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1.
Appetite ; 201: 107623, 2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-39106642

RESUMEN

Research emphasizes the importance of considering how sociocultural factors affect the disordered eating behaviors of Asian American adults. The present study thus investigated how internalized racism and racial collective self-esteem are associated with disordered eating among Asian American adults, as well as the potential mediating role of psychological distress. A final sample of 796 Asian American adults completed a cross-sectional survey that contained the study's questionnaires. Regression analyses revealed that internalized racism was positively associated with disordered eating, whereas racial collective self-esteem was negatively associated with disordered eating among Asian American adults. Psychological distress mediated both of the aforementioned associations. Researchers and practitioners are encouraged to be cognizant about how Asian American adult clients' experiences of internalized racism and psychological distress may affect their disordered eating. Researchers and practitioners may also strive to increase racial collective self-esteem among this population. Future researchers may consider building upon these findings by conducting longitudinal research or focusing on specific Asian ethnic groups for further studies about disordered eating among Asian Americans.

2.
Opt Lett ; 49(13): 3785-3788, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38950267

RESUMEN

Photonics in the ultraviolet provides an avenue for key advances in biosensing, pharmaceutical research, and environmental sensing. However, despite recent progress in photonic integration, a technological solution to fabricate photonic integrated circuits (PICs) operating in the UV-C wavelength range, namely, between 200 and 280 nm, remains elusive. Filling this gap will open opportunities for new applications, particularly in healthcare. A major challenge has been to identify materials with low optical absorption loss in this wavelength range that are at the same time compatible with waveguide design and large-scale fabrication. In this work, we unveil that thermal silicon oxide (TOX) on a silicon substrate is a potential candidate for integrated photonics in the UV-C, by removing the silicon substrate under selected regions to form single-side suspended ridge waveguides. We provide design guidelines for low-loss waveguide geometries, avoiding wrinkling due to residual intrinsic stress, and experimentally demonstrate waveguides that exhibit optical propagation losses below 3 and 4 dB/cm at a wavelength of 266 nm with claddings of air and water, respectively. This result paves the way for on-chip UV-C biological sensing and imaging.

3.
Eat Disord ; : 1-18, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38855897

RESUMEN

Studies exploring disordered eating among transgender and nonbinary populations have primarily focused on minority stressors with a dearth of research examining the role of gender identity pride on body appreciation and intuitive eating. To address this gap in the literature, the present study, comprised of 148 transgender and nonbinary adults (Mage = 24.68, SD = 6.64), tested the associations among gender identity pride, body appreciation, and intuitive eating, controlling for demographics and minority stress variables. The study also tested body appreciation as a mediator in the cross-sectional association between gender identity pride and intuitive eating. Regression models indicated that greater gender identity pride was significantly associated with greater body appreciation, but not intuitive eating. Greater body appreciation was a significant mediator in the positive association between gender identity pride and intuitive eating. Findings support the significant role and relevance of examining gender identity pride as related to body appreciation and intuitive eating. Future research may determine the causal impact of gender identity pride on body image and eating behaviors in transgender and nonbinary populations. Clinicians may consider the positive role of gender identity pride when addressing body image and eating behaviors with their transgender and nonbinary clients.

4.
Body Image ; 50: 101730, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38823220

RESUMEN

Latinx young adults in the U.S. experience significant disparities related to body image and sexual health. These challenges partly stem from the intersections of racism, ethnocentrism, and colorism perpetuated through Eurocentric beauty standards and norms surrounding sexuality. Despite the salience of skin tone within the Latinx community, the impact of skin tone ideologies on body shame and sexual risk remains unexplored. Addressing this gap, the present study examined the influence of skin tone ideologies (i.e., colorist attraction and skin tone self-concept) on sexual risk and body shame among a sample of 539 Latinx young adults. The study also explored the potential moderating effect of self-esteem on colorist attraction and skin tone self-concept on body shame and sexual risk. Results revealed that both colorist attraction and skin-tone self-concept were positively associated with body shame. Colorist attraction was positively associated with sexual risk, whereas skin tone self-concept was not associated. Furthermore, self-esteem moderated the positive significant association between skin tone self-concept and body shame, such that the association was only significant among Latinx young adults who reported mean and high levels of self-esteem; self-esteem did not moderate any of the other study's associations. These findings inform the development of tailored mental and sexual health interventions to reduce health disparities among Latinx young adults, considering the influence of skin tone socialization.


Asunto(s)
Imagen Corporal , Hispánicos o Latinos , Autoimagen , Conducta Sexual , Vergüenza , Pigmentación de la Piel , Humanos , Femenino , Adulto Joven , Imagen Corporal/psicología , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Masculino , Adulto , Conducta Sexual/etnología , Conducta Sexual/psicología , Adolescente , Racismo/psicología , Racismo/etnología , Estados Unidos/etnología
5.
J Couns Psychol ; 71(4): 215-228, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38829362

RESUMEN

Trans young adults of color experience systemic harm that contributes to negative health outcomes and hinders their ability to live freely. The present study used a grounded theory qualitative methodology rooted in a critical-ideological paradigm to understand the intersections of racial and gender oppression. Trans young adults of color from across the United States (N = 15; ages 20-29; majority racial identities: Asian, Black, and multiracial; majority gender identities: nonbinary and transmasculine) participated in a semistructured interview. Analyses identified a six-category empirical framework explaining major dimensions and processes of intersectional experiences of trans people of color. The core category, Reclaiming Creativity, reflected how trans communities of color use creativity to build their identities and communities beyond intersectional oppressive societal norms and imagine a better, more liberated world. The remaining five categories were Creating and Recreating Identity, Experiencing Discrimination and Its Impacts on Wellness, Surviving Oppression and Compromising Authentic Self, Embracing Identity Strengths, and Finding Liberation. They provided insights into the role of creativity within the intersectional experiences of trans young adults of color. In doing so, they provided directions to address structural injustice, pursue liberation, and allow creativity to flourish. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Creatividad , Personas Transgénero , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Negro o Afroamericano/psicología , Teoría Fundamentada , Investigación Cualitativa , Identificación Social , Personas Transgénero/psicología , Estados Unidos , Asiático , Grupos Raciales
7.
J Clin Psychol ; 80(7): 1582-1595, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38509784

RESUMEN

OBJECTIVES: The present study utilized an intersectional framework to examine if two forms of gendered racism, psychological emasculation and messages about Asian American men being undesirable partners, were associated with Asian American men's nicotine use. We also examined the potential mediating roles of two racial identity statuses, racial conformity and racial immersion. METHODS: A sample of 356 Asian American men living in the United States of America (USA) completed a cross-sectional survey via Qualtrics containing measures assessing the aforementioned constructs of interest. The primary analysis examined separate parallel mediation models, situating psychological emasculation and undesirable partner as separate independent variables, racial conformity and racial immersion as parallel mediators, nicotine use as the outcome, and age and employment as covariates. RESULTS: In separate parallel mediation models, the links between psychological emasculation and undesirable partner on one hand, and nicotine use on the other, were completely mediated only by racial conformity, and not significantly mediated by racial immersion. Specifically, greater endorsement of gendered racism was associated with greater conformity with (and internalization of) these gendered racist beliefs, which in turn were associated with greater nicotine use. CONCLUSION: Researchers and practitioners may consider racial conformity as an interventional target to ameliorate Asian American men's nicotine use. Future studies should continue to examine other culturally relevant and/or potentially protective constructs (e.g., on the basis of gender, race, and its intersection) that may mitigate Asian American men's nicotine use.


Asunto(s)
Asiático , Racismo , Humanos , Masculino , Asiático/psicología , Adulto , Racismo/psicología , Racismo/etnología , Persona de Mediana Edad , Estudios Transversales , Estados Unidos/etnología , Identificación Social , Adulto Joven , Uso de Tabaco/etnología , Uso de Tabaco/psicología , Conformidad Social
8.
Microscopy (Oxf) ; 73(4): 335-342, 2024 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-38527311

RESUMEN

Chlamydia psittaci is an avian bacterial pathogen that can cause atypical pneumonia in humans via zoonotic transmission. It is a Gram-negative intracellular bacterium that proliferates inside membrane bound inclusions in the cytoplasm of living eukaryotic cells. The study of such cells with C. psittaci inside without destroying them poses a significant challenge. We demonstrated in this work the utility of a combined multitool approach to analyze such complex samples. Atomic force microscopy was applied to obtain high-resolution images of the surface of infected cells upon entrance of bacteria. Atomic force microscopy scans revealed the morphological changes of the cell membrane of Chlamydia infected cells such as changes in roughness of cell membrane and the presence of micro vesicles. 4Pi Raman microscopy was used to image and probe the molecular composition of intracellular bacteria inside intact cells. Information about the structure of the inclusion produced by C. psittaci was obtained and it was found to have a similar molecular fingerprint as that of an intracellular lipid droplet but with less proteins and unsaturated lipids. The presented approach demonstrates complementarity of various microscopy-based approaches and might be useful for characterization of intracellular bacteria.


Asunto(s)
Chlamydophila psittaci , Microscopía de Fuerza Atómica , Espectrometría Raman , Microscopía de Fuerza Atómica/métodos , Espectrometría Raman/métodos , Humanos , Membrana Celular/ultraestructura , Animales
9.
Artículo en Inglés | MEDLINE | ID: mdl-38421740

RESUMEN

OBJECTIVES: Lesbian, gay, bisexual, trans, and queer (LGBTQ+) Asian Americans experience unique psychological health concerns at the intersection of multiple forms of marginalization. White supremacist, cisheteronormative, and colonial ideals and their structural and interpersonal manifestations may encourage family rejection of LGBTQ+ identities within Asian American family units. Family shame, conflicts in allegiances, and internalized anti-LGBTQ+ stigma were hypothesized as mediators in the association between family rejection and psychological distress and disordered eating. METHOD: The present study examined family rejection and its impacts on psychological distress and disordered eating in a sample of LGBTQ+ Asian American adults (N = 155; Mage = 24.26; 30.3% gender diverse) using a cross-sectional survey design and path analysis. RESULTS: There was a significant serial mediation such that family rejection was positively associated with conflicts in allegiances, family shame, and psychological distress (B = .12, p = .01). The same serial mediation was nonsignificant for disordered eating (B = .04, p = .26). CONCLUSIONS: Results indicate the importance of considering conflicts in allegiances, family shame, and the interpersonal dynamics of LGBTQ+ Asian Americans in understanding experiences of psychological distress and disordered eating. Implications are drawn for further research, clinical work, and broader efforts addressing the larger sociocultural environment that encourages family rejection of LGBTQ+ identity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

10.
Psychol Addict Behav ; 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38358656

RESUMEN

OBJECTIVE: Past research has highlighted that sexual minority youth (SMY) are at particular risk for heightened substance use compared to their heterosexual peers; however, few studies have investigated the associations between resilience factors and substance use among SMY. In the present preregistered study, we examined the associations among three different forms of resilience factors (i.e., general social support, lesbian, gay, bisexual, transgender, and queer (LGBTQ)-identity affirmation, LGBTQ community involvement) and alcohol, nicotine, and cannabis use, as well as on positive and negative affect. METHOD: SMY (n = 82, ages 15-19, 56.1% cisgender women, 84.4% White) completed a baseline assessment then a 30-day ecological momentary assessment study. Multilevel regression models evaluated within-day and between-person associations between resilience factors and odds of substance use (alcohol, nicotine, cannabis), substance use quantity on use days (alcohol, cannabis), positive affect, and negative affect. RESULTS: On the day level, general social support was associated with greater positive affect, lesser negative affect, and greater drinks on drinking days. LGBTQ-identity affirmation was associated with greater positive affect, lesser negative affect, and greater odds of nicotine use. LGBTQ community involvement was associated with greater positive affect. CONCLUSIONS: These results highlight the nuanced ways that resilience may engender more positive affect and reduce negative affect while simultaneously promoting substance use. Future research disentangling the mechanisms connecting resilience and substance use among SMY is necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

11.
Genes (Basel) ; 15(2)2024 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-38397136

RESUMEN

Pruritus has long been linked to hepatic dysfunction; however, there are limited data characterizing the association between liver disease and prurigo nodularis (PN), a chronic inflammatory skin disease featuring severe pruritis. We thus conducted a cross-sectional analysis of hepatic comorbidities in PN patients using TriNetX, a large global health research network. This analysis revealed that PN patients had a higher risk (p < 0.001) of developing liver cirrhosis, acute and subacute hepatic failure, inflammatory liver disease, chronic hepatitis, nonalcoholic steatohepatitis, portal hypertension, fatty liver, chronic passive congestion of the liver, and hepatocellular carcinoma compared with healthy controls. The cumulative incidence of liver disease was about three times higher in PN patients compared with healthy controls. These findings provided the basis for translational studies to investigate a genetic mechanism for this association. Cutaneous transcriptomic analysis performed on PN patients revealed the dysregulation of genes related to hepatic failure in lesional PN compared with both nonlesional PN and control skin. Similarly, gene set variation analysis (GSVA) revealed a significantly increased (p < 0.05) activation of liver metabolism, chronic hepatic failure, acute hepatic failure, cholestatic liver disease, polycystic liver disease, and hepatocellular carcinoma pathways in lesional PN compared with control skin. A subsequent genome-wide association study (GWAS) identified shared single-nucleotide polymorphisms (SNPs) in the genes AR, EDIL3, MACROD2, PCSK5, RUNX1T1, TENM4, and ZEB2 between PN and liver disease from the FinnGen cohort. Significant dysregulation of the skin-liver axis in PN patients may explain the increased incidence and severity of hepatic comorbidities and help identify future therapeutic targets for PN.


Asunto(s)
Carcinoma Hepatocelular , Fallo Hepático , Neoplasias Hepáticas , Prurigo , Humanos , Prurigo/genética , Prurigo/tratamiento farmacológico , Estudios Transversales , Estudio de Asociación del Genoma Completo , Prurito/tratamiento farmacológico , Prurito/etiología , Prurito/patología , Neoplasias Hepáticas/genética , Perfilación de la Expresión Génica , Genómica , Fallo Hepático/complicaciones , Proteínas de Unión al Calcio , Moléculas de Adhesión Celular
12.
J Racial Ethn Health Disparities ; 11(1): 339-347, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36745263

RESUMEN

BACKGROUND: The COVID-19 pandemic has exacerbated health and social disparities among US Pacific Islanders (PI). Historically, PIs have experienced a high burden of mental illness yet have underutilized mental health services. These already large treatment gaps in mental health care among PIs may worsen during the COVID-19 pandemic. In the face of pre-existing challenges, little is known about the impacts of the COVID-19 pandemic on mental health outcomes among PIs. METHODS: A community-based, cross-sectional survey was administered to members of 13 PI churches across the San Francisco Bay Area. We assessed the burden of psychological distress among PIs and its associations with demographic, sociocultural, and health factors. KEY RESULTS: Among 439 PI respondents, nearly half reported moderate or severe psychological distress. Only about one-tenth took prescription medication for mental health and less than half utilized a mental health provider in the past year. Most trusted PI churches to provide health and social services. Respondents reporting moderate or severe psychological distress were less likely to utilize a mental health provider in the past year and more likely to feel marginalized, excluded, isolated, or alienated from society "most of the time" or "always." Psychological distress was also associated with "fair" or "poor" health status, female gender, older adults, low trust in PI churches to provide health and social services, and concern over household finances. CONCLUSION: Partnerships with faith-based and community-based organizations are essential to address unmet mental health needs and promote support-seeking behaviors among PIs during this ongoing pandemic and beyond.


Asunto(s)
COVID-19 , Distrés Psicológico , Humanos , Femenino , Anciano , COVID-19/epidemiología , Pandemias , San Francisco/epidemiología , Estudios Transversales , Pueblos Isleños del Pacífico
14.
J Med Virol ; 95(12): e29273, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-38050831

RESUMEN

Detection of HIV drug resistance (HIVDR) is vital to successful anti-retroviral therapy (ART). HIVDR testing to determine drug-resistance mutations is routinely performed in Australia to guide ART choice in newly diagnosed people living with HIV or in cases of treatment failure. In 2022, our clinical microbiology laboratory sought to validate a next-generation sequencing (NGS)-based HIVDR assay to replace the previous Sanger-sequencing (SS)-based ViroSeq. NGS solutions for HIVDR offer higher throughput, lower costs and higher sensitivity for variant detection. We sought to validate the previously described low-cost probe-based NGS method (veSEQ-HIV) for whole-genome recovery and HIVDR-testing in a diagnostic setting. veSEQ-HIV displayed 100% and 98% accuracy in major and minor mutation detection, respectively, and 100% accuracy of subtyping (provided > 1000 mapped reads were obtained). Pairwise comparison exhibited low inter-and intrarun variability across the whole-genome (Jaccard index [J] = 0.993; J = 0.972) and the Pol gene (J = 0.999; J = 0.999), respectively. veSEQ-HIV met all our pre-set criteria based on WHO recommendations and successfully replaced ViroSeq in our laboratory. Scaling-down veSEQ-HIV to a limited batch size and sequencing on Illumina iSeq. 100, allowed easy implementation of the assay into the workflow of a small sequencing laboratory with minimal staff and equipment and the ability to meet clinically relevant test turn-around times. As HIVDR-testing moves from SS- to NGS-based methods and new ART drugs come to market (particularly those with targets outside the Pol region), whole-genome recovery using veSEQ-HIV provides a robust, cost-effective and "future-proof" NGS method for HIVDR-testing.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , VIH-1 , Humanos , VIH-1/genética , Australia , Infecciones por VIH/tratamiento farmacológico , Fármacos Anti-VIH/farmacología , Fármacos Anti-VIH/uso terapéutico , Mutación , Secuenciación Completa del Genoma , Farmacorresistencia Viral/genética , Genotipo
15.
Medicines (Basel) ; 10(10)2023 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-37887264

RESUMEN

Background: Sarcoidosis is a multisystem granulomatous disease with a wide variety of presentations and clinical courses. Cutaneous manifestations and comorbidities associated with sarcoid prognosis remain understudied. Methods: An EPIC query was run for patients age 18+ at the Johns Hopkins Hospital with a diagnosis of sarcoidosis of the skin according to the ICD-10-CM code D86.3. Data were obtained from a population-based sample of 240 patients from 2015 to 2020. Results: A total of 240 patients were included in the cohort study. The mean (SD) age was 43.76 (11.72) years, and 30% of participants were male; 76.25% of patients identified as black, 19.58% as white, and 4.17% as other. The average age of onset in remissive patients was significantly higher than progressive (47 ± 12 vs. 40 ± 10, p = 0.0005); 49% of black patients experienced progressive sarcoid compared to 32.6% of white patients (p = 0.028). Progressive disease was associated with the presence of lupus pernio (aOR = 3.29, 95% CI, 1.60-6.77) and at least one autoimmune comorbidity (aOR 6.831, 95% CI 1.819-11.843). Conclusions: When controlling for patient demographics, lupus pernio and the presence of at least one autoimmune condition were associated with progressive cutaneous sarcoidosis.

16.
Am J Hematol ; 98(12): E369-E372, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37740927

RESUMEN

We used the information component (IC), a disproportionate Bayesian analysis comparing the number of observed versus expected adverse drug reactions, to determine the potential association between anti-neoplastic agents and thrombotic microangiopathy (TMA). The IC025 indicates the lower end of 95% of IC, in which a value >0 suggests a disproportionality signal between the drug of interest and the adverse drug reaction. Carfilzomib had the highest IC025 for TMA among all studied chemotherapies followed by gemcitabine, mitomycin, bevacizumab, and bortezomib.


Asunto(s)
Antineoplásicos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Microangiopatías Trombóticas , Humanos , Farmacovigilancia , Teorema de Bayes , Microangiopatías Trombóticas/inducido químicamente , Microangiopatías Trombóticas/epidemiología , Antineoplásicos/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/etiología
17.
Eat Behav ; 51: 101817, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37734352

RESUMEN

To date, psychosocial and interpersonal protective factors such as family connectedness have received little attention in studies of eating behaviors among sexual minority Asian Americans. Therefore, we investigated associations of family connectedness and two types of eating behavior regulation motives and the moderating role of individualism in these associations among 134 sexual minority Asian American young adults. Linear regression models assessed the main and interaction effects of family connectedness and individualism on introjected and identified eating behavior regulation motives. We observed a significant interaction effect between family connectedness and individualism only on introjected regulation. For participants with low levels of individualism, those who reported high levels of family connectedness had lower scores for introjected regulation of eating behavior. The findings of this study highlight the importance of examining strengths related to sexual minority Asian Americans by demonstrating the important role family connectedness plays in eating behavior regulation motives, particularly for those with lower individualism.


Asunto(s)
Asiático , Relaciones Familiares , Conducta Alimentaria , Minorías Sexuales y de Género , Humanos , Adulto Joven
18.
Nephrology (Carlton) ; 28(11): 639-643, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37635271

RESUMEN

We present the case of a recent ABO incompatible kidney transplant recipient with persistent SARS-CoV-2 infection and pneumonitis. Serial whole genome sequencing confirmed intra-host viral evolution, which was used as a surrogate to confirm active viral replication and support re-treatment with antivirals, late in the course of infection. A prolonged course of remdesivir combined with immunosuppression modulation resulted in successful clearance of virus and clinical improvement. The diagnostic process undertaken in this case provides a useful guide for other clinicians when approaching similar patients.


Asunto(s)
COVID-19 , Trasplante de Riñón , Neumonía , Humanos , Sistema del Grupo Sanguíneo ABO , Incompatibilidad de Grupos Sanguíneos , COVID-19/diagnóstico , Rechazo de Injerto , Terapia de Inmunosupresión , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/métodos , SARS-CoV-2/genética , Masculino , Persona de Mediana Edad , Antivirales/uso terapéutico , Neumonía/tratamiento farmacológico
19.
Eat Disord ; 31(6): 533-552, 2023 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-37032549

RESUMEN

Research related to disordered eating among sexual minority Asian American men is scarce. Thus, the present study utilized an intersectional framework to examine how three different forms of racism (i.e. sexual racism, gendered racism, and internalized racism) are associated with disordered eating among sexual minority Asian American men, as well as the mediating role of emotional eating. A cross-sectional survey containing the study's measures of interest were administered to participants. The final sample consisted of 180 sexual minority Asian American men. Both sexual racism and internalized racism were positively associated with disordered eating whereas gendered racism was not associated with disordered eating Emotional eating mediated the association between internalized racism and disordered eating, though it did not mediate the association between sexual racism and disordered eating. Researchers and practitioners are encouraged to utilize an intersectional framework that takes into account multiple forms of racism, especially sexual racism and internalized racism, when considering this underrepresented population's disordered eating. Results also demonstrate the importance of addressing racism in eating disorder prevention efforts among sexual minority Asian American men.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Racismo , Minorías Sexuales y de Género , Masculino , Humanos , Racismo/psicología , Asiático , Estudios Transversales
20.
J Am Acad Dermatol ; 88(6): 1308-1316, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36828138

RESUMEN

BACKGROUND: Emerging evidence suggests that cutaneous immune-related adverse events (cirAEs) are associated with a survival benefit in the setting of advanced melanoma treated with immune checkpoint inhibitor (ICI) therapy. Previous studies have not examined the role of melanoma subtypes on cirAE development and downstream therapeutic outcomes. OBJECTIVE: Examine the impact of melanoma subtypes on cirAE onset and survival among ICI recipients. METHODS: Retrospective multi-institutional cohort study. Multivariate time-series regressions were utilized to assess relationships between melanoma subtype, cirAE development, and survival. RESULTS: Among 747 ICI recipients, 236 (31.6%) patients developed a cirAE. Patients with acral melanoma were less likely to develop a cirAE (hazard ratio [HR] = 0.41, P = .016) compared to patients with nonacral cutaneous melanoma. Across all melanoma subtypes, cirAEs were associated with reduced mortality (HR = 0.76, P = .042). Patients with acral (HR = 2.04, P = .005), mucosal (HR = 2.30, P < .001), and uveal (HR = 4.09, P < .001) primaries exhibited the worst survival. LIMITATIONS: Retrospective cohort study. CONCLUSION: This is the first study to demonstrate differences in cirAE development among melanoma subtypes. The presence of cirAEs was associated with better survival. Further, the lower incidence of cirAEs may be a marker of immunotherapy response, which is reflected in the association between acral melanoma and mortality.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Humanos , Melanoma/tratamiento farmacológico , Melanoma/epidemiología , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/epidemiología , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Estudios Retrospectivos , Estudios de Cohortes , Incidencia , Melanoma Cutáneo Maligno
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