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Li Y, Meng F, Jiang H, Peng Q, Fu J, Yin D, Hou X, Li C. Paradoxical skin lesions induced by IL-17 inhibitors in SAPHO syndrome. J DERMATOL TREAT 2024; 35:2295239. [PMID: 38153122 DOI: 10.1080/09546634.2023.2295239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Yuan Li
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Fanzhang Meng
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Haixu Jiang
- School of Chinese Materia, Beijing University of Chinese Medicine, Beijing, China
| | - Qiuwei Peng
- Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingyuan Fu
- School of Chinese Materia, Beijing University of Chinese Medicine, Beijing, China
| | - Dan Yin
- Department of Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiujuan Hou
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Li
- Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China
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Ramos J, Silva A, Roda Â, Alves J. Annular cutaneous sarcoidosis following COVID-19 vaccination. J Eur Acad Dermatol Venereol 2024; 38:e377-e379. [PMID: 38299691 DOI: 10.1111/jdv.19828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Affiliation(s)
- José Ramos
- Dermatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - António Silva
- Dermatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ângela Roda
- Dermatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - João Alves
- Dermatology Department, Hospital Garcia de Orta, Almada, Portugal
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Soto-García D, Suh-Oh HJ, Álvarez C, Martínez-Fernández S, García-Arroyo FR, Couselo-Rodríguez C, Flórez Á. Acquired perforating dermatoses and cabozantinib: A novel cutaneous toxicity. J Dtsch Dermatol Ges 2024; 22:594-596. [PMID: 38426664 DOI: 10.1111/ddg.15350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024]
Affiliation(s)
- Diego Soto-García
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
- DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Hae Jin Suh-Oh
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
- DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Carlos Álvarez
- Department of Pathology, University Hospital of Pontevedra, Pontevedra, Spain
| | - Sandra Martínez-Fernández
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
- DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | | | - Carmen Couselo-Rodríguez
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
- DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Ángeles Flórez
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
- DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
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Jiao B, Zhang H, Jiang H, Liu S, Wang Y, Chen Y, Duan H, Niu Y, Shen M, Wang H, Dai Y. Granulysin-mediated reduction of PDZRN3 induces Cx43 gap junctions activity exacerbating skin damage in trichloroethylene hypersensitivity syndrome. Ecotoxicology and Environmental Safety 2024; 274:116174. [PMID: 38471344 DOI: 10.1016/j.ecoenv.2024.116174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 03/14/2024]
Abstract
Trichloroethylene (TCE)-induced hypersensitivity syndrome (THS) has been a concern for many researchers in the field of environmental and occupational health. Currently, there is no specific treatment for THS, leaving patients to contend with severe infections arising from extensive skin lesions, consequently leading to serious adverse effects. However, the pathogenesis of severe skin damage in THS remains unclear. This study aims to investigate the specific danger signals and mechanisms underlying skin damage in THS through in vivo and in vitro experiments. We identified that cell supernatant containing 15 kDa granulysin (GNLY), released from activated CD3-CD56+NK cells or CD3+CD56+NKT cells in PBMC induced by TCE or its metabolite, promoted apoptosis in HaCaT cells. The apoptosis level decreased upon neutralization of GNLY in the supernatant by a GNLY-neutralizing antibody in HaCaT cells. Subcutaneous injection of recombinant 15 kDa GNLY exacerbated skin damage in the THS mouse model and better mimicked patients' disease states. Recombinant 15 kDa GNLY could directly induce cellular communication disorders, inflammation, and apoptosis in HaCaT cells. In addition to its cytotoxic effects, GNLY released from TCE-activated NK cells and NKT cells or synthesized GNLY alone could induce aberrant expression of the E3 ubiquitin ligase PDZRN3, causing dysregulation of the ubiquitination of the cell itself. Consequently, this resulted in the persistent opening of gap junctions composed of connexin43, thereby intensifying cellular inflammation and apoptosis through the "bystander effect". This study provides experimental evidence elucidating the mechanisms of THS skin damage and offers a novel theoretical foundation for the development of effective therapies targeting severe dermatitis induced by chemicals or drugs.
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Affiliation(s)
- Bo Jiao
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hua Zhang
- Department of Occupational disease, Qingdao Central Hospital, Shandong, China
| | - Haiqin Jiang
- Institute of Dermatology, Chinese Academy of Medical Sciences, National Center for STD and Leprosy Control, China CDC, Nanjing, China
| | - Shuai Liu
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yican Wang
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yuanyuan Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Huawei Duan
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yong Niu
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Meili Shen
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hongsheng Wang
- Institute of Dermatology, Chinese Academy of Medical Sciences, National Center for STD and Leprosy Control, China CDC, Nanjing, China
| | - Yufei Dai
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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Uozumi S, Enokida T, Suzuki S, Nishizawa A, Kamata H, Okano T, Kawasaki T, Fujisawa T, Ueda Y, Okano S, Tahara M, Yamaguchi M. Efficacy and safety of adapalene gel as a reactive treatment for cetuximab-induced skin toxicity in recurrent or metastatic squamous cell carcinoma of the head and neck: A historical cohort comparison study. J Oncol Pharm Pract 2024; 30:295-303. [PMID: 37098185 DOI: 10.1177/10781552231171699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
INTRODUCTION Despite the common occurrence of cetuximab (Cmab)-induced skin toxicity, management strategies are not well established. The traditional mainstay method consists of topical steroids, which, if used excessively, may give rise to other concerns. Alternatively, adapalene can activate epidermal growth factor receptor pathways to potentially alleviate these toxicities. METHODS We prospectively studied 31 patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) who were eligible to use adapalene gel as a reactive treatment for topical steroid-refractory skin toxicity. For comparison, we retrospectively reviewed 99 patients with R/M SCCHN (historical control cohort) whose skin toxicity was mainly treated with topical steroids. We compared the frequency and severity of Cmab-induced skin toxicity, Cmab therapy status (e.g., dose modification), side effects caused by topical steroids and adapalene gel itself, and other medical interventions. RESULTS Adapalene gel was used by eight patients (25.8%) in the prospective cohort. Patients in the historical control cohort more frequently required escalation of topical steroid potency (34.3% vs. 12.9%, p = 0.022). Although there was no statistically significant difference in the frequency of grade ≥3 facial skin rash and paronychia between the two cohorts, the prospective cohort showed a significantly shorter time to complete recovery from grade 2/3 paronychia (16 vs. 47 days, p = 0.017). Further, while no skin infections were observed in the prospective cohort, 13 patients in the historical control cohort developed skin infections, especially periungual infection (0% vs. 13.1%, p = 0.024). In addition, no patients in the prospective cohort received a dose reduction of Cmab due to skin toxicities, compared to 20 patients in the historical control cohort (0% vs. 20.2%, p = 0.003). No apparent adapalene gel-related side effects were observed. CONCLUSIONS Adapalene gel may be an effective management option for topical steroid-refractory Cmab-induced skin toxicities and could improve compliance with Cmab therapy.
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Affiliation(s)
- Shinya Uozumi
- Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomohiro Enokida
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shinya Suzuki
- Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Aya Nishizawa
- Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Hayato Kamata
- Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomoka Okano
- Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Toshikatsu Kawasaki
- Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takao Fujisawa
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuri Ueda
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Mimura C, Nagano T, Miwa N, Matsumura K, Yamada J, Satoh H, Suraya R, Hazama D, Tamura D, Yamamoto M, Tachihara M, Nishimura Y, Kobayashi K. Mechanism of action of adapalene for treating EGFR-TKI-induced skin disorder. Thorac Cancer 2024; 15:722-729. [PMID: 38379420 PMCID: PMC10961223 DOI: 10.1111/1759-7714.15249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Skin disorders are the most common side effect associated with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. It is important to manage skin lesions. Adapalene has been used to treat skin lesions caused by EGFR-TKIs in some cases. The aim of this study was to investigate the functional mechanism of adapalene in erlotinib-induced skin disorder. METHODS To analyze the effect of adapalene on skin rash, afatinib and adapalene were administered to mice. The relationship between the concentration of adapalene and skin disorders was also examined by analyzing AQP3 expression. A skin lesion model was experimentally established in human skin keratinocytes (HaCaT) by using erlotinib with TNF-α and IL-1β. We used qRT-PCR to analyze chemokine-induced inflammation and western blotting to analyze the effects of adapalene on the NF-κB signaling pathway. Antimicrobial peptides and adhesion factors were also examined using qRT-PCR. RESULTS Mice administered 0.01% adapalene had less skin inflammation than mice treated with afatinib alone. The expression level of AQP3 decreased in an adapalene concentration-dependent manner. The mRNA levels of proinflammatory cytokines such as CCL2 and CCL27 in HaCaT cells were significantly reduced by adapalene. The expression of an antimicrobial peptide, hBD3, was upregulated after adapalene treatment. Adhesion factors, such as E-cadherin, were significantly downregulated by EGFR-TKI and significantly upregulated by adapalene treatment. Western blot analysis suggested that erlotinib-induced phosphorylation of p65 was decreased by adapalene. CONCLUSION We suggest that adapalene may be a possible treatment option for skin disorders induced by EGFR-TKIs.
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Affiliation(s)
- Chihiro Mimura
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | - Tatsuya Nagano
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | - Nanako Miwa
- Department of Respiratory MedicineKobe City Nishi‐Kobe Medical CenterKobeJapan
| | - Kanoko Matsumura
- Department of Respiratory MedicineTakatsuki General HospitalTakatsukiJapan
| | - Jun Yamada
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | - Hiroki Satoh
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | - Ratoe Suraya
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | - Daisuke Hazama
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | | | - Masatsugu Yamamoto
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | - Motoko Tachihara
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
| | | | - Kazuyuki Kobayashi
- Division of Respiratory MedicineKobe University Graduate School of MedicineKobeJapan
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Alamon-Reig F, Bosch-Amate X, Giavedoni P, Nikolaou V, Mangas C, Apalla Z, Mayor A, Oikonomou C, Starace M, Sibaud V, Carrera C. Use of omalizumab is associated with improvement of pruritic skin disorders induced by immune checkpoint inhibitors: A retrospective cohort from the European Task Force of Dermatology for Cancer patients. J Am Acad Dermatol 2024; 90:429-432. [PMID: 37844688 DOI: 10.1016/j.jaad.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Francesc Alamon-Reig
- Department of Dermatology, Hospital Clínic de Barcelona, FRCB, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Bosch-Amate
- Department of Dermatology, Hospital Clínic de Barcelona, FRCB, Universitat de Barcelona, Barcelona, Spain
| | - Priscila Giavedoni
- Department of Dermatology, Hospital Clínic de Barcelona, FRCB, Universitat de Barcelona, Barcelona, Spain
| | - Vasiliki Nikolaou
- DermatoOncology Department, Andreas Sygros Hospital, University of Athens, Athens, Greece
| | - Cristina Mangas
- Dermatology and Oncology Department, Istituto Oncologico Svizzera Italiana (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Zoe Apalla
- Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ander Mayor
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain
| | - Chrysa Oikonomou
- Dermatology Department, General University Hospital of Patra, Patra, Greece
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Vincent Sibaud
- Departments of Oncodermatology and Clinical Research, Oncopole Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - Cristina Carrera
- Department of Dermatology, Hospital Clínic de Barcelona, FRCB, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain.
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8
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Caré W, Delacour H, Vodovar D, Langrand J, Laborde-Castérot H. Occupational vesicant-induced skin lesions. Contact Dermatitis 2024; 90:91-93. [PMID: 37775955 DOI: 10.1111/cod.14432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Weniko Caré
- Paris Poison Control Center, Toxicology Federation (FeTox), Hôpital Fernand Widal, AP-HP. Nord Université Paris Cité, Paris, France
- Department of Internal Medicine, Bégin Military Teaching Hospital, Saint-Mandé, France
- INSERM, UMR-S 1144, Paris, France
| | - Hervé Delacour
- Department of Medical Biology, Bégin Military Teaching Hospital, Saint-Mandé, France
- Val-de-Grâce School, Paris, France
| | - Dominique Vodovar
- Paris Poison Control Center, Toxicology Federation (FeTox), Hôpital Fernand Widal, AP-HP. Nord Université Paris Cité, Paris, France
- INSERM, UMR-S 1144, Paris, France
| | - Jérôme Langrand
- Paris Poison Control Center, Toxicology Federation (FeTox), Hôpital Fernand Widal, AP-HP. Nord Université Paris Cité, Paris, France
- INSERM, UMR-S 1144, Paris, France
| | - Hervé Laborde-Castérot
- Paris Poison Control Center, Toxicology Federation (FeTox), Hôpital Fernand Widal, AP-HP. Nord Université Paris Cité, Paris, France
- INSERM, UMR 1153, Paris, France
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9
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Wang X, Fu T, Sun W. Camrelizumab-induced oral lichenoid reaction with subepithelial CD4+ T-cell infiltration. J Oncol Pharm Pract 2024; 30:228-234. [PMID: 37817675 DOI: 10.1177/10781552231203723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Camrelizumab is a novel anti-programed cell death-1 (PD-1) antibody that has been investigated for the treatment of various malignancies. Increasing immune-related adverse events have been reported in clinical practice, with CD4+ T-cell-mediated-reactive cutaneous capillary endothelial proliferation being the most common. Camrelizumab-induced oral lichenoid reaction (OLR) appears to be a rare adverse effect compared with other anti-PD therapies induced OLR, with the main pathogenesis of activated CD8+ T cells mediating autoimmune reactions. Herein, we report a rare case of camrelizumab-induced OLR and a possible pathogenic mechanism of subepithelial CD4+ T-cell infiltration. CASE REPORT A 57-year-old male patient, who was diagnosed with metastatic esophageal squamous cell carcinoma three years prior, presented with a two-month history of oral erosion that developed while under camrelizumab therapy. Diffuse erythematous and erosive lesions surrounded by bilateral white lesions on the buccal mucosa were detected in his physical examination. Hematoxylin and eosin staining of the lesions revealed the presence of basal keratinocyte degeneration and band-like subepithelial T-cell infiltration. The immunostaining for CD4 on T-cell was positive, while CD8 were sporadically positive. Flow cytometry showed a gradual increase in the CD4+ T-cell proportion in the peripheral blood, with the CD8+ T-cell percentage almost unchanged and in the normal range. We obtained a score of 6 based on the Naranjo algorithm, which means a probable adverse drug reaction. MANAGEMENT AND OUTCOME The patient exhibited notable improvement after two weeks of treatment with topical glucocorticoid without regulating his immunotherapy, and remained in stable condition in the follow-up. DISCUSSION This case may offer new insight to clinicians on the pathogenesis of anti-PD-1-induced OLR. More critically, it may provide some ideas for a more precise anti-PD therapy or corresponding combination therapy for patients becoming resistant to immunotherapy due to exhausted CD4+ T-cell responses in the tumor microenvironment.
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Affiliation(s)
- Xiangjian Wang
- Department of Oral Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Tao Fu
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Weilian Sun
- Department of Oral Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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van Hoeve K, Thomas D, Hillary T, Hoffman I, Dreesen E. Identifying risk factors of anti-TNF induced skin lesions and other adverse events in paediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:95-104. [PMID: 38291690 DOI: 10.1002/jpn3.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVES While higher infliximab (IFX) trough concentrations (TCs) are associated with better outcomes in patients with inflammatory bowel disease (IBD), they could pose a risk for adverse events (AEs), including IFX-induced skin lesions. Therefore, we studied correlations between IFX TCs and occurrence of AEs in paediatric IBD patients. METHODS In this single-centre study, all children with Crohn's disease (CD) and ulcerative colitis (UC) receiving IFX maintenance therapy who underwent proactive drug monitoring between March 2015 and August 2022 were included. IFX doses/intervals/TCs and patient characteristics were systematically registered, as well as AEs and skin lesions appearance. RESULTS A total of 109 patients (72 CD and 37 UC) contributed 2913 IFX TCs. During a median follow-up of 3.0 [1.5-4.5] years, we observed 684 AEs in 101 patients and 49 skin lesions in 35 patients. There was no significant difference (p = .467) in median TCs between patients with and without skin lesions. However, higher median IFX doses were associated with an increased hazard rate of skin lesions [HR 1.084 (1.024-1.148), p = .005], in addition to female sex [2.210 (1.187-5.310), p = .016] and diagnosis of CD [1.695 (1.241-1.877), p = .011]. Considering IFX therapeutic TC cut-offs of 5.0 and 9.0 µg/mL, there was no significant difference in AE rate (p = .749 and p = .833, respectively). Also, no significant association between IFX doses and AE rate (p = .159). CONCLUSIONS Increasing the IFX dose to achieve therapeutic TCs may not increase the overall risk of AEs in paediatric IBD patients. However, concerns arise regarding the risk of skin lesions, especially in female CD patients.
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Affiliation(s)
- Karen van Hoeve
- Department of Paediatric gastroenterology & Hepatology & Nutrition, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Debby Thomas
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Tom Hillary
- Department of Dermatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Ilse Hoffman
- Department of Paediatric gastroenterology & Hepatology & Nutrition, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Erwin Dreesen
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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11
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Topal IO, Karadağ AS. Reply to the letter "skin manifestations following anti-COVID-19 vaccination: A multicentric study from Turkey: Correspondence". J Cosmet Dermatol 2024; 23:7. [PMID: 37382044 DOI: 10.1111/jocd.15884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/21/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Ilteris Oguz Topal
- Department of Dermatology and Venereology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, Memorial Ataşehir Hospital, Istanbul, Turkey
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12
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Torrecilla-Vall-Llossera C, Jucglà Serra A, Molinero Caturla J, Moreno-Vílchez C, Penín Mosquera RM, Marcoval Caus J. Sarcoid-like Reactions to Immune Checkpoint Inhibitors. Actas Dermosifiliogr 2024; 115:80-83. [PMID: 37482293 DOI: 10.1016/j.ad.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 07/25/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) can cause immune-mediated cutaneous adverse events, including sarcoid-like reactions. The aim of this study was to retrospectively analyze clinical and histologic data from patients who developed cutaneous sarcoid-like reactions between 2019 and 2022 while under treatment with ICIs. We studied 7 patients (6 women and 1 man) with a median age of 65years. Median time to onset of symptoms was 4months. The most common presentation was papular sarcoidosis of the knees followed by subcutaneous sarcoidosis. Diagnosis was confirmed histologically in all cases, and no differences were observed relative to idiopathic sarcoidosis. Discontinuation of ICI therapy was required in just two patients. ICI-induced sarcoid-like reactions tend to be mild and generally do not require treatment discontinuation. Histologic confirmation is essential for distinguishing these reactions from tumor progression.
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Affiliation(s)
- C Torrecilla-Vall-Llossera
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
| | - A Jucglà Serra
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - J Molinero Caturla
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - C Moreno-Vílchez
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - R M Penín Mosquera
- Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - J Marcoval Caus
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
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Torrecilla-Vall-Llossera C, Jucglà Serra A, Molinero Caturla J, Moreno-Vílchez C, Penín Mosquera RM, Marcoval Caus J. [Translated article] Sarcoid-like Reactions to Immune Checkpoint Inhibitors. Actas Dermo-Sifiliográficas 2024; 115:T80-T83. [PMID: 37923080 DOI: 10.1016/j.ad.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/01/2023] [Indexed: 11/07/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) can cause immune-mediated cutaneous adverse events, including sarcoid-like reactions. The aim of this study was to retrospectively analyze clinical and histologic data from patients who developed cutaneous sarcoid-like reactions between 2019 and 2022 while under treatment with ICIs. We studied 7 patients (6 women and 1 man) with a median age of 65years. Median time to onset of symptoms was 4months. The most common presentation was papular sarcoidosis of the knees followed by subcutaneous sarcoidosis. Diagnosis was confirmed histologically in all cases, and no differences were observed relative to idiopathic sarcoidosis. Discontinuation of ICI therapy was required in just two patients. ICI-induced sarcoid-like reactions tend to be mild and generally do not require treatment discontinuation. Histologic confirmation is essential for distinguishing these reactions from tumor progression.
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Affiliation(s)
- C Torrecilla-Vall-Llossera
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
| | - A Jucglà Serra
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - J Molinero Caturla
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - C Moreno-Vílchez
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - R M Penín Mosquera
- Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - J Marcoval Caus
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
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Yao M, Zeng Q, Luo P, Yang G, Li J, Sun B, Liang B, Zhang A. Assessing the health risks of coal-burning arsenic-induced skin damage: A 22-year follow-up study in Guizhou, China. Sci Total Environ 2023; 905:167236. [PMID: 37739080 DOI: 10.1016/j.scitotenv.2023.167236] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Risk assessment of arsenic-induced skin damage has always received significant global attention. Theories derived from arsenic exposure in drinking water may not be applicable to the coal-burning type to arsenic-exposed area. Furthermore, very few studies have successfully determined the reference value of cumulative arsenic (CA) exposure that leads to specific skin lesions. In this study, we conducted a 22-year follow-up investigation to assess the risk of skin lesions and cancer resulting from long-term, multi-channel arsenic exposure from hazard identification, dose-response assessment, exposure assessment, and risk characterization. The results show that the arsenic exposure can significantly increase the prevalence of skin lesions. For each interquartile range increase of hair arsenic (HA) and CA, the risk of skin damage increased by 1.91 and 3.90 times, respectively. The lower confidence limit of the benchmark dose of HA of arsenic-induced various skin lesions ranged from 0.07 to 0.12 μg·g-1, and 932.57 to 1368.92 mg for CA. The chronic daily intake, lifetime average daily dose in the arsenic-exposed area after the comprehensive prevention and control measures have decreased significantly, but remained higher than the daily baseline level of 3.0 μg·kg-1·d-1. Even as recently as 2020, the hazard quotients and hazard index still exceeded 1, measuring 155.33 and 55.20, and the lifetime excess risk of skin cancer (2.80 × 10-3) remains significantly higher than the acceptable level of 10-6. Our study underscores the effectiveness of comprehensive prevention and control measures in managing high arsenic exposure in coal-burning arsenic poisoning areas. However, it is crucial to acknowledge that the risk of both non-carcinogenic and carcinogenic effects on the skin remains substantially higher than the acceptable level. We recommend setting reference limits for monitoring skin damage among individuals exposed to arsenic, with a recommended upper limit of 0.07 μg·g-1 for HA and a maximum acceptable level of 935.57 mg for CA.
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Affiliation(s)
- Maolin Yao
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Qibing Zeng
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Peng Luo
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Guanghong Yang
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Jun Li
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Baofei Sun
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Bing Liang
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Aihua Zhang
- The key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education & School of Public Health, Guizhou Medical University, Guiyang 550025, China.
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15
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Yeh CN, Huang WK, Lu CW, Chen CP, Lin SH, Pan YR, Wu CE. A Potential Association of Zinc Deficiency and Tyrosine Kinase Inhibitor-Induced Hand-Foot Skin Reaction. Biol Trace Elem Res 2023; 201:5540-5545. [PMID: 36892689 DOI: 10.1007/s12011-023-03618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/28/2023] [Indexed: 03/10/2023]
Abstract
Hand-foot skin reaction (HFSR) is a common skin-related adverse event induced by multikinase inhibitors targeting both platelet-derived growth factor receptor and vascular endothelial growth factor receptor, possibly due to inadequate repair following frictional trauma. Zinc is a trace element and essential nutrient in humans that plays critical roles in the development and differentiation of skin cells. Zinc transporters (Zrt- and Irt-like proteins and Zn transporters) and metallothioneins are involved in zinc efflux, uptake, and homeostasis and have been reported to be involved in skin differentiation. The underlying mechanism of HFSR remains unclear, and the association between HFSR and zinc has not been previously studied. However, some case reports and case series provide potential evidence to suggest that zinc deficiency may be involved in HFSR development and zinc supplementation may relieve HFSR symptoms. However, no large-scale clinical studies have been conducted to examine this role. Therefore, this review summarizes the evidence supporting a possible link between HFSR development and zinc and proposes potential mechanisms underlying this association based on current evidence.
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Affiliation(s)
- Chun-Nan Yeh
- Department of General Surgery and Liver Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Kuan Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan
| | - Chun-Wei Lu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chiao-Ping Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan
| | - Sheng-Hsuan Lin
- Department of General Surgery and Liver Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ru Pan
- Department of General Surgery and Liver Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chiao-En Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan.
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16
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Qian Y, Zhu L, Chen J, Zhou Y, Huang Z, Liang L, Ding B. Di-(2-ethylhexyl) phthalate aggravates psoriasis-like skin lesions: In vitro and in vivo evaluation. Toxicol Appl Pharmacol 2023; 479:116707. [PMID: 37783235 DOI: 10.1016/j.taap.2023.116707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/17/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023]
Abstract
Di-(2-ethylhexyl) phthalate (DEHP), which is a widely used phthalate (PAE), has recently received public attention owing to it causing health problems. The aim of this study was to elucidate the aggravating effects of DEHP on psoriasis and skin toxicity. Human keratinocyte (HaCaT) cells were treated with gradient concentrations of DEHP, and mice with imiquimod (IMQ)-induced psoriasiform dermatitis were hypodermically injected with 40 μg/kg/day of DEHP for seven consecutive days. The skin condition was assessed based on the psoriasis area and severity index score, which indicated the deterioration of IMQ-induced psoriasis-like skin lesions after DEHP exposure. To further analyze the effect of DEHP on psoriasis, the proliferation, inflammation, and tight junction (TJ) damage were examined, which correlated with the development and severity of psoriasis. The results showed that DEHP promoted proliferation both in vivo and in vitro, which manifested as epidermal thickening; an increase in cell viability; upregulation of Ki67, CDK2, cyclinD1, and proliferating cell nuclear antigen; and downregulation of p21. An excessive inflammatory response is an important factor that exacerbates psoriasis, and our results showed that DEHP can trigger the release of inflammatory cytokines as well as the infiltration of T cells. TJ disorders were found in mice and cells after DEHP treatment. Additionally, p38 mitogen-activated protein kinase (MAPK) was strongly activated during this process, which may have contributed to skin toxicity caused by DEHP. In conclusion, DEHP treatment promotes proliferation, inflammation, TJ disruption, and p38 MAPK activation in HaCaT cells and psoriasis-like skin lesions.
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Affiliation(s)
- Yuxin Qian
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Lijian Zhu
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Jingya Chen
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Yilin Zhou
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Zhiguang Huang
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Linjie Liang
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Bin Ding
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou 310000, China.
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Naruse S, Takashima S, Natsuga K, Ujiie H. Dermal discoloration due to osmium tetroxide. Clin Toxicol (Phila) 2023; 61:1004-1005. [PMID: 37987740 DOI: 10.1080/15563650.2023.2281253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Osmium tetroxide is a strong oxidizing agent. After dermal exposure to osmium tetroxide, skin discoloration and red papules can occur. We describe a patient with skin discoloration due to osmium tetroxide. CASE SUMMARY A 25-year-old postgraduate student unintentionally exposed his hand to osmium tetroxide while working in a laboratory setting. After immediate washing, he sought medical care due to left middle finger discoloration. He reported no discomfort in the affected area. Thorough water rinsing was continued, and corticosteroid ointment was applied. IMAGES Our patient developed dark brown pigmentation on the ventral side of the left middle finger. The pigmentation disappeared one week later. CONCLUSION Osmium tetroxide may induce dark brown skin discoloration.
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Affiliation(s)
- Satsuki Naruse
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shota Takashima
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ken Natsuga
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideyuki Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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18
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Kawsar A, Hussain K, Fearfield L, Muinonen-Martin AJ. How to recognize and manage skin toxicities associated with immune checkpoint inhibitors: a practical approach. Br J Dermatol 2023; 189:i3-i10. [PMID: 37903072 DOI: 10.1093/bjd/ljad257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 11/01/2023]
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized treatment strategies in the field of oncology. Their favourable outcomes in terms of efficacy and side-effect profile can be thwarted by the development of immune-related adverse events (irAEs). Cutaneous irAEs are relatively common in patients undergoing immunotherapy and include common inflammatory dermatoses (e.g. eczematous, psoriasiform and lichenoid phenotypes), maculopapular eruptions, pruritus and immunobullous disorders. Most of these reactions can be managed without ICIs having to be stopped completely; however, there are some life-threatening toxicities that dermatologists and oncologists should be aware of. In this review, we focus on how to recognize the commonly associated cutaneous irAEs, touching upon rarer reactions and red flags; finally, we provide guidance on their management.
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Affiliation(s)
- Anusuya Kawsar
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Khawar Hussain
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
- The Leeds Centre for Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Louise Fearfield
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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Peñuelas Leal R, Labrandero Hoyos C, Martínez-Doménech Á, Grau-Echevarría A, Lorca Sprohnle J, Esquembre AC, Hernández Bel P. Hydroxocobalamin discoloration, a self-resolving emergency. Int J Dermatol 2023; 62:e540-e542. [PMID: 37326448 DOI: 10.1111/ijd.16745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/07/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023]
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20
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Yang L, Zhang Q, Yang Y, Wang Q. PYR-41, an inhibitor of ubiquitin-activating enzyme E1, attenuates 2,4-dinitrochlorobenzene-induced atopic dermatitis-like skin lesions in mice. FASEB J 2023; 37:e23210. [PMID: 37738047 DOI: 10.1096/fj.202200951rrr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/15/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
PYR-41 is an irreversible and cell permeable inhibitor of ubiquitin-activating enzyme E1, and has been reported to inhibit the degradation of IκB protein. Previous studies have shown that PYR-41 has effects on anti-inflammatory, but whether it has therapeutic effects on allergic dermatitis is unclear. The aim of this research was to explore the therapeutic effects of PYR-41 on atopic dermatitis. The effects of PYR-41 on the activation of NF-κB signaling pathway and the expression of inflammatory genes in HaCat cells were tested by western blot and qPCR. A mouse model was built, and the AD-like skin lesions were induced by 2,4-dinitrochlorobenzene (DNCB). Then, the treatment effects of PYR-41 were examined by skin severity score, ear swelling, ELISA, and qPCR. The results showed that PYR-41 can significantly reduce the K63-linked ubiquitination level of nuclear factor-κB essential modulator (NEMO) and tumor necrosis factor receptor associated factor 6 (TRAF6), inhibit the proteasomal degradation of IκBα, thereby activate TNF-α-induced NF-κB signaling pathway in HaCat cells. In addition, DNCB-treated mice have significant reduction in symptoms after treated by PYR-41, including reduced ear thickening and reduced skin damage. Serum tests showed that PYR-41 significantly reduced the expression of IgE, IFN-γ, and TNF-α. In conclusion, the current results suggest that PYR-41 has potential to reduce the symptoms of atopic dermatitis.
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Affiliation(s)
- Lian Yang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Stomatology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Zhang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yili Yang
- China Regional Research Center, International Center for Genetic Engineering and Biotechnology, Taizhou, P. R. China
| | - Qun Wang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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21
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Palmeiro AG, Silva L, Pimentel B, Passos J, Moura C, Amaro C. MEK inhibitor-induced paronychia in a paediatric population: A tertiary centre experience. Australas J Dermatol 2023; 64:e245-e251. [PMID: 37224380 DOI: 10.1111/ajd.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023]
Abstract
The cutaneous toxicity of MEK inhibitors may limit treatment adherence. The authors present a retrospective study of 41 paediatric patients with NF-1 undergoing therapy with selumetinib and propose a treatment algorithm.
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Affiliation(s)
- Ana Gusmão Palmeiro
- Dermatology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Leandro Silva
- Dermatology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Bernardo Pimentel
- Dermatology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - João Passos
- Neurology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
- Pediatric Neuro-Oncology Unit, Pediatrics Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Cecília Moura
- Dermatology Department, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
| | - Cristina Amaro
- Dermatology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
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22
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Parillo M, Mallio CA, Van der Molen AJ, Rovira À, Ramalho J, Ramalho M, Gianolio E, Karst U, Radbruch A, Stroomberg G, Clement O, Dekkers IA, Nederveen AJ, Quattrocchi CC. Skin Toxicity After Exposure to Gadolinium-Based Contrast Agents in Normal Renal Function, Using Clinical Approved Doses: Current Status of Preclinical and Clinical Studies. Invest Radiol 2023; 58:530-538. [PMID: 37185158 DOI: 10.1097/rli.0000000000000973] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES The aim of this study was to summarize the current preclinical and clinical evidence on the association between exposure to gadolinium (Gd) compounds and skin toxicity in a setting similar to clinical practice. MATERIALS AND METHODS A search of MEDLINE and PubMed references from January 2000 to December 2022 was performed using keywords related to gadolinium deposition and its effects on the skin, such as "gadolinium," "gadolinium-based contrast agents," "skin," "deposition," and "toxicity." In addition, cross-referencing was added when appropriate. For preclinical in vitro studies, we included all the studies that analyzed the response of human dermal fibroblasts to exposure to various gadolinium compounds. For preclinical animal studies and clinical studies, we included only those that analyzed animals or patients with preserved renal function (estimated glomerular filtration rate >30 mL/min/1.73 m 2 ), using a dosage of gadolinium-based contrast agents (GBCAs) similar to that commonly applied (0.1 mmol/kg). RESULTS Forty studies were selected. Preclinical findings suggest that Gd compounds can produce profibrotic responses in the skin in vitro, through the activation and proliferation of dermal fibroblasts and promoting their myofibroblast differentiation. Gadolinium influences the process of collagen production and the collagen content of skin, by increasing the levels of matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1. Preclinical animal studies show that Gd can deposit in the skin with higher concentrations when linear GBCAs are applied. However, these deposits decrease over time and are not associated with obvious macroscopic or histological modifications. The clinical relevance of GBCAs in inducing small fiber neuropathy remains to be determined. Clinical studies show that Gd is detectable in the skin and hair of subjects with normal renal function in higher concentrations after intravenous administration of linear compared with macrocyclic GBCA. However, these deposits decrease over time and are not associated with cutaneous or histological modifications. Also, subclinical dermal involvement related to linear GBCA exposure may be detectable on brain MRI. There is no conclusive evidence to support a causal relationship between GBCA administration at the clinical dose and cutaneous manifestations in patients with normal renal function. CONCLUSIONS Gadolinium can produce profibrotic responses in the skin, especially acting on fibroblasts, as shown by preclinical in vitro studies. Gadolinium deposits are detectable in the skin even in subjects with normal renal function with higher concentrations when linear GBCAs are used, as confirmed by both preclinical animal and human studies. There is no proof to date of a cause-effect relationship between GBCA administration at clinical doses and cutaneous consequences in patients with normal renal function. Multiple factors, yet to be determined, should be considered for sporadic patients with normal renal function who develop clinical skin manifestations temporally related to GBCA administration.
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Affiliation(s)
- Marco Parillo
- From the Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo A Mallio
- From the Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Aart J Van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joana Ramalho
- Department of Neuroradiology, Centro Hospitalar Universitário de Lisboa Central, Lisbon
| | - Miguel Ramalho
- Department of Radiology, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Eliana Gianolio
- Department of Molecular Biotechnologies and Health Science, University of Turin, Turin, Italy
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster
| | - Alexander Radbruch
- Department of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Gerard Stroomberg
- RIWA-Rijn-Association of River Water Works, Nieuwegein, the Netherlands
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Paris, France
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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23
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Robijns J, Lodewijckx J, Claes M, Tuts L, Lenaerts M, Wessels T, Requilé A, Luyten D, Verheezen J, Joosens E, Mebis J. Evaluation of a novel skin care product for the management of chemotherapy-related dermatologic toxicities: A quasi-experimental study. Eur J Oncol Nurs 2023; 63:102278. [PMID: 36898268 DOI: 10.1016/j.ejon.2023.102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/24/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE Evaluate the efficacy of a novel skincare product for the management of chemotherapy-related dermatological toxicities. METHODS A monocentric, prospective, interventional, open-label, pretest-posttest, single-group study with cancer patients receiving chemotherapy (n = 100) was set up. All enrolled patients applied the emollient daily to their face and body for three weeks. The severity of the skin reactions was evaluated by a researcher using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 at baseline and end of the trial. Patient-reported outcomes (PROs) included the frequency and severity of skin symptoms (Numerical rating scale, NRS), quality of life (QoL; Skindex-16 and Dermatology Life Quality Index), Patient Benefit Index (PBI), and treatment satisfaction. PROs were collected at baseline, weekly, and at the end of the trial. RESULTS According to the CTCAE and NRS, the novel emollient significantly improved the severity and frequency of xerosis and pruritus (Ps ≤ .001). A significant reduction in the NRS score for frequency of erythema was measured (p < .001). The frequency and severity of burning and pain did not change. Regarding the patients' QoL, no beneficial effect of the skin care product was measurable. 44% of the patients experienced at least one patient-relevant treatment benefit. 87% of the patients were satisfied with the emollient and would recommend it. CONCLUSIONS This study shows that the novel emollient significantly reduced chemotherapy-induced skin toxicity, more specifically xerosis and pruritus without hampering patient's QoL. Future research is needed to make definite conclusions using a study design including a control group and a long-term follow-up.
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Affiliation(s)
- Jolien Robijns
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
| | - Joy Lodewijckx
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Marithé Claes
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Laura Tuts
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Melissa Lenaerts
- Faculty of Health, Medicine and Life Sciences, Department of Surgery, GROW School for Oncology & Reproduction, Maastricht University, Universiteitssingel 50, 6229ER, Maastricht, Netherlands
| | - Tim Wessels
- Limburg Oncology Center, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Annelies Requilé
- Limburg Oncology Center, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Daisy Luyten
- Limburg Oncology Center, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jolanda Verheezen
- Limburg Oncology Center, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Eric Joosens
- Limburg Oncology Center, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jeroen Mebis
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium; Limburg Oncology Center, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
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Khatun M, Siddique AE, Wahed AS, Haque N, Tony SR, Islam J, Alam S, Sarker MK, Kabir I, Hossain S, Sumi D, Saud ZA, Barchowsky A, Himeno S, Hossain K. Association between serum periostin levels and the severity of arsenic-induced skin lesions. PLoS One 2023; 18:e0279893. [PMID: 36598904 PMCID: PMC9812306 DOI: 10.1371/journal.pone.0279893] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/18/2022] [Indexed: 01/05/2023] Open
Abstract
Arsenic is a potent environmental toxicant and human carcinogen. Skin lesions are the most common manifestations of chronic exposure to arsenic. Advanced-stage skin lesions, particularly hyperkeratosis have been recognized as precancerous diseases. However, the underlying mechanism of arsenic-induced skin lesions remains unknown. Periostin, a matricellular protein, is implicated in the pathogenesis of many forms of skin lesions. The objective of this study was to examine whether periostin is associated with arsenic-induced skin lesions. A total of 442 individuals from low- (n = 123) and high-arsenic exposure areas (n = 319) in rural Bangladesh were evaluated for the presence of arsenic-induced skin lesions (Yes/No). Participants with skin lesions were further categorized into two groups: early-stage skin lesions (melanosis and keratosis) and advanced-stage skin lesions (hyperkeratosis). Drinking water, hair, and nail arsenic concentrations were considered as the participants' exposure levels. The higher levels of arsenic and serum periostin were significantly associated with skin lesions. Causal mediation analysis revealed the significant effect of arsenic on skin lesions through the mediator, periostin, suggesting that periostin contributes to the development of skin lesions. When skin lesion was used as a three-category outcome (none, early-stage, and advanced-stage skin lesions), higher serum periostin levels were significantly associated with both early-stage and advanced-stage skin lesions. Median (IQR) periostin levels were progressively increased with the increasing severity of skin lesions. Furthermore, there were general trends in increasing serum type 2 cytokines (IL-4, IL-5, IL-13, and eotaxin) and immunoglobulin E (IgE) levels with the progression of the disease. The median (IQR) of IL-4, IL-5, IL-13, eotaxin, and IgE levels were significantly higher in the early-and advanced-stage skin lesions compared to the group of participants without skin lesions. The results of this study suggest that periostin is implicated in the pathogenesis and progression of arsenic-induced skin lesions through the dysregulation of type 2 immune response.
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Affiliation(s)
- Moriom Khatun
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
| | - Abu Eabrahim Siddique
- Department of Biological Sciences, State University of New York at Buffalo, Buffalo, New York, United States of America
| | - Abdus S. Wahed
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Nazmul Haque
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
| | - Selim Reza Tony
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
| | - Jahidul Islam
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
| | - Shahnur Alam
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | | | | | - Shakhawoat Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
| | - Daigo Sumi
- Laboratory of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima, Japan
| | - Zahangir Alam Saud
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
| | - Aaron Barchowsky
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Seiichiro Himeno
- Laboratory of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima, Japan
- Division of Health Chemistry, School of Pharmacy, Showa University, Tokyo, Japan
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail:
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寺尾 香, 阿部 理. [Drug eruption and drug-induced skin diseases in the elderly patients]. Nihon Ronen Igakkai Zasshi 2023; 60:345-351. [PMID: 38171750 DOI: 10.3143/geriatrics.60.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
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Chari A, Minnema MC, Berdeja JG, Oriol A, van de Donk NWCJ, Rodríguez-Otero P, Askari E, Mateos MV, Costa LJ, Caers J, Verona R, Girgis S, Yang S, Goldsmith RB, Yao X, Pillarisetti K, Hilder BW, Russell J, Goldberg JD, Krishnan A. Talquetamab, a T-Cell-Redirecting GPRC5D Bispecific Antibody for Multiple Myeloma. N Engl J Med 2022; 387:2232-2244. [PMID: 36507686 DOI: 10.1056/nejmoa2204591] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND G protein-coupled receptor, family C, group 5, member D (GPRC5D) is an orphan receptor expressed in malignant plasma cells. Talquetamab, a bispecific antibody against CD3 and GPRC5D, redirects T cells to mediate killing of GPRC5D-expressing myeloma cells. METHODS In a phase 1 study, we evaluated talquetamab administered intravenously weekly or every other week (in doses from 0.5 to 180 μg per kilogram of body weight) or subcutaneously weekly, every other week, or monthly (5 to 1600 μg per kilogram) in patients who had heavily pretreated relapsed or refractory multiple myeloma that had progressed with established therapies (a median of six previous lines of therapy) or who could not receive these therapies without unacceptable side effects. The primary end points - the frequency and type of dose-limiting toxic effects (study part 1 only), adverse events, and laboratory abnormalities - were assessed in order to select the recommended doses for a phase 2 study. RESULTS At the data-cutoff date, 232 patients had received talquetamab (102 intravenously and 130 subcutaneously). At the two subcutaneous doses recommended for a phase 2 study (405 μg per kilogram weekly [30 patients] and 800 μg per kilogram every other week [44 patients]), common adverse events were cytokine release syndrome (in 77% and 80% of the patients, respectively), skin-related events (in 67% and 70%), and dysgeusia (in 63% and 57%); all but one cytokine release syndrome event were of grade 1 or 2. One dose-limiting toxic effect of grade 3 rash was reported in a patient who had received talquetamab at the 800-μg dose level. At median follow-ups of 11.7 months (in patients who had received talquetamab at the 405-μg dose level) and 4.2 months (in those who had received it at the 800-μg dose level), the percentages of patients with a response were 70% (95% confidence interval [CI], 51 to 85) and 64% (95% CI, 48 to 78), respectively. The median duration of response was 10.2 months and 7.8 months, respectively. CONCLUSIONS Cytokine release syndrome, skin-related events, and dysgeusia were common with talquetamab treatment but were primarily low-grade. Talquetamab induced a substantial response among patients with heavily pretreated relapsed or refractory multiple myeloma. (Funded by Janssen Research and Development; MonumenTAL-1 ClinicalTrials.gov number, NCT03399799.).
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Affiliation(s)
- Ajai Chari
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Monique C Minnema
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jesus G Berdeja
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Albert Oriol
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Niels W C J van de Donk
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Paula Rodríguez-Otero
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Elham Askari
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - María-Victoria Mateos
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Luciano J Costa
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jo Caers
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Raluca Verona
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Suzette Girgis
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Shiyi Yang
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Rachel B Goldsmith
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Xiang Yao
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Kodandaram Pillarisetti
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Brandi W Hilder
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jeffery Russell
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jenna D Goldberg
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Amrita Krishnan
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
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Mohammadi M, Kohan L, Saeidi M, Saghaeian Jazi M, Mohammadi S. The antifibrotic effects of naringin in a hypochlorous acid (HOCl)-induced mouse model of skin fibrosis. Immunopharmacol Immunotoxicol 2022; 44:704-711. [PMID: 35583493 DOI: 10.1080/08923973.2022.2077217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/07/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Fibrosis is a chronic inflammation caused by the loss of innate compensational mechanisms. Naringin (NR) is a flavonoid with antineoplastic and anti-inflammatory effects. Here, we aimed to investigate the antifibrotic effects of NR and underlying mechanisms in a Hypochlorous acid (HOCl)-induced mouse model of skin fibrosis. MATERIALS AND METHODS A total of 24 six-week-old female BALB/c mice were randomly allocated into five groups: HOCl, Sham, PBS, HOCl + NR and DMSO and selected skin regions were treated for 6 weeks, until sacrifice. The histopathologic and collagenesis of skin resections were analyzed using H&E and PR staining. The mRNA levels of COL1, COL3 and αSMA genes were quantified. Serum samples were also used to evaluate TGF-β levels and LDH activity. RESULTS HOCl could increase the relative collagen content, while NR administration on HOCl-treated biopsies decreased collagenesis. COL1, COL3 and αSMA mRNA levels were significantly increased among HOCl-treated skin samples, while NR treatment could decrease these mRNA levels of genes to the extent equal to the levels in the Sham group. Similarly, Naringin-treated samples could decrease TGF-β levels. CONCLUSIONS We demonstrated that Naringin could exert protective effects against fibrotic complications of HOCL in skin tissue in vivo, by reducing the collagenesis and decreasing the levels of fibrosis-associated genes.
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Affiliation(s)
- Mahmoud Mohammadi
- Department of Biology, Islamic Azad University, Arsanjan Branch, Arsanjan, Iran
| | - Leila Kohan
- Department of Biology, Islamic Azad University, Arsanjan Branch, Arsanjan, Iran
| | - Mohsen Saeidi
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Medical Immunology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Marie Saghaeian Jazi
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Saeed Mohammadi
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Alshana U, Altun B, Ertaş N, Çakmak G, Kadioglu E, Hisarlı D, Aşık E, Atabey E, Çelebi CR, Bilir N, Serçe H, Tuncer AM, Burgaz S. Evaluation of low-to-moderate arsenic exposure, metabolism and skin lesions in a Turkish rural population exposed through drinking water. Chemosphere 2022; 304:135277. [PMID: 35688195 DOI: 10.1016/j.chemosphere.2022.135277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is no human data regarding the exposure, metabolism and potential health effects of arsenic (As) contamination in drinking water in the Central Anatolian region of Turkey. METHODS Residents in ten villages with drinking water of total As (T-As) level >50 μg L-1 and 10-50 μg L-1 were selected as an exposed group (n = 420) and <10 μg L-1 as an unexposed group (n = 185). Time-weighted average-As (TWA-As) intake was calculated from T-As analysis of drinking water samples. Concentrations of T-As in urine and hair samples, urinary As species [i.e., As(III), As(V), MMA(V) and DMA(V], and some micronutrients in serum samples of residents of the study area were determined. Primary and secondary methylation indices (PMI and SMI, respectively) were assessed from urinary As species concentrations and the presence of skin lesion was examined. RESULTS TWA-As intake was found as 75 μg L-1 in the exposed group. Urinary and hair T-As and urinary As species concentrations were significantly higher in the exposed group (P < 0.05). The PMI and SMI values revealed that methylation capacities of the residents were efficient and that there was no saturation in As metabolism. No significant increase was observed in the frequency of skin lesions (hyperpigmentation, hypopigmentation, keratosis) of the exposed group (P > 0.05). Only frequency of keratosis either at the hand or foot was higher in individuals with hair As concentration >1 μg g-1 (P < 0.05). CONCLUSIONS Individuals living in the study area were chronically exposed to low-to-moderate As due to geological contamination in drinking water. No significant increase was observed in the frequency of skin lesions. Because of the controversy surrounding the health risks of low-to-moderate As exposure, it is critical to initiate long-term follow-up studies on health effects in this region.
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Affiliation(s)
- Usama Alshana
- Gazi University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara, Turkey
| | - Beril Altun
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey
| | - Nusret Ertaş
- Gazi University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara, Turkey
| | - Gonca Çakmak
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey
| | - Ela Kadioglu
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey
| | - Deniz Hisarlı
- Middle East Technical University, Department of Biochemistry, Ankara, Turkey
| | - Elif Aşık
- Middle East Technical University, Department of Biotechnology, Ankara, Turkey
| | - Eşref Atabey
- General Directorate of Mineral Research and Exploration, Ankara, Turkey
| | | | - Nazmi Bilir
- Hacettepe University, Faculty of Medicine, Department of Public Health, Ankara, Turkey
| | - Hakan Serçe
- Ürgüp State Hospital, Turkish Ministry of Health, Nevşehir, Turkey
| | - A Murat Tuncer
- Turkish Ministry of Health, Cancer Control Department, Ankara, Turkey
| | - Sema Burgaz
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey.
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29
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Mihindukulasooriya SP, Dinh DTT, Herath KHINM, Kim HJ, Han EJ, Cho J, Ko MO, Jeon YJ, Ahn G, Jee Y. Sargassum horneri extract containing polyphenol alleviates DNCB-induced atopic dermatitis in NC/Nga mice through restoring skin barrier function. Histol Histopathol 2022; 37:839-852. [PMID: 35634683 DOI: 10.14670/hh-18-473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by skin barrier dysfunction. Sargassum horneri (S. horneri) is a brown alga that has been widely used in traditional medicine of eastern Asian countries. Recent studies proved that a brown alga S. horneri has anti-inflammatory activity. In this study, we investigated the effect of S. horneri ethanol extract (SHE) against AD in 2,4-dinitrobenzene (DNCB) induced AD in NC/Nga mice. We observed that SHE treatment decreased the epidermal thickness and epidermal hyperplasia that had been worsened through DNCB application. Moreover, SHE significantly inhibited the proliferation of mast cells and decreased the expression of IL-13 on CD4⁺ cells prompted by elevated thymic stromal lymphopoietin (TSLP) expression in DNCB-induced AD in mice. We also demonstrated that SHE directly inhibited the expression of keratinocyte-produced TSLP known to exacerbate skin barrier impairment. Especially, the decrease of filaggrin, an integral component of proper skin barrier function through a function in aggregating keratin filaments, observed in DNCB-induced AD mice was significantly improved when treated with SHE. More importantly, we proved that SHE was able to decrease the serum levels of IgG₁ and IgG₂ₐ, two crucial factors of AD, indicating the protective effect of SHE. Taken together, our findings suggest that SHE may protect NC/Nga mice against DNCB-induced AD via promoting skin barrier function.
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Affiliation(s)
| | - Duong Thi Thuy Dinh
- Interdisciplinary Graduate Program in Advanced Convergence Technology and Science, Jeju National University, Jeju, Republic of Korea
| | - Kalahe Hewage Iresha Nadeeka Madushani Herath
- Interdisciplinary Graduate Program in Advanced Convergence Technology and Science, Jeju National University, Jeju, Republic of Korea
- Department of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Republic of Korea
- Department of Biosystems Engineering, Faculty of Agriculture and Plantation Management, Wayamba University of Sri Lanka, Makandura, Sri Lanka
| | - Hyo Jin Kim
- Department of Food Bioengineering, Jeju National University, Jeju, Republic of Korea
| | - Eui-Jeong Han
- Department of Food Technology and Nutrition, Chonnam National University, Yeosu, Republic of Korea
| | - Jinhee Cho
- Department of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Republic of Korea
| | - Mi-Ok Ko
- Department of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Republic of Korea
| | - You-Jin Jeon
- Department of Marine Life Science, School of Marine Biomedical Sciences, Jeju National University, Jeju, Republic of Korea
| | - Ginnae Ahn
- Department of Food Technology and Nutrition, Chonnam National University, Yeosu, Republic of Korea
| | - Youngheun Jee
- Department of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Republic of Korea
- Interdisciplinary Graduate Program in Advanced Convergence Technology and Science, Jeju National University, Jeju, Republic of Korea.
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30
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Li G, Gong S, Wang N, Yao X. Toxic epidermal necrolysis induced by sintilimab in a patient with advanced non-small cell lung cancer and comorbid pulmonary tuberculosis: A case report. Front Immunol 2022; 13:989966. [PMID: 36090976 PMCID: PMC9459224 DOI: 10.3389/fimmu.2022.989966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/08/2022] [Indexed: 11/27/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have had a revolutionary effect on the treatment of patients with advanced non-small cell lung cancer (NSCLC), especially squamous cell lung cancer. However, ICIs may cause associated immune-related adverse events (ir-AEs). No case of sintilimab-induced toxic epidermal necrolysis (TEN) has been reported. In this report, we discussed a patient with advanced NSCLC and comorbid pulmonary tuberculosis who underwent immunotherapy and chemotherapy as neoadjuvant therapy and anti-tuberculosis therapy concurrently. Partial response (PR) of the tumor was achieved after three cycles of neoadjuvant therapy without cutaneous toxicities. Video-assisted thoracoscopic surgery (VATS) left lower lobectomy was performed successfully. Sintilimab and chemotherapy were administered as adjuvant therapy, after which the patient suffered severe TEN that rapidly progressed to cover >50% of the skin. TEN was associated with extensive rashes of the trunk and pruritus. With history of sintilimab use, clinical symptoms, and physical examination, TEN was diagnosed. Intravenous methylprednisolone and oral prednisone were administered until the patient totally recovered from the cutaneous toxicities caused by sintilimab. Monitoring of such rare but severe cutaneous toxicities is essential in patients who are treated with sintilimab.
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Affiliation(s)
- Gang Li
- Department of Thoracic Surgery, The Public Health Clinical Center of Chengdu, Chengdu, China
| | - Sheng Gong
- Department of Thoracic Surgery, The Public Health Clinical Center of Chengdu, Chengdu, China
| | - Ning Wang
- Department of Public Health, Chengdu Medical College, Chengdu, China
| | - Xiaojun Yao
- Department of Thoracic Surgery, The Public Health Clinical Center of Chengdu, Chengdu, China
- *Correspondence: Xiaojun Yao,
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31
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Jamshaid H, Din FU, Malik M, Mukhtiar M, Choi HG, Ur-Rehman T, Khan GM. A cutback in Imiquimod cutaneous toxicity; comparative cutaneous toxicity analysis of Imiquimod nanotransethosomal gel with 5% marketed cream on the BALB/c mice. Sci Rep 2022; 12:14244. [PMID: 35987944 PMCID: PMC9392762 DOI: 10.1038/s41598-022-18671-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/17/2022] [Indexed: 12/21/2022] Open
Abstract
Herein, Imiquimod (IMQ) was incorporated in nanotransethosomes (nTES) to develop the IMQ-nTES nano-drug delivery system. IMQ-nTES was optimized using 23 factorial design. The optimized formulation was expressed with a particle size of 192.4 ± 1.60 nm, Poly-dispersibility of 0.115 ± 0.008, and IMQ percent entrapment efficiency of 91.05 ± 3.22%. Smooth and round morphology of IMQ-nTES vesicles was confirmed by TEM micrographs. Moreover, FTIR results have shown drug-excipient compatibility. The IMQ-nTES was laden inside the low molecular weight chitosan gel, which exhibited easy application, spreadability and no irritation to the applied skin. The release pattern has clearly exhibited improved dissolution properties of IMQ with the provision of the sustain release pattern. Higher IMQ content was deposited in deeper epidermis and dermis with IMQ-nTES gel, in contrast to ALDARA. In vivo, comparative toxicity study on BALB/c mice has shown significantly reduced (p < 0.001) psoriatic area severity index (PASI) score and less increment in ear thickness. Epidermal hyperplasia was an obvious finding with ALDARA which was, providentially, minimal in IMQ-nTES gel-treated skin. FTIR analysis of skin tissue has shown an enhancement of lipid and protein content in the ALDARA group, however, in the IMQ-nTES group no such change was observed. With ALDARA application, CD4+ T-cells and constitutive NF-κβ expression were significantly elevated, in comparison to the IMQ-nTES gel treated group. Moreover, the adequate expression of IFN-γ and cytotoxic CD8+ T-cells were suggesting the preserved IMQ efficacy with IMQ-nTES gel. Quantification of cutaneous as well as systemic inflammatory markers has also suggested the reduced psoriatic potential of IMQ-nTES gel. In essence, IMQ-nTES gel can be a suitable alternative to ALDARA owing to its better safety profile.
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Affiliation(s)
- Humzah Jamshaid
- Nanomedicine Research Group, Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan
- Department of Pharmacy, Ibadat International University, Islamabad, Pakistan
| | - Fakhar Ud Din
- Nanomedicine Research Group, Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan.
| | - Maimoona Malik
- Nanomedicine Research Group, Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan
| | - Muhammad Mukhtiar
- Department of Pharmacy, Faculty of Medical and Health Sciences, University of Poonch Rawalakot, Rawalakot, AJK, Pakistan
| | - Han Gon Choi
- College of Pharmacy, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, 15588, South Korea.
| | - Tofeeq Ur-Rehman
- Nanomedicine Research Group, Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan
| | - Gul Majid Khan
- Nanomedicine Research Group, Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan.
- Islamia College University, Peshawar, Khyber Pakhtunkhwa, Pakistan.
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32
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Park BC, Jung S, Chen ST, Dewan AK, Johnson DB. Challenging Dermatologic Considerations Associated with Immune Checkpoint Inhibitors. Am J Clin Dermatol 2022; 23:707-717. [PMID: 35708849 DOI: 10.1007/s40257-022-00706-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
Immune checkpoint inhibitors have emerged as a new paradigm in oncologic care for many malignancies. However, nonspecific immune activation has led to "collateral damage" in the form of immune-related adverse events, with skin being a commonly affected organ. Cutaneous immune-related adverse events include a wide spectrum of clinical presentations and challenging considerations, often necessitating dermatology referral to support diagnosis and management, particularly for atypical presentations or more severe, cutaneous immune-related adverse events that may require specialized dermatologic evaluations including biopsy and histopathology. Close collaborations between oncologists and dermatologists may optimize clinical decision making in the following challenging management settings: non-steroidal therapies for corticosteroid-refractory, cutaneous immune-related adverse events, immune checkpoint inhibitor rechallenge, balancing cutaneous immune-related adverse events and treatments, and immune checkpoint inhibitors in patients with pre-existing autoimmune disease, skin conditions, and organ transplants. These complex clinical decisions that often lack rigorous data should be made in close collaboration with dermatologists to minimize unnecessary morbidity and mortality. This article provides a review of approaches to challenging dermatologic considerations associated with immune checkpoint inhibitor therapies.
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Affiliation(s)
- Benjamin C Park
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Seungyeon Jung
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Steven T Chen
- Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Anna K Dewan
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, 2220 Pierce Avenue, 777 Preston Research Building, Nashville, TN, 3723, USA.
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33
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Dunn-Valadez S, Bathini S, Elston C, Rangaraju S, Stasi AD, Worth S, Morlote D, Harada S, Vachhani P. IDH1 inhibitor-induced neutrophilic dermatosis in a patient with acute myeloid leukemia. Cancer Treat Res Commun 2022; 31:100560. [PMID: 35460975 DOI: 10.1016/j.ctarc.2022.100560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/13/2022] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
Ivosidenib is an oral inhibitor of mutant Isocitrate dehydrogenase 1 (IDH1). It is approved for treatment of patients with relapsed or refractory IDH1-mutated acute myeloid leukemia (AML) and patients with newly diagnosed IDH1-mutated AML who are 75 years or older or those who are ineligible to receive intensive chemotherapy. While generally well tolerated, differentiation syndrome has been reported in 15-20% of patients. Here, we report a case of acute febrile neutrophilic dermatosis or Sweet's syndrome in conjunction with the use of ivosidenib for the treatment of relapsed AML. We discuss the clinical presentation of this rare entity, review relevant literature, and comment on its association with differentiation syndrome.
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Affiliation(s)
- Sydney Dunn-Valadez
- Dept of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Srilakshmi Bathini
- Dept of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Carly Elston
- Dept of Dermatology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sravanti Rangaraju
- Div of Hematology/Oncology, Dept of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Antonio Di Stasi
- Div of Hematology/Oncology, Dept of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sarah Worth
- Dept of Pharmacy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Diana Morlote
- Div of Anatomic Pathology and Neuropathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Shuko Harada
- Div of Anatomic Pathology and Neuropathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Pankit Vachhani
- Div of Hematology/Oncology, Dept of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
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Hirata M, Demachi T, Yanagawa T, Yarimizu A, Nomura K, Kuribayashi M, Kimura K, Beppu N, Song J, Takenaka Y, Nishimura Y, Kimura T, Uchino M, Ikeuchi H, Nagai M, Ikeda M, Kataoka K. [Challenge of Skin Treatment Led by Nurses and Pharmacists for Advanced Colorectal Cancer Patients Treated with Anti-EGFR Antibodies]. Gan To Kagaku Ryoho 2022; 49:421-424. [PMID: 35444126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Preemptive skin treatment led by nurses and pharmacists was started for patients with metastatic colorectal cancer (mCRC)who received anti-EGFR antibody treatment. Incidence of skin-related toxicities, amount of topical moisturizers used, and administered cycles of anti-EGFR antibody were retrospectively compared between a preemptive skin treatment group and a control group. Thirty-four mCRC patients before the introduction of preemptive skin treatment led by nurses and 23 mCRC patients treated with preemptive skin treatment led by nurses were evaluated. The incidence of 6- and 12- week Grade 2 or higher skin-related toxicity was 23.5% in the control group and 8.7% in the preemptive group(p=0.18), and 67.7% in the control group and 30.4% in the preemptive group(p=0.0076), respectively. Mean amounts of moisturizer used were both lower in the control group than in the preemptive group at both 6 weeks and 7-12 weeks(6 weeks; 275 g vs 550 g, p=0.036, 7-12 weeks; 575 g vs 1,175 g, p=0.013). However, the amount of topical steroid used was similar in both groups. Preemptive moisturizer skin treatment led by nurses and pharmacists may decrease the incidence of skin- related toxicity.
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Reese CF, Chinnakkannu P, Tourkina E, Hoffman S, Kuppuswamy D. Multiple subregions within the caveolin-1 scaffolding domain inhibit fibrosis, microvascular leakage, and monocyte migration. PLoS One 2022; 17:e0264413. [PMID: 35213624 PMCID: PMC8880820 DOI: 10.1371/journal.pone.0264413] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/10/2022] [Indexed: 12/27/2022] Open
Abstract
The caveolin-1 scaffolding domain (CSD, amino acids 82–101 of caveolin-1) has been shown to suppress bleomycin-induced lung and skin fibrosis and angiotensin II (AngII)-induced myocardial fibrosis. To identify active subregions within CSD, we split its sequence into three slightly overlapping 8-amino acid subregions (82–89, 88–95, and 94–101). Interestingly, all three peptides showed activity. In bleomycin-treated mice, all three subregions suppressed the pathological effects on lung and skin tissue morphology. In addition, while bone marrow monocytes isolated from bleomycin-treated mice showed greatly enhanced migration in vitro toward CXCL12, treatment in vivo with CSD and its subregions almost completely suppressed this enhanced migration. In AngII-induced heart failure, both 82–89 and 88–95 significantly suppressed fibrosis (both Col I and HSP47 levels), microvascular leakage, and heart weight/ body weight ratio (HW/BW) while improving ventricular function. In contrast, while 94–101 suppressed the increase in Col I, it did not improve the other parameters. The idea that all three subregions can be active depending on the assay was further supported by experiments studying the in vitro migration of human monocytes in which all three subregions were extremely active. These studies are very novel in that it has been suggested that there is only one active region within CSD that is centered on amino acids 90–92. In contrast, we demonstrate here the presence of other active regions within CSD.
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Affiliation(s)
- Charles F. Reese
- Division of Rheumatology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, Unites States of America
| | - Panneerselvam Chinnakkannu
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, Unites States of America
| | - Elena Tourkina
- Division of Rheumatology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, Unites States of America
| | - Stanley Hoffman
- Division of Rheumatology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, Unites States of America
| | - Dhandapani Kuppuswamy
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, Unites States of America
- * E-mail:
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Liu L, Mai Y, Liang Y, Zhou X, Chen K. Experimental study on the effect of chrysin on skin injury induced by amiodarone extravasation in rats. Microvasc Res 2022; 139:104257. [PMID: 34534572 DOI: 10.1016/j.mvr.2021.104257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/22/2021] [Accepted: 09/10/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Amiodarone is the first choice for the treatment of arrhythmia, but it is easy to cause extravasation during infusion, after extravasation, it often cause skin injury. The healing of skin injury induced by amiodarone is an inflammatory process. Chrysin, a natural flavonoid, has been investigated to have anti-inflammatory and antioxidant effects. It was reported that chrysin can promote wound healing. So this study aims to investigate the effect of chrysin on amiodarone extravasation-induced skin injury model in rats. METHODS The rat model of skin extravasation injury was established by subcutaneous injection of 0.5 mL of amiodarone. After successful modeling, the rats were randomly assigned to the five groups: control group, 10% DMSO group, and low-dose, medium-dose, and high-dose chrysin groups (10, 20 and 40 mg/mL). The extravasation injury model was given locally on the same day for seven days. On day 0, 3, 7 and 10 of administration, the lesion's image were taken to calculate the area, and the tissue of the lesion were collected for H&E staining. Then, the level of IL-6 and TNF-α were measured by ELISA, and the protein expression level of bFGF in the wound tissue were detected by immunohistochemical staining. RESULTS It was found that chrysin groups (20 and 40 mg/mL) compared to contronl group and 10% DMSO solvent group significantly decreased area injury, IL-6 and TNF-α(P < 0.05) on day 3, 7, 10. On the other hand, the chrysin group (40 mg/mL) compared to contronl group and 10% DMSO group significantly increase bFGF(P < 0.05) on day 3, 7. CONCLUSION Chrysin were effective in reducing injury area, reducing inflammation, and promoting the secretion of bFGF, it can promote the healing of skin injury induced by amiodarone extravasation in rats. These findings provide a good theoretical and experimental basis for the prevention and treatment of amiodarone extravasation-induced skin injury, and provide evidence for finding potential healing agents for the prevention and treatment of amiodarone and other corrosive extravasation-induced injuries from the molecular and cytological levels, thus solving the clinical problems.
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Affiliation(s)
- Liuhong Liu
- Guangdong Pharmaceutical University, Guangzhou, 510000, Guangdong, China; The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510000, Guangdong, China
| | - Yongyi Mai
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510000, Guangdong, China
| | - Yunfang Liang
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510000, Guangdong, China
| | - Xiaozhou Zhou
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510000, Guangdong, China
| | - Ken Chen
- Guangdong Pharmaceutical University, Guangzhou, 510000, Guangdong, China.
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Abstract
ABSTRACT Acquired perforating dermatoses (APDs) are a group of diverse skin disorders in patients with systemic disease, most commonly chronic renal failure and diabetes mellitus. APD induced by medication has seldom been reported. Anti-PD-1 monoclonal antibody has recently been used as a broad-spectrum, effective, durable, and relatively safe antitumor therapy for various malignancies. Thus far, known side effects involving skin have included rash, pruritus, and vitiligo. Here, we present a rare case of a unilateral linear eruption with histopathologic features of APD in a 36-year-old man during treatment with Terepril monoclonal antibody. To the best of our knowledge, APD induced by the PD-1 inhibitor has not been described in the medical literature.
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Affiliation(s)
- Xiaoyan Liu
- Department of Dermatology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Department of Dermatology, Affiliated Hospital of Chengde Medical College
| | - Huayang Wang
- Department of Dermatology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yinsheng Wan
- Department of Biology, Providence College, Providence, RI; and
| | - Ying Guo
- Ackerman Academy of Dermatopathology, New York, NY
| | - Shi-Jun Shan
- Department of Dermatology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Jin Y, Chen X, Gao Z, Shen X, Fu H, Pan Z, Yan H, Yang B, He Q, Xu Z, Luo P. Bisdemethoxycurcumin alleviates vandetanib-induced cutaneous toxicity in vivo and in vitro through autophagy activation. Biomed Pharmacother 2021; 144:112297. [PMID: 34649218 DOI: 10.1016/j.biopha.2021.112297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 12/20/2022] Open
Abstract
High incidence of cutaneous toxicity ranging from 29.2% to 71.2% has been reported during clinical use of vandetanib, which is a multi-target kinase inhibitor indicated for the treatment of unresectable medullary thyroid carcinoma. The cutaneous toxicity of vandetanib has limited its clinical benefits, but the underlying mechanisms and protective strategies are not well studied. Hence, we firstly established an in vivo model by continuously administrating vandetanib at 55 mg/kg/day to C57BL/6 for 21 days and verified that vandetanib could induce skin rash in vivo, which was consistent with the clinical study. We further cultured HaCaT and NHEK cells, the immortalized or primary human keratinocyte line, and investigated vandetanib (0-10 μM, 0-24 h)-caused alteration in cellular survival and death processes. The western blot showed that the expression level of apoptotic-related protein, c-PARP, c-Caspase 3 and Bax were increased, while the anti-apoptotic protein Bcl2 and MCL1 level were decreased. Meanwhile, vandetanib downregulated mitochondrial membrane potential which in turn caused the release of Cytochrome C, excessive production of reactive oxygen species and DNA damage. Furthermore, we found that 5 μM bisdemethoxycurcumin partially rescued vandetanib-induced mitochondria pathway-dependent keratinocyte apoptosis via activation of autophagy in vivo and in vitro, thereby ameliorated cutaneous toxicity. Conclusively, our study revealed the mechanisms of vandetanib-induced apoptosis in keratinocytes during the occurrence of cutaneous toxicity, and suggested bisdemethoxycurcumin as a potential protective drug. This work provided a potentially promising therapeutic strategy for the treatment of vandetanib-induced cutaneous toxicity.
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Affiliation(s)
- Ying Jin
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Xueqin Chen
- Department of Oncology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang, PR China
| | - Zizheng Gao
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Xiaofei Shen
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Huangxi Fu
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Zezheng Pan
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Hao Yan
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Bo Yang
- Institute of Pharmacology & Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China
| | - Qiaojun He
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China; Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, Hangzhou 310018, Zhejiang, PR China; Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang, PR China
| | - Zhifei Xu
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China.
| | - Peihua Luo
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, PR China; Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China.
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Ri M, Iida S, Maruyama D, Sakabe A, Kamei R, Nakashima T, Tohkin M, Osaga S, Tobinai K, Fukuhara N, Miyazaki K, Tsukamoto N, Tsujimura H, Yoshimitsu M, Miyamoto K, Tsukasaki K, Nagai H. HLA genotyping in Japanese patients with multiple myeloma receiving bortezomib: An exploratory biomarker study of JCOG1105 (JCOG1105A1). Cancer Sci 2021; 112:5011-5019. [PMID: 34626515 PMCID: PMC8645746 DOI: 10.1111/cas.15158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022] Open
Abstract
Bortezomib (Btz) shows robust efficacy in patients with multiple myeloma (MM); however, some patients experience suboptimal responses and show specific toxicities. Therefore, we attempted to identify specific HLA alleles associated with Btz-related toxicities and response to treatment. Eighty-two transplant-ineligible patients with newly diagnosed MM enrolled in a phase II study (JCOG1105) comparing two less intensive melphalan, prednisolone, plus Btz (MPB) regimens were subjected to HLA typing. The frequency of each allele was compared between the groups, categorized based on toxicity grades and responses to MPB therapy. Among 82 patients, the numbers of patients with severe peripheral neuropathy (PN; grade 2 or higher), skin disorders (SD; grade 2 or higher), and pneumonitis were 16 (19.5%), 15 (18.3%), and 6 (7.3%), respectively. Complete response was achieved in 10 (12.2%) patients. Although no significant HLA allele was identified by multiple comparisons, several candidates were identified. HLA-B*40:06 was more prevalent in patients with severe PN than in those with less severe PN (odds ratio [OR] = 6.76). HLA-B*40:06 and HLA-DRB1*12:01 were more prevalent in patients with SD than in those with less severe SD (OR = 7.47 and OR = 5.55, respectively). HLA-DRB1*08:02 clustered in the group of patients with pneumonitis (OR = 11.34). Complete response was achieved in patients carrying HLA-DQB1*03:02, HLA-DQB1*05:01, and HLA-DRB1*01:01 class II alleles. HLA genotyping could help predict Btz-induced toxicity and treatment efficacy in patients with MM, although this needs further validation.
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Affiliation(s)
- Masaki Ri
- Department of Hematology and OncologyNagoya City University HospitalNagoyaJapan
| | - Shinsuke Iida
- Department of Hematology and OncologyNagoya City University HospitalNagoyaJapan
| | - Dai Maruyama
- Department of HematologyNational Cancer Center HospitalTokyoJapan
- Department of Hematology OncologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Aya Sakabe
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Ryo Kamei
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Takuto Nakashima
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Masahiro Tohkin
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Satoshi Osaga
- Clinical Research Management CenterNagoya City University HospitalNagoyaJapan
| | - Kensei Tobinai
- Department of HematologyNational Cancer Center HospitalTokyoJapan
| | - Noriko Fukuhara
- Department of Hematology and RheumatologyTohoku University HospitalSendaiJapan
| | - Kana Miyazaki
- Department of Hematology and OncologyMie University Graduate School of MedicineTsuJapan
| | | | | | - Makoto Yoshimitsu
- Department of Hematology and ImmunologyKagoshima University HospitalKagoshimaJapan
| | - Kenichi Miyamoto
- JCOG Data Center/Operating OfficeNational Cancer Center HospitalTokyoJapan
| | - Kunihiro Tsukasaki
- Department of HematologyInternational Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Hirokazu Nagai
- Department of HematologyNational Hospital Organization Nagoya Medical CenterNagoyaJapan
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Ran NA, Hedberg ML, Rosenbach M. Blue Pigmentation of the Skin, Sclera, and Teeth. JAMA 2021; 326:1851-1852. [PMID: 34751725 DOI: 10.1001/jama.2021.16176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nina A Ran
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Matthew L Hedberg
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Misha Rosenbach
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Arora S, Agrawal NK, Shanthaiah DM, Verma A, Singh S, Patne SCU, Kalra S, Singh P, Goyal S. Early detection of cutaneous complications of insulin therapy in type 1 and type 2 diabetes mellitus. Prim Care Diabetes 2021; 15:859-864. [PMID: 34154931 DOI: 10.1016/j.pcd.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/01/2021] [Accepted: 06/12/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Subcutaneous insulin therapy is associated with important injection site complications, which can influence insulin pharmacokinetics resulting in glycemic fluctuations above and below target levels for blood glucose. OBJECTIVE Our objective was to assess the prevalence and risk factors of cutaneous complications including insulin derived amyloidosis in insulin-injecting diabetes patients and to study the role of ultrasonography (in comparison to gel-assisted palpation) in early diagnosis of lipohypertrophy (LH). METHODS This was a cross-sectional study conducted at a tertiary care center in India, wherein 500 patients injecting insulin for ≥2 years were randomly enrolled and evaluated for the presence of cutaneous complications of insulin therapy through clinical examination, ultrasonography and punch biopsy of skin. RESULTS Clinical examination detected LH in 44.6% of patients. Ultrasonography diagnosed additional 13.4% of patients with LH which were missed on clinical examination. Incorrect rotation of sites (P < 0.001) and insulin syringe reusage for more than five times (P < 0.001) significantly increased the risk of LH. Skin biopsy was performed in 100 cases, out of which two patients showed apple green birefringence and its association with insulin was confirmed by positive staining with anti insulin antibody in these two patients. CONCLUSION Improper rotation of sites and reuse of needles were the leading causes of LH in Indian diabetic patients. Ultrasonography is more objective and reliable method of detecting LH. Insulin-derived amyloidosis may be a more common complication of insulin therapy than previously thought.
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Affiliation(s)
- Saurabh Arora
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Neeraj Kumar Agrawal
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Dhananjaya Melkunte Shanthaiah
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Ashish Verma
- Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Sanjay Singh
- Department of Dermatology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Shashikant C U Patne
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
| | - Parminder Singh
- Department of Endocrinology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
| | - Saloni Goyal
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
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Zawatsky CN, Park JK, Abdalla J, Kunos G, Iyer MR, Cinar R. Peripheral Hybrid CB 1R and iNOS Antagonist MRI-1867 Displays Anti-Fibrotic Efficacy in Bleomycin-Induced Skin Fibrosis. Front Endocrinol (Lausanne) 2021; 12:744857. [PMID: 34650521 PMCID: PMC8505776 DOI: 10.3389/fendo.2021.744857] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022] Open
Abstract
Scleroderma, or systemic sclerosis, is a multi-organ connective tissue disease resulting in fibrosis of the skin, heart, and lungs with no effective treatment. Endocannabinoids acting via cannabinoid-1 receptors (CB1R) and increased activity of inducible NO synthase (iNOS) promote tissue fibrosis including skin fibrosis, and joint targeting of these pathways may improve therapeutic efficacy. Recently, we showed that in mouse models of liver, lung and kidney fibrosis, treatment with a peripherally restricted hybrid CB1R/iNOS inhibitor (MRI-1867) yields greater anti-fibrotic efficacy than inhibiting either target alone. Here, we evaluated the therapeutic efficacy of MRI-1867 in bleomycin-induced skin fibrosis. Skin fibrosis was induced in C57BL/6J (B6) and Mdr1a/b-Bcrp triple knock-out (KO) mice by daily subcutaneous injections of bleomycin (2 IU/100 µL) for 28 days. Starting on day 15, mice were treated for 2 weeks with daily oral gavage of vehicle or MRI-1867. Skin levels of MRI-1867 and endocannabinoids were measured by mass spectrometry to assess target exposure and engagement by MRI-1867. Fibrosis was characterized histologically by dermal thickening and biochemically by hydroxyproline content. We also evaluated the potential increase of drug-efflux associated ABC transporters by bleomycin in skin fibrosis, which could affect target exposure to test compounds, as reported in bleomycin-induced lung fibrosis. Bleomycin-induced skin fibrosis was comparable in B6 and Mdr1a/b-Bcrp KO mice. However, the skin level of MRI-1867, an MDR1 substrate, was dramatically lower in B6 mice (0.023 µM) than in Mdr1a/b-Bcrp KO mice (8.8 µM) due to a bleomycin-induced increase in efflux activity of MDR1 in fibrotic skin. Furthermore, the endocannabinoids anandamide and 2-arachidonylglycerol were elevated 2-4-fold in the fibrotic vs. control skin in both mouse strains. MRI-1867 treatment attenuated bleomycin-induced established skin fibrosis and the associated increase in endocannabinoids in Mdr1a/b-Bcrp KO mice but not in B6 mice. We conclude that combined inhibition of CB1R and iNOS is an effective anti-fibrotic strategy for scleroderma. As bleomycin induces an artifact in testing antifibrotic drug candidates that are substrates of drug-efflux transporters, using Mdr1a/b-Bcrp KO mice for preclinical testing of such compounds avoids this pitfall.
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Affiliation(s)
- Charles N. Zawatsky
- Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
| | - Joshua K. Park
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
| | - Jasmina Abdalla
- Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
| | - George Kunos
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
| | - Malliga R. Iyer
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
- Section on Medicinal Chemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
| | - Resat Cinar
- Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
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Abstract
The use of cannabis for skin diseases and hair regrowth is at the preliminary stage. LEGALIZATION Many countries have approved cannabis for medical use; however, four countries Canada, Uruguay, South Africa, and Georgia have legalized it for both medical and recreational purposes. THE ENDOCANNABINOID SYSTEM The endocannabinoid system may maintain skin homeostasis; two notable endocannabinoids include 2-Arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA). ROUTES OF ADMINISTRATION AND PHARMACOKINETICS Topical cannabinoids can avoid the first-pass metabolism and reduce respiratory side effects; however, the high hydrophobicity of cannabinoids may hinder percutaneous absorption. SKIN DISORDERS AND HAIR GROWTH Human clinical studies suggest that cannabinoids may be used in eczema, acne, pruritus, and systemic sclerosis treatment. Cannabidiol (CBD) may enhance hair growth via multiple mechanisms. SAFETY Topical cannabis may cause mild side effects such as pruritus, burning, erythema, and stinging; they are relatively safer than inhalation and oral cannabis. Cannabis use may be associated with allergic symptoms and reduced immune response to live vaccination. CANNABINOIDS IN PRACTICE Despite growing interest, dermatologists should be cautious prescribing cannabinoids due to insufficient clinical data on both efficacy and safety.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Mediprobe Research Inc, London, Ontario, Canada
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Wu YC, Chen WY, Chen CY, Lee SI, Wang YW, Huang HH, Kuo SM. Farnesol-Loaded Liposomes Protect the Epidermis and Dermis from PM 2.5-Induced Cutaneous Injury. Int J Mol Sci 2021; 22:6076. [PMID: 34199947 PMCID: PMC8200188 DOI: 10.3390/ijms22116076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
Particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) increases oxidative stress through free radical generation and incomplete volatilization. In addition to affecting the respiratory system, PM2.5 causes aging- and inflammation-related damage to skin. Farnesol (Farn), a natural benzyl semiterpene, possesses anti-inflammatory, antioxidative, and antibacterial properties. However, because of its poor water solubility and cytotoxicity at high concentrations, the biomedical applications of Farn have been limited. This study examined the deleterious effects of PM2.5 on the epidermis and dermis. In addition, Farn-encapsulated liposomes (Lipo-Farn) and gelatin/HA/xanthan gel containing Lipo-Farn were prepared and applied in vivo to repair and alleviate PM2.5-induced damage and inflammation in skin. The prepared Lipo-Farn was 342 ± 90 nm in diameter with an encapsulation rate of 69%; the encapsulation significantly reduced the cytotoxicity of Farn. Lipo-Farn exhibited a slow-release rate of 35% after 192 h of incubation. The half-maximal inhibitory concentration of PM2.5 was approximately 850 μg/mL, and ≥400 μg/mL PM2.5 significantly increased IL-6 production in skin fibroblasts. Severe impairment in the epidermis and hair follicles and moderate impairment in the dermis were found in the groups treated with post-PM2.5 and continuous subcutaneous injection of PM2.5. Acute and chronic inflammation was observed in the skin in both experimental categories in vivo. Treatment with 4 mM Lipo-Farn largely repaired PM2.5-induced injury in the epidermis and dermis, restored injured hair follicles, and alleviated acute and chronic inflammation induced by PM2.5 in rat skin. In addition, treatment with 4 mM pure Farn and 2 mM Lipo-Farn exerted moderate reparative and anti-inflammatory effects on impaired skin. The findings of the current study indicate the therapeutic and protective effects of Lipo-Farn against various injuries caused by PM2.5 in the pilosebaceous units, epidermis, and dermis of skin.
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Affiliation(s)
- Yu-Chiuan Wu
- Hualien Armed Forces General Hospital, Hualien County 97144, Taiwan; (Y.-C.W.); (W.-Y.C.)
- School of Culinary Arts, National Kaohsiung University of Hospitality and Tourism, Kaohsiung City 81271, Taiwan
| | - Wei-Yun Chen
- Hualien Armed Forces General Hospital, Hualien County 97144, Taiwan; (Y.-C.W.); (W.-Y.C.)
| | - Chun-Yin Chen
- Department of Biomedical Engineering, I-Shou University, Kaohsiung City 84001, Taiwan; (C.-Y.C.); (S.I.L.); (Y.-W.W.)
| | - Sheng I. Lee
- Department of Biomedical Engineering, I-Shou University, Kaohsiung City 84001, Taiwan; (C.-Y.C.); (S.I.L.); (Y.-W.W.)
| | - Yu-Wen Wang
- Department of Biomedical Engineering, I-Shou University, Kaohsiung City 84001, Taiwan; (C.-Y.C.); (S.I.L.); (Y.-W.W.)
| | - Han-Hsiang Huang
- Department of Veterinary Medicine, National Chiayi University, Chiayi City 60054, Taiwan
| | - Shyh-Ming Kuo
- Department of Biomedical Engineering, I-Shou University, Kaohsiung City 84001, Taiwan; (C.-Y.C.); (S.I.L.); (Y.-W.W.)
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Abstract
PURPOSE OF REVIEW To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes. RECENT FINDINGS Five cases of a severe and previously unrecognized lung disease characterized by B-cell bronchiolitis and alveolar ductitis with emphysema (BADE) were identified among workers at a machining facility that used MWFs, although MWF exposure could not be confirmed as the etiology. In the United Kingdom, MWF is now the predominant cause of occupational hypersensitivity pneumonitis (HP). Under continuous conditions associated with respiratory disease outbreaks, over a working lifetime of 45 years, workers exposed to MWF at 0.1 mg/m3 are estimated to have a 45.3% risk of acquiring HP or occupational asthma under outbreak conditions and a 3.0% risk assuming outbreak conditions exist in 5% of MWF environments. In addition to respiratory outcomes, skin diseases such as allergic and irritant contact dermatitis persist as frequent causes of occupational disease following MWF exposure. SUMMARY Healthcare providers need to consider MWF exposure as a potential cause for work-related respiratory and skin diseases. Additional work is necessary to more definitively characterize any potential association between MWF exposures and BADE. Medical surveillance should be implemented for workers regularly exposed to MWF.
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Affiliation(s)
- Randall J Nett
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia
| | - Marcia Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia
| | - George R Grimes
- Division of Field Studies and Engineering, NIOSH, CDC, Cincinnati, Ohio, USA
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Bax CE, Chakka S, Concha JSS, Zeidi M, Werth VP. The effects of immunostimulatory herbal supplements on autoimmune skin diseases. J Am Acad Dermatol 2021; 84:1051-1058. [PMID: 32553683 PMCID: PMC7736300 DOI: 10.1016/j.jaad.2020.06.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 12/24/2022]
Abstract
The use of herbal supplements that promise to improve immune health has gained popularity among dermatology patients. However, there is little to no evidence that herbal supplements improve dermatologic conditions. Several in vitro and in vivo studies have shown that Spirulina platensis, Aphanizomenon flos-aqua, Chlorella, Echinacea, and alfalfa activate immune cells via certain cytokines and chemokines. Case reports suggest the association of ingesting immunostimulatory herbs and the clinical onset or flares of diseases characterized by an exaggerated immune response such as lupus erythematosus, dermatomyositis, and autoimmune blistering disorders. Therefore, it is imperative to investigate the prevalence of herbal supplement use in this patient population. In addition, in vitro studies should examine the underlying mechanisms by which herbs stimulate immune pathways that are already overactive in autoimmune patients.
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Affiliation(s)
- Christina E Bax
- Corporal Michael J. Crescenz Veterans Affairs Medical Center and the Department of Dermatology, University of Pennsylvania
| | - Srita Chakka
- Corporal Michael J. Crescenz Veterans Affairs Medical Center and the Department of Dermatology, University of Pennsylvania
| | - Josef Symon S Concha
- Corporal Michael J. Crescenz Veterans Affairs Medical Center and the Department of Dermatology, University of Pennsylvania
| | - Majid Zeidi
- Corporal Michael J. Crescenz Veterans Affairs Medical Center and the Department of Dermatology, University of Pennsylvania
| | - Victoria P Werth
- Corporal Michael J. Crescenz Veterans Affairs Medical Center and the Department of Dermatology, University of Pennsylvania.
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Park HJ, Jeong OY, Chun SH, Cheon YH, Kim M, Kim S, Lee SI. Butyrate Improves Skin/Lung Fibrosis and Intestinal Dysbiosis in Bleomycin-Induced Mouse Models. Int J Mol Sci 2021; 22:ijms22052765. [PMID: 33803282 PMCID: PMC7967124 DOI: 10.3390/ijms22052765] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/14/2022] Open
Abstract
Systemic sclerosis (SSc) is an autoimmune disorder characterized by fibrosis of the skin and internal organs. Despite several studies on SSc treatments, effective treatments for SSc are still lacking. Since evidence suggests an association between intestinal microbiota and SSc, we focused on butyrate, which has beneficial effects in autoimmune diseases as a bacterial metabolite. Here, we investigated the therapeutic potential of sodium butyrate (SB) using a bleomycin-induced fibrosis mouse model of SSc and human dermal fibroblasts (HDFs). SB attenuated bleomycin-induced dermal and lung fibrosis in mice. SB influenced fecal microbiota composition (phyla Actinobacteria and Bacteroidetes, genera Bifidobacterium and Ruminococcus_g2). SB controlled macrophage differentiation in mesenteric lymph nodes, spleen, and bronchoalveolar lavage cells of mice with bleomycin-induced skin fibrosis. Profibrotic and proinflammatory gene expression was suppressed by SB administration in skin. Furthermore, SB inhibited transforming growth factor β1-responsive proinflammatory expression with increased acetylation of histone 3 in HDFs. Subcutaneous SB application had antifibrogenic effects on the skin. Butyrate ameliorated skin and lung fibrosis by improving anti-inflammatory activity in a mouse model of SSc. Butyrate may exhibit indirect and direct anti-fibrogenic action on fibroblasts by regulating macrophage differentiation and inhibition of histone deacetylase 3. These findings suggest butyrate as an SSc treatment.
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Affiliation(s)
- Hee Jin Park
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
| | - Ok-Yi Jeong
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
- Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Korea
| | - Sung Hak Chun
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
| | - Yun Hong Cheon
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
| | - Mingyo Kim
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
| | - Suhee Kim
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
- Correspondence: (S.K.); (S.-I.L.)
| | - Sang-Il Lee
- Department of Internal Medicine and Institute of Health Science, College of Medicine, Gyeongsang National University and Hospital, Jinju 52727, Korea; (H.J.P.); (O.-Y.J.); (S.H.C.); (Y.H.C.); (M.K.)
- Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Korea
- Correspondence: (S.K.); (S.-I.L.)
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Yang W, Cai X, Zhang S, Han X, Ji L. Dipeptidyl peptidase-4 inhibitor treatment and the risk of bullous pemphigoid and skin-related adverse events: A systematic review and meta-analysis of randomized controlled trials. Diabetes Metab Res Rev 2021; 37:e3391. [PMID: 32741073 DOI: 10.1002/dmrr.3391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/24/2022]
Abstract
AIMS This meta-analysis aimed to evaluate the risk of developing bullous pemphigoid (BP) and other skin-related adverse events (AEs) in patients with type 2 diabetes (T2DM) undergoing dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment in randomized controlled trials (RCTs). METHODS In this meta-analysis, the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched for RCTs, which involve patients with T2DM reporting skin-related AEs. RCTs that comparatively evaluated the effects of DPP-4i treatment and placebo on patients with T2DM and reported skin-related AEs were included in the analysis. The odds ratio (OR) and 95% confidence interval (CI) were calculated using the Peto's methods. The GRADE approach was used to rate the quality of evidence. RESULTS A total of 46 randomized placebo-controlled trials, including 3 trials with reports of BP (n = 38 011), that reported skin-related AEs were included (n = 59 332). Compared to the placebo group, the risk of developing BP was significantly higher in the DPP-4i treatment group (OR = 7.38, 95% CI 2.00-27.25, I2 = 0%, P = .003; quality rating: very low). Additionally, DPP-4i treatment was associated with an increased overall risk of developing skin-related AEs (OR = 1.22, 95% CI 1.02-1.46, I2 = 32%, P = .03; quality rating: moderate). CONCLUSIONS This meta-analysis suggested that treatment with DPP-4is, including sitagliptin, saxagliptin, and linagliptin, was associated with an increased risk of developing BP. Additionally, the risk of developing skin-related AEs increased when all DPP-4is were combined. Skin lesion, especially BP, should be monitored in patients with diabetes undergoing DPP-4i treatment. Future studies should evaluate the susceptible population and develop strategies for early detection of skin-related AEs.
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Affiliation(s)
- Wenjia Yang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xiaoling Cai
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Simin Zhang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xueyao Han
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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Edwards CL, Comito F, Agraso Busto S, Harland C, Turajlic S, Larkin J, Heelan K, Fearfield L. Cutaneous toxicities in patients with melanoma receiving checkpoint inhibitor therapy: a retrospective review. The experience of a single large specialist institution. Clin Exp Dermatol 2021; 46:338-341. [PMID: 33010053 DOI: 10.1111/ced.14469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 01/19/2023]
Abstract
Checkpoint inhibitor (CPI) therapy has significantly improved overall survival for metastatic melanoma, and is now approved for use in the adjuvant setting. Modulating the immune system is recognized to cause cutaneous immune-related adverse events (irAEs). We conducted a retrospective observational cohort study of adult patients with melanoma at our tertiary referral centre, who received CPI therapy from 2006 to March 2018. This is the single largest study of cutaneous irAEs occurring on CPI therapy in patients with melanoma to date and encompasses 12 years. The results showed that cutaneous toxicity occurs in 24% of patients but is generally manageable, with < 5% patients discontinuing treatment.
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Affiliation(s)
- C L Edwards
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
| | - F Comito
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
| | - S Agraso Busto
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
| | - C Harland
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
| | - S Turajlic
- Department of, Cancer Dynamics Laboratory, Francis Crick Institute, London, UK
| | - J Larkin
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
| | - K Heelan
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
| | - L Fearfield
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
- Departments of, Department of, Dermatology, Royal Marsden NHS Foundation Trust, London, UK
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50
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Wang E, Kraehenbuehl L, Ketosugbo K, Kern JA, Lacouture ME, Leung DYM. Immune-related cutaneous adverse events due to checkpoint inhibitors. Ann Allergy Asthma Immunol 2021; 126:613-622. [PMID: 33609771 DOI: 10.1016/j.anai.2021.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/13/2021] [Accepted: 02/10/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To familiarize the reader with the most common cutaneous adverse events with immune checkpoint inhibitors (CPIs) and their grading and treatment. DATA SOURCES Recent research articles, relevant review articles, and case series/reports in English from the PubMed database mostly, from 2010 onward. STUDY SELECTIONS Most data are from retrospective studies and case series. Older studies regarding the mechanism were included if they were of particular importance. RESULTS An understanding of this review should enable the reader to identify specific skin disorders in patients receiving immune CPIs, grade the adverse event, and be able to treat or refer the patient as needed. CONCLUSION Allergists/immunologists need to be familiar with these immune-related cutaneous adverse events because their incidence will increase with the ever-expanding use of CPIs and, in particular, because patients will certainly continue to be referred suspecting drug allergies.
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Affiliation(s)
- Evelyn Wang
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Lukas Kraehenbuehl
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Swim Across America/Ludwig Collaborative Laboratory, Immunology Program, Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kwami Ketosugbo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jeffrey A Kern
- Cancer Center, Division of Oncology, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Mario E Lacouture
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
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