Invited Commentary: Use of Arsenical Skin Lesions to Predict Risk of Internal Cancer--Implications for Prevention and Future Research

Abstract5-Aminolevulinic acid (ALA)-induced photodynamic therapy (ALA-PDT) has achieved remarkable research accomplishments over the past 30 years, yet its application in medical oncology still awaits clear recognition as a valid alternative therapeutic modality. It is well documented that topical ALA-PDT enables the treatment of multiple skin lesions simultaneously, and provides excellent cosmetic results with no acquired multi-drug resistance (MDR). Furthermore, upon disease recurrence the treatment can be repeated resulting in the same therapeutic efficacy. Additionally, in oncological surgery, ALA fluorescence-guided resection is a practical and simple method for visualizing intra-operative brain and urological tumors with millimeter accuracy. The urgent challenge is to direct future research of ALA-phototherapy and fluorescence diagnosis to the maturation of their medical status in oncology. Therefore, the future objectives are to amplify critical evidence-based results of ALA-PDT safety and efficacy and to validate its unique advantages over other technologies. Strong statistical PDT documentation and the positive predictive values of protoporphyrin IX (PpIX)-guided surgery will persuade the medical community to implement ALA-based therapeutics into standard clinical and surgical oncology practice. Research must address the phenomenon that no MDR develops as a consequence of PDT, since MDR is the major stumbling block in oncological therapeutics. A feasible goal should be to improve ALA administration protocols based on recent knowledge that preactivation of the enzyme porphobilinogen deaminase enhances PpIX accumulation in cancer cells and photodestruction. Moreover the recent introduction of multifunctional ALA prodrugs that maximize photosensitizer biosynthesis, targeting multiple sub-cellular targets, may increase PDT anti-cancer efficacy in additional disease settings. In conclusion, well-documented clinical results, new ALA delivery protocols, and novel multifunctional ALA prodrugs may advance ALA-PDT to becoming a front-line cancer therapy.

Download Full-text

Nutritional deficiency and arsenical manifestations: a perspective study in an arsenic-endemic region of West Bengal, India

Public Health Nutrition ◽

10.1017/s1368980012004697 ◽

2012 ◽

Vol 16 (9) ◽

pp. 1644-1655 ◽

Cited By ~ 28

Author(s):

Debasree Deb ◽

Anirban Biswas ◽

Aloke Ghose ◽

Arabinda Das ◽

Kunal K Majumdar ◽

...

Keyword(s):

West Bengal ◽

Skin Lesions ◽

Nutritional Deficiency ◽

Endemic Region ◽

Cross Sectional ◽

Increased Risk ◽

Males And Females ◽

Group 2 ◽

Arsenical Skin Lesions ◽

Group 1

AbstractObjectiveTo assess whether nutritional deficiency increases susceptibility to arsenic-related health effects.DesignAssessment of nutrition was based on a 24 h recall method of all dietary constituents.SettingEpidemiological cross-sectional study was conducted in an arsenic-endemic area of West Bengal with groundwater arsenic contamination.SubjectsThe study was composed of two groups – Group 1 (cases,n108) exhibiting skin lesions and Group 2 (exposed controls,n100) not exhibiting skin lesions – age- and sex-matched and having similar arsenic exposure through drinking water and arsenic levels in urine and hair.ResultsBoth groups belonged to low socio-economic strata (Group 1 significantly poorer,P< 0·01) and had low BMI (prevalence of BMI < 18·5 kg/m2: in 38 % in Group 1 and 27 % in Group 2). Energy intake was below the Recommended Daily Allowance (set by the Indian Council of Medical Research) in males and females in both groups. Increased risk of arsenical skin lesions was found for those in the lowest quintile of protein intake (v. highest quintile: OR = 4·60, 95 % CI 1·36, 15·50 in males; OR = 5·62, 95 % CI 1·19, 34·57 in females). Significantly lower intakes of energy, protein, thiamin, niacin, Mg, Zn and choline were observed in both males and females of Group 1 compared with Group 2. Significantly lower intakes of carbohydrate, riboflavin, niacin and Cu were also observed in female cases with skin lesions compared with non-cases.ConclusionsDeficiencies of Zn, Mg and Cu, in addition to protein, B vitamins and choline, are found to be associated with arsenical skin lesions in West Bengal.

Download Full-text

The immune response in trichloroethylene hypersensitivity syndrome: A review

Toxicology and Industrial Health ◽

10.1177/0748233717731213 ◽

2017 ◽

Vol 33 (11) ◽

pp. 876-883 ◽

Cited By ~ 6

Author(s):

Jia-xiang Zhang ◽

Na Li ◽

Hui Wang ◽

Tong Shen ◽

Qi-xing Zhu

Keyword(s):

Immune Dysfunction ◽

Hypersensitivity Syndrome ◽

Skin Lesions ◽

Organ Injury ◽

Future Research ◽

Organic Substances ◽

Research Directions ◽

Type Iv ◽

Liver And Kidney ◽

Future Research Directions

Trichloroethylene (TCE) has been used for a variety of industrial and consumer cleaning purposes because of its ability to dissolve organic substances. The multisystem injuries include those of skin, liver, and kidney, which are defined as TCE hypersensitivity syndrome (THS). THS is a serious occupational health issue. However, the mechanism of immune dysfunction leading to organ injury is poorly understood. Many studies reveal that skin lesions and organ injury caused by TCE are consistent with type IV hypersensitivity, also called delayed hypersensitivity, mediated by T cells. However, many researchers found T cell-mediated type IV hypersensitivity could not account for the pathogenesis of THS fully. Humoral immunity, including immunoglobulins and complement activation, may also play a possible role in THS pathogenesis. This review will describe the history, current understanding, and future research directions of the mechanism of THS.

Download Full-text

The use of teledermoscopy in the accurate identification of cancerous skin lesions in the adult population: A systematic review

Journal of Telemedicine and Telecare ◽

10.1177/1357633x16686770 ◽

2017 ◽

Vol 24 (2) ◽

pp. 75-83 ◽

Cited By ~ 18

Author(s):

Amy F Bruce ◽

Jennifer A Mallow ◽

Laurie A Theeke

Keyword(s):

Systematic Review ◽

Rural Communities ◽

Web Applications ◽

Adult Population ◽

Skin Lesions ◽

Telecommunication Networks ◽

Future Research ◽

Measurement Tool ◽

Accurate Identification ◽

Cross Sectional

Background The use of teledermoscopy in the diagnostic management of pre-cancerous and cancerous skin lesions involves digital dermoscopic images transmitted over telecommunication networks via email or web applications. Teledermoscopy may improve the accuracy in clinical diagnoses of melanoma skin cancer if integrated into electronic medical records and made available to rural communities, potentially leading to decreased morbidity and mortality. Objective and method The purpose of this paper is to present a systematic review of evidence on the use of teledermoscopy to improve the accuracy of skin lesion identification in adult populations. The PRISMA method guided the development of this systematic review. A total of seven scholarly databases were searched for articles published between the years of 2000 and 2015. All studies were critically appraised using the Rosswurm and Larrabee critique worksheet, placed in a matrix for comparison evaluating internal and external validity and inspected for homogeneity of findings. Results Sixteen articles met inclusion criteria for this review. A majority of the studies were cross-sectional and non-experimental. Ten of the 16 focused on interobserver concordance and diagnostic agreement between teledermoscopy and another comparator. Instrumentation in conducting the studies showed inconsistency with reported results. Discussion Higher level evidence is needed to support clinical application of teledermoscopy for accuracy of diagnostic measurement in the treatment of pre-cancerous and cancerous skin lesions in adults. Future research is needed to develop a standardized, reliable and valid measurement tool for implementation in clinical practice.

Download Full-text

Super placebos: A feasibility study combining contextual factors to promote placebo effects

10.31234/osf.io/sh4f6 ◽

2020 ◽

Author(s):

Jay A. Olson ◽

Michael Lifshitz ◽

Amir Raz ◽

Samuel P. L. Veissière

Keyword(s):

Pediatric Population ◽

Contextual Factors ◽

Skin Lesions ◽

Future Research ◽

Placebo Effects ◽

Ample Evidence ◽

Hyperactivity Disorder ◽

Placebo Intervention ◽

Chronic Skin ◽

Study Participants

Ample evidence demonstrates that placebo effects are modulated by contextual factors. Few interventions, however, attempt to combine a broad range of these factors. Here, we explore the therapeutic power of placebos by leveraging factors including social proof, positive suggestion, and social learning. This study aimed to test the feasibility of an elaborate "super placebo" intervention to reduce symptoms of various disorders in a pediatric population. In a single-arm qualitative study, participants entered an inactive MRI scanner which they were told could help their brain heal itself through the power of suggestion. The sample included 11 children (6-13 years old) diagnosed with disorders known to be receptive to placebos and suggestion (Attention Deficit Hyperactivity Disorder, Tourette Syndrome, chronic skin picking, and migraines). The children were given positive suggestions before entering the scanner for 2 to 4 sessions over the span of approximately one month. We assessed open-ended treatment outcomes via recorded interviews and home visits. The procedure was feasible and no adverse events occurred. Ten of the eleven parents reported improvements in their children after the intervention, ranging from minor transient changes to long-term reductions in subjective and objective symptoms (e.g., migraines and skin lesions). These preliminary findings demonstrate the feasibility and promise of combining a broad range of contextual factors in placebo studies. Future research is needed to assess the causal effects of such interventions.

Download Full-text

Super Placebos: A Feasibility Study Combining Contextual Factors to Promote Placebo Effects

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.644825 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jay A. Olson ◽

Michael Lifshitz ◽

Amir Raz ◽

Samuel P. L. Veissière

Keyword(s):

Pediatric Population ◽

Contextual Factors ◽

Skin Lesions ◽

Future Research ◽

Placebo Effects ◽

Ample Evidence ◽

Hyperactivity Disorder ◽

Placebo Intervention ◽

Chronic Skin ◽

Study Participants

Background: Ample evidence demonstrates that placebo effects are modulated by contextual factors. Few interventions, however, attempt to combine a broad range of these factors. Here, we explore the therapeutic power of placebos by leveraging factors including social proof, positive suggestion, and social learning. This study aimed to test the feasibility of an elaborate “super placebo” intervention to reduce symptoms of various disorders in a pediatric population.Methods: In a single-arm qualitative study, participants entered an inactive MRI scanner which they were told could help their brain heal itself through the power of suggestion. The sample included 11 children (6–13 years old) diagnosed with disorders known to be receptive to placebos and suggestion (Attention Deficit Hyperactivity Disorder, Tourette Syndrome, chronic skin picking, and migraines). The children were given positive suggestions during 2–4 placebo machine sessions over the span of approximately 1 month. We assessed open-ended treatment outcomes via recorded interviews and home visits.Results: The procedure was feasible and no adverse events occurred. Ten of the 11 parents reported improvements in their children after the intervention, ranging from minor transient changes to long-term reductions in subjective and objective symptoms (e.g., migraines and skin lesions).Discussion: These preliminary findings demonstrate the feasibility and promise of combining a broad range of contextual factors in placebo studies. Future research is needed to assess the causal effects of such interventions.

Download Full-text

Modification of DNMTs Gene Expressions by GST O1 and GST O2 Polymorphism in Chronic Arsenic Exposed People with and without malignancy from West Bengal, India.

10.21203/rs.3.rs-319040/v1 ◽

2021 ◽

Author(s):

Sarmishtha Chanda ◽

Jayashree Roy ◽

Aditi Mukhopadhyay ◽

Tushar Chakraborty ◽

Debendranath Guha Mazumder

Keyword(s):

Drinking Water ◽

Expression Profile ◽

West Bengal ◽

Clinical Manifestations ◽

Skin Lesions ◽

Cumulative Exposure ◽

Arsenic Content ◽

Wild Type ◽

Skin Manifestations ◽

Arsenical Skin Lesions

Abstract Background: Chronic Arsenic exposure causes skin manifestations and even cancer. However, the response varies widely among persons despite receiving similar cumulative exposure through their food or drinking water or both. These differentiations in manifestations may be due to polymorphic distribution of arsenic metabolizing genes among exposed people. Method: Polymorphism of GSTO1, GSTO2 and their frequency distribution may modify skin manifestations and development of arsenic induced cancer in exposed persons through food chain. Polymorphic variations of GSTO1 and GSTO2 have been studied on 112 subject including control. They were recruited from one of major arsenic affected district, Nadia of West Bengal, India, having high arsenic content in their food. Exposed subjects were categorized into three groups, i.e, with arsenical skin lesions and with out arsenical skin lesions and arsenic induced cancer. Control subjects were 33 in number. Concentration of arsenic in their urine, hair, drinking water, food, extent of clinical manifestations, GST O1and O2status was determined. DNMT1, 3A, and 3B were studied for their expression profile and analyzed with GSTO1 and O2 polymorphisms. Result: Genetic polymorphism of GSTO1 gene polymorphism is significantly associated with arsenic induced skin scores in skin lesion positive cases and arsenic induced cancer cases and also significant increase is seen in DNMT expression and MDA level in exposed cases with homozygous wild type variants. Total urinary arsenic decreases significantly in wild type GSTO1 genotype, although, GSTO2 polymorphism showed no statistically significant differences in skin manifestations, and DNMTs expression. Frequency of GSTO1 and O2 polymorphic variety showed prevalence of wild type homozygous in arsenic induced cancer cases.Conclusion: GSTO1 polymorphism shows significant association with DNMT expression profile in arsenic exposed people.

Download Full-text