation when applied topically to chemically induced skin cancer in mice. We utilized a statistical Box-Behnken experimental design and applied three variables at three levels: lecithin concentration, cholesterol concentration and a mixture of ethanol and isopropyl alcohol concentrations. All formulations were prepared to calculate the entrapment efficiency %, zeta potential, size of the vesicles and drug release % after 1, 2, 4, 8 and 24 h. The size of the vesicles for the formulations was between 124 ± 14.2 nm and 560 ± 127 nm, while the entrapment efficiency was between 97.8 ± 0.23% and 99.4 ± 0.24%, and the drug release % after 8 h was between 38 ± 0.82% and 66 ± 0.52%. All formulations were introduced into the Box-Behnken software, which selected three formulations; then, one was assigned as an optimal formula. The in vivo antitumor activity of metformin-loaded ethosomal gel on skin cancer was greater than the antitumor activity of the gel preparation containing free metformin. Lower lecithin, high ethanol and isopropyl alcohol and moderate cholesterol contents improved the permeation rate. Overall, we can conclude that metformin-loaded ethosomes are a promising remedy for treating skin cancers, and more studies are warranted to approve this activity in other animal models of skin cancers.
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Affiliation(s)
- Ibrahim A. Mousa
- General Authority of Health Care, Ismailia Governorate, Ismailia 11517, Egypt;
| | - Taha M. Hammady
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt;
| | - Shadeed Gad
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt;
| | - Sawsan A. Zaitone
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Mohamed El-Sherbiny
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Riyadh P.O. Box 71666, Saudi Arabia;
- Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura 3155, Egypt
| | - Ossama M. Sayed
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Sinai University, Kantra 41636, Egypt;
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Tulipano G. Integrated or Independent Actions of Metformin in Target Tissues Underlying Its Current Use and New Possible Applications in the Endocrine and Metabolic Disorder Area. Int J Mol Sci 2021; 22:13068. [PMID: 34884872 PMCID: PMC8658259 DOI: 10.3390/ijms222313068] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Metformin is considered the first-choice drug for type 2 diabetes treatment. Actually, pleiotropic effects of metformin have been recognized, and there is evidence that this drug may have a favorable impact on health beyond its glucose-lowering activity. In summary, despite its long history, metformin is still an attractive research opportunity in the field of endocrine and metabolic diseases, age-related diseases, and cancer. To this end, its mode of action in distinct cell types is still in dispute. The aim of this work was to review the current knowledge and recent findings on the molecular mechanisms underlying the pharmacological effects of metformin in the field of metabolic and endocrine pathologies, including some endocrine tumors. Metformin is believed to act through multiple pathways that can be interconnected or work independently. Moreover, metformin effects on target tissues may be either direct or indirect, which means secondary to the actions on other tissues and consequent alterations at systemic level. Finally, as to the direct actions of metformin at cellular level, the intracellular milieu cooperates to cause differential responses to the drug between distinct cell types, despite the primary molecular targets may be the same within cells. Cellular bioenergetics can be regarded as the primary target of metformin action. Metformin can perturb the cytosolic and mitochondrial NAD/NADH ratio and the ATP/AMP ratio within cells, thus affecting enzymatic activities and metabolic and signaling pathways which depend on redox- and energy balance. In this context, the possible link between pyruvate metabolism and metformin actions is extensively discussed.
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Affiliation(s)
- Giovanni Tulipano
- Unit of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
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9
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Weniger Basalzellkarzinome nach Metformin. AKTUELLE DERMATOLOGIE 2021. [DOI: 10.1055/a-1580-3465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Pihl C, Togsverd-Bo K, Andersen F, Haedersdal M, Bjerring P, Lerche CM. Keratinocyte Carcinoma and Photoprevention: The Protective Actions of Repurposed Pharmaceuticals, Phytochemicals and Vitamins. Cancers (Basel) 2021; 13:cancers13153684. [PMID: 34359586 PMCID: PMC8345172 DOI: 10.3390/cancers13153684] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Keratinocyte carcinoma is the most common type of cancer. Sun exposure and ultraviolet radiation are significant contributors to the development of carcinogenesis, mediated by DNA damage, increased oxidative stress, inflammation, immunosuppression and dysregulated signal transduction. Photoprevention involves using different compounds to delay or prevent ultraviolet radiation-induced skin cancer. In this review, we look at new avenues for systemic photoprevention that are based on pharmaceuticals, plant-derived phytochemicals and vitamins. We also investigate the mechanisms underlying these strategies for preventing the onset of carcinogenesis. Abstract Ultraviolet radiation (UVR) arising from sun exposure represents a major risk factor in the development of keratinocyte carcinomas (KCs). UVR exposure induces dysregulated signal transduction, oxidative stress, inflammation, immunosuppression and DNA damage, all of which promote the induction and development of photocarcinogenesis. Because the incidence of KCs is increasing, better prevention strategies are necessary. In the concept of photoprevention, protective compounds are administered either topically or systemically to prevent the effects of UVR and the development of skin cancer. In this review, we provide descriptions of the pathways underlying photocarcinogenesis and an overview of selected photoprotective compounds, such as repurposed pharmaceuticals, plant-derived phytochemicals and vitamins. We discuss the protective potential of these compounds and their effects in pre-clinical and human trials, summarising the mechanisms of action involved in preventing photocarcinogenesis.
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Affiliation(s)
- Celina Pihl
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
- Correspondence:
| | - Katrine Togsverd-Bo
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Flemming Andersen
- Department of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark; (F.A.); (P.B.)
- Private Hospital Molholm, 7100 Vejle, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Peter Bjerring
- Department of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark; (F.A.); (P.B.)
| | - Catharina Margrethe Lerche
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
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Metformin use and keratinocyte carcinoma risk. J Am Acad Dermatol 2021; 85:e263. [PMID: 34246699 DOI: 10.1016/j.jaad.2021.04.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 11/21/2022]
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12
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Adalsteinsson JA, Waldman R, Ratner D, Feng H, Tryggvadottir L, Jonasson JG. Reply to: Metformin use and keratinocyte carcinoma risk. J Am Acad Dermatol 2021; 85:e265. [PMID: 34052334 DOI: 10.1016/j.jaad.2021.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Jonas A Adalsteinsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Dermatology, University of Connecticut, Farmington, Connecticut.
| | - Reid Waldman
- Department of Dermatology, University of Connecticut, Farmington, Connecticut
| | - Désirée Ratner
- Department of Dermatology, New York University Langone Health, New York, New York
| | - Hao Feng
- Department of Dermatology, University of Connecticut, Farmington, Connecticut
| | - Laufey Tryggvadottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Icelandic Cancer Registry, Reykjavik, Iceland
| | - Jon Gunnlaugur Jonasson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Pathology, Landspitali National-University Hospital, Reykjavik, Iceland
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