1
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Tosti G, Pepe F, Gnagnarella P, Silvestri F, Gaeta A, Queirolo P, Gandini S. The Role of Nicotinamide as Chemo-Preventive Agent in NMSCs: A Systematic Review and Meta-Analysis. Nutrients 2023; 16:100. [PMID: 38201930 PMCID: PMC10780437 DOI: 10.3390/nu16010100] [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: 11/16/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Nicotinamide is the active form of vitamin B3 (niacin) obtained through endogenous synthesis, mainly through tryptophan metabolism and dietary supplements, fish, meats, grains, and dairy products. It participates in cellular energy metabolism and modulates multiple cellular survival and death pathways. Nicotinamide has been widely studied as a safe chemopreventive agent that reduces actinic keratosis (AKs) and non-melanoma skin cancers (NMSC). METHODS We used the Medline, EMBASE, PubMed, and Cochrane databases to search the concepts "nicotinamide", "chemoprevention", and "skin cancer" up to August 2023. Three independent authors screened titles and abstracts for intervention and study design before searching full texts for eligibility criteria. The primary outcome was the impact of oral nicotinamide on the incidence of NMSC in high-risk patients. We also conducted a systematic search to identify relevant epidemiological studies published evaluating dietary niacin intake and the risk of NMSC. RESULTS Two hundred and twenty-five studies were reviewed, and four met the inclusion criteria. There was no association between NAM consumption and risk for squamous cell carcinoma (SCC) (rate ratio (RR) 0.81, 95% CI 0.48-1.37; I2 = 0%), basal cell carcinoma (BCC) (RR 0.88, 95% CI 0.50-1.55; I2 = 63%), and NMSC (RR 0.82, 95% CI 0.61-1.12; I2 = 63%). Adverse events were rare and acceptable, allowing optimal compliance of patients to the treatment. We found only one article evaluating the association between niacin dietary intake and NMSC risk, supporting a potential beneficial role of niacin intake concerning SCC but not BCC or melanoma. CONCLUSIONS The present meta-analysis shows, by pooling immunocompetent and immunosuppressed patients, that there is insufficient evidence that oral nicotinamide therapy significantly reduces the number of keratinocyte cancers.
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Affiliation(s)
- Giulio Tosti
- Dermato-Oncology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.P.); (F.S.)
| | - Francesca Pepe
- Dermato-Oncology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.P.); (F.S.)
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Flavia Silvestri
- Dermato-Oncology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.P.); (F.S.)
| | - Aurora Gaeta
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (A.G.); (S.G.)
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca 8, 20126 Milan, Italy
| | - Paola Queirolo
- Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Sara Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (A.G.); (S.G.)
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2
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Han L, Huang X, Zhao B, Zhu H, Wang R, Liu S, Lin H, Feng F, Ma X, Liu F, Xue J, Liu W. TGF-β1 mediates tumor immunosuppression aggravating at the late stage post-high-light-dose photodynamic therapy. Cancer Immunol Immunother 2023; 72:3079-3095. [PMID: 37351605 DOI: 10.1007/s00262-023-03479-3] [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: 10/11/2022] [Accepted: 06/08/2023] [Indexed: 06/24/2023]
Abstract
Photodynamic therapy (PDT) is an emerging clinical treatment that is expected to become an important adjuvant strategy for the immunotherapeutic cancer treatment. Recently, numerous works have reported combination strategies. However, clinical data showed that the anti-tumor immune response of PDT was not lasting though existing. The immune activation effect will eventually turn to immunosuppressive effect and get aggravated at the late stage post-PDT. So far, the mechanism is still unclear, which limits the design of specific correction strategies and further development of PDT. Several lines of evidence suggest a role for TGF-β1 in the immunosuppression associated with PDT. Herein, this study systematically illustrated the dynamic changes of immune states post-PDT within the tumor microenvironment. The results clearly demonstrated that high-light-dose PDT, as a therapeutic dose, induced early immune activation followed by late immunosuppression, which was mediated by the activated TGF-β1 upregulation. Then, the mechanism of PDT-induced TGF-β1 accumulation and immunosuppression was elucidated, including the ROS/TGF-β1/MMP-9 positive feedback loop and CD44-mediated local amplification, which was further confirmed by spatial transcriptomics, as well as by the extensive immune inhibitory effect of local high concentration of TGF-β1. Finally, a TGF-β blockade treatment strategy was presented as a promising combinational strategy to reverse high-light-dose PDT-associated immunosuppression. The results of this study provide new insights for the biology mechanism and smart improvement approaches to enhance tumor photodynamic immunotherapy.
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Affiliation(s)
- Lingfei Han
- Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 211198, China
| | - Xiaoxian Huang
- Department of Natural Medicinal Chemistry, China Pharmaceutical University, Nanjing, 211198, China
| | - Bin Zhao
- Department of Natural Medicinal Chemistry, China Pharmaceutical University, Nanjing, 211198, China
- Tumor Precise Intervention and Translational Medicine Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China
| | - Hongtan Zhu
- Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 211198, China
| | - Ruyi Wang
- Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 211198, China
| | - Shaoxia Liu
- Tumor Precise Intervention and Translational Medicine Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China
| | - Honglei Lin
- Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 211198, China
| | - Feng Feng
- Department of Natural Medicinal Chemistry, China Pharmaceutical University, Nanjing, 211198, China
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Xiao Ma
- Gansu Institute for Drug Control, Gansu, 730000, China
| | - Fulei Liu
- Tumor Precise Intervention and Translational Medicine Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China.
- Pharmaceutical Department, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China.
| | - Jingwei Xue
- Tumor Precise Intervention and Translational Medicine Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China.
| | - Wenyuan Liu
- Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 211198, China.
- Zhejiang Center for Safety Study of Drug Substances (Industrial Technology Innovation Platform), Hangzhou, 310018, China.
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3
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Hunt SV, Jamison A, Malhotra R. Oral nicotinamide for non-melanoma skin cancers: A review. Eye (Lond) 2023; 37:823-829. [PMID: 35347291 PMCID: PMC10050186 DOI: 10.1038/s41433-022-02036-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 12/15/2022] Open
Abstract
There has been much interest in the role of oral nicotinamide supplementation in reducing the incidence of non-melanoma skin cancers. This article reviews the hypothesised mechanisms of action of nicotinamide, and the available literature outlining its role for this purpose. There have been five randomised controlled trials (RCT), one histopathological study and two case series exploring the effect of oral nicotinamide supplementation on UV-induced immunosuppression of the skin, and incidence of actinic keratoses and non-melanoma skin cancers (NMSC). The largest RCT received criticism of the statistical analyses used, but the critics still acknowledged a likely benefit of treatment with oral nicotinamide in reducing the incidence of NMSC. Nicotinamide has a favourable safety profile. Current evidence is not definitive that oral nicotinamide supplementation reduces the incidence of NMSC, but it constitutes a low-risk management option that may be particularly relevant for high-risk individuals, and should be discussed as an option for these patients.
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Affiliation(s)
| | - Aaron Jamison
- Corneoplastic unit, Queen Victoria Hospital, East Grinstead, England
| | - Raman Malhotra
- Corneoplastic unit, Queen Victoria Hospital, East Grinstead, England
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4
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Hofer SJ, Kroemer G, Kepp O. Autophagy-inducing nutritional interventions in experimental and clinical oncology. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2022; 373:125-158. [PMID: 36283765 DOI: 10.1016/bs.ircmb.2022.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Numerous pro-autophagic dietary interventions are being investigated for their potential cancer-preventive or therapeutic effects. This applies to different fasting regimens, methionine restriction and ketogenic diets. In addition, the supplementation of specific micronutrients such as nicotinamide (vitamin B3) or spermidine induces autophagy. In humans, leanness, plant-based diets (that may lead to partial methionine restriction) and high dietary uptake of spermidine are associated with a low incidence of cancers. Moreover, clinical trials have demonstrated the capacity of nicotinamide to prevent non-melanoma skin carcinogenesis. Multiple interventional trials are evaluating the capacity of autophagy-inducing regimens to improve the outcome of chemotherapy and immunotherapy. Here, we discuss the mechanistic underpinnings of autophagy induction by nutritional interventions, as well as the mechanisms through which autophagy induction in malignant or immune cells improves anticancer immunosurveillance.
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Affiliation(s)
- Sebastian J Hofer
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Center, Université Paris Saclay, Villejuif, France; Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Paris, France; Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Center, Université Paris Saclay, Villejuif, France; Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Paris, France; Institut du Cancer Paris Carpem, Department of Biology, APHP, Hôpital Européen Georges Pompidou, Paris, France.
| | - Oliver Kepp
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Center, Université Paris Saclay, Villejuif, France; Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Paris, France.
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5
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Bayless S, Travers JB, Sahu RP, Rohan CA. Inhibition of photodynamic therapy induced-immunosuppression with aminolevulinic acid leads to enhanced outcomes of tumors and pre-cancerous lesions. Oncol Lett 2021; 22:664. [PMID: 34386086 PMCID: PMC8298988 DOI: 10.3892/ol.2021.12925] [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: 04/23/2021] [Accepted: 06/18/2021] [Indexed: 11/06/2022] Open
Abstract
Photodynamic therapy (PDT) is a treatment option for tumors and pre-cancerous lesions, but it has immunosuppressive side effects that limit its effectiveness. Recent studies suggest that PDT-mediated immunosuppression occurs through a cyclooxygenase type 2 (COX-2) mediated pathway that leads to increases in regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs), which act as negative regulators of immune responses. Given this pathway, there are three main methods to block immunosuppression: i) Inhibiting the proliferation of Tregs, which can be achieved with the administration of cyclophosphamide or inhibitors of indoleamine 2,3-dioxygenase 1, an activator of Tregs; ii) inhibiting MDSCs by reducing hypoxia around the tumor to create an unfavorable environment or administering all-trans-retinoic acid, which converts MDSCs to a non-immunosuppressive state; and iii) inhibiting COX-2 through selective or non-selective COX-inhibitors. In the present review article, strategies that have shown increased efficacy of PDT in treating tumors and pre-cancerous lesions by blocking the immunosuppressive side effects are outlined and discussed.
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Affiliation(s)
- Sharlo Bayless
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA
| | - Jeffrey B Travers
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA.,Department of Dermatology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA.,Deparment of Dermatology, Dayton Veterans Administration Medical Center, Dayton, OH 45428, USA
| | - Ravi P Sahu
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA
| | - Craig A Rohan
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA.,Department of Dermatology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA
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6
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Buqué A, Bloy N, Kroemer G, Galluzzi L. Possible mechanisms of cancer prevention by nicotinamide. Br J Pharmacol 2020; 178:2034-2040. [DOI: 10.1111/bph.15096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Aitziber Buqué
- Department of Radiation Oncology Weill Cornell Medical College New York NY USA
| | - Norma Bloy
- Department of Radiation Oncology Weill Cornell Medical College New York NY USA
| | - Guido Kroemer
- Equipe labellisée par la Ligue contre le cancer Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers Paris France
- Pôle de Biologie, Hôpital Européen Georges Pompidou, AP‐HP Paris France
- Suzhou Institute for Systems Medicine Chinese Academy of Sciences Suzhou China
- Department of Women's and Children's Health Karolinska University Hospital Stockholm Sweden
| | - Lorenzo Galluzzi
- Department of Radiation Oncology Weill Cornell Medical College New York NY USA
- Sandra and Edward Meyer Cancer Center New York NY USA
- Caryl and Israel Englander Institute for Precision Medicine New York NY USA
- Department of Dermatology Yale School of Medicine New Haven CT USA
- Université de Paris Paris France
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7
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Thompson KG, Kim N. Dietary supplements in dermatology: A review of the evidence for zinc, biotin, vitamin D, nicotinamide, and Polypodium. J Am Acad Dermatol 2020; 84:1042-1050. [PMID: 32360756 DOI: 10.1016/j.jaad.2020.04.123] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
Dietary supplements are commonly recommended by dermatologists in the treatment of skin, hair, and nail disorders. This review of oral over-the-counter supplement use in dermatology summarizes current evidence for the use of zinc, biotin, vitamin D, nicotinamide, and Polypodium in the management of common dermatologic disorders. Evidence for the safety and efficacy of these supplements is limited. Very few large-scale randomized controlled trials exist for these over-the-counter supplements, particularly biotin and Polypodium. The lack of standardized dosing and standardized outcome measures makes comparison across existing studies challenging, and the lack of adverse events reporting in the majority of studies limits analysis of supplement safety. The most promising evidence exists for the use of nicotinamide in preventing nonmelanoma skin cancers. There is some evidence for the role of vitamin D in decreasing melanoma risk and progression in some individuals and for the photoprotective role of Polypodium, although additional high-quality studies are needed to determine appropriate dosing. Current evidence is insufficient to recommend the use of biotin or zinc supplements in dermatology. Large-scale randomized controlled trials investigating safety and efficacy are needed before widespread incorporation of these oral supplements into the general practice of dermatology.
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Affiliation(s)
| | - Noori Kim
- Department of Dermatology, Johns Hopkins University, Baltimore, Maryland.
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8
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The Role of Nicotinamide in Cancer Chemoprevention and Therapy. Biomolecules 2020; 10:biom10030477. [PMID: 32245130 PMCID: PMC7175378 DOI: 10.3390/biom10030477] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/09/2020] [Accepted: 03/17/2020] [Indexed: 12/24/2022] Open
Abstract
Nicotinamide (NAM) is a water-soluble form of Vitamin B3 (niacin) and a precursor of nicotinamide-adenine dinucleotide (NAD+) which regulates cellular energy metabolism. Except for its role in the production of adenosine triphosphate (ATP), NAD+ acts as a substrate for several enzymes including sirtuin 1 (SIRT1) and poly ADP-ribose polymerase 1 (PARP1). Notably, NAM is an inhibitor of both SIRT1 and PARP1. Accumulating evidence suggests that NAM plays a role in cancer prevention and therapy. Phase III clinical trials have confirmed its clinical efficacy for non-melanoma skin cancer chemoprevention or as an adjunct to radiotherapy against head and neck, laryngeal, and urinary bladder cancers. Evidence for other cancers has mostly been collected through preclinical research and, in its majority, is not yet evidence-based. NAM has potential as a safe, well-tolerated, and cost-effective agent to be used in cancer chemoprevention and therapy. However, more preclinical studies and clinical trials are needed to fully unravel its value.
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9
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Galbraith AR, Seabloom DE, Wuertz BR, Antonides JD, Steele VE, Wattenberg LW, Ondrey FG. Chemoprevention of Lung Carcinogenesis by Dietary Nicotinamide and Inhaled Budesonide. Cancer Prev Res (Phila) 2019; 12:69-78. [PMID: 30606719 DOI: 10.1158/1940-6207.capr-17-0402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/17/2018] [Accepted: 12/18/2018] [Indexed: 11/16/2022]
Abstract
Nicotinamide, the amide form of vitamin B3, and budesonide, a synthetic glucocorticoid used in the treatment of asthma, were evaluated to determine their individual and combinational chemopreventive efficacy on benzo(a)pyrene-induced lung tumors in female A/J mice. Nicotinamide fed at a dietary concentration of 0.75% significantly inhibited tumor multiplicity. Nicotinamide by aerosol inhalation at doses up to 15 mg/kg/day did not result in a statistically significant reduction in tumor multiplicity. Finally, dietary nicotinamide was administered with aerosol budesonide and tumor multiplicity reduced by 90% at 1 week and 49% at 8 weeks post last carcinogen dose. We conclude nicotinamide is an effective and safe agent for lung cancer dietary prevention at both early- and late-stage carcinogenesis and that efficacy is increased with aerosol budesonide. Combination chemoprevention with these agents is a well-tolerated and effective strategy which could be clinically advanced to human studies.
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Affiliation(s)
- Arthur R Galbraith
- Carcinogenesis and Chemoprevention Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Donna E Seabloom
- AeroCore Testing Services, Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.,Department of Otolaryngology, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Beverly R Wuertz
- AeroCore Testing Services, Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.,Department of Otolaryngology, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Jennifer D Antonides
- Carcinogenesis and Chemoprevention Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Vernon E Steele
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Lee W Wattenberg
- Carcinogenesis and Chemoprevention Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Frank G Ondrey
- Carcinogenesis and Chemoprevention Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. .,AeroCore Testing Services, Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.,Department of Otolaryngology, Medical School, University of Minnesota, Minneapolis, Minnesota
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10
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Ibbotson S, Wong T, Morton C, Collier N, Haylett A, McKenna K, Mallipeddi R, Moseley H, Rhodes L, Seukeran D, Ward K, Mohd Mustapa M, Exton L. Adverse effects of topical photodynamic therapy: a consensus review and approach to management. Br J Dermatol 2018; 180:715-729. [DOI: 10.1111/bjd.17131] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2018] [Indexed: 12/21/2022]
Affiliation(s)
- S.H. Ibbotson
- Photobiology Unit Department of Dermatology University of Dundee Ninewells Hospital and Medical School Dundee U.K
| | - T.H. Wong
- Stirling Community Hospital StirlingU.K
| | | | - N.J. Collier
- Photobiology Unit Dermatology Centre University of Manchester and Salford Royal NHS Foundation Trust ManchesterU.K
| | - A. Haylett
- Photobiology Unit Dermatology Centre University of Manchester and Salford Royal NHS Foundation Trust ManchesterU.K
| | - K.E. McKenna
- Department of Dermatology Belfast City Hospital BelfastU.K
| | - R. Mallipeddi
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - H. Moseley
- Photobiology Unit Department of Dermatology University of Dundee Ninewells Hospital and Medical School Dundee U.K
| | - L.E. Rhodes
- Photobiology Unit Dermatology Centre University of Manchester and Salford Royal NHS Foundation Trust ManchesterU.K
| | | | | | | | - L.S. Exton
- British Association of Dermatologists London U.K
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11
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Early and Late Onset Side Effects of Photodynamic Therapy. Biomedicines 2018; 6:biomedicines6010012. [PMID: 29382133 PMCID: PMC5874669 DOI: 10.3390/biomedicines6010012] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 01/20/2018] [Accepted: 01/25/2018] [Indexed: 01/06/2023] Open
Abstract
Photodynamic Therapy (PDT) is a non-invasive treatment successfully used for neoplastic, inflammatory and infectious skin diseases. One of its strengths is represented by the high safety profile, even in elderly and/or immuno-depressed subjects. PDT, however, may induce early and late onset side effects. Erythema, pain, burns, edema, itching, desquamation, and pustular formation, often in association with each other, are frequently observed in course of exposure to the light source and in the hours/days immediately after the therapy. In particular, pain is a clinically relevant short-term complication that also reduces long-term patient satisfaction. Rare complications are urticaria, contact dermatitis at the site of application of the photosensitizer, and erosive pustular dermatosis. Debated is the relationship between PDT and carcinogenesis: the eruptive appearance of squamous cell carcinoma (SCC) in previously treated areas has been correlated to a condition of local and/or systemic immunosuppression or to the selection of PDT-resistant SCC. Here we review the literature, with particular emphasis to the pathogenic hypotheses underlying these observations.
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12
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Park SM, Li T, Wu S, Li WQ, Weinstock M, Qureshi AA, Cho E. Niacin intake and risk of skin cancer in US women and men. Int J Cancer 2017; 140:2023-2031. [PMID: 28152570 PMCID: PMC5937269 DOI: 10.1002/ijc.30630] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 01/13/2017] [Indexed: 12/20/2022]
Abstract
A recent clinical trial found a protective role of niacinamide, a derivative of niacin, against skin cancer recurrence. However, there is no epidemiologic study to assess the association between niacin intake and risk of skin cancer [basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma]. We prospectively evaluated whether total, dietary and supplemental niacin intake was associated with skin cancer risk based on 72,308 women in the Nurses' Health Study (1984-2010) and 41,808 men in the Health Professionals Follow-up Study (1986-2010). Niacin intake was assessed every 2 to 4 years during follow-up and cumulative averaged intake. Cox proportional hazard models were used to compute the hazard ratios (HR) and 95% confidence intervals (CI) and cohort-specific results were pooled using a random-effects model. During the follow-up, we documented 23,256 BCC, 2,530 SCC and 887 melanoma cases. Total niacin intake was inversely associated with SCC risk; the pooled HR for top vs. bottom quintiles was 0.84 (95% CI = 0.74-0.95; ptrend = 0.08). However, there were a marginally positive association between total niacin intake and BCC risk; the pooled HR for top versus bottom quintiles was 1.05 (95% CI = 1.01-1.10; ptrend < 0.01). Higher total niacin intake was also marginally positively associated with melanoma risk in men, but not in women. The results were similar in stratified analyses according to sun exposure related factors and by body location of melanoma and SCC. Our study supports a potential beneficial role of niacin intake in relation to SCC but not of BCC or melanoma.
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Affiliation(s)
- Sang Min Park
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Tricia Li
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Shaowei Wu
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wen-Qing Li
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Martin Weinstock
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
- Department of Veterans Affairs Medical Center, Center for Dermatoepidemiology, Providence, RI
- Department of Dermatology, Rhode Island Hospital, Providence, RI
| | - Abrar A. Qureshi
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
- Department of Dermatology, Rhode Island Hospital, Providence, RI
| | - Eunyoung Cho
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
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13
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Abstract
A well-established link between ultraviolet exposure and the carcinogenesis of keratinocyte carcinomas exists. Despite increased sun protection efforts, skin cancer remains the most common cancer in the USA. Numerous studies on the topic of chemoprevention investigate alternative topical, oral, and injectable agents to reduce skin cancer incidence in those at risk. Such agents include sunscreen, numerous vitamins and minerals, difluoromethylornithine, non-steroidal anti-inflammatory drugs, various peptides, field therapy, statins, and polyphenols. In this focused review, we discuss the risks and benefits of chemoprotective agents reported in clinical studies conducted in humans. We report several agents that may reduce skin cancer incidence in those at risk.
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14
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Tuong W, Kuo S, Sivamani RK. Photoprotective effect of botanicals and vitamins: A systematic review of clinical trials. J DERMATOL TREAT 2015; 26:558-70. [PMID: 25865615 DOI: 10.3109/09546634.2015.1027647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Overexposure to solar radiation is a major contributor to skin cancer development and premature skin aging. Botanical extracts and vitamins may represent novel photoprotective agents. OBJECTIVE We sought to systemically review clinical evidence for the use of botanically derived agents and vitamins as photoprotective agents. METHODS We systematically searched Embase and PubMed databases. Two independent reviewers reviewed abstracts for inclusion. Additional relevant studies were identified by a manual review of reference lists. Data from eligible studies were extracted independently and discrepancies were resolved by consensus. RESULTS A total of 51 studies met inclusion criteria. Limited available evidence indicates that several botanical agents and vitamins in topical or oral forms may have promising photoprotective effects. However, generalizability of results is limited by small sample sizes. CONCLUSION AND RELEVANCE Botanical extracts and vitamins may add to the armamentarium of sun-protective agents. Additional high-quality trials are needed to strengthen support for their use.
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Affiliation(s)
- William Tuong
- a Department of Dermatology , University of California Davis , Sacramento , CA , USA
| | - Sandy Kuo
- a Department of Dermatology , University of California Davis , Sacramento , CA , USA
| | - Raja K Sivamani
- a Department of Dermatology , University of California Davis , Sacramento , CA , USA
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Lucas RM, Norval M, Neale RE, Young AR, de Gruijl FR, Takizawa Y, van der Leun JC. The consequences for human health of stratospheric ozone depletion in association with other environmental factors. Photochem Photobiol Sci 2015; 14:53-87. [DOI: 10.1039/c4pp90033b] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ozone depletion, climate and human health.
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Affiliation(s)
- R. M. Lucas
- National Centre for Epidemiology and Population Health
- The Australian National University
- Canberra 2601
- Australia
- Telethon Kids Institute
| | - M. Norval
- Biomedical Sciences
- University of Edinburgh Medical School
- Edinburgh EH8 9AG
- UK
| | - R. E. Neale
- QIMR Berghofer Medical Research Institute
- Brisbane 4029
- Australia
| | - A. R. Young
- King's College London (KCL)
- St John's Institute of Dermatology
- London SE1 9RT
- UK
| | - F. R. de Gruijl
- Department of Dermatology
- Leiden University Medical Centre
- NL-2300 RC Leiden
- The Netherlands
| | - Y. Takizawa
- Akita University Graduate School of Medicine
- Akita Prefecture
- Japan
- National Institute for Minamata Diseases
- Kumamoto Prefecture
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Bardazzi F, Loi C, Magnano M, Burtica EC, Giordano F, Patrizi A. Methyl-aminolevulinic acid photodynamic therapy for actinic keratoses: a useful treatment or a risk factor? A retrospective study. J DERMATOL TREAT 2014; 26:168-70. [DOI: 10.3109/09546634.2014.915004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Reginato E, Wolf P, Hamblin MR. Immune response after photodynamic therapy increases anti-cancer and anti-bacterial effects. World J Immunol 2014; 4:1-11. [PMID: 25364655 PMCID: PMC4214901 DOI: 10.5411/wji.v4.i1.1] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/20/2013] [Accepted: 02/18/2014] [Indexed: 02/05/2023] Open
Abstract
Photodynamic therapy (PDT) is a clinically approved procedure for treatment of cancer and infections. PDT involves systemic or topical administration of a photosensitizer (PS), followed by irradiation of the diseased area with light of a wavelength corresponding to an absorbance band of the PS. In the presence of oxygen, a photochemical reaction is initiated, leading to the generation of reactive oxygen species and cell death. Besides causing direct cytotoxic effects on illuminated tumor cells, PDT is known to cause damage to the tumor vasculature and induce the release of pro-inflammatory molecules. Pre-clinical and clinical studies have demonstrated that PDT is capable of affecting both the innate and adaptive arms of the immune system. Immune stimulatory properties of PDT may increase its beneficial effects giving the therapy wider potential to become more extensively used in clinical practice. Be sides stimulating tumor-specific cytotoxic T-cells capable to destroy distant untreated tumor cells, PDT leads to development of anti-tumor memory immunity that can potentially prevent the recurrence of cancer. The immunological effects of PDT make the therapy more effective also when used for treatment of bacterial infections, due to an augmented infiltration of neutrophils into the infected regions that seems to potentiate the outcome of the treatment.
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Pilkington SM, Massey KA, Bennett SP, Al-Aasswad NM, Roshdy K, Gibbs NK, Friedmann PS, Nicolaou A, Rhodes LE. Randomized controlled trial of oral omega-3 PUFA in solar-simulated radiation-induced suppression of human cutaneous immune responses. Am J Clin Nutr 2013; 97:646-52. [PMID: 23364005 DOI: 10.3945/ajcn.112.049494] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Skin cancer is a major public health concern, and the majority of cases are caused by solar ultraviolet radiation (UVR) exposure, which suppresses skin immunity. Omega-3 (n-3) PUFAs protect against photoimmunosuppression and skin cancer in mice, but the impact in humans is unknown. OBJECTIVES We hypothesized that EPA-rich n-3 PUFA would abrogate photoimmunosuppression in humans. Therefore, a nutritional study was performed to assess the effect on UVR suppression of cutaneous cell-mediated immunity (CMI) reflected by nickel contact hypersensitivity (CHS). DESIGN In a double-blind, randomized controlled study, 79 volunteers (nickel-allergic women, 22-60 y old, with phototype I or II) took 5 g n-3 PUFA-containing lipid (70% EPA plus 10% DHA) or a control lipid daily for 3 mo. After supplementation, nickel was applied to 3 skin sites preexposed on 3 consecutive days to 1.9, 3.8, or 7.6 J/cm(2) of solar-simulated radiation (SSR) and to 3 unexposed control sites. Nickel CHS responses were quantified after 72 h and the percentage of immunosuppression by SSR was calculated. Erythrocyte [red blood cell (RBC)] EPA was measured by using gas chromatography. RESULTS SSR dose-related suppression of the nickel CHS response was observed in both groups. Photoimmunosuppression appeared less in the n-3 PUFA group than in the control group (not statistically significant [mean difference (95% CI): 6.9% (-2.1%, 15.9%)]). The difference was greatest at 3.8 J/cm(2) SSR [mean difference: 11% (95% CI: 0.5%, 21.4%)]. Postsupplementation RBC EPA was 4-fold higher in the n-3 PUFA group than in the control group (mean difference: 2.69% (95% CI: 2.23%, 3.14%), which confirmed the EPA bioavailability. CONCLUSION Oral n-3 PUFAs appear to abrogate photoimmunosuppression in human skin, providing additional support for their chemopreventive role; verification of study findings is required. This trial was registered at clinicaltrials.gov as NCT01032343.
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Ibbotson S. Photodynamic therapy and immunosuppression. Br J Dermatol 2012; 167:465-7. [DOI: 10.1111/j.1365-2133.2012.11189.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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