A terapia fotodinâmica (TFD) associada à administração tópica de agentes fotossensibilizantes é uma terapia promissora para o tratamento tópico do câncer de pele. A protoporfirina IX (PpIX) é uma substância fotodinamicamente ativa usada na TFD, entretanto, devido a sua alta lipofilia ela forma agregados em meio aquoso, o que diminui sua atividade fotodinâmica e dificulta sua administração na pele. Assim, sistemas de liberação nanoparticulados vêm sendo investigados para melhorar a distribuição da PpIX na pele e facilitar sua penetração até as células tumorais. Os dendrímeros de poliamidoamina (PAMAM) representam uma nova geração de nanosistemas que tem despertado grande interesse nos últimos anos. Eles são uma classe especial de polímeros que apresentam estrutura muito ramificada e regular e que interagem com a PpIX formando complexos (nanopartículas dendriméricas de PpIX-PAMAM). A aplicação de uma corrente elétrica de baixa intensidade, conhecida como iontoforese, pode influenciar na penetração cutânea dessas nanopartículas, direcionando-as para o interior das células. Desta forma, o objetivo deste trabalho foi avaliar a influência da iontoforese e de nanopartículas de PAMAM de geração 4 hidroxilado (PAMAM G4-OH) com a PpIX na localização subcelular e penetração deste agente fotossensibilizante em tumores cutâneos. Assim foram preparados complexos de PpIX-PAMAM, os quais foram caracterizados em função do tamanho de partículas e potencial zeta. A localização subcelular da PpIX a partir dos complexos foi investigada em carcinoma de células escamosas. A influência dos complexos na geração de oxigênio singleto quando a PpIX sofre irradiação também foi avaliada. Por fim, a penetração da PpIX a partir dos complexos PpIX-PAMAM foi avaliada, in vivo, em pele sadia e em tumores induzidos em camundongos Nude BalbC, com e sem aplicação da iontoforese. O tamanho médio das nanopartículas dendriméricas contendo a PpIX dispersas em meio aquoso foi de aproximadamente 220 nm. Quando avaliadas em função do tempo, este tamanho sofreu um aumento de apenas 5% depois de 24 h, permanecendo constante por 7 dias. O potencial zeta das dispersões foi de 10 mV, em pH 7, e de 30 mV, em pH 5,5, possibilitando a contribuição da eletromigração durante a iontoforese. Nos estudos em cultura de células tumorais observou-se que a complexação com o PAMAM aumentou 30 vezes a localização da PpIX na mitocôndria quando comparada a PpIX livre. Além disso, a quantidade de oxigênio singleto gerada foi semelhante para a PpIX livre não agregada e complexada, 4,3 x 10-3 e 4,6 x 10-3 , respectivamente, sugerindo que o PAMAM manteve a atividade fotodinâmica da PpIX. Nos experimentos in vivo, em pele sadia, verificou-se que a PpIX administrada a partir do complexo com o PAMAM se distribuiu homogeneamente pela pele, enquanto que a PpIX livre apresentou uma fluorescência localizada em apenas algumas área da superfície da pele. A iontoforese facilitou a penetração da PpIX para as camadas mais profundas da pele. Finalmente, no tratamento dos tumores cutâneos, a administração tópica dos complexos por apenas 30 min possibilitou a penetração da PpIX até os tumores localizados abaixo da pele, em concentrações semelhantes para a aplicação passiva e iontoforética. Portanto, a complexação da PpIX com o PAMAM é um sistema de liberação nanoparticulado promissor para o tratamento tópico de tumores cutâneos por TFD. / Photodynamic therapy (PDT) associated with topical administration of photosensitizer agents is a promising therapy for topical treatment of skin cancer. Protoporphyrin IX (PpIX) is a photosensitizer commonly used in PDT; however, due to its high lipophilicity it aggregates in aqueous medium, which decreases its photodynamic activity and hinders its penetration through the skin. In this way, nanoparticles have been designed to improve the distribution of PpIX in the skin and enhance its tumor cell penetration. The polyamidoamine dendrimers (PAMAM) represent a new generation of nanosystems that has aroused great interest in recent years. They are hyberbranched polymers capable to form complexes with PpIX (PpIX-PAMAM), increasing PpIX aqueous solubility. The application of a low intensity electrical current, known as iontophoresis, may influence the nanoparticles skin penetration, directing them to the tumor cells. Therefore, the aim of this study was to evaluate the influence of iontophoresis and PpIX-PAMAM G4-OH complexes in PpIX subcellular localization and penetration into skin tumors. The complexes were prepared and characterized as a function of particle size and zeta potential. The subcellular localization of PpIX from the complexes was investigated in squamous cell carcinoma. The influence of PpIX-PAMAM on the generation of singlet oxygen after irradiation was also evaluated. Finally, the penetration of PpIX from the PpIX-PAMAM complexes was evaluated in vivo in healthy skin and in tumors induced in BalbC nude mice with and without application of iontophoresis. The average size of PpIX-PAMAM nanoparticles dispersed in aqueous medium was approximately 220 nm. When evaluated as a function of time, this size was increased only 5% after 24 h and remained constant for 7 days. The zeta potential of the dispersions was 10 mV at pH 7 and 30 mV at pH 5.5, allowing the contribution of electromigration during iontophoresis. In studies in culture tumor cells it was observed that complexation with PAMAM increased 30 times the localization of PpIX in the mitochondria compared to free PpIX. Furthermore, the amount of singlet oxygen generated when PpIX-PAMAM was irradiated was similar to that generated by the irradiation of the non-aggregated free PpIX, 4.6 x 10-3 and 4.3 x 10-3, respectively, suggesting that PAMAM did not modify the photodynamic activity of PpIX. In vivo experiments on healthy skin have shown that PpIX from the PpIX-PAMAM was homogeneously distributed throughout the skin, whereas free PpIX fluorescence was visualized only in some restricted areas of the skin surface. Iontophoresis facilitated PpIX diffusion to deep layers of the skin. Finally, the treatment of skin tumors have shown that the topical administration of the PpIX-PAMAM for only 30 min, passively or by iontophoresis, allowed the penetration of PpIX into the tumors located below the skin. Therefore, the PpIX complexation with PAMAM is a promising nanoparticle delivery system for the topical treatment of skin tumors by PDT.

Melanoma is one of the most aggressive types of cancer. It originates from the transformation of melanocytes present in the epidermal/dermal junction of the human skin. It is commonly accepted that melanomagenesis is influenced by the interaction of environmental factors, genetic factors, as well as tumor-host interactions. DNA photoproducts induced by UV radiation are, in normal cells, repaired by the nucleotide excision repair (NER) pathway. The prominent role of NER in cancer resistance is well exemplified by patients with Xeroderma Pigmentosum (XP). This disease results from mutations in the components of the NER pathway, such as XPA and XPC proteins. In humans, NER pathway disruption leads to the development of skin cancers, including melanoma. Similar to humans afflicted with XP, Xpa and Xpc deficient mice show high sensibility to UV light, leading to skin cancer development, except melanoma. The Endothelin 3 (Edn3) signaling pathway is essential for proliferation, survival and migration of melanocyte precursor cells. Excessive production of Edn3 leads to the accumulation of large numbers of melanocytes in the mouse skin, where they are not normally found. In humans, Edn3 signaling pathway has also been implicated in melanoma progression and its metastatic potential. The goal of this study was the development of the first UV-induced melanoma mouse model dependent on the over-expression of Edn3 in the skin. The UV-induced melanoma mouse model reported here is distinguishable from all previous published models by two features: melanocytes are not transformed a priori and melanomagenesis arises only upon neonatal UV exposure. In this model, melanomagenesis depends on the presence of Edn3 in the skin. Disruption of the NER pathway due to the lack of Xpa or Xpc proteins was not essential for melanomagenesis; however, it enhanced melanoma penetrance and decreased melanoma latency after one single neonatal erythemal UV dose. Exposure to a second dose of UV at six weeks of age did not change time of appearance or penetrance of melanomas in this mouse model. Thus, a combination of neonatal UV exposure with excessive Edn3 in the tumor microenvironment is sufficient for melanomagenesis in mice; furthermore, NER deficiency exacerbates this process.

Les infections virales sont responsables de 15 à 20 % des cancers humains. L étude des mécanismes moléculaires avec lesquels les virus oncogènes induisent la transformation cellulaire est essentielle pour la compréhension des cancers qui en résultent. Cela permettra également la découverte de nouveaux mécanismes pouvant être impliqués dans le développement de cancers, qui peuvent être ciblés par des approches thérapeutiques. Les virus du papillome humain (HPV) sont des petit virus à ADN qui futs isolés de la peau de patients souffrants de Epidermodysplasia Verruciformis (EV) qui cause un risque élevé d'infection par les HPV et le développement de cancer de la peau non mélanique (NMSC). Certains HPV cutanés, tels que HPV5, 8 et 38, sont suspectés de jouer un rôle dans de développement du cancer de la peau. Cependant, le lien direct entre les HPV cutanés et l'étiologie du cancer n'est pas encore clairement établi. Des études de notre laboratoire ont montré que les oncoprotéines HPV38 E6 et E7 sont capables d'immortaliser des kératinocytes primaires humains in vitro et in vivo. Pour immortaliser des cellules, d'importantes voies de signalisations, telles que les voies de p53 et celle de NF-KB, doivent être affectées. Dans cette étude, nous avons cherché à mettre en évidence les mécanismes moléculaires menant à la dérégulation de p53 et de NF-KB par E6 et E7 de HPV38, dans des kératinocytes humains. Nous avons montré que HPV38 E6 et E7 induisent la formation d'un complexe protéique incluant IKKβ, ΔNp73α, EZH2 et DNMT1. La formation de ce groupement protéique corrèle avec l'inhibition de la transcription de certains gènes cibles de p53, tel que PIG3. Nous avons également mis en évidence l'activation de la voie NF-KB par les oncoprotéins E6 et E7 de HPV38. Cette activation est importante par le rôle joué par NF-KB dans la protection des cellules de l apoptose induite par TNF-α et par l'exposition aux rayonnements UVB. De plus nous avons observé que E7 est la principale oncoprotéine de HPV38 responsable de la dérégulation des voies p53 et NF-KB. Nos études mettent en évidence de nouveaux mécanismes moléculaires qui peuvent être essentiels dans le processus de transformation cellulaire par HPV38 / Viral infections contribute to 15–20% of all human cancers. Studying the mechanisms employed by the oncogenic viruses to induce cellular transformation is essential for a better understanding of the resulting cancers and the discovery of new mechanisms involved in cancer development which can be targeted in therapeutic approaches. Human papillomaviruses (HPVs) are small dsDNA viruses which have been clearly associated with certain cancers. They were first isolated from the skin of patients suffering from Epidermodysplasia Verruciformis (EV) having an increased susceptibility to infection by specific HPV types and to the development of non-melanoma skin cancer (NMSC). Certain cutaneous HPV types, such as 5, 8, and 38, are suspected to play a role in skin cancer development. However the direct role of cutaneous HPV in the etiology of cancer is still under debate. Previous studies from our laboratory have reported that HPV38 E6 and E7 proteins are able to immortalize human primary keratinocytes in vitro and in vivo. Cellular immortalization can be achieved through the deregulation of important signaling pathways including p53 and NF-KB. In the present work, we have investigated the molecular mechanisms of p53 and NF-KB pathways deregulation by E6 and E7 oncoproteins from HPV38 in human keratinocytes. We show here that HPV38 E6E7 induce the formation of a transcription repressor complex including IKKβ, ΔNp73α, and polycomb group members EZH2 and DNMT1. The formation of this protein complex correlates with the inhibition of several p53-target genes, such as PIG3. We also report in these studies that HPV38 E6E7 activate NF KB pathway, which plays an important role in the survival of HPV38 E6E7-immortalized human keratinocytes upon TNF-α– and UVB-mediated apoptosis. In addition our data highlight E7 being the main HPV38 protein mediating p53 and NF-KB deregulation. Our studies shed light on novel molecular mechanisms that could be important for HPV38-mediated cellular transformation

Context: The facial subunit principle organizes the facial skin into subunits. Facial reconstruction for skin cancer based on aesthetic units consists of replacing the entire subunit when a large part of a subunit has been removed. Aims: To determine the prevalence of facial skin cancer, their location by facial aesthetic units, and the type of facial reconstruction used in each of them. Settings and Design: An observational cross-sectional study was conducted at the Head and Neck Surgery Service of a general hospital between 2017 and 2018. Materials and Methods: A population census was conducted during this period. Statistical Analysis Used: The categorical variables were expressed as frequencies (percentages). Continuous variables were described as the means and standard deviations or medians and interquartile ranges. Results: The most common skin cancer was basal cell skin cancer, followed by epithelial skin cancer and, at last, melanoma. In general, the most frequent localization of these cancers was the nose. Conclusions: In spite of primary closure being the most common form of reconstruction, a considerable number of patients required facial reconstruction based on aesthetic facial units, with satisfying results. / Revisión por pares

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The ultraviolet (UV) spectrum has been known to cause damage to skin in varying degrees. UVB radiation (290-320 nm) in particular, has been proven to be highly mutagenic and carcinogenic in many animal experiments compared to either UVA or UVC. The alarming rate of increase in skin cancer incidence has prompted many investigators to pursue other alternatives to sunscreens including changes in lifestyle habits and dietary consumption in order to boost our efforts in tackling this widespread disease. Previous studies employing confocal reflectance, MTT assay and histology suggest that milk phospholipids may possess protective properties against UVB-mediated damage but the molecular mechanism for this effect remains unclear. This study aims to evaluate changes in cell morphology, apoptosis and p21 expression in tissue engineered epidermis to increase our understanding of the mechanisms behind the potential protective effects of milk phospholipids against UV-induced photodamage. Human skin tissue equivalents were incubated in either 1% milk phospholipid solution or maintenance media then exposed to 120 mJ/cm2 dose of 300 nm UVB after 24 hours. The upregulation of p21 protein in response to DNA damage was measured with Western blot and immunofluorescence microscopy and markers for apoptosis and hyperplasia were examined 24 hours after irradiation. Results revealed that p21 levels and the amount of apoptotic markers such as fragmented DNA and nuclear condensation were significantly reduced in UV-exposed tissues pre-incubated with milk phospholipids compared to levels seen in both the positive control and UV-exposed skin tissue not incubated with milk phospholipids. This decrease in p21 expression may imply a reduction in DNA damage 24 hours after UV exposure or a decrease in acquired photodamage at the outset. Milk phospholipid incubation however, induced an increase in epidermal thickening with or without UV exposure, which may imply induction of a protective mechanism to enhance the barrier properties of skin.

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