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Austin E, Mineroff J, Dana I, Jagdeo J. Blue light aminolevulinic acid photodynamic therapy downregulates cell division and proliferation pathways in cutaneous squamous cell carcinoma. J Biophotonics 2024; 17:e202300369. [PMID: 38332564 DOI: 10.1002/jbio.202300369] [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] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/12/2023] [Accepted: 12/28/2023] [Indexed: 02/10/2024]
Abstract
5-Aminolevulinic acid (5-ALA) photodynamic therapy (PDT) is a treatment for actinic keratosis (AK) and has been studied as a treatment for noninvasive cutaneous squamous cell carcinoma (cSCC). PDT induces apoptosis and necrosis in AKs and cSCC. 5-ALA blue light PDT may modulate gene expression and pathways in surviving cells. In this study, differential gene expression and pathway analysis of cSCC and human dermal fibroblasts were compared before and after 5-ALA blue light PDT using RNA sequencing. No genes were differentially expressed after correcting for multiple testing (false discovery rate < 0.05). As a result, transcription factor, gene enrichment, and pathway analysis were performed with genes identified before multiple testing (p < 0.05). Pathways associated with proliferation and carcinogenesis were downregulated. These findings using 5-ALA blue light PDT are similar to previously published studies using methyl-aminolevulinic and red light protocols, indicating that surviving residual cells may undergo changes consistent with a less aggressive cancerous phenotype.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
- Department of Dermatology, VA New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Jessica Mineroff
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
- Department of Dermatology, VA New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Isabella Dana
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
- Department of Dermatology, VA New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
- Department of Dermatology, VA New York Harbor Healthcare System, Brooklyn, New York, USA
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Patel P, Wang J, Bitterman D, Mineroff J, Austin E, Jagdeo J. Systematic review of randomized controlled trials of topicals for actinic keratosis field therapy. Arch Dermatol Res 2024; 316:108. [PMID: 38498070 DOI: 10.1007/s00403-024-02839-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/20/2024] [Accepted: 02/06/2024] [Indexed: 03/19/2024]
Abstract
Cutaneous field cancerization in dermatology describes the anatomic region of photodamaged skin with actinic keratoses (AKs) or cutaneous squamous cell carcinoma (cSCC) that is surrounded by cellular atypia, forming a dysplastic field. The concept of field cancerization is especially relevant in dermatology, as actinic keratoses and the surrounding dysplastic region can progress to carcinomas, necessitating the treatment of the field. Recent research has focused on field-directed therapy using topical agents. This study aims to systematically review randomized controlled trials on topical treatments for actinic keratosis field cancerization, following the PRISMA guidelines. Clinical recommendations were based on the Oxford Centre for Evidence-Based Medicine. We identified 20 original randomized controlled trials for topical cutaneous field therapy. 0.5% 5-Fluorouracil/salicylic acid and 0.5% 5-fluorouracil received a clinical recommendation grade of A, while diclofenac sodium received a clinical recommendation grade of B. Calcipotriol/5-fluorouracil, Imiquimod, sunscreen combination therapies, and tirbanibulin received a recommendation grade of C. This review provides a framework for clinicians when considering topical treatments for patients with field cancerization.
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Affiliation(s)
- Paras Patel
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Jennifer Wang
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8 Floor, Brooklyn, NY, 11203, USA
| | - David Bitterman
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
- New York Medical College, Valhalla, NY, USA
| | - Jessica Mineroff
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8 Floor, Brooklyn, NY, 11203, USA
| | - Evan Austin
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8 Floor, Brooklyn, NY, 11203, USA
| | - Jared Jagdeo
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA.
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8 Floor, Brooklyn, NY, 11203, USA.
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Mineroff J, Wang JY, Philip R, Austin E, Jagdeo J. Near-infrared light does not induce DNA damage in human dermal fibroblasts. J Biophotonics 2024; 17:e202300388. [PMID: 38019097 DOI: 10.1002/jbio.202300388] [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: 09/18/2023] [Revised: 10/21/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023]
Abstract
Photobiomodulation (PBM) can be used to treat a range of conditions in dermatology. PBM refers to the changes induced by red (RL, 620-700 nm) and near-infrared (NIR, 700-1440 nm) light. Light radiation-induced DNA damage is a major contributor to aging and skin cancer. It is crucial to study the effects of PBM on DNA to ensure safety. Our lab previously demonstrated that RL (633 ± 6 nm) did not result in human dermal fibroblasts (HDFs) DNA damage. This study employed similar methods to investigate NIR effects. Commercially available LED-NIR (830 ± 5 nm) panels (66, 132, and 264 J/cm2 ) did not result in DNA damage measured by cyclobutane pyrimidine dimers and pyrimidine-6,4-pyrimidone photoproducts in HDFs compared to temperature-matched controls immediately, 3 h, and 24 h following irradiation and compared to positive and negative controls. This demonstrates that LED-NIR does not damage DNA in HDFs in vitro.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, New York Harbor Veterans Affairs Healthcare System-Brooklyn Campus, Brooklyn, New York, USA
| | - Jennifer Y Wang
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, New York Harbor Veterans Affairs Healthcare System-Brooklyn Campus, Brooklyn, New York, USA
| | - Raichel Philip
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Evan Austin
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, New York Harbor Veterans Affairs Healthcare System-Brooklyn Campus, Brooklyn, New York, USA
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, New York Harbor Veterans Affairs Healthcare System-Brooklyn Campus, Brooklyn, New York, USA
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Mineroff J, Austin E, Feit E, Ho A, Lowe B, Marson J, Mojeski J, Wechter T, Nguyen JK, Jagdeo J. Male facial rejuvenation using a combination 633, 830, and 1072 nm LED face mask. Arch Dermatol Res 2023; 315:2605-2611. [PMID: 37418018 DOI: 10.1007/s00403-023-02663-w] [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: 03/31/2023] [Revised: 05/23/2023] [Accepted: 06/25/2023] [Indexed: 07/08/2023]
Abstract
Home-based photobiomodulation is a popular treatment modality for patients seeking non-invasive aesthetic treatment. Studies demonstrate that photobiomodulation is effective for skin rejuvenation, which is aimed at improving the overall appearance of the skin by reducing fine lines and wrinkles and improving skin texture, skin tone, and dyspigmentation. Most current skin rejuvenation research focuses on treatments in women. However, men's aesthetics remains an underserved market. A combined red light (RL) and near-infrared (NIR) light-emitting diode (LED) has been designed specifically to target male skin, which may have different physiological and biophysical properties compared to female skin. Herein, the safety and efficacy of a commercially available RL and NIR (633, 830, and 1072 nm) LED array designed to be worn as a face mask was assessed. Primary outcomes included adverse events and facial rejuvenation as determined by participant-reported satisfaction scales and quantitative digital skin photography and computer analysis after 6 weeks of treatment. The participants reported overall favorable results and improvements in all individual categories, were satisfied with the treatment, and would recommend the product to others. The participants perceived the greatest improvement in fine lines and wrinkles, skin texture, and youthful appearance. Photographic digital analysis demonstrated favorable improvements in wrinkles, UV spots, brown spots, pores, and porphyrins. These results support the use of RL and NIR to treat male skin. Advantages of the LED facemask include its safety, efficacy, convenient home-based use, minimal associated downtime, simple operation, non-invasiveness, and appreciable results in as few as 6 weeks.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Eric Feit
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Anthony Ho
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Brian Lowe
- Philadelphia College of Pharmacy, 600 S 43rd St, Philadelphia, PA, 19104, USA
| | - Justin Marson
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Jacob Mojeski
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Todd Wechter
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Julie K Nguyen
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA.
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA.
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA.
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Cohen M, Austin E, Bradu S, Jagdeo J. The Association Between Herpes Simplex Virus and Alzheimer's Disease: A Systematic Review. J Drugs Dermatol 2023; 22:1046-1052. [PMID: 37801540 DOI: 10.36849/jdd.6785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Alzheimer's disease (AD) is a significant public health concern, affecting more than 6 million Americans; and currently, there are no cure or effective treatment options. The underlying etiology and pathogenesis are not fully understood, presenting a barrier to therapy. A substantial amount of data exists associating infection with Herpes simplex virus 1 (HSV-1) and AD. This review of published studies highlights the epidemiological associations between HSV-1 and AD. A systematic search of PubMed, Embase, and Web of Science was conducted on January 6, 2022, using PRISMA guidelines. Articles that presented epidemiological data correlating HSV-1 with AD were included. Bibliographies were screened for additional relevant articles as well. After review, 21 studies were included: 2 review articles and 19 population-based studies including case control, cohort, and cross-sectional studies. The quantitative data derived from the studies in this report substantiate a relationship between infection with HSV-1 and AD. Based on these results, it may be of reasonable benefit to more consistently treat latent or active HSV-1 infection with anti-viral medications to potentially reduce the risk of AD. Furthermore, a prospective randomized controlled clinical trial could elucidate the benefit of anti-viral therapy to prevent or limit AD.J Drugs Dermatol. 2023;22(10):1046-1052 doi:10.36849/JDD.6785.
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Mineroff J, Austin E, Jagdeo J. Cutaneous effects of photobiomodulation with 1072 nm light. Arch Dermatol Res 2023; 315:1481-1486. [PMID: 36495337 DOI: 10.1007/s00403-022-02480-7] [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: 10/14/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022]
Abstract
Photobiomodulation, also known as low-level light therapy, has gained popularity in treating a variety of dermatologic and non-dermatologic conditions. The near-infrared (NIR) portion ranging from 700 to 1440 nm has a broad spectrum but most current research focuses on relatively shorter wavelengths. To date, clinical research regarding the application of 1072 NIR is limited to treatments for infections and photorejuvenation treatment in females. However, 1072 NIR light therapy may benefit male patients. This theoretical application is based on the biological properties of this subgroup having increased cutaneous density and thickness and the physical properties of 1072 NIR allowing it to penetrate increased depth. 1072 NIR can reach more cells throughout the epidermis and dermis compared to other parts of the electromagnetic spectrum traditionally used in phototherapy to provide unique and targeted benefits. 1072 NIR light-emitting diodes are commercially available and therefore hold tremendous potential to become accessible, affordable treatment options. Given the increased demand and market size for aesthetics for men that remains untapped, there is opportunity for future research to elucidate the potential for this wavelength as a safe and effective treatment.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, State University of New York, Downstate Health Sciences University, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA.
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Benoit M, Austin E, Simcox N, Rabinowitz P, Yost M. Predictors of Dairy Worker Pre-Test and Post-Test Performance on a Dairy Safety Knowledge Test: Impact of Education Level and Native Language. J Agromedicine 2022; 28:456-469. [PMID: 36300904 DOI: 10.1080/1059924x.2022.2140732] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Efficacy-driven assessments of linguistically appropriate occupational health and safety training (OHS) for dairy workers remain uncommon. This study analyzes predictors of performance on a dairy safety knowledge test using pre-and-post knowledge assessments. The safety training course was delivered by iPad™ to Idahoan dairy workers, managers, and owners. OBJECTIVE To determine the predictors of safety knowledge scores among dairy worker course participants. METHODS Predictors of pre-test (baseline) scores and change in test scores of n = 1,336 participants were compared, and multivariate iterative linear regressions were used to predict test performance, adjusting for variables such as occupation, years of formal education, native language, and years in dairy work. RESULTS Test scores for Spanish and English speakers improved between pre-test and post-test. Years of formal education was the most predictive variable of higher baseline scores and change in test scores among dairy safety course participants, regardless of language. CONCLUSION Dairy worker safety training course results showed improvements in safety knowledge and test scores. Years of formal education of participants appears to be a key determinant of increases in safety knowledge, and therefore safety training programs need to address the learning needs of less educated workers.
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Affiliation(s)
- M Benoit
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - E Austin
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - N Simcox
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - P Rabinowitz
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - M Yost
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
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Wang JY, Austin E, Jagdeo J. Visible red light does not induce DNA damage in human dermal fibroblasts. J Biophotonics 2022; 15:e202200023. [PMID: 35894162 DOI: 10.1002/jbio.202200023] [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: 01/30/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
Visible red light (RL) therapy is a rapidly expanding treatment option for dermatological conditions, including acne, psoriasis and chronic wounds. It is currently unknown if high fluences of RL induce DNA damage via reactive oxygen species (ROS) stress or other pathways. Our lab previously demonstrated that RL generates ROS in human dermal fibroblasts (HDFs). Other studies show that UV and blue light generate ROS and DNA damage in fibroblasts. This study aims to determine if RL induces DNA damage in HDFs. We found that 320 J/cm2 , 640 J/cm2 and 1280 J/cm2 RL (633 ± 6 nm) did not measurably increase DNA damage in the form of cyclobutane pyrimidine dimers (CPD) or 6-4 photoproducts (6-4PP) immediately, 3 hours and 24 hours following irradiation. Our study further supports that RL therapy is safe in human skin fibroblasts.
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Affiliation(s)
- Jennifer Y Wang
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, VA New York Harbor Healthcare System - Brooklyn Campus, Veterans Hospital, Brooklyn, New York, USA
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Austin E, Huang A, Wang JY, Cohen M, Heilman E, Maverakis E, Michl J, Jagdeo J. Red Light Phototherapy Using Light-Emitting Diodes Inhibits Melanoma Proliferation and Alters Tumor Microenvironments. Front Oncol 2022; 12:928484. [PMID: 35847848 PMCID: PMC9278815 DOI: 10.3389/fonc.2022.928484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/25/2022] [Indexed: 01/26/2023] Open
Abstract
Background Total annual cancer rates have decreased due to improved treatment and prevention. However, the incidence of melanoma is rising, and not all patients respond to immune and targeted approaches. Therefore, we sought to determine the efficacy of red light (RL) phototherapy in preclinical models of melanoma. Methods Melanoma cells (A375, B16F10, MNT-1) were irradiated with RL. Melanoma proliferation, apoptosis, oxidative stress, and p53 phosphorylation were measured in vitro. In C57BL/6 mice, phototherapy safety, B16F10 tumor growth, and immunocyte infiltration were assessed following RL. Results In vitro, 640 J/cm2 RL decreased cellular proliferation without increasing apoptosis, while 1280 J/cm2 increased apoptosis. RL increased intracellular reactive oxygen species generation and p53 phosphorylation. In animal models, 2560 J/cm2 RL significantly prevented melanoma growth and increased the expression of CD103+ dendritic cells. 1280 and 1920 J/cm2 RL decreased tumor volume, but not significantly. RL did not cause skin inflammation or erythema in normal skin. Conclusion RL represents a potentially safe and effective melanoma therapeutic. RL prevented tumor growth and increased the expression of immune markers, such as CD103, that are associated with favorable melanoma outcomes. Further research is needed to determine the optimal clinical treatment regimen for melanoma using RL.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States,Department of Dermatology, University of California (UC) Davis Medical Center, Sacramento, CA, United States
| | - Alisen Huang
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States
| | - Jennifer Y. Wang
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States
| | - Marc Cohen
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States
| | - Edward Heilman
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States
| | - Emanual Maverakis
- Department of Dermatology, University of California (UC) Davis Medical Center, Sacramento, CA, United States
| | - Josef Michl
- Department of Pathology, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Jared Jagdeo
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States,Department of Dermatology, University of California (UC) Davis Medical Center, Sacramento, CA, United States,*Correspondence: Jared Jagdeo,
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Alsoufi B, Kozik D, Sparks J, Wilkens S, Austin E, Trivedi J. Increasing Donor-Recipient Weight Mismatch is Associated with Shorter Waitlist Duration and No Increased Morbidity or Mortality. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Austin E, Blakely B, Salmon P, Braithwaite J, Clay-Williams R. The scope for adaptive capacity in emergency departments: modelling performance constraints using control task analysis and social organisational cooperation analysis. Ergonomics 2022; 65:467-484. [PMID: 34649471 DOI: 10.1080/00140139.2021.1992004] [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: 10/30/2020] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
Patient flow between the emergency department (ED) and hospital wards becomes problematic when bed availability is limited. To better understand the constraints that shape patient flow and everyday work in the ED, we applied Control Task Analysis (i.e. Contextual Activities Template, CAT) and Social Organisational Cooperation Analysis (SOCA) phases from the Cognitive Work Analysis framework to identify ways in which to optimise patient flow. The model and analysis were created through observations in the ED of clinicians (e.g. nurses, doctors), and professional staff (e.g. ward personnel, clerks). The CAT and SOCA-CAT models illustrate workspaces, patient journey phases, and patient volume within the department that are heavily loaded with tasks and human and non-human agents performing these tasks, while others are underutilised. The findings suggest that an ED's adaptive capacity could be strengthened through the integration of additional human and non-human agents allowing the redistribution of clinical and non-clinical tasks. Practitioner Summary: Workflow in EDs is constrained by uneven geographical distribution of activities, insufficient adaptive support during critical patient journey phases and periods of high patient volume. Adaptive capacity could be strengthened by additional human and non-human agents in combination with a redistribution of tasks, supporting seamless successful structural and behavioural adaptation in ED.
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Affiliation(s)
- E Austin
- Macquarie University, Sydney, Australia
| | - B Blakely
- Macquarie University, Sydney, Australia
| | - P Salmon
- University of the Sunshine Coast, Maroochydore, Australia
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Zeng J, Bergersen A, Price E, Callegari M, Austin E, Oduyemi O, Poling K, Hsu CH, Funk J, Twiss C. Symptom Resolution and Recurrent Urinary Incontinence Following Removal of Painful Midurethral Slings. Urology 2022; 159:78-82. [PMID: 34474043 DOI: 10.1016/j.urology.2021.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate pain improvement and recurrent stress incontinence (SUI) following painful synthetic midurethral sling (MUS) removal. METHODS We conducted a retrospective review of patients who underwent synthetic MUS removal at our institution from 2009-2016 for the indication of pain. We recorded sling type (transobturator vs retropubic), complete vs partial removal, and presenting symptoms. Postoperative pain improvement was categorized as resolved (pain resolved, requiring no further therapy), improved (pain less bothersome, may require further therapy), or unresolved (no/minimal improvement, requiring further management). Recurrent incontinence and further reconstructive procedures were assessed. RESULTS 87 patients (49 complete and 38 partial removal) with pain as the primary indication for removal were included. Median age at intervention was 54 years with median follow-up of 8 months. Overall, pain improved or resolved in 78.1% of cases. Complete removal was associated with significantly greater percentage of pain resolution (63.3%) compared to partial removal (26.3%) (P = 0.002) regardless of sling type. No significant differences in recurrent SUI were noted in complete vs partial removal. Additional reconstructive procedures were performed in 28 patients, most commonly sling placement, with no significant difference in complete (20.4%) vs partial (28.9%) removal groups (P = 0.36). The overall complication rate was low (5.7%), a majority of which were transfusions (4.6%). CONCLUSION Following MUS removal, most patients experienced resolution or improvement of pain. Complete sling removal was associated with significantly greater percentage of pain resolution compared to partial removal in both retropubic and transobturator slings. Rates of recurrent SUI and reintervention for SUI were not related to the extent of sling removal.
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Affiliation(s)
- Jiping Zeng
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Andrew Bergersen
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Elinora Price
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | | | - Evan Austin
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Odutoyosi Oduyemi
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Kristi Poling
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Chiu-Hsieh Hsu
- Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona
| | - Joel Funk
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Christian Twiss
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona.
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Austin E, Koo E, Merleev A, Torre D, Marusina A, Luxardi G, Mamalis A, Isseroff RR, Ma'ayan A, Maverakis E, Jagdeo J. Transcriptome analysis of human dermal fibroblasts following red light phototherapy. Sci Rep 2021; 11:7315. [PMID: 33795767 PMCID: PMC8017006 DOI: 10.1038/s41598-021-86623-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022] Open
Abstract
Fibrosis occurs when collagen deposition and fibroblast proliferation replace healthy tissue. Red light (RL) may improve skin fibrosis via photobiomodulation, the process by which photosensitive chromophores in cells absorb visible or near-infrared light and undergo photophysical reactions. Our previous research demonstrated that high fluence RL reduces fibroblast proliferation, collagen deposition, and migration. Despite the identification of several cellular mechanisms underpinning RL phototherapy, little is known about the transcriptional changes that lead to anti-fibrotic cellular responses. Herein, RNA sequencing was performed on human dermal fibroblasts treated with RL phototherapy. Pathway enrichment and transcription factor analysis revealed regulation of extracellular matrices, proliferation, and cellular responses to oxygen-containing compounds following RL phototherapy. Specifically, RL phototherapy increased the expression of MMP1, which codes for matrix metalloproteinase-1 (MMP-1) and is responsible for remodeling extracellular collagen. Differential regulation of MMP1 was confirmed with RT-qPCR and ELISA. Additionally, RL upregulated PRSS35, which has not been previously associated with skin activity, but has known anti-fibrotic functions. Our results suggest that RL may benefit patients by altering fibrotic gene expression.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA.,Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA
| | - Eugene Koo
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA
| | - Alexander Merleev
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA
| | - Denis Torre
- Department of Pharmacological Sciences, Mount Sinai Center for Bioinformatics, Icahn School of Medicine at Mount Sinai Health, New York, NY, USA
| | - Alina Marusina
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA
| | - Guillaume Luxardi
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA
| | - Andrew Mamalis
- Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA
| | - Roslyn Rivkah Isseroff
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA.,Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA
| | - Avi Ma'ayan
- Department of Pharmacological Sciences, Mount Sinai Center for Bioinformatics, Icahn School of Medicine at Mount Sinai Health, New York, NY, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA
| | - Jared Jagdeo
- Department of Dermatology, University of California at Davis, Sacramento, CA, USA. .,Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA. .,Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA.
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Kurtti A, Austin E, Jagdeo J. Representation of skin color in dermatology-related Google image searches. J Am Acad Dermatol 2021; 86:705-708. [PMID: 33744357 DOI: 10.1016/j.jaad.2021.03.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/08/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Alana Kurtti
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, New York
| | - Evan Austin
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, New York; Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Jared Jagdeo
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, New York; Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York.
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15
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Austin E, Geisler AN, Nguyen J, Kohli I, Hamzavi I, Lim HW, Jagdeo J. Visible light. Part I: Properties and cutaneous effects of visible light. J Am Acad Dermatol 2021; 84:1219-1231. [PMID: 33640508 DOI: 10.1016/j.jaad.2021.02.048] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/22/2022]
Abstract
Approximately 50% of the sunlight reaching the Earth's surface is visible light (400-700 nm). Other sources of visible light include lasers, light-emitting diodes, and flash lamps. Photons from visible light are absorbed by photoreceptive chromophores (e.g., melanin, heme, and opsins), altering skin function by activating and imparting energy to chromophores. Additionally, visible light can penetrate the full thickness of the skin and induce pigmentation and erythema. Clinically, lasers and light devices are used to treat skin conditions by utilizing specific wavelengths and treatment parameters. Red and blue light from light-emitting diodes and intense pulsed light have been studied as antimicrobial and anti-inflammatory treatments for acne. Pulsed dye lasers are used to treat vascular lesions in adults and infants. Further research is necessary to determine the functional significance of visible light on skin health without confounding the influence of ultraviolet and infrared wavelengths.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, New York
| | | | - Julie Nguyen
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, New York
| | - Indermeet Kohli
- Department of Dermatology, Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan
| | - Iltefat Hamzavi
- Department of Dermatology, Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan
| | - Henry W Lim
- Department of Dermatology, Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, New York.
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16
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Geisler AN, Austin E, Nguyen J, Hamzavi I, Jagdeo J, Lim HW. Visible light. Part II: Photoprotection against visible and ultraviolet light. J Am Acad Dermatol 2021; 84:1233-1244. [PMID: 33640513 DOI: 10.1016/j.jaad.2020.11.074] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 09/17/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 01/08/2023]
Abstract
Cutaneous photobiology studies have focused primarily on the ultraviolet portion of the solar spectrum. Visible light (VL), which comprises 50% of the electromagnetic radiation that reaches the Earth's surface and, as discussed in Part I of this CME, has cutaneous biologic effects, such as pigment darkening and erythema. Photoprotection against VL includes avoiding the sun, seeking shade, and using photoprotective clothing. The organic and inorganic ultraviolet filters used in sunscreens do not protect against VL, only tinted sunscreens do. In the United States, these filters are regulated by the Food and Drug Administration as an over-the-counter drug and are subject to more stringent regulations than in Europe, Asia, and Australia. There are no established guidelines regarding VL photoprotection. Alternative measures to confer VL photoprotection are being explored. These novel methods include topical, oral, and subcutaneous agents. Further development should focus on better protection in the ultraviolet A1 (340-400 nm) and VL ranges while enhancing the cosmesis of the final products.
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Affiliation(s)
| | - Evan Austin
- Department of Dermatology, Center for Photomedicine, SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, New York
| | - Julie Nguyen
- Department of Dermatology, Center for Photomedicine, SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, New York
| | - Iltefat Hamzavi
- Department of Dermatology, Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan
| | - Jared Jagdeo
- Department of Dermatology, Center for Photomedicine, SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, New York.
| | - Henry W Lim
- Department of Dermatology, Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan
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17
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Masub N, Austin E, Huang A, Jagdeo J. High-fluence light emitting diode-red light inhibits cell cycle progression in human dermal fibroblasts. J Biophotonics 2021; 14:e202000359. [PMID: 33038043 PMCID: PMC8935855 DOI: 10.1002/jbio.202000359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 05/11/2023]
Abstract
Skin fibrosis is a debilitating feature of several systemic and dermatologic diseases. While current treatment options carry significant risk of side effects and recurrence, high-fluence light emitting diode-generated red light (LED-RL) is an alternative therapeutic that is safe, non-invasive, and accessible. We previously demonstrated LED-RL decreases fibroblast proliferation, a key pathogenic component of fibrosis. However, the cellular mechanism by which high fluence LED-RL modulates fibroblast proliferation is unclear. Herein, we explored the effects of high fluence LED-RL on human dermal fibroblast cell cycle progression. We demonstrate that LED-RL at 640 J/cm2 induced significant arrest of cells in G0 /G1 compared to temperature-matched control. This was accompanied by a corresponding increase in expression of checkpoint regulator p53 in irradiated cells. These data demonstrate high fluence LED-RL may exert its anti-proliferative effect on fibroblasts by inducing G0 /G1 arrest. Further, this study provides insight into the molecular mechanism underlying LED-RL as an anti-fibrotic therapeutic.
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Affiliation(s)
- Natasha Masub
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
| | - Alisen Huang
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
- Dermatology Service, VA New York Harbor Healthcare System – Brooklyn Campus, Brooklyn, NY
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18
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Nguyen JK, Austin E, Huang A, Mamalis A, Jagdeo J. The IL-4/IL-13 axis in skin fibrosis and scarring: mechanistic concepts and therapeutic targets. Arch Dermatol Res 2020; 312:81-92. [PMID: 31493000 PMCID: PMC7008089 DOI: 10.1007/s00403-019-01972-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [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: 06/05/2019] [Revised: 07/22/2019] [Accepted: 08/29/2019] [Indexed: 02/06/2023]
Abstract
Skin fibrosis, characterized by excessive fibroblast proliferation and extracellular matrix deposition in the dermis, is the histopathologic hallmark of dermatologic diseases such as systemic sclerosis, hypertrophic scars, and keloids. Effective anti-scarring therapeutics remain an unmet need, underscoring the complex pathophysiologic mechanisms of skin fibrosis. The Th2 cytokines interleukin (IL)-4 and IL-13 have been implicated as key mediators in the pathogenesis of fibroproliferative disorders. The goal of this article is to summarize the current understanding of the role of the IL-4/IL-13 axis in wound healing and skin fibrosis. We conducted a literature search to identify research studies investigating the roles of IL-4 and IL-13 in fibrotic skin diseases. While transforming growth factor-beta has long been regarded as the main driver of fibrotic processes, research into the cellular and molecular biology of wound healing has revealed other pathways that promote scar tissue formation. IL-4 and IL-13 are important mediators of skin fibrosis, supported by evidence from in vitro data, animal models of fibrosis, and clinical studies. Overactive signaling of the IL-4/IL-13 axis contributes to the initiation and perpetuation of fibrotic skin diseases. Further insights into the IL-4/IL-13 axis may reveal potential targets for the development of novel therapies that prevent or treat fibrotic skin diseases.
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Affiliation(s)
- Julie K Nguyen
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Evan Austin
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Alisen Huang
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Andrew Mamalis
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA.
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY, USA.
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19
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Jagdeo J, Nguyen JK, Ho D, Wang EB, Austin E, Mamalis A, Kaur R, Kraeva E, Schulman JM, Li CS, Hwang ST, Wun T, Maverakis E, Isseroff RR. Safety of light emitting diode-red light on human skin: Two randomized controlled trials. J Biophotonics 2020; 13:e201960014. [PMID: 31483941 PMCID: PMC8887049 DOI: 10.1002/jbio.201960014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/31/2019] [Accepted: 09/01/2019] [Indexed: 05/08/2023]
Abstract
Therapeutic applications of light emitting diode-red light (LED-RL) are expanding, yet data on its clinical effects are lacking. Our goal was to evaluate the safety of high fluence LED-RL (≥160 J/cm2 ). In two phase I, single-blind, dose escalation, randomized controlled trials, healthy subjects received LED-RL or mock irradiation to the forearm thrice weekly for 3 weeks at fluences of 160-640 J/cm2 for all skin types (STARS 1, n = 60) and at 480-640 J/cm2 for non-Hispanic Caucasians (STARS 2, n = 55). The primary outcome was the incidence of adverse events (AEs). The maximum tolerated dose was the highest fluence that did not elicit predefined AEs. Dose-limiting AEs, including blistering and prolonged erythema, occurred at 480 J/cm2 in STARS 1 (n = 1) and 640 J/cm2 in STARS 2 (n = 2). AEs of transient erythema and hyperpigmentation were mild. No serious AEs occurred. We determined that LED-RL is safe up to 320 J/cm2 for skin of color and 480 J/cm2 for non-Hispanic Caucasian individuals. LED-RL may exert differential cutaneous effects depending on race and ethnicity, with darker skin being more photosensitive. These findings may guide future studies to evaluate the efficacy of LED-RL for the treatment of various diseases.
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Affiliation(s)
- Jared Jagdeo
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
| | - Julie K. Nguyen
- Department of Dermatology, The State University of New York Downstate Medical Center, Brooklyn, NY
- Dermatology Service, VA New York Harbor Healthcare System Brooklyn Campus, Brooklyn, NY
| | - Derek Ho
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
| | - Erica B. Wang
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
| | - Evan Austin
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Andrew Mamalis
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Department of Dermatology, The State University of New York Downstate Medical Center, Brooklyn, NY
| | - Ramanjot Kaur
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
| | - Ekaterina Kraeva
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
| | - Joshua M. Schulman
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
| | - Chin-Shang Li
- Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Sacramento, CA
| | - Samuel T. Hwang
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Ted Wun
- Division of Hematology & Oncology, Department of Internal Medicine, University of California Davis, Sacramento, CA
- Division of Hematology & Oncology, Sacramento VA Medical Center, Mather, CA
- UC Davis Clinical and Translational Sciences Center, Sacramento, CA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - R. Rivkah Isseroff
- Department of Dermatology, University of California, Davis, Sacramento, CA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA
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20
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Huang A, Nguyen JK, Austin E, Mamalis A, Cohen M, Semkhayev B, Ho D, Jagdeo J. Facial rejuvenation using photodynamic therapy with a novel preparation of ALA and hyaluronic acid in young adults. Arch Dermatol Res 2020; 312:567-573. [PMID: 32060617 PMCID: PMC7429523 DOI: 10.1007/s00403-020-02038-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/18/2020] [Indexed: 11/24/2022]
Abstract
Photodynamic therapy (PDT) is a well-established, non-invasive treatment modality that has shown desirable effects such as improvement of fine lines, dyspigmentation, and other signs of photodamage. Many patients seek to decrease, or reverse, effects of sun damage on the skin. Hyaluronic acid (HA), a naturally occurring glycosaminoglycan found in the body, has enormous potential to bind water which allows the skin to retain moisture and maintain elasticity. Topical application of HA has been found to produce anti-wrinkle effects. We conducted a pilot case series evaluating the safety and efficacy of a commercially available 2% 5-aminolevulinic acid (ALA) gel with hyaluronic acid (ALA-HA) and light-emitting diode-red light (LED-RL) for facial rejuvenation as determined by clinical assessments and digital skin analysis of rhytides, pore size, and erythema. All patients noted improvement of their skin and experienced minimal pain during PDT. Evaluation by dermatologists demonstrated significant improvement in overall skin appearance. Digital analysis of photographs revealed improvement of skin spots, wrinkles, pores, texture, UV spots, brown spots, red areas, and porphyrins. Our findings demonstrated safety and efficacy of this novel preparation of photodynamic gel with HA and subsequent activation with LED-RL.
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Affiliation(s)
- Alisen Huang
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Julie K Nguyen
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Andrew Mamalis
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Marc Cohen
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Boris Semkhayev
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Derek Ho
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Box 46, Brooklyn, NY, USA.
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Austin E, Nguyen JK, Jagdeo J. Topical Treatments for Melasma: A Systematic Review of Randomized Controlled Trials. J Drugs Dermatol 2019; 18:S1545961619P1156X. [PMID: 31741361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Melasma is an acquired skin disease characterized by symmetric hyperpigmentation on sun-exposed areas, particularly on the face. Recently, there has been tremendous scientific interest in novel, safe, and effective topical agents to manage melasma. Objective: To evaluate topical treatments for melasma and provide evidence-based recommendations for clinical use and further research. Methods: We performed a systematic review of randomized controlled trials (RCTs) on topical agents for the treatment of melasma on March 4th, 2019 using PRISMA guidelines. Clinical recommendations were based on the American College of Physicians guidelines. Results: After screening, we identified 35 original RCTs using azelaic acid, cysteamine, epidermal growth factor, hydroquinone (liposomal-delivered), lignin peroxidase, mulberry extract, niacinamide, Rumex occidentalis, triple combination therapy, tranexamic acid, 4-n-butylresorcinol, glycolic acid, kojic acid, aloe vera, ascorbic acid, dioic acid, ellagic acid and arbutin, flutamide, parsley, or zinc sulfate for melasma. Conclusions: Cysteamine, triple combination therapy, and tranexamic acid received strong clinical recommendations for the treatment of melasma. Cysteamine has excellent efficacy and is reported to have anti-cancer properties, but has not been directly compared with hydroquinone. Triple combination agents and tranexamic acid are effective, but carry theoretical risks for ochronosis and thrombosis, respectively. Natural compounds are associated with low risk for adverse events, but more research is needed to determine the efficacy, optimal formulation, and appropriate concentration of novel treatments. J Drugs Dermatol. 2019;18(11):1156-1171.
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Abstract
Purpose of Review Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Advances in the understanding of cutaneous field cancerization have led to novel therapeutic approaches to the management of actinic keratoses (AKs). Herein, we review the literature on the pathophysiology and emerging research of field cancerization in dermatology. Recent Findings The classification systems for grading AK lesions are being refined with investigations focusing on their clinical utility. There is a growing shift towards field-directed treatment for AKs as the importance of field cancerization becomes clearer. Current field-directed therapies are being optimized and novel therapeutic modalities are being studied. Summary Field cancerization underlies the transformation of photodamaged skin into AKs and potentially cutaneous SCC (cSCC). Clinically meaningful classification systems for AKs are needed to better inform decisions regarding treatment. As we learn more about the role of field characterization in photodamage, AKs and cSCCs, therapeutic strategies are becoming more field-directed rather than lesion-directed.
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Affiliation(s)
- Alisen Huang
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Julie K Nguyen
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Andrew Mamalis
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
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23
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Wang EB, Kaur R, Nguyen J, Ho D, Austin E, Maverakis E, Li CS, Hwang ST, Isseroff RR, Jagdeo J. A single-blind, dose-escalation, phase I study of high-fluence light-emitting diode-red light on Caucasian non-Hispanic skin: study protocol for a randomized controlled trial. Trials 2019; 20:177. [PMID: 30894210 PMCID: PMC6425608 DOI: 10.1186/s13063-019-3278-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/27/2018] [Accepted: 03/04/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Visible light (400 to 700 nm) is common in our environment, comprising 44% of total solar radiation and a large component of environmental light exposure. The effects of visible light on skin remain undefined. The red light portion of the visible spectrum (600 to 700 nm) may be used to treat skin diseases as a monotherapeutic modality or in combination with other agents. Light-emitting diode-red light (LED-RL) phototherapy may represent an important advance in light-based treatment modalities because it is non-invasive, inexpensive, portable, and easily combinable with other therapies. We previously determined the maximum tolerated dose (MTD) of high-fluence LED-RL (HF-LED-RL) in skin of color individuals to be 320 J/cm2. To the best of our knowledge, no clinical trials have been performed to determine the safety of higher doses of HF-LED-RL in Caucasian non-Hispanic individuals. The aim of this study is to investigate the safety of HF-LED-RL at doses of 480 and 640 J/cm2 in healthy Caucasian non-Hispanic individuals. METHODS This is a single-blind, dose-escalation, randomized, controlled, phase I trial titled Safety Trial Assessing Red-light on Skin (STARS) 2. Healthy subjects will be randomly assigned to groups of five (three subjects randomly assigned to HF-LED-RL phototherapy and two subjects randomly assigned to mock therapy). Subjects in group 1 will receive HF-LED-RL or mock irradiation at the starting dose of 480 J/cm2, and the dose will be escalated in the subsequent group (group 2) to 640 J/cm2. The MTD is defined as the dose level below the dose at which two or more subjects (>20% of the cohort) experience a dose-limiting toxicity (DLT). After either the MTD is established or the study endpoint of 640 J/cm2 is achieved, additional HF-LED-RL phototherapy subjects and mock therapy subjects will be enrolled at that fluence (group 3) for a total number of up to 60 subjects. Each subject will receive a total of nine irradiation sessions, three times per week for three consecutive weeks. DISCUSSION This follow-up study aims to provide important knowledge about safety and cutaneous effects of HF-LED-RL phototherapy of 480 and 640 J/cm2 in Caucasian non-Hispanic subjects. The importance of this clinical trial is that it may establish new treatment paradigms and a safety profile for LED-RL based on race and ethnicity. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03433222 . Registered on February 1, 2018 - Retrospectively registered. Protocol date and version: January 12, 2018; version 1.
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Affiliation(s)
- Erica B Wang
- Department of Dermatology, Stanford University, 269 Campus Drive CCSR 2150, Stanford, CA, 94305, USA
| | - Ramanjot Kaur
- Dermatology Service, Sacramento VA Medical Center, 10535 Hospital Way, Mather, CA, 95655, USA
- Department of Dermatology, University of California Davis, 3301 C Street, Suite 1400, Sacramento, CA, 95816, USA
| | - Julie Nguyen
- Department of Dermatology, The State University of New York Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Derek Ho
- Department of Dermatology, The State University of New York Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Evan Austin
- Department of Dermatology, The State University of New York Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California Davis, 3301 C Street, Suite 1400, Sacramento, CA, 95816, USA
| | - Chin-Shang Li
- School of Nursing, The State University of New York, University of Buffalo, 3435 Main St, Buffalo, NY, 14214, USA
| | - Samuel T Hwang
- Department of Dermatology, University of California Davis, 3301 C Street, Suite 1400, Sacramento, CA, 95816, USA
| | - R Rivkah Isseroff
- Dermatology Service, Sacramento VA Medical Center, 10535 Hospital Way, Mather, CA, 95655, USA
- Department of Dermatology, University of California Davis, 3301 C Street, Suite 1400, Sacramento, CA, 95816, USA
| | - Jared Jagdeo
- Department of Dermatology, The State University of New York Downstate Medical Center, 450 Clarkson Avenue MSC 46, Brooklyn, NY, 11203, USA.
- Dermatology Service, VA New York Harbor Healthcare System - Brooklyn Campus, 800 Poly Pl, Brooklyn, NY, 11209, USA.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA -
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Abstract
As the prevalence of lasers and light devices to treat dermatologic conditions increases, patient reported outcomes (PROs) will be an essential component of evaluating clinical efficacy and patient satisfaction. PROs may be used to identify patients' values, weigh risks and benefits of various therapies, identify barriers to treatment and help guide the development of new therapies. Utilizing patient and physician assessments may help determine if a new treatment is objectively better than currently available therapies. In creating a patient-centered treatment plan using laser and light modalities, it is critical to evaluate side effects using PROs. Determining and resolving barriers to treatment has benefits at the individual level and the population level. Many PRO measures (PROMs) are available to use for general and specific dermatologic conditions. The Dermatologic Life Quality Index, Skindex, and FACE-Q are PROMs that have been used in laser and light therapy studies. Selecting the proper instrument should be based on study aims to yield high quality data. Herein, we assess PROs use in laser and light treatment protocols to improve patient care, increase patient satisfaction and reduce barriers to care, and review dermatology PRO measures (PROMs) used in published laser and light clinical studies.
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Affiliation(s)
- Alisen Huang
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA -
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Abstract
Photodynamic therapy (PDT) is a medical procedure that involves incubation of an exogenously applied photosensitizer (PS) followed by visible light photoactivation to induce cell apoptosis. The Federal Drug Administration has approved PDT for the treatment of actinic keratosis, and clinical guidelines recommend PDT as a treatment for certain non-melanoma skin cancers and acne vulgaris. PDT is an advantageous therapeutic modality as it is low cost, non-invasive, and associated with minimal adverse events and scaring. In the first step of PDT, a PS is applied and allowed to accumulate intracellularly. Subsequent light irradiation induces reactive oxygen species formation, which may ultimately lead to cell apoptosis, membrane disruption, mitochondrial damage, immune modulation, keratinocyte proliferation, and collagen turnover. Herein, we present an in vitro method to study PDT in an adherent cell line. This treatment protocol is designed to simulate PDT and may be adjusted to studying the use of PDT with various cell lines, photosensitizers, incubation temperatures, or photoactivation wavelengths. Squamous cell carcinoma cells were incubated with 0, 0.5, 1.0, and 2 mM 5-aminolevulinic acid (5-ALA) for 30 min and photoactivated with 417 nm blue light for 1,000 s. The primary outcome measure was apoptosis and necrosis, as measured by annexin-V and 7-aminoactinomycin D flow cytometry. There was a dose-dependent increase in cell apoptosis following thirty-minute incubation of 5-ALA. To achieve high inter-test validity, it is important to maintain consistent incubation and light parameters when performing in vitro PDT experiments. PDT is a useful clinical procedure and in vitro research may allow for the development of novel PSs, optimization of protocols, and new indications for PDT.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, University of California, Davis; Dermatology Service, Sacramento VA Medical Center;
| | - Jared Jagdeo
- Department of Dermatology, University of California, Davis; Dermatology Service, Sacramento VA Medical Center; Department of Dermatology, State University of New York, Downstate Medical Center
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Sweeney DL, Wang EB, Austin E, Jagdeo J. Combined Hyperthermic 1060nm Diode Laser Lipolysis With Topical Skin Tightening Treatment: Case Series. J Drugs Dermatol 2018; 17:780-785. [PMID: 30005101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND As body contouring procedures have become more popular, post-procedural skin laxity is a concern. Non-invasive body contouring technologies may effectively reduce body fat, but modestly affect skin tightening. OBJECTIVE To assess the efficacy and safety of a topical skin tightening agent in combination with hyperthermic diode laser lipolysis. METHODS Herein, we describe five patients in which a skin tightening concentrate of 5% yeast extract, 2% hydrolyzed rice protein content, and 2.5% tripeptide was used after 1500-2100 J/cm2 of hyperthermic 1060 nm diode laser. RESULTS Overall, all patients had a subjective positive response and high satisfaction with the combined treatment results of improvement in skin laxity and fat reduction. In all five cases, patients demonstrated visible fat reduction and skin improvement on photographs taken between weeks 6-18 compared to baseline. Blinded investigators correctly predicted the order of the photographs based on treatment results. No adverse events were reported. CONCLUSION This case series demonstrated that a combined topical skin tightening concentrate with a hyperthermic laser lipolysis device may achieve improved aesthetic outcomes without adverse events. J Drugs Dermatol. 2018;17(7):780-785.
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Farber H, Badlam J, Frost A, Benza R, Austin E, Badesch D, Chung W, Poms A, Feldkircher K, Yu C, Pauciulo M, Nichols W, Elliott C. The United States Pulmonary Hypertension Scientific Registry (USPHSR): Objectives and Preliminary Data. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Austin E, Millsop JW, Ely H, Jagdeo J, Schulman JM. Psoriasiform Pemphigus Foliaceus in an African American Female: An Important Clinical Manifestation. J Drugs Dermatol 2018; 17:471-473. [PMID: 29601624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 50-year-old African-American woman presented to the dermatology clinic with a pruritic eruption of 3 years' duration. On clinical examination, the patient had well-demarcated, pink, atrophic plaques and superficial erosions over the inframammary folds and mid-chest. She also had well-demarcated, hyperpigmented, hyperkeratotic scaly plaques over the abdomen, suprapubic region, elbows, knees, and back with sporadic small superficial blisters. A punch biopsy of the right abdomen was performed and revealed psoriasiform epidermal hyperplasia, focal parakeratosis, and acantholysis throughout the superficial spinous and granular layers. Only a sparse inflammatory infiltrate was present in the underlying dermis. Clinical and histological findings supported the diagnosis of pemphigus foliaceus (PF), but psoriasis was included in the differential diagnosis due to the presence of discrete plaques with an erythematous border. We hypothesize that patients with psoriasiform presentations of PF may be misdiagnosed with plaque psoriasis. It is important to distinguish between PF and psoriasis as there is evidence that ultraviolet light, a common treatment for psoriasis, may exacerbate PF. We document and highlight this atypical psoriasiform presentation of PF in a patient with skin of color to raise awareness and improve diagnosis and outcomes. <p><em>J Drugs Dermatol. 2018;17(4):471-473.</em></p>.
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Austin E, Huang A, Adar T, Wang E, Jagdeo J. Electronic device generated light increases reactive oxygen species in human fibroblasts. Lasers Surg Med 2018; 50:689-695. [PMID: 29399830 DOI: 10.1002/lsm.22794] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2017] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Our skin is constantly exposed to light from solar radiation and electronic devices, which impact skin physiology and aging. The biological altering properties of ultraviolet (UV) solar radiation on skin have been well established. There is significant scientific and public interest on the effects of electronic device generated light (EDGL) on skin. Currently, the effects of EDGL on skin are largely unknown. EDGL includes UV, visible, and infrared light from consumer electronics such as smartphones, computers, and televisions. In this study, we measured the wavelength specific irradiance from electronic devices, and irradiated fibroblasts with white EDGL to determine changes in reactive oxygen species generation, apoptosis, and necrosis. METHODS To determine the EDGL output of commonly used consumer electronic devices, we measured the irradiance from electronic devices at the manufacturers' recommended reading distances and at 1 cm. To determine the effect of EDGL on human skin cells, we irradiated AG13145 fibroblasts with EDGL for 1 hour at a distance of 1 cm and measured changes in reactive oxygen species generation, apoptosis, and necrosis. RESULTS ROS increased significantly by 81.71%, 85.79%, and 92.98% relative to control following 1 hour of white EDGL from iPhone 8+, iPhone 6, and iPad (first generation), respectively. There was a non-significant change in apoptosis following irradiation with an iPhone 8+, iPhone 6, and iPad. Total necrosis was less than 2% for all treatment and control groups. CONCLUSIONS Our results suggest that short exposures of EDGL increase ROS generation, but the long-term effects associated with repeated exposures of EDGL are unknown. As electronic devices become more widely used and integrated into society globally, we anticipate greater scientific research and general public interest on the effects of visible EDGL on skin. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Evan Austin
- Dermatology Service, Sacramento VA Medical Center, Mather, California
- Department of Dermatology, University of California at Davis, Sacramento, California
| | - Amy Huang
- Department of Internal Medicine, Mount Sinai Medical Center, New York, New York
| | - Tony Adar
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Erica Wang
- Dermatology Service, Sacramento VA Medical Center, Mather, California
- Department of Dermatology, University of California at Davis, Sacramento, California
| | - Jared Jagdeo
- Dermatology Service, Sacramento VA Medical Center, Mather, California
- Department of Dermatology, University of California at Davis, Sacramento, California
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, New York
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Jagdeo J, Austin E, Mamalis A, Wong C, Ho D, Siegel DM. Light-emitting diodes in dermatology: A systematic review of randomized controlled trials. Lasers Surg Med 2018; 50:613-628. [PMID: 29356026 PMCID: PMC6099480 DOI: 10.1002/lsm.22791] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE In dermatology, patient and physician adoption of light-emitting diode (LED) medical technology continues to grow as research indicates that LEDs may be used to treat skin conditions. The goal of this systematic review is to critically analyze published randomized controlled trials (RCTs) and provide evidence-based recommendations on the therapeutic uses of LEDs in dermatology based on published efficacy and safety data. METHODS A systematic review of the published literature on the use of LED treatments for skin conditions was performed on September 13th 2017. RESULTS Thirty-one original RCTs were suitable for review. CONCLUSIONS LEDs represent an emerging modality to alter skin biology and change the paradigm of managing skin conditions. Acne vulgaris, herpes simplex and zoster, and acute wound healing received grade of recommendation B. Other skin conditions received grade of recommendation C or D. Limitations of some studies include small patient sample sizes (n < 20), absent blinding, no sham placebo, and varied treatment parameters. Due to few incidences of adverse events, affordability, and encouraging clinical results, we recommend that physicians use LEDs in clinical practice and researchers continue to explore the use of LEDs to treat skin conditions. Lasers Surg. Med. 9999:1-16, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Jared Jagdeo
- Department of DermatologyUniversity of California at DavisSacramentoCalifornia
- Dermatology ServiceSacramento VA Medical CenterMatherCalifornia
- Department of DermatologyDownstate Medical CenterState University of New YorkBrooklynNew York
| | - Evan Austin
- Department of DermatologyUniversity of California at DavisSacramentoCalifornia
- Dermatology ServiceSacramento VA Medical CenterMatherCalifornia
| | - Andrew Mamalis
- Department of DermatologyDownstate Medical CenterState University of New YorkBrooklynNew York
| | | | - Derek Ho
- Department of DermatologyUniversity of California at DavisSacramentoCalifornia
- Dermatology ServiceSacramento VA Medical CenterMatherCalifornia
| | - Daniel M. Siegel
- Department of DermatologyDownstate Medical CenterState University of New YorkBrooklynNew York
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Austin E, Mamalis A, Ho D, Jagdeo J. Laser and light-based therapy for cutaneous and soft-tissue metastases of malignant melanoma: a systematic review. Arch Dermatol Res 2017; 309:229-242. [PMID: 28314913 DOI: 10.1007/s00403-017-1720-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 07/22/2016] [Revised: 11/22/2016] [Accepted: 01/20/2017] [Indexed: 11/25/2022]
Abstract
Invasive cutaneous melanoma is a growing health concern. Although surgical excision can effectively treat in situ tumors, use for metastatic melanoma is limited. Laser and light-based therapies may be a valuable palliative treatment option for patients with stage III and stage IV cutaneous metastatic melanoma. Our goal is to review the published literature and provide evidence-based recommendations on laser and light-based palliative therapies for metastatic melanoma. A search of the databases Pubmed, EMBASE, Web of Science, and CINAHL was performed on March 10, 2016. Key search terms were related to melanoma, laser, and light-based modalities. Our search initially identified 13,923 articles and 27 original articles met inclusion criteria for our review. Grade of recommendation: C for non-fractionated carbon dioxide laser, Grade of recommendation: D for fractionated carbon dioxide laser, ruby laser, neodymium laser, near-infrared diode laser, and photodynamic therapy. Non-fractionated carbon dioxide laser had the best palliative efficacy of the reviewed laser and light-based therapies, while other treatment modalities may have potential as adjunctive therapy to standard of care.
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Affiliation(s)
- Evan Austin
- Department of Dermatology, University of California at Davis, 3301C Street Suite #1400, Sacramento, California, 95816, USA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA
| | - Andrew Mamalis
- Department of Dermatology, University of California at Davis, 3301C Street Suite #1400, Sacramento, California, 95816, USA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA
| | - Derek Ho
- Department of Dermatology, University of California at Davis, 3301C Street Suite #1400, Sacramento, California, 95816, USA
- Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA
| | - Jared Jagdeo
- Department of Dermatology, University of California at Davis, 3301C Street Suite #1400, Sacramento, California, 95816, USA.
- Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA.
- Department of Dermatology, Downstate Medical Center, State University of New York, Brooklyn, NY, USA.
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Koo E, Austin E, Mamalis A, Jagdeo J. Efficacy of ultra short sub-30 minute incubation of 5-aminolevulinic acid photodynamic therapy in vitro. Lasers Surg Med 2017; 49:592-598. [PMID: 28370019 DOI: 10.1002/lsm.22648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE The estimated incidence of cutaneous squamous cell carcinoma (SCC) is 700,000 cases per year. In the US, SCC incidence is highest among fair skinned adults older than 50 years of age. Thus, as the population ages, the reported number of SCCs will likely increase in the future. Photodynamic therapy (PDT) is an FDA approved therapy for treatment of actinic keratoses (AKs), a precursor to cutaneous SCC lesions. The FDA approved incubation time of the photosensitizing agent 5-aminolevulinic acid (ALA) is 14-18 hours. Recent studies have investigated short ALA incubation times of 1-3 hours with ALA and PDT demonstrating treatment success. Therefore, the question exists whether ALA incubation periods of less than 30 minutes are efficacious. Herein, we evaluate the efficacy of short ALA incubation periods by measuring apoptosis after 10, 15, and 20 minutes of ALA incubation. STUDY DESIGN/MATERIALS AND METHODS AG13145 normal human dermal fibroblasts HDFs were incubated with 10, 15, or 20 minute of ALA at various concentrations (0, 0.05, 0.075, 0.1, 0.25, 0.375, 0.5, 1, and 2 mM). After ALA incubation, samples were treated with 1,000 seconds (16 minutes 40 seconds) of Blu-U fluorescent blue light (417 ± 5 nm) for a fluence of 10 J/cm2 . Immediately following treatment with blue light, samples were collected and stained for apoptosis and necrosis with annexin-V and 7-aminoactinomycin D (7-AAD), and then analyzed by flow cytometry. RESULTS HDFs incubated with ALA for 10 minute at 36 °C followed by 10 J/cm2 of blue light had no statistically significant changes in apoptosis. HDFs incubated with ALA for 15 or 20 minutes at 36 °C followed by 10 J/cm2 of blue light had statistically significant increases in the percentages of cells positive for apoptosis in the 0.5, 1.0, and 2.0 mM ALA doses (P < 0.05). CONCLUSIONS We found that incubation of ALA for at least 15 minutes followed by 10 J/cm2 of blue light resulted in a statistically significant increase in apoptosis. Lasers Surg. Med. 49:592-598, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Eugene Koo
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, University of California Davis, Sacramento, California
| | - Evan Austin
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, University of California Davis, Sacramento, California
| | - Andrew Mamalis
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Jared Jagdeo
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, University of California Davis, Sacramento, California.,Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
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Ahmad Z, Austin E, Bajalan M. Three-dimensional printing in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Austin E, Vahle N. Relationships of the Managing Emotions in Others Scale (MEOS) with HEXACO personality and with trait EI factors and facets. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.05.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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36
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Ye Z, Bailey K, Austin E. Family History of Atherosclerotic Vascular Disease Is Associated With the Presence of Abdominal Aortic Aneurysm. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Muzny C, Burkholder G, Austin E, Schwebke J. 8: Missed opportunities for trichomonas vaginalis diagnosis and treatment at an urban HIV clinic. Am J Obstet Gynecol 2015. [DOI: 10.1016/j.ajog.2015.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Probst FJ, James RA, Burrage LC, Rosenfeld JA, Bohan TP, Ward Melver CH, Magoulas P, Austin E, Franklin AIA, Azamian M, Xia F, Patel A, Bi W, Bacino C, Belmont JW, Ware SM, Shaw C, Cheung SW, Lalani SR. De novo deletions and duplications of 17q25.3 cause susceptibility to cardiovascular malformations. Orphanet J Rare Dis 2015; 10:75. [PMID: 26070612 PMCID: PMC4472615 DOI: 10.1186/s13023-015-0291-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 06/02/2015] [Indexed: 01/28/2023] Open
Abstract
Background Genomic disorders resulting from deletion or duplication of genomic segments are known to be an important cause of cardiovascular malformations (CVMs). In our previous study, we identified a unique individual with a de novo 17q25.3 deletion from a study of 714 individuals with CVM. Methods To understand the contribution of this locus to cardiac malformations, we reviewed the data on 60,000 samples submitted for array comparative genomic hybridization (CGH) studies to Medical Genetics Laboratories at Baylor College of Medicine, and ascertained seven individuals with segmental aneusomy of 17q25. We validated our findings by studying another individual with a de novo submicroscopic deletion of this region from Cytogenetics Laboratory at Cincinnati Children’s Hospital. Using bioinformatic analyses including protein-protein interaction network, human tissue expression patterns, haploinsufficiency scores, and other annotation systems, including a training set of 251 genes known to be linked to human cardiac disease, we constructed a pathogenicity score for cardiac phenotype for each of the 57 genes within the terminal 2.0 Mb of 17q25.3. Results We found relatively high penetrance of cardiovascular defects (~60 %) with five deletions and three duplications, observed in eight unrelated individuals. Distinct cardiac phenotypes were present in four of these subjects with non-recurrent de novo deletions (range 0.08 Mb–1.4 Mb) in the subtelomeric region of 17q25.3. These included coarctation of the aorta (CoA), total anomalous pulmonary venous return (TAPVR), ventricular septal defect (VSD) and atrial septal defect (ASD). Amongst the three individuals with variable size duplications of this region, one had patent ductus arteriosus (PDA) at 8 months of age. Conclusion The distinct cardiac lesions observed in the affected patients and the bioinformatics analyses suggest that multiple genes may be plausible drivers of the cardiac phenotype within this gene-rich critical interval of 17q25.3. Electronic supplementary material The online version of this article (doi:10.1186/s13023-015-0291-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- F J Probst
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - R A James
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - L C Burrage
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - J A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - T P Bohan
- Department of Neurology, Memorial Hermann Texas Medical Center, Houston, TX, USA
| | - C H Ward Melver
- Genetic Center, Children's Hospital Medical Center Of Akron, Akron, OH, USA
| | - P Magoulas
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - E Austin
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - A I A Franklin
- Department of Developmental Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - M Azamian
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - F Xia
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - A Patel
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - W Bi
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - C Bacino
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - J W Belmont
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - S M Ware
- Departments of Pediatrics and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - C Shaw
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - S W Cheung
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA
| | - S R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS BCM225, Houston, TX, USA.
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Best PB, Elwen SH, Palsbøll PJ, Thornton M, Austin E, Vinding K. Possible non-offspring nursing in the southern right whale,Eubalaena australis. J Mammal 2015. [DOI: 10.1093/jmammal/gyv042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Glemser O, Marsmann H, Austin E. Notizen: Zur Existenz von Thorium(IV)-oxidhydroxid. Zeitschrift für Naturforschung B 2014. [DOI: 10.1515/znb-1966-1226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- O. Glemser
- Anorganisch-Chemisches Institut der Universität Göttingen
| | - H. Marsmann
- Anorganisch-Chemisches Institut der Universität Göttingen
| | - E. Austin
- Anorganisch-Chemisches Institut der Universität Göttingen
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Rostambeigi N, Dekarske A, Austin E, Golzarian J, Cressman E. Simulation study on cost-effectiveness of radioembolization compared with trans-arterial chemoembolization for hepatocellular carcinoma. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Chen LY, Chong JP, Chang IC, Austin E, Quay CN, Richards AM, Ling LH. Plasma mid-regional pro-atrial natriuretic peptide is associated with and improves prediction of lone atrial fibrillation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tyson S, Austin E, Laughlin A, Green J, Minuzzo B. SAFETY AROUND THE HOME: AN INTERACTIVE, EVIDENCE-BASED GUIDE TO CREATING A SAFE HOME ENVIRONMENT. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580d.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mikhail I, Austin E, Buckman S, Lee C, Goodman N, White J. P03.14. Cancer complementary and alternative medicine research among NCI’s cancer centers program and the integrative medicine programs: an inventory. Altern Ther Health Med 2012. [PMCID: PMC3373353 DOI: 10.1186/1472-6882-12-s1-p267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yousif N, Ao L, Li J, Aly A, Austin E, Fullerton D, Meng X. Myocardial Tissue TLR4 Plays A Major Role In Mediating Myocardial Injury Following Cold Ischemia And Reperfusion Through Up-regulation Of MCP-1. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Koske AK, Austin E, Boehmer J, Lindemayer M, Stormer D, Juanes F. Trophic Cascades: Predators, Prey and the Changing Dynamics of Nature.. J. Terborgh and J. A. Estes, editors. Integr Comp Biol 2010. [DOI: 10.1093/icb/icq156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hamid R, Hedges LK, Austin E, Phillips JA, Loyd JE, Cogan JD. Transcripts from a novel BMPR2 termination mutation escape nonsense mediated decay by downstream translation re-initiation: implications for treating pulmonary hypertension. Clin Genet 2010; 77:280-6. [PMID: 20095988 DOI: 10.1111/j.1399-0004.2009.01311.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bone morphogenetic protein receptor type 2 (BMPR2) gene mutations are a major risk factor for heritable pulmonary arterial hypertension (HPAH), an autosomal dominant fatal disease. We have previously shown that BMPR2 transcripts that contain premature termination codon (PTC) mutations are rapidly and nearly completely degraded through nonsense mediated decay (NMD). Here we report a unique PTC mutation (W13X) that did not behave in the predicted manner. We found that patient-derived cultured lymphocytes (CLs) contained readily detectable levels of the PTC-containing transcript. Further analysis suggested that this transcript escaped NMD by translational re-initiation at a downstream Kozak sequence, resulting in the omission of 173 amino acids. Treatment of CLs containing the PTC with an aminoglycoside decreased the truncated protein levels, with a reciprocal increase in full-length BMPR2 protein and, importantly, BMPR-II signaling. This is the first demonstration of aminoglycoside-mediated 'repair' of a BMPR2 mutation at the protein level in patient-derived cells and has obvious implications for treatment of HPAH where no disease-specific treatment options are available. Our data also suggest the need for a more thorough characterization of mutations prior to labeling them as haploinsufficient or dominant negative based simply on sequencing data.
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Affiliation(s)
- R Hamid
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
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Henson J, Krajewski K, Edmonds H, Sehic A, Austin E, Mitchell M. 31 CEREBRAL PERFUSION IN NEONATES UNDERGOING REPAIR OF COMPLEX CONGENITAL HEART DEFECTS IS DETERMINED BY CARBON DIOXIDE PREOPERATIVELY BUT BY BLOOD PRESSURE POSTOPERATIVELY. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0015.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Henson J, Krajewski K, Edmonds H, Sehic A, Austin E, Mitchell M. Cerebral Perfusion in Neonates Undergoing Repair of Complex Congenital Heart Defects is Determined by Carbon Dioxide Preoperatively but by Blood Pressure Postoperatively. J Investig Med 2006. [DOI: 10.1177/108155890605402s110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- J. Henson
- University of Louisville, Louisville, KY
| | | | - H. Edmonds
- University of Louisville, Louisville, KY
| | - A. Sehic
- University of Louisville, Louisville, KY
| | - E. Austin
- University of Louisville, Louisville, KY
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Pantalos G, Ionan C, Colyer J, Koenig S, Mitchell M, Austin E, Speakman J, Lucci C, Johnson G, Gartner M. Initial in vitro and in vitro performance results for the pediatric cardiopulmonary assist system (pCAS). J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83946-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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