RESUMO
Immune checkpoint inhibitors (ICPis) have revolutionized outcomes in various advanced malignancies. Therapeutic restoration of a robust T-cell response against malignant cells is also at the root of distinct cutaneous immune-related adverse events (cirAEs). As approved indications for ICPis increase and interdisciplinary collaboration with oncology grows, identifying the most common skin toxicities from ICPis, particularly on melanin-rich skin,1 and understanding treatment strategies are increasingly crucial for dermatologists. This brief review highlights common cirAEs and summarizes the latest evidence for interventions.
Assuntos
Toxidermias , Inibidores de Checkpoint Imunológico , Administração Cutânea , Toxidermias/etiologia , Humanos , Imunoterapia , PeleAssuntos
Urticária Crônica/tratamento farmacológico , Dermatologia/métodos , Uso Off-Label , Anticorpos Monoclonais Humanizados/uso terapêutico , Cetirizina/uso terapêutico , Urticária Crônica/imunologia , Urticária Crônica/psicologia , Dermatologia/normas , Quimioterapia Combinada/métodos , Quimioterapia Combinada/normas , Humanos , Omalizumab/uso terapêutico , Guias de Prática Clínica como Assunto , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Ácido Tranexâmico/uso terapêutico , Resultado do TratamentoRESUMO
The coronavirus disease 2019 pandemic has quickly and abruptly altered workflow and education across medical specialties. As the health crisis persists in the United States, change will be the norm for the foreseeable future. Dermatology residents report high levels of anxiety, with concerns ranging from redeployment to career prospects.1.
Assuntos
Ansiedade/prevenção & controle , Competência Clínica , Dermatologia/educação , Dermatologia/métodos , Educação a Distância/métodos , Internato e Residência/métodos , Ansiedade/psicologia , Competência Clínica/normas , Dermatologia/normas , Humanos , Internato e Residência/normasRESUMO
With rising skin cancer rates and interest in preventing photoaging, adjuvants for sunscreens are in high demand. The potential of curcumin has been posited due to its anti-inflammatory, antioxidant and wound healing properties. In prior studies, curcumin decreased UV-induced inflammation, apoptotic changes in human keratinocytes and dermal fibroblasts, and the expression of matrix metalloproteinases. However, curcumin's utility has been hindered by poor aqueous solubility and rapid degradation in vivo. To overcome these limitations, we synthesized curcumin nanoparticles (curc-np), which offer sustained topical delivery and enhanced bioavailability. Curc-np and controls were applied to the skin of BALB/c mice prior to UVB irradiation. Twenty-four hours later, mice pretreated with curc-np showed less erythema, induration and scale compared to controls. Histopathology showed fewer sunburn cells, and TUNEL assay indicated decreased apoptosis in curc-np treated mice. Immunohistochemistry illustrated less p53 expression in skin pretreated with curc-np. Furthermore, cytokine analysis revealed significantly less IL-6 and significantly greater anti-inflammatory IL-10 in skin of curc-np-treated mice as compared to controls. Taken together, our results reinforce curcumin's established anti-inflammatory effects in the skin and highlight its potential as a photoprotective adjuvant when delivered through nanoparticles. Further investigation alongside sunscreens against UV-induced damage is warranted.
Assuntos
Adjuvantes Imunológicos/farmacologia , Anti-Inflamatórios/farmacocinética , Curcumina/farmacocinética , Queratinócitos/efeitos dos fármacos , Adjuvantes Imunológicos/administração & dosagem , Animais , Anti-Inflamatórios/administração & dosagem , Curcumina/administração & dosagem , Relação Dose-Resposta a Droga , Camundongos , Camundongos Endogâmicos BALB C , Nanomedicina/métodos , Nanopartículas/administração & dosagem , Raios Ultravioleta/efeitos adversosAssuntos
Melanoma , Mídias Sociais , Bibliometria , Humanos , Fator de Impacto de Revistas , SíndromeRESUMO
The ongoing outbreak of COVID-19 has quickly become a daunting challenge to global health. In the absence of targeted therapy and a reported 5.5% case fatality rate in the United States, treatments preventing rapid cardiopulmonary failure are urgently needed. Clinical features, pathology and homology to better understood pathogens suggest that uncontrolled inflammation and a cytokine storm likely drive COVID-19's unrelenting disease process. Interventions that are protective against acute lung injury and ARDS can play a critical role for patients and health systems during this pandemic. Nitric oxide is an antimicrobial and anti-inflammatory molecule with key roles in pulmonary vascular function in the context of viral infections and other pulmonary disease states. This article reviews the rationale for exogenous nitric oxide use for the pathogenesis of COVID-19 and highlights its potential for contributing to better clinical outcomes and alleviating the rapidly rising strain on healthcare capacity.