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Mansilla-Polo M, Luque-Luna M, Morgado-Carrasco D. Vitamin D and Skin Cancer: A Controversial Society. Literature Update and Review. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:679-692. [PMID: 38556198 DOI: 10.1016/j.ad.2024.03.019] [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: 12/22/2023] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Abstract
Vitamin D (VD) deficiency has been associated with various tumors. However, the association between VD and skin cancer is controversial. Although in non-melanoma skin cancer, adequate or even high levels of VD can be associated with a higher risk of developing tumors, this could be biased by the direct association between sun exposure and VD levels. Regarding melanoma, results are contradictory. Most studies analyzed state that higher levels of VD could reduce the risk of melanoma, be associated with melanomas with better prognosis and with an enhanced antitumor response, and also with fewer adverse events associated with melanoma immunotherapy. However, prospective studies of adequate methodological quality are still needed to assess the association between VD levels and its supplementation and development/prognosis in skin cancer.
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Affiliation(s)
- M Mansilla-Polo
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, España
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España; Servicio de Dermatología, Hospital de Figueres, Fundació Salut Empordà, Figueres, Girona, España.
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Slominski RM, Kim TK, Janjetovic Z, Brożyna AA, Podgorska E, Dixon KM, Mason RS, Tuckey RC, Sharma R, Crossman DK, Elmets C, Raman C, Jetten AM, Indra AK, Slominski AT. Malignant Melanoma: An Overview, New Perspectives, and Vitamin D Signaling. Cancers (Basel) 2024; 16:2262. [PMID: 38927967 PMCID: PMC11201527 DOI: 10.3390/cancers16122262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Melanoma, originating through malignant transformation of melanin-producing melanocytes, is a formidable malignancy, characterized by local invasiveness, recurrence, early metastasis, resistance to therapy, and a high mortality rate. This review discusses etiologic and risk factors for melanoma, diagnostic and prognostic tools, including recent advances in molecular biology, omics, and bioinformatics, and provides an overview of its therapy. Since the incidence of melanoma is rising and mortality remains unacceptably high, we discuss its inherent properties, including melanogenesis, that make this disease resilient to treatment and propose to use AI to solve the above complex and multidimensional problems. We provide an overview on vitamin D and its anticancerogenic properties, and report recent advances in this field that can provide solutions for the prevention and/or therapy of melanoma. Experimental papers and clinicopathological studies on the role of vitamin D status and signaling pathways initiated by its active metabolites in melanoma prognosis and therapy are reviewed. We conclude that vitamin D signaling, defined by specific nuclear receptors and selective activation by specific vitamin D hydroxyderivatives, can provide a benefit for new or existing therapeutic approaches. We propose to target vitamin D signaling with the use of computational biology and AI tools to provide a solution to the melanoma problem.
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Affiliation(s)
- Radomir M. Slominski
- Department of Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Tae-Kang Kim
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Zorica Janjetovic
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Anna A. Brożyna
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, 87-100 Torun, Poland;
| | - Ewa Podgorska
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Katie M. Dixon
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2050, Australia; (K.M.D.); (R.S.M.)
| | - Rebecca S. Mason
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2050, Australia; (K.M.D.); (R.S.M.)
| | - Robert C. Tuckey
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia;
| | - Rahul Sharma
- Department of Biomedical Informatics and Data Science, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - David K. Crossman
- Department of Genetics and Bioinformatics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Craig Elmets
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Chander Raman
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Anton M. Jetten
- Cell Biology Section, NIEHS—National Institutes of Health, Research Triangle Park, NC 27709, USA;
| | - Arup K. Indra
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Corvallis, OR 97331, USA
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrzej T. Slominski
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Pathology and Laboratory Medicine Service, Veteran Administration Medical Center, Birmingham, AL 35233, USA
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Mansilla-Polo M, Luque-Luna M, Morgado-Carrasco D. [Translated article] Vitamin D and Skin Cancer: A Controversial Society. Literature Update and Review. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00438-1. [PMID: 38823772 DOI: 10.1016/j.ad.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 06/03/2024] Open
Abstract
Vitamin D (VD) deficiency has been associated with various tumors. However, the association between VD and skin cancer is controversial. Although in non-melanoma skin cancer, adequate or even high levels of VD can be associated with a higher risk of developing tumors, this could be biased by the direct association between sun exposure and VD levels. Regarding melanoma, results are contradictory. Most studies analyzed state that higher levels of VD could reduce the risk of melanoma, be associated with melanomas with better prognosis and with an enhanced antitumor response, and also with fewer adverse events associated with melanoma immunotherapy. However, prospective studies of adequate methodological quality are still needed to assess the association between VD levels and its supplementation and development/prognosis in skin cancer.
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Affiliation(s)
- M Mansilla-Polo
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, Spain
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Servicio de Dermatología, Hospital de Figueres, Fundació Salut Empordà, Figueres, Girona, Spain.
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Dai Y, Chen Y, Pu Y, Jiang R. Circulating vitamin D concentration and risk of 14 cancers: a bidirectional Mendelian randomization study. J Cancer Res Clin Oncol 2023; 149:15457-15467. [PMID: 37642723 DOI: 10.1007/s00432-023-05322-9] [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: 07/23/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Observational studies have revealed relationships between circulating vitamin D concentrations and the risk of different types of cancer, although the potential causal relationship remains controversial. This study aims to investigate the presence of a causal relationship between circulating vitamin D concentrations and the risk of different types of cancer. METHODS Summary statistics from corresponding genome-wide association studies (GWASs) were used to investigate the causal relationship between circulating vitamin D concentrations and the risk of 14 cancers. A two-sample Mendelian randomization (MR) analysis using inverse-variance weighting (IVW) as the primary method was performed. Additionally, the results were verified using four other methods, including MR-Egger, weighted median, weighted mode, and simple mode. Multiple sensitivity analyses were conducted to ensure the robustness of our MR findings. RESULTS The MR analysis showed no causal relationship between circulating vitamin D concentrations and most types of cancer, except for a causal relationship with melanoma skin cancer (MSC) (odds ratio [OR]IVW = 1.003, 95% confidence intervals [CI] 1.001-1.005, P = 0.004). Conversely, reverse MR revealed a causal relationship between circulating vitamin D concentration and colorectal cancer (ORIVW = 0.398, 95% CI 0.195-0.813, P = 0.01; ORweighted median = 0.352, 95% CI 0.135-0.917, P = 0.03). CONCLUSIONS Our findings provide support for a causal relationship between circulating vitamin D concentration and risk of MSC. Additionally, we found a causal relationship between circulating vitamin D concentration and risk of colorectal cancer in reverse-MR analysis. This evidence indicate that vitamin D is of great significance in the prevention and treatment of MSC and the prognosis of colorectal cancer.
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Affiliation(s)
- Yuxuan Dai
- Department of Plastic Surgery, The Third Bethune Hospital of Jilin University, Changchun, 130000, China
| | - Yu Chen
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China
| | - Yifu Pu
- Laboratory of Genetic Metabolic Diseases and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Rui Jiang
- Department of Orthopedics, The Third Bethune Hospital of Jilin University, Erdao District, 126 Xiantai Street, Changchun, 130000, Jilin, China.
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Chen X, Song S, Shi J, Wang Z, Song W, Wang J, Wang G, Wang X. Evaluating the effect of body mass index and 25-hydroxy-vitamin D level on basal cell carcinoma using Mendelian randomization. Sci Rep 2023; 13:16552. [PMID: 37783777 PMCID: PMC10545741 DOI: 10.1038/s41598-023-43926-w] [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: 03/11/2023] [Accepted: 09/30/2023] [Indexed: 10/04/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common cancer with a rising incidence among white-skinned individuals. A number of epidemiological studies have suggested that obesity and serum 25-hydroxy-vitamin D (25(OH)D) levels may affect the arising of BCC. To address this, we selected 443 and 96 single nucleotide polymorphisms (SNPs) associated with body mass index (BMI) and serum level of 25(OH)D from large-scale genome-wide association studies (GWAS), respectively. The univariable and multivariable two-sample Mendelian randomization (MR) analyses were conducted with a series of sensitivity analyses to ensure the results were reliable and reproducible. The results of univariable two-sample MR analysis showed that higher BMI was related to lower risk for BCC (Odds ratio(OR) = 0.90; 95% confidence interval (CI),[0.81,0.99]; p = 0.02). In addition, this causal effect of BMI on BCC still remained (OR = 0.88; 95%CI,[- 0.22, - 0.03], p-value = 0.008) after adjusting for 25(OH)D level in the multivariable MR analysis. However, the results suggested that 25(OH)D level was not associated with BCC(OR = 1.02; 95%CI, [0.94,1.09], p-value = 0.67). In conclusion, similar to the conclusions of retrospective observational studies, the MR results indicate that high BMI is an independent protective factor for BCC. Meanwhile, vitamin D levels may not be causally associated with the risk of basal cell carcinoma and increasing vitamin D supplementation is unlikely to reduce the risk.
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Affiliation(s)
- Xuezhao Chen
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Shan Song
- Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinyu Shi
- Shanxi Medical University, Taiyuan, China
- Department of Breast Surgery, The Fifth Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhiyao Wang
- Department of Clinical Medical College, Shanxi Datong University, Datong, China
| | - Wenyu Song
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Jiaxin Wang
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Guoyan Wang
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Xiaobing Wang
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China.
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Hyeraci M, Papanikolau ES, Grimaldi M, Ricci F, Pallotta S, Monetta R, Minafò YA, Di Lella G, Galdo G, Abeni D, Fania L, Dellambra E. Systemic Photoprotection in Melanoma and Non-Melanoma Skin Cancer. Biomolecules 2023; 13:1067. [PMID: 37509103 PMCID: PMC10377635 DOI: 10.3390/biom13071067] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Non-melanoma skin cancers (NMSCs), which include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and actinic keratosis (AK), are the most common cancer diseases in the Caucasian race. If diagnosed late and improperly treated, BCC and SCC can become locally advanced and metastasize. Malignant melanoma (MM) is less frequent but more lethal than NMSC. Given the individual and social burdens of skin cancers, performing an adequate prevention is needed. Ultraviolet (UV) ray exposure is one of the main risk factors for skin cancer. Thus, the first-choice prevention strategy is represented by photoprotection that can be both topical and systemic. The latter consists of the oral administration of molecules which protect human skin against the damaging effects of UV rays, acting through antioxidant, anti-inflammatory, or immunomodulator mechanisms. Although several compounds are commonly used for photoprotection, only a few molecules have demonstrated their effectiveness in clinical trials and have been included in international guidelines for NMSC prevention (i.e., nicotinamide and retinoids). Moreover, none of them have been demonstrated as able to prevent MM. Clinical and preclinical data regarding the most common compounds used for systemic photoprotection are reported in this review, with a focus on the main mechanisms involved in their photoprotective properties.
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Affiliation(s)
- Mariafrancesca Hyeraci
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131Padua, Italy
| | | | - Marta Grimaldi
- Department of Medical and Surgical Sciences, Division of Dermatology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Ricci
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Sabatino Pallotta
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Rosanna Monetta
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Ylenia Aura Minafò
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Giovanni Di Lella
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Giovanna Galdo
- Dermatology Unit, AORN San Giuseppe Moscati, 83100 Avellino, Italy
| | - Damiano Abeni
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Elena Dellambra
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy
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Abdelwahab R, Huang R, Potla S, Bhalla S, AlQabandi Y, Nandula SA, Boddepalli CS, Gutlapalli SD, Lavu VK, Mohammed L. The Relationship between Vitamin D and Basal Cell Carcinoma: A Systematic Review. Cureus 2022; 14:e29496. [PMID: 36312675 PMCID: PMC9595244 DOI: 10.7759/cureus.29496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/23/2022] [Indexed: 11/14/2022] Open
Abstract
This systematic review studies the relationship between vitamin D serum levels and basal cell carcinoma (BCC). The primary source of vitamin D is sunlight exposure. Recently, an increase in the intake of vitamin D supplements has been noticed. The protective value of vitamin D is well established and has been studied several times for the health of the bones, cartilage, growth, various dermatological diseases, and also as a chemoprotective agent against several cancers. On the scientific front, it has yet to be established that increasing serum vitamin D levels increase the incidence of BCC. We included reports that investigated this relationship in this review. We applied keywords in published papers in PubMed, ScienceDirect, Cochrane, and Google Scholar to find relevant studies. After applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist and the quality appraisal for 68 records, we included only ten studies. In these studies, serum levels of vitamin D were measured. Five of them supported the link between BCC incidence and development and high serum vitamin D levels (e.g., Mahamat-Saleh Y, et al.), while the other five did not (e.g., Tang JY, et al.). We included only two studies that investigated the vitamin D receptor (VDR) polymorphism. Experts debate adding a high dose of vitamin D supplements to our daily routine. After studying most of the reports, it was ascertained that the literature supports keeping vitamin D serum levels below 30-60 nmol/L. However, further studies should be done to help find a healthy balance of vitamin D serum levels, especially when it comes to increasing the risk of cancer like BCC.
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Exposome and Skin. Part 2. The Influential Role of the Exposome, Beyond UVR, in Actinic Keratosis, Bowen's Disease and Squamous Cell Carcinoma: A Proposal. Dermatol Ther (Heidelb) 2022; 12:361-380. [PMID: 35112326 PMCID: PMC8850498 DOI: 10.1007/s13555-021-00644-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Indexed: 02/07/2023] Open
Abstract
Actinic keratosis (AK) is the main risk factor for the development of cutaneous invasive squamous cell carcinoma (SCC). It represents the first sign of severe chronic ultraviolet radiation exposure, which has a clear significant effect. Nevertheless, the skin is exposed to many other exposome factors which should be thoroughly considered. Our aim was to assess the impact of exposome factors other than ultraviolet radiation (UVR) on the etiopathology of AK and Bowen's disease (BD) and progression of AK to SCC and to design tailored prevention strategies. We performed an exhaustive literature search in September 2021 through PubMed on the impact of exposome factors other than UVR on AK, BD and SCC. We conducted several parallel searches combining terms of the following topics: AK, BD, SCC and microbiome, hormones, nutrition, alcohol, tobacco, viral infections, chemical contaminants and air pollution. Notably, skin microbiome studies have shown how Staphylococcus aureus infections are associated with AK and AK-to-SCC progression by the production of chronic inflammation. Nutritional studies have demonstrated how a caloric restriction in fat intake, oral nicotinamide and moderate consumption of wine significantly reduce the number of premalignant keratoses and SCC. Regarding lifestyle factors, both alcohol and smoking are associated with the development of SCC in a dose-dependent manner. Relevant environmental factors are viral infections and chemical contaminants. Human papillomavirus infections induce deregulation of cellular proliferation and are associated with AK, BD and SCC. In addition to outdoor jobs, occupations such as industrial processing and farming also increase the risk of developing keratoses and SCC. The exposome of AK will undoubtedly help the understanding of its etiopathology and possible progression to SCC and will serve as a basis to design tailored prevention strategies.
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Abstract
Nonmelanoma skin cancer (NMSC), the most widely diagnosed cancer in the United States, is rising in incidence despite public health and educational campaigns that highlight the importance of sun avoidance. It is,therefore, important to establish other modifiable risk factors that may be contributing to this increase. There is a growing body of evidence in the literature suggesting certain nutrients may have protective or harmful effects on NMSC. We review the current literature on nutrition and its effect on NMSC with a focus on dietary fat, vitamin A, nicotinamide, folate, vitamin C, vitamin D, vitamin E, polyphenols, and selenium.
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Affiliation(s)
- Victoria Stoj
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Neda Shahriari
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Kimberly Shao
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.
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Morgado-Águila C, Gil-Fernández G, Dávila-Villalobos OR, Pérez-Rey J, Rey-Sánchez P, Rodríguez-Velasco FJ. Vitamin D serum levels and non-melanoma skin cancer risk. PeerJ 2021; 9:e12234. [PMID: 34631325 PMCID: PMC8475539 DOI: 10.7717/peerj.12234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background Skin cancer is one of the common malignancies. There is sufficient evidence that sunlight (ultraviolet radiation) contributes to the development of skin cancer, but there is also evidence that relates adequate serum levels of vitamin D produced on the skin by the action of ultraviolet radiation with the decreased risk of various types of cancers, including skin cancer. The aim of this study was to investigate the association of vitamin D serum levels among patients with non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma) and controls. Methods A prospective observational case-control study was conducted in a sample of 84 subjects in Extremadura (Spain). Forty-one patients with histologically diagnosed basal cell carcinomas and squamous cell carcinomas and 43 healthy controls were randomly chosen to assess whether vitamin D (25(OH)D3) serum level, age and sex were related to non-melanoma skin cancer and to determine the possible risk of this type of skin cancer for these variables. Results When analysing serum vitamin D levels, we ensured that all our subjects, both cases and controls, had normal or low serum vitamin D levels, even though the samples were taken during months with the highest solar irradiance in our region. It is striking in our results that there was a higher percentage of subjects with deficits of vitamin D who did not have skin cancer (66%) than patients with deficits with these types of skin cancers (34%). When adjusting the model for age and sex, vitamin D values above 18 ng/ml increased the risk of suffering from non-melanoma skin cancer by nearly 7-fold (aOR: 6.94, 95% CI [1.55-31.11], p = 0.01). Conclusions Despite the controversial data obtained in the literature, our results suggest that lower levels of vitamin D may be related to a reduced incidence of non-melanoma skin cancer.
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Affiliation(s)
- Carolina Morgado-Águila
- Department of Plastic and Reconstructive Surgery, Cáceres University Hospital Complex, Extremadura Health Service, Cáceres, Extremadura, Spain
| | - Guadalupe Gil-Fernández
- Department of Nursing, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Extremadura, Spain
| | - Orlando Rafael Dávila-Villalobos
- Department of Gynecology and Obstetrics, Cáceres University Hospital Complex, Extremadura Health Service, Cáceres, Extremadura, Spain
| | - Jesús Pérez-Rey
- Department of Public Health, Extremadura Health Service, Extremadura Health Service, Cáceres, Extremadura, Spain
| | - Purificación Rey-Sánchez
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, Extremadura, Spain
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Vitamin D and the Risk of Non-Melanoma Skin Cancer: A Systematic Literature Review and Meta-Analysis on Behalf of the Italian Melanoma Intergroup. Cancers (Basel) 2021; 13:cancers13194815. [PMID: 34638299 PMCID: PMC8508211 DOI: 10.3390/cancers13194815] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/23/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Vitamin D has been extensively studied in relation to cancer risk at several body sites, but its relationship with non-melanoma skin cancer (NMSC), the most frequent malignancy in humans, is still unclear. Here, we performed a systematic literature search and meta-analysis of published studies and did not find convincing evidence that a causal association exists between vitamin D intake (from foods and supplements), vitamin D blood concentration, or polymorphisms of the genes coding for the vitamin D receptor and binding protein, and NMSC risk. Abstract We aimed to provide a comprehensive overview of the link between vitamin D and non-melanoma skin cancer (NMSC). For this purpose, we conducted a systematic literature review (updated to 3 February 2021) and meta-analysis of the studies reporting on the association between vitamin D intake (from diet and supplements) and blood concentration, polymorphisms of the vitamin D receptor (VDR) and vitamin D binding protein (VDBP) genes, and the risk of NMSC. Random effects meta-analysis models were fitted to merge study-specific risk estimates into summary relative risk (SRR) and corresponding 95% confidence intervals (CI). Twenty-four studies altogether were included. There was a suggestive association between increasing serum/plasma vitamin D concentration and NMSC risk (SRR for highest vs. lowest concentration 1.67, 95%CI 0.61–4.56), although with large heterogeneity across studies (I2 = 91%). NMSC risk was associated with highest vitamin D intake in observational studies but not in clinical trials. Finally, there was no significant association between any polymorphism of the VDR and VDBP genes and NMSC risk. In conclusion, no strong relationship between vitamin D metabolism and NMSC risk appears to exist according to our systematic review and meta-analysis, although some findings are worthy of further investigation.
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Lee HJ, Kim CO, Lee DC. Association between Daily Sunlight Exposure and Fractures in Older Korean Adults with Osteoporosis: A Nationwide Population-Based Cross-Sectional Study. Yonsei Med J 2021; 62:593-599. [PMID: 34164956 PMCID: PMC8236351 DOI: 10.3349/ymj.2021.62.7.593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/07/2021] [Accepted: 04/19/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE We aimed to investigate the association between daily sunlight exposure duration and fractures in older Korean adults with osteoporosis. MATERIALS AND METHODS We utilized data from the 2008-2011 Korea National Health and Nutrition Examination Survey. Osteoporosis was diagnosed based on a T-score of ≤-2.5 using dual energy X-ray absorptiometry. The duration of daily sunlight exposure and fracture were assessed via intensive health interviews by trained staff using standardized health questionnaires. Fracture was defined as one or more fractures of the femur, wrist, and spine. RESULTS A total of 638 patients with osteoporosis aged ≥65 years were included. The odds ratio (OR) of total fractures was 0.55 times lower in the group with ≥5 h of daily sunlight exposure than in the group with <5 h of exposure after adjusting for age, sex, family history of osteoporosis or fracture, body mass index, bone mineral density of the femoral neck, serum 25-hydroxyvitamin D, current smoking, alcohol intake, daily calcium intake, and physical activity [95% confidence interval (CI) 0.31-0.97, p=0.040]. In patients with vitamin D insufficiency, the OR of total fracture was 0.52 times lower in the group with ≥5 h of daily sunlight exposure than in the group with less exposure after adjusting the above variables (95% CI 0.28-0.97, p=0.041). CONCLUSION Sunlight exposure for ≥5 h a day was significantly associated with a decreased OR of fracture in older Korean adults with osteoporosis. This association was also significant in patients with vitamin D insufficiency.
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Affiliation(s)
- Hye Jun Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Choon Ok Kim
- Department of Clinical Pharmacology, Severance Hospital, Yonsei University Health System, Seoul, Korea.
| | - Duk Chul Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea.
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13
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Abstract
PRECIS In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk. PURPOSE The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG. METHODS We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude. RESULTS In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04). CONCLUSION NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.
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14
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Vornicescu C, Ungureanu L, Șenilă SC, Vesa ȘC, Cosgarea R, Baican CI, Mihu MC. Assessment of sun-related behavior and serum vitamin D in basal cell carcinoma: Preliminary results. Exp Ther Med 2020; 20:187. [PMID: 33101477 PMCID: PMC7579778 DOI: 10.3892/etm.2020.9317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022] Open
Abstract
Ultraviolet radiation (UV), mainly from sunlight, is the main risk factor of the most common human skin cancer, basal cell carcinoma (BCC). A positive effect of UV on the skin is its contribution to the synthesis of vitamin D, which is important in sustaining general health, but having high levels of vitamin D is considered a risk factor for BCC. However, vitamin D receptor has antagonistic effects to UV radiation in regulating Sonic Hedgehog pathway. This is a pilot study aimed at characterizing the sun-related behavior and vitamin D status of 52 BCC patients and 59 controls from our geographical area. Patients were included in 4 subgroups: Single, multiple, recurrent, and both multiple and recurrent BCCs. Patients, more than controls, had at least one sunburn in childhood and lentigines (P<0.001). Also, they spent daily, on average, more time in the sun than controls (P<0.001) (3.00-8.00 and 1.50-4.00 h respectively). Outdoor work was similar in both groups. Participants had lower vitamin D serum levels than expected. Due to the small number of cases, no statistically significant differences were found between the subgroups but some tendencies were noted. Patients with only one recurrent BCC had less sunburns than the ones who also developed tumors at multiple sites (P=0.2). Patients with multiple and recurrent tumors had slightly lower vitamin D levels compared with single BCC patients (P=0.1) although they used more vitamin D supplements after the BCC diagnosis (P=0.2). Having a diagnosis of BCC, made patients more compliant to the use of sunscreen cream, but even so, half of them still did not use it. In conclusion, more effort should be invested in sun-related education and public health actions should focus on vitamin D deficiencies.
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Affiliation(s)
- Corina Vornicescu
- Department of Morphological Sciences-Histology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Loredana Ungureanu
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Simona Corina Șenilă
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.,Department of Dermatology, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Rodica Cosgarea
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Corina Iulia Baican
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.,Department of Dermatology, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Mihaela Carmen Mihu
- Department of Morphological Sciences-Histology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.,Department of Radiology, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
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15
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Mahamat-Saleh Y, Aune D, Schlesinger S. 25-Hydroxyvitamin D status, vitamin D intake, and skin cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Sci Rep 2020; 10:13151. [PMID: 32753685 PMCID: PMC7403339 DOI: 10.1038/s41598-020-70078-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/14/2020] [Indexed: 02/06/2023] Open
Abstract
Sun exposure is a major environmental risk factor for skin cancers and is also an important source of vitamin D. However, while experimental evidence suggests that vitamin D may have a protective effect on skin cancer risk, epidemiologic studies investigating the influence of 25-hydroxyvitamin D (25(OH)D) level and/or vitamin D intake on skin cancer risk are conflicting. A systematic review and dose–response meta-analyses of prospective studies was conducted to clarify these associations. Relevant studies were identified by searching the PubMed database up to 30th August 2019. Random effects dose–response meta-analyses were used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs). Overall, thirteen prospective studies were included. Circulating level of 25(OH)D was associated with higher risks of melanoma (SRR (95% CI) per 30 nmol = 1.42 (1.17–1.72)) and keratinocyte cancer (KC) (SRR (95% CI) per 30 nmol/L = 1.30 (1.13–1.49)). The SRR (95% CI) per 30 nmol/L increase in 25(OH) D level was 1.41 (1.19–1.67), and 1.57 (0.64–3.86), for basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), respectively. However, while we found that vitamin D intake (from diet, supplemental and total) was not associated with risks of melanoma and SCC, vitamin D intake was associated with slightly increased BCC risk, albeit with no heterogeneity across skin cancer type. This meta-analysis suggests positive associations between circulating 25(OH)D level and risk of melanoma and KC, however, this finding is most likely confounded by sun exposure. We found no associations between vitamin D intake skin cancers, except positive associations with BCC risk.
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Affiliation(s)
- Yahya Mahamat-Saleh
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris Saclay, 94 805, Villejuif, France. .,Inserm U1018, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Department of Nutrition, Bjørknes University College, Oslo, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research At Heinrich Heine University, Düsseldorf, Germany
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16
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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: 6] [Impact Index Per Article: 1.5] [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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17
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Hosseini MS, Salarvand F, Ehsani AH, Noormohammadpour P, Azizzadeh S, Mousavi M, Morsali M. Relationship Between Level of Serum 25-Hydroxyvitamin D and Risk of Squamous Cell Carcinoma in an Iranian Population. Dermatol Pract Concept 2019; 9:278-282. [PMID: 31723461 DOI: 10.5826/dpc.0904a06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 10/31/2022] Open
Abstract
Background The relationship between vitamin D and skin squamous cell carcinoma (SCC) is not well defined. Objective To investigate the relationship between vitamin D levels and the incidence of skin SCC for the first time in Iran. Methods and Study Design In this case-control study, 126 subjects were enrolled (63 in each group) out of referents to Razi Skin Hospital in Tehran in 2014. The risk factors for cancer gathered by self-reported questionnaires and blood samples were obtained to measure the level of 25-hydroxyvitamin D. Multivariate logistic regression was used to neutralize the effect of confounding factors. Results Cases of SCC were more likely to be in men, older than 49 years and working in an outdoor environment, and with longtime exposure to sunlight and a personal history of skin cancers. Family history of skin cancer and of cigarette smoking were not significantly related to SCC. In the SCC and control groups, 69.8% and 31.7%, respectively, had sufficient levels of vitamin D (P < 0.001). Mean level of 25-hydroxyvitamin D was 40.99 ng/mL in the SCC group and 26.34 ng/mL in the control group (P < 0.05). In the unadjusted model, the level of vitamin D as a continuous variable was positively related to SCC risk. In the adjusted model, vitamin D did not independently predict the likelihood of SCC. Conclusion Vitamin D level and SCC risk are directly related, although not in an independent fashion. Indeed, this relation is severely confounded by exposure to sunlight, which was evidenced by an increased vitamin D level in the people working outside and the higher prevalence of SCC in the same population.
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Affiliation(s)
- Mahboobeh-Sadat Hosseini
- Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fereshteh Salarvand
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Houshang Ehsani
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Noormohammadpour
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Azizzadeh
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohaddese Mousavi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Morsali
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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18
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Passeron T, Bouillon R, Callender V, Cestari T, Diepgen TL, Green AC, van der Pols JC, Bernard BA, Ly F, Bernerd F, Marrot L, Nielsen M, Verschoore M, Jablonski NG, Young AR. Sunscreen photoprotection and vitamin D status. Br J Dermatol 2019; 181:916-931. [PMID: 31069788 PMCID: PMC6899926 DOI: 10.1111/bjd.17992] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 12/16/2022]
Abstract
Background Global concern about vitamin D deficiency has fuelled debates on photoprotection and the importance of solar exposure to meet vitamin D requirements. Objectives To review the published evidence to reach a consensus on the influence of photoprotection by sunscreens on vitamin D status, considering other relevant factors. Methods An international panel of 13 experts in endocrinology, dermatology, photobiology, epidemiology and biological anthropology reviewed the literature prior to a 1‐day meeting in June 2017, during which the evidence was discussed. Methods of assessment and determining factors of vitamin D status, and public health perspectives were examined and consequences of sun exposure and the effects of photoprotection were assessed. Results A serum level of ≥ 50 nmol L−1 25(OH)D is a target for all individuals. Broad‐spectrum sunscreens that prevent erythema are unlikely to compromise vitamin D status in healthy populations. Vitamin D screening should be restricted to those at risk of hypovitaminosis, such as patients with photosensitivity disorders, who require rigorous photoprotection. Screening and supplementation are advised for this group. Conclusions Sunscreen use for daily and recreational photoprotection does not compromise vitamin D synthesis, even when applied under optimal conditions. What's already known about this topic? Knowledge of the relationship between solar exposure behaviour, sunscreen use and vitamin D is important for public health but there is confusion about optimal vitamin D status and the safest way to achieve this. Practical recommendations on the potential impact of daily and/or recreational sunscreens on vitamin D status are lacking for healthy people.
What does this study add? Judicious use of daily broad‐spectrum sunscreens with high ultraviolet (UV) A protection will not compromise vitamin D status in healthy people. However, photoprotection strategies for patients with photosensitivity disorders that include high sun‐protection factor sunscreens with high UVA protection, along with protective clothing and shade‐seeking behaviour are likely to compromise vitamin D status. Screening for vitamin D status and supplementation are recommended in patients with photosensitivity disorders.
Linked Comment: https://doi.org/10.1111/bjd.18126. https://doi.org/10.1111/bjd.18494 available online
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Affiliation(s)
- T Passeron
- Department of Dermatology, CHU Nice, Université Côte d'Azur, CHU Nice, 151, route de Ginestière, 06200, Nice, France.,C3M, INSERM U1065 Université Côte d'Azur, 151, route de Ginestière, 06200, Nice, France
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Gasthuisberg, 3000, Leuven, Belgium
| | - V Callender
- Callender Dermatology & Cosmetic Center, 12200 Annapolis Road, Suite 315, Glenn Dale, MD, 20769, U.S.A
| | - T Cestari
- Federal University of Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Ramiro Barcellos 2350 zone 13, Porto Alegre, RS, 90035-903, Brazil
| | - T L Diepgen
- Department of Clinical Social Medicine, University of Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany
| | - A C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia.,CRUK Manchester Institute and Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, M13 9NQ, U.K
| | - J C van der Pols
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - B A Bernard
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - F Ly
- Faculty of Medicine, Pharmacy and Odontology, University Cheikh Anta Diop of Dakar, BP 5825, Dakar, Senegal
| | - F Bernerd
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - L Marrot
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - M Nielsen
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - M Verschoore
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - N G Jablonski
- Department of Anthropology, The Pennsylvania State University, 409 Carpenter Building, University Park, PA, 16802, U.S.A
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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19
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Abstract
Although first discovered in 1931, vitamin D has seen an increased interest in the scientific community over the past decades, including the dermatology field. Vitamin D promotes calcium and phosphorus absorption; however, the actions of vitamin D are not confined to bone. Indeed, there is now overwhelming and compelling scientific data that vitamin D plays a crucial role in a plethora of cellular function and in extra-skeletal health. Except for fatty fish livers, very few foods naturally contain vitamin D; and the major source of vitamin D comes from skin exposure to sunlight via ultraviolet B. Keratinocytes are unique in the body as not only do they provide the primary source of vitamin D for the body, but they also possess both the enzymatic machinery to metabolize the vitamin D produced to active metabolites. This has been referred to as the photoendocrine vitamin D system. Vitamin D regulates keratinocytes proliferation and differentiation; and plays a role in the defense against opportunistic infections. Multiple factors are linked to vitamin D status; and a growing number of dermatologic diseases has been linked to vitamin D status such as atopic dermatitis, psoriasis, vitiligo, and cutaneous cancers. In this article, we reviewed the potential determinants of vitamin D status, as its implications in dermatologic diseases.
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Affiliation(s)
- Christina Bergqvist
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France
| | - Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France - .,EA 7379 EpidermE, Université Paris-Est Créteil, Créteil, France
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20
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Çerman AA, Karabay EA, Altunay IK, Cesur SK. Vitamin D levels in actinic keratosis: a preliminary study. An Bras Dermatol 2018; 93:535-538. [PMID: 30066760 PMCID: PMC6063125 DOI: 10.1590/abd1806-4841.20186999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/23/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Recent studies that investigated the effect of vitamin D on skin cancer risk have exhibited inconsistent results. OBJECTIVE The aim of the study was to evaluate vitamin D status in patients with actinic keratosis. METHODS A cross-sectional study was conducted on 31 patients with actinic keratosis and 29 healthy controls. Serum vitamin D levels in the study group were determined by liquid chromatography/tandem mass spectrometry. RESULTS Serum 25(OH)D levels in patients with actinic keratosis were significantly higher than those of the healthy controls (P=0.04). Prevalence of 25(OH)D deficiency was significantly higher in the healthy controls (75.9%) compared to the patients with actinic keratosis (54.8%), but the difference was not statistically significant (P= 0.09). STUDY LIMITATIONS The cross-sectional design of the study, data on smoking based on patient self-report, and subjects' different dietary habits, which can influence 25(OH)D levels, are the study's limitations. CONCLUSION Serum vitamin D level can be used as a marker for ultraviolet B radiation from sun exposure; therefore, it can be used in individuals at risk of actinic keratosis. Oral intake of vitamin D through diet or supplements is proposed instead of prolonged ultraviolet exposure to maintain adequate vitamin D serum levels. Further research is needed to elucidate the role of vitamin D in skin carcinogenesis.
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Affiliation(s)
- Aslı Aksu Çerman
- Department of Dermatology and Venereology, Şişli
Hamidiye Etfal Training and Research Hospital, Health Science University, Istanbul,
Turkey
| | - Ezgi Aktaş Karabay
- Department of Dermatology and Venereology, Faculty of Medicine,
Bahçeşehir University, Istanbul, Turkey
| | - Ilknur Kivanc Altunay
- Department of Dermatology and Venereology, Şişli
Hamidiye Etfal Training and Research Hospital, Health Science University, Istanbul,
Turkey
| | - Seher Küçükoğlu Cesur
- Department of Dermatology and Venereology, Medicalpark
Bahçelievler Hospital, Istanbul, Turkey
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21
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Winsløw U, Nordestgaard B, Afzal S. High plasma 25-hydroxyvitamin D and high risk of nonmelanoma skin cancer: a Mendelian randomization study of 97 849 individuals. Br J Dermatol 2018; 178:1388-1395. [DOI: 10.1111/bjd.16127] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- U.C. Winsløw
- Department of Clinical Biochemistry and the Copenhagen General Population Study; Herlev and Gentofte Hospital; Copenhagen University Hospital; Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - B.G. Nordestgaard
- Department of Clinical Biochemistry and the Copenhagen General Population Study; Herlev and Gentofte Hospital; Copenhagen University Hospital; Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - S. Afzal
- Department of Clinical Biochemistry and the Copenhagen General Population Study; Herlev and Gentofte Hospital; Copenhagen University Hospital; Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
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22
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Chen ST, Li X, Han J. Personal history of non-melanoma skin cancer diagnosis and death from melanoma in women. Int J Cancer 2017; 142:1536-1541. [PMID: 29171018 DOI: 10.1002/ijc.31176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/17/2017] [Accepted: 11/21/2017] [Indexed: 11/07/2022]
Abstract
Melanoma incidence is increasing. We evaluated risk of melanoma death after diagnosis of non-melanoma skin cancer (NMSC). We followed 77,288 female American nurses from the Nurses' Health Study from 1986 to 2012. We used Cox proportional hazards models to determine the hazard ratio (HR) of lethal and non-lethal melanoma diagnosis and melanoma death, according to personal NMSC history. Among melanoma cases, we examined the HR of melanoma death and the odds ratio (OR) of melanoma with a Breslow thickness ≥0.8 mm or Clark's levels of IV and V according to history of NMSC. We documented 930 melanoma cases without NMSC history and 615 melanoma cases with NMSC history over 1.8 million person-years. The multivariate-adjusted HR (95% confidence interval) of melanoma death associated with personal history of NMSC was 2.89 (1.85-4.50). Women with history of NMSC were more likely to develop non-lethal melanoma than lethal melanoma (HR (95% CI): 2.31 (2.05-2.60) vs. 1.74 (1.05-2.87)). Among melanoma cases, women with history of NMSC had a non-significant decreased risk of melanoma deaths (0.87 (0.55-1.37)), Breslow thickness ≥0.8 mm (0.85 (0.59-1.21)) and Clark's levels IV and V (0.81(0.52-1.24)). Women with NMSC history were less likely to be diagnosed with a lethal melanoma than a non-lethal melanoma, but overall rate of melanoma diagnosis was increased in both subtypes, leading to the increased risk of melanoma death. Our findings suggest the continued need for dermatologic screening for patients after NMSC diagnosis, given increased melanoma risk. Early detection among NMSC patients may decrease deaths from melanoma.
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Affiliation(s)
- Steven T Chen
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Xin Li
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN.,Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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23
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Park SM, Li T, Wu S, Li WQ, Qureshi AA, Cho E. Vitamin D Intake and Risk of Skin Cancer in US Women and Men. PLoS One 2016; 11:e0160308. [PMID: 27557122 PMCID: PMC4996491 DOI: 10.1371/journal.pone.0160308] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 07/18/2016] [Indexed: 12/22/2022] Open
Abstract
Previous studies suggested a protective effect of vitamin D against skin cancer development. However, epidemiologic studies on orally taken vitamin D and risk of skin cancer (basal cell carcinoma [BCC], squamous cell carcinoma [SCC], and melanoma) are few. We prospectively evaluated whether total, dietary and supplemental vitamin D intake were associated with skin cancer risk based on 63,760 women in the Nurses' Health Study (1984–2010) and 41,530 men in the Health Professionals Follow-up Study (1986–2010). Dietary information on vitamin D intake was assessed every 2 to 4 years during the follow-up and cumulative averaged intake was used. We used Cox proportional hazard models to compute the hazard ratios (HR) and 95% confidence intervals (CI). Pooled HR of cohort-specific results were calculated using a random-effects model. During the follow-up, we documented 20,840 BCC, 2,329 SCC and 1,320 melanoma cases. Vitamin D consumption was not associated with the risk of SCC or melanoma but was modestly positively associated with BCC; the pooled HRs of BCC for extreme quintiles of vitamin D intake were 1.10 (95%CI = 1.05–1.15; Ptrend = 0.05) for total vitamin D and 1.13 (95% CI = 1.07 to 1.20; Ptrend <0.01) for dietary vitamin D. Stratified analysis according to sun exposure related factors showed similar results. In conclusion, vitamin D intake was positively associated with risk of BCC, while null associations were found with SCC and melanoma. Our data do not support a beneficial role of orally taken vitamin D on skin cancer carcinogenesis.
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Affiliation(s)
- Sang Min Park
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Family Medicine & Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Tricia Li
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, United States of America
| | - Shaowei Wu
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, United States of America
| | - Wen-Qing Li
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, United States of America
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | - Abrar A. Qureshi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, United States of America
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, United States of America
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
- * E-mail:
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Correia de Sá TR, Silva R, Lopes JM. Basal cell carcinoma of the skin (part 1): epidemiology, pathology and genetic syndromes. Future Oncol 2015; 11:3011-21. [PMID: 26449153 DOI: 10.2217/fon.15.246] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer worldwide with increasing incidence, but difficult to assess due to the current under registration practice. Despite the low mortality rate, BCC is a cause of great morbidity and an economic burden to health services. There are several risk factors that increase the risk of BCC and partly explain its incidence. Low-penetrance susceptibility alleles, as well as genetic alterations in signaling pathways, namely SHH pathway, also contribute to the carcinogenesis. BCC associate with several genetic syndromes, of which basal cell nevus syndrome is the most common.
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Affiliation(s)
| | - Roberto Silva
- Faculty of Medicine, Porto University, 4099-002 Porto, Portugal
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Consiglio M, Viano M, Casarin S, Castagnoli C, Pescarmona G, Silvagno F. Mitochondrial and lipogenic effects of vitamin D on differentiating and proliferating human keratinocytes. Exp Dermatol 2015; 24:748-53. [PMID: 26010336 DOI: 10.1111/exd.12761] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2015] [Indexed: 12/11/2022]
Abstract
Even in cells that are resistant to the differentiating effects of vitamin D, the activated vitamin D receptor (VDR) can downregulate the mitochondrial respiratory chain and sustain cell growth through enhancing the activity of biosynthetic pathways. The aim of this study was to investigate whether vitamin D is effective also in modulating mitochondria and biosynthetic metabolism of differentiating cells. We compared the effect of vitamin D on two cellular models: the primary human keratinocytes, differentiating and sensitive to the genomic action of VDR, and the human keratinocyte cell line HaCaT, characterized by a rapid growth and resistance to vitamin D. We analysed the nuclear translocation and features of VDR, the effects of vitamin D on mitochondrial transcription and the consequences on lipid biosynthetic fate. We found that the negative modulation of respiratory chain is a general mechanism of action of vitamin D, but at high doses, the HaCaT cells became resistant to mitochondrial effects by upregulating the catabolic enzyme CYP24 hydroxylase. In differentiating keratinocytes, vitamin D treatment promoted intracellular lipid deposition, likewise the inhibitor of respiratory chain stigmatellin, whereas in proliferating HaCaT, this biosynthetic pathway was not inducible by the hormone. By linking the results on respiratory chain and lipid accumulation, we conclude that vitamin D, by suppressing respiratory chain transcription in all keratinocytes, is able to support both the proliferation and the specialized metabolism of differentiating cells. Through mitochondrial control, vitamin D can have an essential role in all the metabolic phenotypes occurring in healthy and diseased skin.
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Affiliation(s)
| | - Marta Viano
- Department of Oncology, University of Torino, Italy
| | - Stefania Casarin
- Chirurgia Generale e Specialistiche, Banca della Cute, AOU Città della Salute e della Scienza Torino, Italy
| | - Carlotta Castagnoli
- Chirurgia Generale e Specialistiche, Banca della Cute, AOU Città della Salute e della Scienza Torino, Italy
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26
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Giammanco M, Di Majo D, La Guardia M, Aiello S, Crescimannno M, Flandina C, Tumminello FM, Leto G. Vitamin D in cancer chemoprevention. PHARMACEUTICAL BIOLOGY 2015; 53:1399-1434. [PMID: 25856702 DOI: 10.3109/13880209.2014.988274] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
CONTEXT There is increasing evidence that Vitamin D (Vit D) and its metabolites, besides their well-known calcium-related functions, may also exert antiproliferative, pro-differentiating, and immune modulatory effects on tumor cells in vitro and may also delay tumor growth in vivo. OBJECTIVE The aim of this review is to provide fresh insight into the most recent advances on the role of Vit D and its analogues as chemopreventive drugs in cancer therapy. METHODS A systematic review of experimental and clinical studies on Vit D and cancer was undertaken by using the major electronic health database including ISI Web of Science, Medline, PubMed, Scopus and Google Scholar. RESULTS AND CONCLUSION Experimental and clinical observations suggest that Vit D and its analogues may be effective in preventing the malignant transformation and/or the progression of various types of human tumors including breast cancer, prostate cancer, colorectal cancer, and some hematological malignances. These findings suggest the possibility of the clinical use of these molecules as novel potential chemopreventive and anticancer agents.
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Abstract
Exposure of the skin to solar ultraviolet (UV) radiation has both risks and benefits for human health. Absorption of UV-B radiation by DNA results in mutations that underlie the development of skin cancers, as is apparent from genetic studies showing high occurrence of UV signature mutations within these tumors. UV-B radiation is also absorbed by 7-dehydrocholesterol to initiate vitamin D synthesis. In experimental studies vitamin D metabolites enhance apoptosis of malignant cells, inhibit angiogenesis and proliferation and increase differentiation, potentially reducing skin cancer development and improving prognosis after diagnosis. There are some supporting human data. We review the links between sun exposure, vitamin D and skin cancers.
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Affiliation(s)
- Candy Wyatt
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Rachel E Neale
- QIMR Berghofer Institute of Medical Research, Brisbane, Australia.,QIMR Berghofer Institute of Medical Research, Brisbane, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
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Rice S, Carpenter M, Fityan A, Vearncombe L, Ardern-Jones M, Jackson A, Cooper C, Baird J, Healy E. Limited exposure to ambient ultraviolet radiation and 25-hydroxyvitamin D levels: a systematic review. Br J Dermatol 2015; 172:652-61. [DOI: 10.1111/bjd.13575] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 02/06/2023]
Affiliation(s)
- S.A. Rice
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - M. Carpenter
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - A. Fityan
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
| | - L.M. Vearncombe
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
| | - M. Ardern-Jones
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
| | - A.A. Jackson
- NIHR Biomedical Research Centre (Nutrition); University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - C. Cooper
- MRC Lifecourse Epidemiology Unit; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
- NIHR Musculoskeletal BRU; University of Oxford; Windmill Road Headington Oxford OX3 7LD U.K
| | - J. Baird
- MRC Lifecourse Epidemiology Unit; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - E. Healy
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
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Alberg AJ, Fischer AH. Is a personal history of nonmelanoma skin cancer associated with increased or decreased risk of other cancers? Cancer Epidemiol Biomarkers Prev 2015; 23:433-6. [PMID: 24609852 DOI: 10.1158/1055-9965.epi-13-1309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Two conflicting hypotheses have been tested concerning the association between a personal history of nonmelanoma skin cancer (NMSC) and risk of other malignancies. One hypothesis is that as a marker of extensive sunlight exposure and hence vitamin D status, NMSC should be inversely associated with risk of other cancers. Alternatively, under the multiple primary cancer model, NMSC is postulated to be an informative first cancer to study as a marker of increased risk of subsequent primary cancer diagnoses. In this journal issue, Ong and colleagues report the results of a large-scale study in the United Kingdom with findings that NMSC was significantly associated with increased risk of a broad spectrum of other malignancies, with the associations stronger the younger the age of onset of NMSC. These results are consistent with the larger body of evidence on this topic, which is highly asymmetrical in favor of the multiple primary cancer hypothesis. Two divergent hypotheses have been tested, with the empirical evidence unequivocally indicating that NMSC is a marker of a high cancer risk phenotype. Future research is warranted to better characterize this association, to understand why NMSC is a marker of excess risk of other cancers, and to determine whether this association is clinically relevant.
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Affiliation(s)
- Anthony J Alberg
- Authors' Affiliations: Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina; and Johns Hopkins University School of Medicine, Baltimore, Maryland
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Bronsnick T, Murzaku EC, Rao BK. Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer. J Am Acad Dermatol 2014; 71:1039.e1-1039.e12. [PMID: 25454036 DOI: 10.1016/j.jaad.2014.06.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 06/04/2014] [Accepted: 06/05/2014] [Indexed: 01/12/2023]
Abstract
Patients commonly inquire about dietary modifications as a means to prevent or manage skin disease. Answering these questions is often challenging, given the vast and conflicting evidence that exists on this topic. This 2-part continuing medical education article summarizes the evidence to date to enable physicians to answer patients' questions in an evidence-based manner. Part I includes atopic dermatitis, acne, and nonmelanoma skin cancer. The role of dietary supplementation, dietary exclusion, food allergy, maternal diet, and breastfeeding in the development and/or prevention of atopic dermatitis is summarized. The dermatoendocrinologic mechanism for the effects of glycemic index/glycemic load and milk on acne is described, as well as related clinical evidence for dietary modifications. Finally, evidence and recommendations for restriction or supplementation of dietary factors in the prevention of nonmelanoma skin cancer, including fat, vitamins A, C, D, and E, and selenium, are reported.
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Affiliation(s)
- Tara Bronsnick
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey.
| | - Era Caterina Murzaku
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Babar K Rao
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
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31
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Chinembiri TN, du Plessis LH, Gerber M, Hamman JH, du Plessis J. Review of natural compounds for potential skin cancer treatment. Molecules 2014; 19:11679-721. [PMID: 25102117 PMCID: PMC6271439 DOI: 10.3390/molecules190811679] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/17/2014] [Accepted: 07/23/2014] [Indexed: 02/07/2023] Open
Abstract
Most anti-cancer drugs are derived from natural resources such as marine, microbial and botanical sources. Cutaneous malignant melanoma is the most aggressive form of skin cancer, with a high mortality rate. Various treatments for malignant melanoma are available, but due to the development of multi-drug resistance, current or emerging chemotherapies have a relatively low success rates. This emphasizes the importance of discovering new compounds that are both safe and effective against melanoma. In vitro testing of melanoma cell lines and murine melanoma models offers the opportunity for identifying mechanisms of action of plant derived compounds and extracts. Common anti-melanoma effects of natural compounds include potentiating apoptosis, inhibiting cell proliferation and inhibiting metastasis. There are different mechanisms and pathways responsible for anti-melanoma actions of medicinal compounds such as promotion of caspase activity, inhibition of angiogenesis and inhibition of the effects of tumor promoting proteins such as PI3-K, Bcl-2, STAT3 and MMPs. This review thus aims at providing an overview of anti-cancer compounds, derived from natural sources, that are currently used in cancer chemotherapies, or that have been reported to show anti-melanoma, or anti-skin cancer activities. Phytochemicals that are discussed in this review include flavonoids, carotenoids, terpenoids, vitamins, sulforaphane, some polyphenols and crude plant extracts.
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Affiliation(s)
- Tawona N Chinembiri
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa.
| | - Lissinda H du Plessis
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa.
| | - Minja Gerber
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa.
| | - Josias H Hamman
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa.
| | - Jeanetta du Plessis
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa.
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Caini S, Boniol M, Tosti G, Magi S, Medri M, Stanganelli I, Palli D, Assedi M, Marmol VD, Gandini S. Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: a comprehensive review and meta-analysis. Eur J Cancer 2014; 50:2649-58. [PMID: 25087185 DOI: 10.1016/j.ejca.2014.06.024] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 06/25/2014] [Accepted: 06/28/2014] [Indexed: 12/24/2022]
Abstract
Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60-3.53) and 1.64 (95% CI 1.02-2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63-1.13) for CM and 1.03 (95% CI 0.95-1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.
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Affiliation(s)
- Saverio Caini
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy.
| | - Mathieu Boniol
- International Prevention Research Institute, Lyon, France
| | - Giulio Tosti
- Division of Dermatoncological Surgery, European Institute of Oncology, Milan, Italy
| | - Serena Magi
- Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Matelda Medri
- Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Ignazio Stanganelli
- Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Domenico Palli
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy
| | - Melania Assedi
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy
| | - Veronique Del Marmol
- Department of Dermatology. Hopital Erasme. Université Libre de Bruxelles, Brussels, Belgium
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
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Abstract
PURPOSE OF REVIEW To briefly review recent work within the vitamin D and cancer field, whereas also providing context relating how these findings may impact clinical care and future research efforts. RECENT FINDINGS Vitamin D has now been convincingly shown both in vitro and in preclinical animal models to alter the differentiation, proliferation, and apoptosis of cancer cells. Whether vitamin D prevents cancer in humans or limits cancer progression, however, remain open questions. Epidemiologic and observational data relating circulating 25(OH)D levels and cancer risk suggest an inverse relationship for most cancers including breast, colorectal, leukemia and lymphoma, and prostate, although for each malignancy there also exist studies that have failed to demonstrate such an inverse relationship. Likewise, a more recent report failed to confirm a previously reported association of increased pancreatic cancer risk in patients with higher 25(OH)D levels. A large prospective study in which patients aged at least 50 years receive 2000 IU vitamin D3 daily for 5 years, with cancer as a primary endpoint, has recently been launched. SUMMARY Although much effort has attempted to delineate a causal relationship between vitamin D and a wide array of human cancers, we await large-scale randomized controlled trial data for definitive answers.
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Espié M, Wassermann J, de Kermadec E, Lalloum M, Coussy F. Vitamine D et cancers. Presse Med 2013; 42:1405-11. [DOI: 10.1016/j.lpm.2013.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/24/2013] [Accepted: 07/24/2013] [Indexed: 12/22/2022] Open
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Vitamin D level and basal cell carcinoma, squamous cell carcinoma, and melanoma risk. J Invest Dermatol 2013; 133:589-592. [PMID: 23399821 DOI: 10.1038/jid.2012.427] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Various associations between serum vitamin D levels and skin cancer have been reported. In this issue, van der Pols et al. observed that baseline 25-hydroxyvitamin D (25OHD) levels above 75 nmol/L were associated with an increased incidence of basal cell carcinoma and melanoma, and a nonstatistically significant decreased incidence of squamous cell carcinoma. Complex factors including sun exposure, skin phototype, and anticarcinogenic and procarcinogenic effects of vitamin D are potential causes of the observed associations.
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van der Pols JC, Russell A, Bauer U, Neale RE, Kimlin MG, Green AC. Vitamin D Status and Skin Cancer Risk Independent of Time Outdoors: 11-Year Prospective Study in an Australian Community. J Invest Dermatol 2013; 133:637-641. [DOI: 10.1038/jid.2012.346] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Samimi M, Touzé A, Laude H, Le Bidre E, Arnold F, Carpentier A, Gardair C, Carlotti A, Maubec E, Dupin N, Aubin F, Avril MF, Rozenberg F, Avenel-Audran M, Guyetant S, Lorette G, Machet L, Coursaget P. Vitamin D deficiency is associated with greater tumor size and poorer outcome in Merkel cell carcinoma patients. J Eur Acad Dermatol Venereol 2013; 28:298-308. [PMID: 23368852 DOI: 10.1111/jdv.12101] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 12/20/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Merkel cell polyomavirus has been recognized to be associated with Merkel cell carcinoma (MCC), but the evolution of this cancer probably depends on various factors. Vitamin D deficiency, defined by serum 25-hydroxyvitamin D levels <50 nmol/L, seems to influence cancer behavior and progression, but has never been assessed in MCC patients. OBJECTIVES First, to evaluate whether vitamin D deficiency was associated with tumor characteristics and prognosis in a cohort of MCC patients. Second, to assess expression of the vitamin D receptor (VDR) in MCC tumors. METHODS Clinical findings, Merkel cell polyomavirus markers and vitamin D status were assessed in a cohort of French MCC patients. The study was limited to the 89 patients for whom the serum sample had been collected within 3 years after the diagnosis of MCC. Correlation between vitamin D deficiency and MCC characteristics and outcome were determined in regression analyses. VDR expression in MCC tumours was assessed by immunohistochemistry. RESULTS Vitamin D deficiency was noted in 65.1% of the patients and was independently associated with greater tumor size at diagnosis (P = 0.006) and with metastasis recurrence (HR, 2.89; 95% CI, 1.03 to 8.13; P = 0.043), but not with death from MCC, although there was a trend (HR, 5.28; 95% CI, 0.75 to 36.96; P = 0.093). VDR was found to be strongly expressed in all 28 MCC tumor specimens investigated. CONCLUSION The association between vitamin D deficiency and MCC characteristics and outcome, together with detection of the VDR in MCC cells, suggest that vitamin D could influence the biology of MCC.
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Affiliation(s)
- M Samimi
- INRA ISP, UMR 1282, Tours, France; Université François Rabelais, Tours, France; CHRU de Tours, Service de Dermatologie, Tours, France
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Reichrath J, Reichrath S. The relevance of the vitamin D endocrine system (VDES) for tumorigenesis, prevention, and treatment of non-melanoma skin cancer (NMSC): Present concepts and future perspectives. DERMATO-ENDOCRINOLOGY 2013; 5:38-50. [PMID: 24494041 PMCID: PMC3897597 DOI: 10.4161/derm.24156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/28/2013] [Indexed: 11/19/2022]
Abstract
Solar UV (UV)-B-radiation exerts both beneficial and adverse effects on human health. On the one hand, it is the most important environmental risk factor for the development of non-melanoma skin cancer [NMSC; most importantly basal (BCC) and squamous (SCC) cell carcinomas], that represent the most common malignancies in Caucasian populations. On the other hand, the human body's requirements of vitamin D are mainly achieved by UV-B-induced cutaneous photosynthesis. This dilemma represents a serious problem in many populations, for an association of vitamin D-deficiency and multiple independent diseases including various types of cancer has been convincingly demonstrated. In line with these findings, epidemiologic and laboratory investigations now indicate that vitamin D and its metabolites have a risk reducing effect for NMSC. Potential mechanisms of action include inhibition of the hedgehog signaling pathway (BCC) and modulation of p53-mediated DNA damage response (SCC). As a consequence of these new findings it can be concluded that UV-B-radiation exerts both beneficial and adverse effects on risk and prognosis of NMSC. It can be assumed that many independent factors, including frequency and dose of UV-B exposure, skin area exposed, and individual factors (such as skin type and genetic determinants of the skin`s vitamin D status and of signaling pathways that are involved in the tumorigenesis of NMSC) determine whether UV-B exposure promotes or inhibits tumorigenesis of NMSC. Moreover, these findings may help to explain many of the differential effects of UV-B radiation on risk of NMSC, including variation in the dose-dependent risk for development of SCC in situ (actinic keratosis, AK), invasive SCC, and BCC. In this review, we analyze the relevance of the vitamin D endocrine system (VDES) for tumorigenesis, prevention, and treatment of NMSC and give an overview of present concepts and future perspectives.
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Affiliation(s)
- Jörg Reichrath
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum des Saarlandes; Homburg/Saar, Germany
| | - Sandra Reichrath
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum des Saarlandes; Homburg/Saar, Germany
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Vitamin D beliefs and associations with sunburns, sun exposure, and sun protection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:2386-95. [PMID: 22851950 PMCID: PMC3407911 DOI: 10.3390/ijerph9072386] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 06/12/2012] [Accepted: 06/28/2012] [Indexed: 01/04/2023]
Abstract
The main objective of this study was to examine certain beliefs about vitamin D and associations with sun exposure, sun protection behaviors, and sunburns. A total of 3,922 lifeguards, pool managers, and parents completed a survey in 2006 about beliefs regarding vitamin D and sun-related behaviors. Multivariate ordinal regression analyses and linear regression analysis were used to examine associations of beliefs and other variables. Results revealed that Non-Caucasian lifeguards and pool managers were less likely to agree that they needed to go out in the sun to get enough vitamin D. Lifeguards and parents who were non-Caucasian were less likely to report that sunlight helped the body to produce vitamin D. A stronger belief about the need to go out in the sun to get enough vitamin D predicted more sun exposure for lifeguards. For parents, a stronger belief that they can get enough vitamin D from foods predicted greater sun protection and a stronger belief that sunlight helps the body produce vitamin D predicted lower sun exposure. This study provides information regarding vitamin D beliefs and their association with certain sun related behaviors across different demographic groups that can inform education efforts about vitamin D and sun protection.
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