RESUMO
Woringer-Kolopp (WK) is a rare subtype of cutaneous T-cell lymphoma (CTCL) with limited treatment options. Bexarotene gel is a topical retinoid used in the treatment of CTCL. This report describes three female patients (mean age 66 years) with WK disease who had an effective treatment response to bexarotene 1% gel. This treatment could provide a safe alternative to other current treatment modalities which have higher risks of potential adverse effects and lack of access to other conventional treatments such as light therapy.
Assuntos
Antineoplásicos/administração & dosagem , Reticulose Pagetoide/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Tetra-Hidronaftalenos/administração & dosagem , Administração Cutânea , Idoso , Idoso de 80 Anos ou mais , Bexaroteno , Biomarcadores Tumorais/análise , Biópsia , Feminino , Géis , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Reticulose Pagetoide/química , Reticulose Pagetoide/patologia , Indução de Remissão , Neoplasias Cutâneas/química , Neoplasias Cutâneas/patologia , Resultado do TratamentoAssuntos
Infecções por Rickettsia/diagnóstico , Úlcera Cutânea/microbiologia , Adulto , Antibacterianos/administração & dosagem , Doxiciclina/administração & dosagem , Feminino , Humanos , Reação em Cadeia da Polimerase , Infecções por Rickettsia/tratamento farmacológico , Infecções por Rickettsia/patologiaAssuntos
Alopecia em Áreas/induzido quimicamente , Imunoglobulina G/efeitos adversos , Fatores Imunológicos/efeitos adversos , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Artrite Psoriásica/tratamento farmacológico , Etanercepte , Seguimentos , Humanos , Imunoglobulina G/uso terapêutico , Fatores Imunológicos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Psoríase/tratamento farmacológico , Receptores do Fator de Necrose Tumoral/uso terapêuticoAssuntos
Antineoplásicos Hormonais/efeitos adversos , Radiodermite/induzido quimicamente , Tamoxifeno/efeitos adversos , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/radioterapia , Feminino , Humanos , Radiodermite/diagnóstico , Radiodermite/patologia , Tamoxifeno/uso terapêuticoRESUMO
Non-melanoma skin cancers (NMSCs) are among the most common human malignancies. Current methods for their prevention include avoidance of natural and artificial sources of UV radiation and using photoprotective clothing and sunscreens. However, these methods have proven to be inadequate in stemming the rise in skin cancer incidence over the past several years. There is accumulating evidence that cyclooxygenase-2 (COX-2), an enzyme involved in prostaglandin synthesis, may be involved in the pathogenesis of NMSC. In preclinical studies, animals genetically deficient in the COX-2 enzyme or that have been treated with pharmacological inhibitors of COX-2 develop significantly fewer tumors when subjected to a UV-induced skin carcinogenesis protocol compared with control mice. Several epidemiological studies in humans support the concept that this enzyme is intimately involved in UV-induced skin cancer development, and UV radiation is known to augment COX-2 expression in human skin. Recent studies suggest that drugs that block COX-2 expression may prevent the development of NMSCs. Thus, pharmacologic agents that inhibit the enzyme COX-2 may be effective chemopreventive agents for NMSCs.
Assuntos
Neoplasias Induzidas por Radiação/prevenção & controle , Prostaglandina-Endoperóxido Sintases/fisiologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Raios Ultravioleta/efeitos adversos , Animais , Inibidores de Ciclo-Oxigenase 2/farmacologia , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Modelos Animais de Doenças , Humanos , Camundongos , Neoplasias Induzidas por Radiação/fisiopatologia , Prostaglandina-Endoperóxido Sintases/efeitos dos fármacos , Neoplasias Cutâneas/fisiopatologia , Protetores Solares/uso terapêuticoRESUMO
BACKGROUND: Hyperglycemia is among the major side effects of dexamethasone (DEX). Glucose or glucocorticoid (GC) regulates the expression of thioredoxin-interacting protein (TXNIP) that controls the production of reactive oxygen species (ROS) through the modulation of thioredoxin (TRX) activity. METHODS: Multiple myeloma (MM) cells were grown in 5 or 20 mM/L glucose with or without 25 µM DEX. Semiquantitative reverse transcription-PCR (RT-PCR) was used to assess TXNIP RNA expression in response to glucose and DEX. ROS were detected by 5-6-chloromethyl-2',7'-dichlorodihydrofluorescein diacetate (CM-H2DCFDA). TRX activity was assayed by the insulin disulfide-reducing assay. Proliferation was evaluated using CellTiter96 reagent with 490-nm absorbtion and used to calculate the DEX IC50 in 20 mM/L glucose using the Chou's dose effect equation. RESULTS: TXNIP RNA level responded to glucose or DEX with the same order of magnitude ARH77 > NCIH929 > U266B1 in these cells. MC/CAR cells were resistant to the regulation. ROS level increased concurrently with reduced TRX activity. Surprisingly glucose increased TRX activity in MC/CAR cells keeping ROS level low. DEX and glucose were lacking the expected additive effect on TXNIP RNA regulation when used concurrently in sensitive cells. ROS level was significantly lower when DEX was used in conditions of hyperglycemia in ARH77/NCIH9292 cells but not in U266B1 cells. Dex-IC50 increased 10-fold when the dose response effect of DEX was evaluated with glucose in ARH && and MC/Car cells CONCLUSIONS: Our study shows for the first time that glucose or DEX regulates important components of ROS production through TXNIP modulation or direct interference with TRX activity in MM cells. We show that glucose modulates the activity of DEX through ROS regualtion in MM cells. A better understanding of these pathways may help in improving the efficacy and reducing the toxicity of DEX, a drug still highly used in the treatment of MM. Our study also set the ground to study the relevance of the metabolic milieu in affecting drug response and toxicity in diabetic versus non-diabetic patients with MM.
Assuntos
Proteínas de Transporte/genética , Dexametasona/farmacologia , Glucose/farmacologia , Hiperglicemia/patologia , Mieloma Múltiplo/tratamento farmacológico , Espécies Reativas de Oxigênio/metabolismo , Tiorredoxinas/metabolismo , Anti-Inflamatórios/farmacologia , Proteínas de Transporte/antagonistas & inibidores , Proteínas de Transporte/metabolismo , Citometria de Fluxo , Humanos , Hiperglicemia/tratamento farmacológico , Hiperglicemia/metabolismo , Mieloma Múltiplo/metabolismo , RNA Mensageiro/genética , Edulcorantes/farmacologia , Células Tumorais CultivadasRESUMO
Contact dermatitis is a serious public health and dermatologic concern. The prevalence of contact dermatitis in the United States was estimated to be 13.6 per 1000 population according to the National Health and Nutritional Examination Survey using physical examinations by dermatologists of a selected sample of Americans. The American Medical Care Survey estimated that for all American physicians dermatitis is the second most common dermatologic diagnosis proffered. It is essential that government, industry, and dermatologists work together to enhance regulatory methods to control and prevent contact allergy epidemics. Increased knowledge and awareness of occupational skin diseases by dermatologists and other health care professionals will assist in achieving national public health goals. This article reviews governmental regulations-some helpful for patients and workers and some not helpful for dermatologists in their quest to assist patients with contact dermatitis.