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1.
Int J Mol Sci ; 24(14)2023 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-37511600

RESUMO

Melanin production is an important process that prevents the host skin from harmful ultraviolet radiation; however, an overproduction of melanin results in skin diseases. In the present study, we determined the antioxidative and anti-melanogenic activities of polyphenol- and flavonoid-enriched rice seed extracts in melan-a cells. The polyphenol and flavonoid content of Hopum (HP) and Sebok (SB) rice seed extracts was measured. The antioxidant capacity was determined using the ABTS radical scavenging method. SB contained high amounts of polyphenols and flavonoids, which significantly increased antioxidative activity compared with HP. Various concentrations of these extracts were evaluated in a cytotoxicity using melan-a cells. At 100 µg/mL, there was no significant difference for all treatments compared with untreated cells. Therefore, 100 µg/mL was selected as a concentration for the further experiments. SB significantly suppressed the phosphorylation/activation of p-38 MAPK, increased the expression of phosphorylated ERK 1/2 and Akt, and downregulated the microphthalmia-associated transcription factor (MITF). This resulted in decreased levels of tyrosinase and tyrosinase-related protein-1 and -2. These results indicate the potential of polyphenol- and flavonoid-enriched rice seed as a treatment for hyperpigmentation.


Assuntos
Melaninas , Oryza , Melaninas/metabolismo , Flavonoides/farmacologia , Polifenóis/farmacologia , Regulação para Baixo , Oryza/metabolismo , Transdução de Sinais , Fator de Transcrição Associado à Microftalmia/metabolismo , Antígeno MART-1/metabolismo , Antígeno MART-1/farmacologia , Raios Ultravioleta , Monofenol Mono-Oxigenase/metabolismo , Extratos Vegetais/farmacologia , Linhagem Celular Tumoral
2.
Photodermatol Photoimmunol Photomed ; 33(1): 49-57, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27696509

RESUMO

BACKGROUND: Skin hyperpigmentary disorders including postinflammatory hyperpigmentation, melasma, solar lentigines, and conditions like freckles are common. The light-emitting diodes (LEDs) are the latest category of nonthermal and noninvasive phototherapy to be considered in skin pigmentation disorder treatment. PURPOSE: The purpose of this study was to investigate the effects of 660-nm LED on inhibition of melanogenesis. We investigated whether a 660-nm LED affected melanin synthesis in in vitro and in vivo models, and we explored the mechanisms involved. METHODS: The inhibitory effect of 660-nm LED on melanin synthesis was evaluated in B16F10 cells and HRM-2 melanin-possessing hairless mice were used to evaluate the antimelanogenic effects of 660-nm LED. RESULTS: Interestingly, 660-nm LED inhibited alpha-melanocyte-stimulating hormone-induced tyrosinase activity in B16F10 cells. We also found that 660-nm LED decreased MITF and tyrosinase expression and induced the activation of ERK. These findings suggest that the depigmenting effects of 660-nm LED result from downregulation of MITF and tyrosinase expression due to increased ERK activity. The 660-nm LED reduced UVB-induced melanogenesis in the skin of HRM-2 via downregulation of tyrosinase and MITF. CONCLUSION: These findings suggest 660-nm LED is a potentially depigmentation strategy.


Assuntos
Luz , Melaninas/biossíntese , Fator de Transcrição Associado à Microftalmia/metabolismo , Monofenol Mono-Oxigenase/metabolismo , Biossíntese de Proteínas/efeitos da radiação , Pele/efeitos da radiação , Animais , Linhagem Celular Tumoral , Oxirredutases Intramoleculares/metabolismo , Antígeno MART-1/análise , Glicoproteínas de Membrana/metabolismo , Camundongos , Camundongos Pelados , Fator de Transcrição Associado à Microftalmia/análise , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Monofenol Mono-Oxigenase/análise , Oxirredutases/metabolismo , Proteínas S100/análise , Pele/química , alfa-MSH/metabolismo
3.
Int J Hyperthermia ; 29(3): 234-8, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23590363

RESUMO

PURPOSE: Isolated limb perfusion (ILP) with hyperthermia is an effective treatment for in-transit metastases of malignant melanoma in the extremities. Preclinical studies have shown that hyperthermia may induce an immunogenic death of tumour cells. We therefore decided to study whether ILP may induce tumour-specific immune responses in the clinical setting. METHOD: The number of Melan-A/Mart-1 specific CD8+ T cells, as well as other phenotypically different immune cells, was recorded in peripheral blood in 12 HLA-A2+ patients with in-transit metastases undergoing hyperthermic ILP with melphalan. RESULTS: All patients underwent ILP without any complication and with an overall response rate of 83%. No substantial changes in the number of circulating T-cells, B-cells, NK-cells or monocytes were observed during follow-up. Four out of 12 patients showed an elevation of Melan-A+ CD8+ T-cells 4 weeks after ILP. CONCLUSION: We here report our preliminary observations that a small increase in tumour-specific T-cells could be seen in a subpopulation of patients after ILP. However, much more work is necessary to fully delineate the systemic immune response to hyperthermic ILP.


Assuntos
Hipertermia Induzida , Antígeno MART-1/imunologia , Melanoma/imunologia , Neoplasias Cutâneas/imunologia , Linfócitos T Citotóxicos/imunologia , Idoso , Idoso de 80 Anos ou mais , Extremidades , Feminino , Humanos , Contagem de Linfócitos , Subpopulações de Linfócitos/imunologia , Masculino , Melanoma/patologia , Melanoma/terapia , Pessoa de Meia-Idade , Perfusão , Projetos Piloto , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia
4.
Pigment Cell Melanoma Res ; 25(6): 765-72, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22863119

RESUMO

Human skin hyperpigmentation disorders occur when the synthesis and/or distribution of melanin increases. The distribution of melanin in the skin is achieved by melanosome transport and transfer. The transport of melanosomes, the organelles where melanin is made, in a melanocyte precedes the transfer of the melanosomes to a keratinocyte. Therefore, hyperpigmentation can be regulated by decreasing melanosome transport. In this study, we found that an extract of Saururus chinensis Baill (ESCB) and one of its components, manassantin B, inhibited melanosome transport in Melan-a melanocytes and normal human melanocytes (NHMs). Manassantin B disturbed melanosome transport by disrupting the interaction between melanophilin and myosin Va. Manassantin B is neither a direct nor an indirect inhibitor of tyrosinase. The total melanin content was not reduced when melanosome transport was inhibited in a Melan-a melanocyte monoculture by manassantin B. Manassantin B decreased melanin content only when Melan-a melanocytes were co-cultured with SP-1 keratinocytes or stimulated by α-MSH. Therefore, we propose that specific inhibitors of melanosome transport, such as manassantin B, are potential candidate or lead compounds for the development of agents to treat undesirable hyperpigmentation of the skin.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Furanos/farmacologia , Melanócitos/metabolismo , Melanossomas/metabolismo , Miosina Tipo V/metabolismo , Animais , Transporte Biológico/efeitos dos fármacos , Núcleo Celular/efeitos dos fármacos , Núcleo Celular/metabolismo , Proliferação de Células/efeitos dos fármacos , Técnicas de Cocultura , Furanos/química , Humanos , Queratinócitos/citologia , Queratinócitos/efeitos dos fármacos , Queratinócitos/metabolismo , Antígeno MART-1/metabolismo , Melaninas/metabolismo , Melanócitos/citologia , Melanócitos/efeitos dos fármacos , Melanossomas/efeitos dos fármacos , Melanossomas/enzimologia , Camundongos , Camundongos Endogâmicos C57BL , Monofenol Mono-Oxigenase/metabolismo , Extratos Vegetais/farmacologia , Ligação Proteica/efeitos dos fármacos , Saururaceae/química
5.
Fitoterapia ; 83(6): 989-95, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22714008

RESUMO

In an effort to find botanicals containing polyphenolic compounds with the capacity to inhibit melanin biosynthesis, we identified a novel combination of Siberian larch (Larix sibirica) extract, standardized to 80% taxifolin, and pomegranate fruit (Punica granatum) extract, containing 20% punicalagins, that demonstrates a synergistic reduction of melanin biosynthesis in Melan-a cells. The combination of Siberian larch and pomegranate extracts (1:1) produced a 2-fold reduction in melanin content compared to Siberian larch or pomegranate extracts alone with no corresponding effect on cell viability. Siberian larch and pomegranate fruit extracts inhibited expression of melanocyte specific genes, tyrosinase (Tyr), microphthalmia transcription factor (Mitf), and melanosome structural proteins (Pmel17 and Mart1) but did not inhibit tyrosinase enzyme activity. These results suggest that the mechanism of inhibition of melanin biosynthesis by Siberian larch and pomegranate extracts, alone and in combination, is through downregulation of melanocyte specific genes and not due to inhibition of tyrosinase enzyme activity.


Assuntos
Expressão Gênica/efeitos dos fármacos , Taninos Hidrolisáveis/farmacologia , Larix/química , Lythraceae/química , Melaninas/biossíntese , Extratos Vegetais/farmacologia , Quercetina/análogos & derivados , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Regulação para Baixo , Combinação de Medicamentos , Sinergismo Farmacológico , Frutas , Humanos , Antígeno MART-1/metabolismo , Melaninas/genética , Melanócitos/efeitos dos fármacos , Melanócitos/metabolismo , Antígenos Específicos de Melanoma/genética , Antígenos Específicos de Melanoma/metabolismo , Monofenol Mono-Oxigenase/genética , Monofenol Mono-Oxigenase/metabolismo , Quercetina/farmacologia , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Antígeno gp100 de Melanoma
6.
Pigment Cell Melanoma Res ; 25(1): 57-65, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21982055

RESUMO

In this study, we developed an in vivo vitiligo induction model to explore the underlying mechanisms leading to Koebner's phenomenon and to evaluate the efficacy of therapeutic strategies. The model consisted of 12 pigmented test regions on the back of generalized vitiligo patients that were exposed to three Koebner induction methods: cryotherapy, 755 nm laser therapy, and epidermal abrasion. In addition, four cream treatments (pimecrolimus, tacrolimus, steroid and placebo) were randomly applied. Koebnerization was efficiently induced by all three induction methods. In general, cryotherapy was the best method of Koebner induction, followed by 755 nm laser therapy and epidermal abrasion. Reproducible results were obtained, which showed enhanced depigmented surface areas and higher amounts of T lymphocytes in placebo-treated test zones compared to active treated areas. Tacrolimus and local steroids were better inhibitors of Koebner's process (P < 0.05) compared to pimecrolimus. Our in vivo vitiligo induction model is very informative to investigate vitiligo induction and to determine the efficacy of topical treatments in vitiligo. This proof of concept confirms the efficient comparison of head-to-head therapeutic strategies intra-individually in a standardized, specific and better timed way.


Assuntos
Crioterapia/efeitos adversos , Dermabrasão/efeitos adversos , Imunossupressores/uso terapêutico , Terapia com Luz de Baixa Intensidade/efeitos adversos , Vitiligo/tratamento farmacológico , Vitiligo/etiologia , Administração Cutânea , Adulto , Método Duplo-Cego , Feminino , Humanos , Imunossupressores/administração & dosagem , Células de Langerhans/patologia , Antígeno MART-1/análise , Masculino , Pessoa de Meia-Idade , Furoato de Mometasona , Pomadas , Pregnadienodiois/administração & dosagem , Pregnadienodiois/uso terapêutico , Reprodutibilidade dos Testes , Subpopulações de Linfócitos T/patologia , Tacrolimo/administração & dosagem , Tacrolimo/análogos & derivados , Tacrolimo/uso terapêutico , Triancinolona Acetonida/administração & dosagem , Triancinolona Acetonida/uso terapêutico , Vitiligo/imunologia , Vitiligo/patologia , Antígeno gp100 de Melanoma/análise
7.
Planta Med ; 77(3): 248-51, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20814852

RESUMO

Tyrosinase is a key enzyme in the biosynthetic pathway of melanin pigments. Abnormal accumulation of melanin pigments causes melasma, freckles, and senile lentigo, which can be substantially ameliorated by treatment with arbutin or other tyrosinase inhibitors. In this study, roots of Angelica koreana Maxim. (Umbelliferae) inhibited melanin production in α-melanocyte stimulating hormone ( α-MSH)-activated B16 melanoma cells or melan-a melanocytes. To elucidate the hypopigmenting principle of A. koreana, the plant extracts were subjected to bioassay-guided phytochemical analysis, resulting in the identification of bisabolangelone. Bisabolangelone dose-dependently inhibited α-MSH-induced melanin production in B16 or melan-a cells with IC(15) values of 9-17 µM. The positive control arbutin also inhibited melanin production in B16 cells with an IC(50) value of 317 µM. Bisabolangelone suppressed α-MSH-inducible protein levels of tyrosinase in B16 cells but could not significantly inhibit the catalytic activity of cell-free tyrosinase. Taken together, this study indicates that bisabolangelone is the primary hypopigmenting principle of A. koreana and may have pharmacological potential in the melanin-associated hyperpigmentation disorders.


Assuntos
Angelica/química , Hiperpigmentação/tratamento farmacológico , Melaninas/biossíntese , Monofenol Mono-Oxigenase/metabolismo , Extratos Vegetais/farmacologia , Sesquiterpenos/farmacologia , Pele/efeitos dos fármacos , Animais , Linhagem Celular , Linhagem Celular Tumoral , Fármacos Dermatológicos/farmacologia , Fármacos Dermatológicos/uso terapêutico , Relação Dose-Resposta a Droga , Hiperpigmentação/metabolismo , Concentração Inibidora 50 , Antígeno MART-1/metabolismo , Melanócitos/efeitos dos fármacos , Melanoma Experimental/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Raízes de Plantas , Sesquiterpenos/isolamento & purificação , Sesquiterpenos/uso terapêutico , Pele/citologia , Pele/metabolismo , alfa-MSH/metabolismo
8.
Photodermatol Photoimmunol Photomed ; 26(1): 16-21, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20070834

RESUMO

INTRODUCTION: Phototherapy with visible light is gaining interest in dermatological practice. Theoretically, blue light could induce biological effects comparable to ultraviolet A (UVA) radiation. OBJECTIVES: To study the effects of blue light on normal skin in terms of photodamage, skin ageing and melanogenesis. METHODS: Eight healthy volunteers were included and irradiation with visible blue light was given on five consecutive days. Skin biopsies were analysed with respect to photodamage (p53, vacuolization, sunburn cells), skin ageing (elastosis, MMP-1) and melanogenesis (Melan-A). RESULTS: No inflammatory cells and sunburn cells were visible before or after irradiation. A significant increase in the perinuclear vacuolization of keratinocytes was demonstrated during treatment (P=0.02) with a tendency towards significance after cessation of treatment (P=0.09). No significant change in p53 expression was seen. Signs of elastosis and changes in MMP-1 expression were absent. Minimal clinical hyperpigmentation of the irradiated skin was confirmed histologically with a significant increase in Melan-A-positive cells (P=0.03). CONCLUSIONS: Visible blue light, as given in the present study, does not cause deoxyribonucleic acid damage or early photo-ageing. The biological effects of blue light on normal skin are transient melanogenesis and inexplicable vacuolization without resulting apoptosis. In conclusion, the (short-term) use of visible blue light in dermatological practice is safe.


Assuntos
Luz/efeitos adversos , Fototerapia/efeitos adversos , Envelhecimento da Pele/efeitos da radiação , Pele/patologia , Adulto , Antígenos de Neoplasias/metabolismo , Feminino , Humanos , Antígeno MART-1 , Masculino , Metaloproteinase 1 da Matriz/metabolismo , Proteínas de Neoplasias/metabolismo , Pele/metabolismo , Envelhecimento da Pele/patologia , Queimadura Solar/metabolismo , Queimadura Solar/patologia , Proteína Supressora de Tumor p53/metabolismo
9.
BMC Cancer ; 8: 161, 2008 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-18533025

RESUMO

BACKGROUND: Viscum album (VA) preparations have been used as a complimentary therapy in cancer. In addition to their cytotoxic properties, they have also been shown to have immunostimulatory properties. In the present study, we examine the hypothesis that the VA preparations induce activation of human DC that facilitates effective tumor regression. METHODS: Four day old monocyte-derived immature DCs were treated with VA Qu Spez at 5, 10 and 15 microg/ml for 48 hrs. The expression of surface molecules was analyzed by flow cytometry. The ability of Qu Spez-educated DC to stimulate T cells was analyzed by allogeneic mixed lymphocyte reaction and activation of Melan-A/MART-1-specific M77-80 CD8+T cells. Cytokines in cell free culture supernatant was analyzed by cytokine bead array assay. RESULTS: VA Qu Spez stimulated DCs presented with increased expression of antigen presenting molecule HLA-DR and of co-stimulatory molecules CD40, CD80 and CD86. The VA Qu Spez also induced the secretion of inflammatory cytokines IL-6 and IL-8. Further, Qu Spez-educated DC stimulated CD4+T cells in a allogeneic mixed lymphocyte reaction and activated melanoma antigen Melan-A/MART-1-specific M77-80 CD8+T cells as evidenced by increased secretion of TNF-alpha and IFNgamma. CONCLUSION: The VA preparations stimulate the maturation and activation of human DCs, which may facilitate anti-tumoral immune responses. These results should assist in understanding the immunostimulatory properties of VA preparations and improving the therapeutic strategies.


Assuntos
Adjuvantes Imunológicos/farmacologia , Células Dendríticas/efeitos dos fármacos , Células Dendríticas/imunologia , Fitoterapia/métodos , Extratos Vegetais/farmacologia , Viscum album/química , Antígenos de Neoplasias/farmacologia , Antígeno B7-1/biossíntese , Antígeno B7-1/imunologia , Antígeno B7-2/biossíntese , Antígeno B7-2/imunologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/efeitos dos fármacos , Linfócitos T CD8-Positivos/imunologia , Células Cultivadas , Anergia Clonal/efeitos dos fármacos , Humanos , Interleucina-6/biossíntese , Interleucina-6/imunologia , Interleucina-8/biossíntese , Interleucina-8/imunologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/imunologia , Ativação Linfocitária/efeitos dos fármacos , Teste de Cultura Mista de Linfócitos , Antígeno MART-1 , Proteínas de Neoplasias/farmacologia , Fator de Necrose Tumoral alfa/farmacologia
10.
Int Immunol ; 17(8): 1131-40, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16030131

RESUMO

The majority of maturing T lymphocytes that recognize self-antigens is eliminated in the thymus upon exposure to their target antigens. This physiological process of negative selection requires that tissue-specific antigens be expressed by thymic cells, a phenomenon that has been well studied in experimental animals. Here, we have examined the expression in human thymi of four retinal antigens, that are capable of inducing autoimmune ocular disease retinal S-antigen (S-Ag), recoverin, RPE65 and inter-photoreceptor retinoid-binding protein (IRBP)], as well as four melanocyte-specific antigens, two of which are used as targets for melanoma immunotherapy [gp100, melanoma antigen recognized by T cells 1, tyrosinase-related protein (TRP)-1 and TRP-2]. Using reverse transcription (RT)-PCR, we found that all thymic samples from the 18 donors expressed mRNA transcripts of most or all the eight tested tissue antigens. Yet, the expression of the transcripts varied remarkably among the individual thymic samples. In addition, S-Ag, RPE65 and IRBP were detected by immunostaining in rare cells in sections of human thymi by antibodies against these proteins. Quantitative real-time RT-PCR analysis revealed that the retinal antigen transcripts in the human thymus are present at trace levels, that are lower by approximately five orders of magnitude than those in the retina. Our observations thus support the notions that thymic expression is a common feature for all tissue-specific antigens and that the levels of expression play a role in determining the susceptibility to autoimmunity against these molecules.


Assuntos
Autoantígenos/metabolismo , Timo/imunologia , Antígenos de Neoplasias , Arrestina/genética , Arrestina/imunologia , Autoantígenos/genética , Sequência de Bases , Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/imunologia , Proteínas de Transporte , Pré-Escolar , DNA Complementar/genética , Proteínas do Olho/genética , Proteínas do Olho/imunologia , Feminino , Expressão Gênica , Humanos , Lactente , Lipoproteínas/genética , Lipoproteínas/imunologia , Antígeno MART-1 , Masculino , Melanócitos/imunologia , Glicoproteínas de Membrana/genética , Glicoproteínas de Membrana/imunologia , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/imunologia , Oxirredutases/genética , Oxirredutases/imunologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Recoverina , Proteínas de Ligação ao Retinol/genética , Proteínas de Ligação ao Retinol/imunologia , Linfócitos T/imunologia , Distribuição Tecidual , cis-trans-Isomerases , Antígeno gp100 de Melanoma
11.
J Invest Dermatol ; 121(5): 1150-9, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14708619

RESUMO

The BRN2 transcription factor (POU3F2, N-Oct-3) has been implicated in development of the melanocytic lineage and in melanoma. Using a low calcium medium supplemented with stem cell factor, fibroblast growth factor-2, endothelin-3 and cholera toxin, we have established and partially characterised human melanocyte precursor cells, which are unpigmented, contain immature melanosomes and lack L-dihydroxyphenylalanine reactivity. Melanoblast cultures expressed high levels of BRN2 compared to melanocytes, which decreased to a level similar to that of melanocytes when cultured in medium that contained phorbol ester but lacked endothelin-3, stem cell factor and fibroblast growth factor-2. This decrease in BRN2 accompanied a positive L-dihydroxyphenylalanine reaction and induction of melanosome maturation consistent with melanoblast differentiation seen during development. Culture of primary melanocytes in low calcium medium supplemented with stem cell factor, fibroblast growth factor-2 and endothelin-3 caused an increase in BRN2 protein levels with a concomitant change to a melanoblast-like morphology. Synergism between any two of these growth factors was required for BRN2 protein induction, whereas all three factors were required to alter melanocyte morphology and for maximal BRN2 protein expression. These finding implicate BRN2 as an early marker of melanoblasts that may contribute to the hierarchy of melanocytic gene control.


Assuntos
Endotelina-3/farmacologia , Fator 2 de Crescimento de Fibroblastos/farmacologia , Melanócitos/citologia , Crista Neural/citologia , Fator de Células-Tronco/farmacologia , Células-Tronco/citologia , Fatores de Transcrição/análise , Antígenos de Neoplasias , Diferenciação Celular , Células Cultivadas , Proteínas de Homeodomínio , Humanos , Imuno-Histoquímica , Antígeno MART-1 , Melanócitos/química , Monofenol Mono-Oxigenase/análise , Proteínas de Neoplasias/análise , Fatores do Domínio POU , Células-Tronco/química , Acetato de Tetradecanoilforbol/farmacologia
12.
J Am Coll Surg ; 187(2): 182-8; discussion 188-90, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9704966

RESUMO

BACKGROUND: A minimally invasive standard has yet to be developed for sentinel lymphadenectomy, and many patients undergo this procedure in the main operating room under general anesthesia. These patients often have microscopic metastases in sentinel nodes that could be missed by histopathologic examination. Techniques of reverse transcriptase polymerase chain reaction (RT-PCR) could detect these metastases if the nodes could be preserved intraoperatively. STUDY DESIGN: Fifty patients with melanoma > or = mm thick underwent sentinel lymphadenectomy under local anesthesia in an outpatient surgical unit. Sentinel nodes were identified using blue dye and technetium-99 sulfur colloid and a hand-held gamma probe. Each node was sectioned, with half sent for routine histopathologic study and half preserved in liquid nitrogen. We used RT-PCR to detect mRNA for tyrosinase and Melanoma Antigen Recognized by T cells-1 (MART-1). RESULTS: All patients were able to tolerate sentinel lymph node biopsy under local anesthesia. Sentinel lymph nodes were obtained in 100% of our patients, and usable mRNA was harvested from all but five. Ten patients had positive sentinel node(s) by standard histopathologic examination, and all of these nodes were also positive for MART-1 and tyrosinase. Three patients with negative results by histopathology had positive results by RT-PCR analysis. The average cost of these outpatient operations was 38% less than the same operations performed in the main operating room under general anesthesia. CONCLUSIONS: Sentinel lymphadenectomy under local anesthesia in an outpatient setting and intraoperative lymph node preservation in liquid nitrogen are both feasible. Both tyrosinase and MART-1 are promising markers in the detection of occult melanoma in lymph nodes.


Assuntos
Biomarcadores Tumorais/análise , Linfonodos/química , Melanoma/patologia , Monofenol Mono-Oxigenase/análise , Proteínas de Neoplasias/análise , Neoplasias Cutâneas/patologia , Actinas/análise , Procedimentos Cirúrgicos Ambulatórios/economia , Anestesia Local , Antígenos de Neoplasias/análise , Análise Custo-Benefício , Feminino , Humanos , Linfonodos/patologia , Metástase Linfática/diagnóstico , Antígeno MART-1 , Masculino , Melanoma/economia , Melanoma/cirurgia , Estadiamento de Neoplasias , Reação em Cadeia da Polimerase , DNA Polimerase Dirigida por RNA , Neoplasias Cutâneas/economia , Neoplasias Cutâneas/cirurgia
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