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Among migratory vertebrates, high levels of fidelity to non-breeding sites during adulthood are common. If occupied sites vary in quality, strong site fidelity can have profound consequences for individual fitness and population demography. Given the prevalence of adult site fidelity, the regions of the non-breeding range to which juveniles first migrate, and the scale of any subsequent movements, are likely to be pivotal in shaping distributions and demographic processes across population ranges. However, inherent difficulties in tracking migratory individuals through early life mean that opportunities to quantify juvenile settlement and movements across non-breeding ranges, and the mechanisms involved, are extremely rare. Through long-term, range-wide resightings of hundreds of colour-marked individuals from their first migration to adulthood and the application of state-space models, we quantify levels of juvenile and adult regional-scale movements and distances at different life stages across the whole non-breeding distribution range in a migratory shorebird, the Black-tailed Godwit (Limosa limosa islandica). We show that the probability of individuals changing non-breeding regions (seven historical wintering regions spanning the Western Europe range) at all ages is very low (mean movement probability = 10.9% from first to subsequent winter, and 8.3% from first adult winter to later winters). Movement between regions was also low between autumn and winter of the same year for both juveniles (mean movement probability = 17.0%) and adults (10.4%). The great majority of non-breeding movements from the first autumn to adulthood were within regions and less than 100 km. The scarcity of regional-scale non-breeding movements from the first autumn to adulthood means that the factors influencing where juveniles settle will be key determinants of non-breeding distributions and of the rate and direction of changes in distributions.
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PURPOSE: In this review article, we sought to elucidate how the social determinants of health, including socioeconomic status, education, neighborhood or physical environment, access to healthcare, and race/ethnicity, affect the likelihood of receiving immunotherapy, a novel and expensive treatment for melanoma. Methods: The PubMed database was queried up to May 2023, for studies pertaining to health disparities in melanoma, including studies examining the utilization of immunotherapy agents for the treatment of melanoma across various social determinants of health. RESULTS: Disparities in the utilization of immunotherapy exist across various social determinants. A total of 10 studies were found to report on disparities in receipt of immunotherapy. These studies reported an association between insurance status, education level, socioeconomic status, as well as proximity to a cancer research center, and a lower likelihood of receiving immunotherapy. CONCLUSION: As the number of novel immunotherapy drugs grows, it is important to understand the various disparities affecting the delivery of immunotherapy across social determinants. The findings from this study can help to drive public health policy aimed at addressing inequities in the treatment of melanoma as well as other cancers. J Drugs Dermatol. 2024;23(5):311-315. doi:10.36849/JDD.7803.
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Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Inmunoterapia , Melanoma , Neoplasias Cutáneas , Determinantes Sociales de la Salud , Humanos , Melanoma/terapia , Inmunoterapia/métodos , Disparidades en Atención de Salud/estadística & datos numéricos , Neoplasias Cutáneas/terapia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Clase SocialRESUMEN
Melanin synthesis involves the successful coordination of metabolic pathways across multiple intracellular compartments including the melanosome, mitochondria, ER/Golgi, and cytoplasm. While pigment production offers a communal protection from UV damage, the process also requires anabolic and redox demands that must be carefully managed by melanocytes. In this report we provide an updated review on melanin metabolism, including recent data leveraging new techniques, and technologies in the field of metabolism. We also discuss the many aspects of melanin synthesis that intersect with metabolic pathways known to impact melanoma phenotypes and behavior. By reviewing the metabolism of melanin synthesis, we hope to highlight outstanding questions and opportunities for future research that could improve patient outcomes in pigmentary and oncologic disease settings.
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Melaninas , Melanocitos , Melanoma , Melaninas/biosíntesis , Melaninas/metabolismo , Melanocitos/metabolismo , Melanocitos/patología , Humanos , Melanoma/metabolismo , Melanoma/patología , AnimalesRESUMEN
Importance: Melanoma in Black individuals has an annual incidence of approximately 1 in 100â¯000 people. Most studies of melanoma in Black patients have used population databases, which lack important, precise clinical details. Objective: To identify patient-level and tumor-level characteristics of melanoma in Black patients. Design, Setting, and Participants: This case series included Black patients with melanoma at 2 tertiary care centers (University of Texas Southwestern [UTSW] Medical Center and Parkland Health), affiliated with a single institution, UTSW in Dallas, Texas. Self-reported Black patients with a histopathologic diagnosis of melanoma were identified between January 2006 and October 2022. Main Outcomes and Measures: The main variables were demographics, clinical characteristics, personal and family medical history, immunosuppression history, comorbidities, histopathology reports, molecular/genetic studies, imaging reports, melanoma treatments and responses, time to progression, metastatic sites, and survival rates. Results: A total of 48 Black patients with melanoma (median [range] age at diagnosis, 62 [23-86] years; 30 [63%] female) were included in the study. Of 40 primary cutaneous melanomas, 30 (75%) were located on acral skin, despite only 10 of 30 (33%) being histologically classified as acral lentiginous melanomas. Compared with those with acral disease, patients with nonacral cutaneous melanomas were more likely to be immunocompromised (4 of 10 [40%] vs 2 of 30 [7%]) or have a personal history of cancer (6 of 10 [60%] vs 5 of 30 [17%]), with all 3 patients with superficial spreading melanoma having a history of both. No patients had more than 1 confirmed primary melanoma. Overall, 13 Black patients (27%) with melanoma developed stage IV disease, of whom 12 died because of disease progression. Those diagnosed with advanced acral melanoma, mucosal/ocular melanoma, or melanoma of unknown primary lacked actionable sequence variations, were nonresponsive to immunotherapy, and had the poorest outcomes. No patients with nonacral cutaneous melanomas developed distant metastases or died of melanoma. Conclusions and Relevance: This single-institution case series highlights several features of melanoma in Black patients that have not been captured in existing population-level registries, including precise anatomic sites, immune status, family and personal cancer history, and genetics. Multi-institutional registries would improve understanding of melanoma in Black patients.