This document outlines topics related to hyperpigmentation, including the synthesis of melanin, transport of melanosomes, and a focus on melasma. It lists several references on these topics, such as papers on melanosome membrane dynamics, heterogeneity of melanocytes, and recent progress in understanding melasma pathogenesis.
What is exposome?
The exposome can be defined as the measure of all the exposures of an individual in a lifetime and how those exposures relate to health.
The aging of the skin may be influenced by various internal or external factors.
Here, we explore the role of various exposures in skin aging.
What is exposome?
The exposome can be defined as the measure of all the exposures of an individual in a lifetime and how those exposures relate to health.
The aging of the skin may be influenced by various internal or external factors.
Here, we explore the role of various exposures in skin aging.
— Pterygium is a common disorder in many parts of the world including India. So this study is designed to find out the bio-socio-demographic profile of Pteryzium cases which can help in understanding its distribution. This study observed that mean age of individuals with Pteryzium was 37.23±1.71 years. Maximum number of cases belongs to ≥26-50 years of age (83%). Pterygium was found slightly more in females was 55.71% as compared to males (44.29%). Most of the cases were housewife (52.86%) followed by labourer (14.29%). Majority (80%) cases were exposed to sunlight. Mean size of pterygium was 2.616±0.529 mm ranging from 2 mm to 3.8mm.In our study, with Keratometer, mean astigmatism was found 1.35±1.127D and from Scheimpflug imaging, mean astigmatism was found 1.22±0.95D in this study.
Human Genome Project is a worldwide scientific achievement. It was a thirteen-year project initiated in 1990 and completed in 2003. Human Genome Project helped a lot in the identification of diseased genes as DNA is very significant for understanding the diseased gene and their functions. It helped in the identification of disease loci for many diseases and presented their treatment through preventive measures. It identified the gene loci for many diseases like cancer, asthma, high blood pressure, diabetes type 2, obesity, Alzheimer's disease, Down's syndrome, Turner's syndrome, depression and many types of heart diseases including cardiovascular disease and coronary artery disease. This project does not directly treat the diseases but it helps in the identification of disease gene loci and then allows the treatment of disease through its preventive measures before the appearance of symptoms or at the initial stages of the disease through many techniques like gene therapy, pharmacogenomics, and targeted drug therapy. These are the helpful techniques in the diagnoses of the human disease gene locus.
Mycobacterium Tuberculosis cause severe disease of lungs known as Tuberculosis. It is a major cause
of morbidity and mortality even in the emerging countries also. However, to prepare an antibiotics drug against Mycobacterium tuberculosis is a major challenge
A Retrospective Study of Malaria Cases Reported in a Decade at Tertiary Level...IOSR Journals
Background: Malaria, a non-fatal disease if detected promptly and treated properly, still causes many deaths in malaria-endemic countries. The present study is intended to find out changing pattern of malarial morbidity and mortality in western India Methods: A retrospective record base study was conducted on malarial cases reported at medical out-patient door (OPD) of SMS Hospital Jaipur (Rajasthan) during last decade i.e. from 1st Jan 2003 to 31st Dec 2012. Available data regarding socio-demographic and mortality profile was collected and analyzed. Case fatality Rates and Proportional Death rates were found out along with cause of death in malaria cases. Chi-squire test was used to find out the significance of difference between proportions. Results: Out of total 3748 malaria cases, maximum cases were reported in Aug to Oct i.e. 2614 (69.74%). Mean age of diseases was 37.4 years with 3.2 M:F Ratio. Maximum Case Fatality Rate was reported in 2003 which decreases with time with sum ups and downs and in 2012 it remains only 1.8%. Most frequent (33%) cause of death was cerebral malaria. Conclusions: Malaria has seasonal variation with maximum cases in post monsoon season affecting mainly middle aged persons. Although there is no certain trend on malarial morbidity but malarial mortality has significantly declined trend.
Autologous Bone Marrow Mononuclear Cell Therapy for Autism: An Open Label Pro...DrAlokSharma
Autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders characterized by
deficits in verbal and nonverbal communication, social
interaction, and presence of stereotypical repetitive behavior.
— Pterygium is a common disorder in many parts of the world including India. So this study is designed to find out the bio-socio-demographic profile of Pteryzium cases which can help in understanding its distribution. This study observed that mean age of individuals with Pteryzium was 37.23±1.71 years. Maximum number of cases belongs to ≥26-50 years of age (83%). Pterygium was found slightly more in females was 55.71% as compared to males (44.29%). Most of the cases were housewife (52.86%) followed by labourer (14.29%). Majority (80%) cases were exposed to sunlight. Mean size of pterygium was 2.616±0.529 mm ranging from 2 mm to 3.8mm.In our study, with Keratometer, mean astigmatism was found 1.35±1.127D and from Scheimpflug imaging, mean astigmatism was found 1.22±0.95D in this study.
Human Genome Project is a worldwide scientific achievement. It was a thirteen-year project initiated in 1990 and completed in 2003. Human Genome Project helped a lot in the identification of diseased genes as DNA is very significant for understanding the diseased gene and their functions. It helped in the identification of disease loci for many diseases and presented their treatment through preventive measures. It identified the gene loci for many diseases like cancer, asthma, high blood pressure, diabetes type 2, obesity, Alzheimer's disease, Down's syndrome, Turner's syndrome, depression and many types of heart diseases including cardiovascular disease and coronary artery disease. This project does not directly treat the diseases but it helps in the identification of disease gene loci and then allows the treatment of disease through its preventive measures before the appearance of symptoms or at the initial stages of the disease through many techniques like gene therapy, pharmacogenomics, and targeted drug therapy. These are the helpful techniques in the diagnoses of the human disease gene locus.
Mycobacterium Tuberculosis cause severe disease of lungs known as Tuberculosis. It is a major cause
of morbidity and mortality even in the emerging countries also. However, to prepare an antibiotics drug against Mycobacterium tuberculosis is a major challenge
A Retrospective Study of Malaria Cases Reported in a Decade at Tertiary Level...IOSR Journals
Background: Malaria, a non-fatal disease if detected promptly and treated properly, still causes many deaths in malaria-endemic countries. The present study is intended to find out changing pattern of malarial morbidity and mortality in western India Methods: A retrospective record base study was conducted on malarial cases reported at medical out-patient door (OPD) of SMS Hospital Jaipur (Rajasthan) during last decade i.e. from 1st Jan 2003 to 31st Dec 2012. Available data regarding socio-demographic and mortality profile was collected and analyzed. Case fatality Rates and Proportional Death rates were found out along with cause of death in malaria cases. Chi-squire test was used to find out the significance of difference between proportions. Results: Out of total 3748 malaria cases, maximum cases were reported in Aug to Oct i.e. 2614 (69.74%). Mean age of diseases was 37.4 years with 3.2 M:F Ratio. Maximum Case Fatality Rate was reported in 2003 which decreases with time with sum ups and downs and in 2012 it remains only 1.8%. Most frequent (33%) cause of death was cerebral malaria. Conclusions: Malaria has seasonal variation with maximum cases in post monsoon season affecting mainly middle aged persons. Although there is no certain trend on malarial morbidity but malarial mortality has significantly declined trend.
Autologous Bone Marrow Mononuclear Cell Therapy for Autism: An Open Label Pro...DrAlokSharma
Autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders characterized by
deficits in verbal and nonverbal communication, social
interaction, and presence of stereotypical repetitive behavior.
2-Hydroxyglutarate MR spectroscopy for prediction of isocitrate dehydrogenase...Uzay Emir
Cutting-Edge Advances in Brain Tumor Imaging (2-hydroxyglutarate, IDH mutation Magnetic Resonance Spectroscopy Imaging) at 3 Tesla (3T) and 7 Tesla (7T)
Noninvasive assessment of isocitrate dehydrogenase mutation
2-Hydroxyglutarate MR spectroscopy for prediction of isocitrate dehydrogenase mutant glioma
2-Hydroxyglutarate as a Magnetic Resonance Biomarker for Glioma
Detection of oncogenic IDH mutations using magnetic resonance spectroscopy of 2-hydroxyglutarate
metabolomic analysis
RSNA
Wellcome Centre for Integrative Neuroimaging
FMRIB
Purdue
2-HG IDH1 IDH2 MRS MRSI MRI ultra-high field
CLINICAL ROLE OF MRS QUANTIFICATION OF 2HG IN DIAGNOSIS OF GLIOMAS
Ultra-high-field MRI – Precision Medicine
the clinical application of 7-Tesla imaging
UHF 7T 7Tesla
Semi-LASER, semilaser Slaser
What Is Zika Virus And Its History.
Transmissions Of Zika Virus.
Congenital Zika Syndrome
Molecular Mechanism Of Microcephaly
Role of the Immune System in the Development of the CNS
Diagnosis
Lipogranuloma of Hand Due to High Pressure Diesel Injurysemualkaira
Lipogranuloma has been reported to develop after introduction of lipoid material into the body accidentally, self injection or as a part of medical treatment. From the outset these lesions confuse the physicians with the neoplastic growths unless the history is elicited carefully. Such lesion as a result of exposure to high pressure diesel injury to hand is hardly reported. One of our patients sustained such injury and developed Lipogranuloma of hand. Surgical treatment was offered to this patient in multiple stages and the specimen was found to have Lipogranuloma microscopically. This case was unique because the lesion involved the digit circumferentially which alarm meticulous surgi-cal treatment in order to maintain the neurovascular integrity and the function as well.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
16. Soon-Hyo Kwon, Young-Ji Hwang, Soo-Keun Lee and Kyoung-Chan Park. Heterogeneous Pathology of Melasma and Its Clinical
Implications. Int. J. Mol. Sci. 2016, 17, 824; doi:10.3390/ijms17060824
23. Ai-Young Lee. An updated review of melasma pathogenesis. DERMATOLOGICA SINICA 32 (2014) 233e239
Editor's Notes
Melanocytes (yellow) exist in the basal (bottom) layer of the epidermis and have multiple dendrites that transfer
melanosomes to sites above the nucleus of keratinocytes (grey) to protect their DNA from UV light.
Melanocytes localization in the epidermis and hair. The epidermal melanocytes are located among the basal layer (stratum basalis) of a stratified squamos keratinized epithelium (A). The hair melanocytes are between cells covering the hair papilla in the hair bulb (B). Stem cells for melanocytes are located in the region named the hair bulge
The biochemical and cellular pathways of melanosome production in response to UV light. Ultraviolet (UV) light exposure to a keratinocyte that overcomes the protection of melanosomes (brown/black ovals) leads to DNA stress. Sunscreen and
protective clothing inhibit this reaction. DNA stress leads to proteins, such as p53, that assist with DNA repair and, at the same
time, lead to production of proopiomelanocortin (POMC). POMC is the precursor of α-MSH, which is secreted from the keratinocyte and binds to its receptor (MC1R). MC1R activation increases adenyl cyclase to produce cAMP. Epinephrine binding to the β-adrenergic receptor (betaAR) also increases adenyl cyclase activity, whereas UV light activates bone matrix protein receptors to inhibit the activation. Many other cytokines (described in the text) influence the activity of melanin synthesis. cAMP activity is prolonged by inhibiting its breakdown through phosphodiesterase 4D3 inhibitors (PDEI4). cAMP then activates protein kinase A (PKA) to phosphorylate CREB, which then binds to the CREB responsive element (CRE) to produce the main activator or melanin production (MITF). Signaling through steel factorwhich binds to the receptor cKIT produces MAP kinases that in turn phosphorylate MITF to produce tyrosinase (TYR), TYRP1 (or DCT), and TYRP2. Tyrosinase is the rate-limiting enzyme for converting tyrosine to DOPA and DOPAquinone. Dopaquinone can either take on cysteines to lead to the red pigment pheomelaninor with the use of TYRP2 and TYRP1 produce the brown/black pigment eumelanin. Melanosomes start off as empty lysosome-like structures (stage 1) that pick up either pigment at stage 2. The pigments are then concentrated into stage 3 and stage 4 melanosomes as they travel up actin filaments with the assistance of kinesin/myosin motors to the tip of dendrites. The keratinocyte has special receptors called protease-activated receptor-2 (PAR2) that accept the melanosomes. The melanosomes are then transferred to the keratinocyte by processes resembling phagocytosis. Once in the keratinocyte, the melanosomes are transferred to above the nucleus to provide more protection from UV light—leading to a tan
The graphical presentation of the basic cross-talk between melanocytes and keratinocytes in the epidermis. The melanocytes
proliferation, differentiation, melanogenesis are under control of surrounding keratinocytes. Melanocyte and up to 40 keratinocytes form the epidermal melanin unit. CF stem cell factor; bFGF basic fibroblast growth factor; GM-CSF granulocyte-macrophage colonystimulating factor; ET-1 endothelin 1; a-MSH melanocyte-stimulating hormones; PGE2 prostaglandin E2; PGF2aprostaglandin F2a; NGF nerve growth factor; c-Kit tyrosine kinase receptor; FGFR1/2 fibroblast growth factor receptor; GM-CSFR granulocytemacrophage colony-stimulating factor receptor; ETBR endothelin B receptor; MC1R melanocortin 1 receptor; EP1/EP3/FP prostanoid receptors; NGFR nerve growth factor receptor; MAPK mitogen-activated protein (MAP) kinases ; PKC Protein kinase C; PKA Protein kinase A; PLC phospholipase C; TYR tyrosinase; TRP1 tyrosinase-related protein 1; TRP2 tyrosinase-related protein 2; MITF-M Melanocyte-specific MITF (Microphthalmia-associated transcription factor) isoform; CRE cAMP response elements; CREB cAMP response element-binding.
Melanosome maturation. a| Schematic diagram of a portion of the cell body and dendrite of a skin melanocyte, with stage I, II, III and IV melanosomes and other relevant organelles indicated. The degree of melanization is indicated by black. Vesicles budding from the trans-Golgi network contain tyrosinase. Stage I premelanosomes probably correspond to the coated endosome described in the text. b| Electron micrograph of a melanocyte, which demonstrates the salient features of stages II, III, and IV melanosomes. Courtesy of L. Collinson and C. Hopkins, Imperial College, London, UK.
Model of melanosome transport in epidermal melanocytes.Schematic diagram of a portion of the cell body and dendrite of a skin melanocyte. Melanosomes mature in the perinuclear region and bind kinesin, a plus-end-directed microtubule motor.
Melanosomes move along microtubules towards the cell periphery. Once at the periphery, melanosomes detach from microtubules and bind actin filaments through the molecular motor, myosin Va. This step retains melanosomes at the periphery of the cell, from where they can be transferred to adjacent keratinocytes.
Schematic view of melanogenesis induced by external stimuli, particularly UV radiation. Direct effects on melanocytes and
indirect effects on keratinocytes/fibroblasts releasing melanogenic factors, such as proopiomelanocortin (POMC)-derived peptides (MSH, ACTH), ET-1, SCF, bFGF, or NGF, are involved in melanogenesis. Protein kinase C (PKC), NO, and cAMP are major intracellular signal transduction pathways. The black ovals indicate melanosomes (DAG, 1,2-diacylglycerol; NO, nitric oxide; MSH, melanocyte-stimulating hormone; ACTH, adrenocorticotrophic hormone; ET-1, endothelin-1; SCF, stem cell factor; bFGF,
basic fibroblast growth factor; NGF, nerve growth factor; MC1R, melanocortin-1 receptor; TYR, tyrosinase; TRP, tyrosinase-related protein).
The role of mast cells in melanogenesis and photoaging. UV= ultraviolet; MMPs = matrix
metalloproteases; VEGF = vascular endothelial growth factor; FGF-2 = fibroblast growth factor-2;
TGF-β= transforming growth factor-β; ECM = extracellular matrix; BM = basement membrane.
Factors involved in e melanogenesis in melasma versus other hyperpigmentation disorders. Decreased expression of H19 RNA
and WIF-1 is involved in the pathogenesis of melasma, but not post-inflammatory hyperpigmentation and UV-induced
pigmentation (WIF-1, Wnt inhibitory factor 1).
Schematic view of the role of H19-derived miR-675 in keratinocytes in melasma. MiR-675 is delivered from keratinocytes to
melanocytes and fibroblasts via membranebound exosomes. MiR-675 could exert the action through either microphthalmiaassociated transcription factor (MITF) in melanocytes or CDH11 in fibroblasts/keratinocytes as its target. CDH11 in fibroblasts or keratinocytes is involved in melanogenesis via the canonical Wnt and AKT activation pathways in neighboring melanocytes through the induction of Ncadherin (CDH, cadherin; AKT, apoptosis signal-regulating kinase; TYR, tyrosinase; TRP, tyrosinase-related protein).
Role of WIF-1 in fibroblasts (or keratinocytes) in melanogenesis. Reduced WIF-1 expression in fibroblasts (or keratinocytes) increases Wnt expression and action in melanocytes through the canonical Wnt/beta-catenin pathway with microphthalmia-associated transcription factor (MITF) upregulation and the non-canonical pathway with NFATc2 translocation to nucleus
(WIF-1, Wnt inhibitory factor 1; LEF-1, lymphocyte enhancer binding factor 1; NFAT, nuclear factor of activated T cells).
Mechanism involved in estrogen-induced melanogenesis and PDZK1 role in melasma. (A) By binding to ERs, estrogen
enhances cAMP levels and upregulates CREB, MITF, and tyrosinase family protein expression, with the involvement of the PKA pathway. (B) PDZK1 could facilitate the estrogen action by interaction with other proteins including ion exchangers, resulting in the stimulation of melanogenesis and melanosome transfer in melasma patients (ER, estrogen receptor; PKA, protein kinase A; CREB, cAMP responsive-element-binding protein; CBP, CREB-binding protein; MITF, micropthalmia-associated transcription factor; TYR, tyrosinase; TRP, tyrosinase-related protein; PDZK1, PDZ domain protein kidney 1; NHE, sodium–hydrogen exchanger; CFTR, cystic fibrosis transmembrane conductance regulator).
A schematic view of the role of triggering factors in melasma development: increased expression of NGF receptor with NGF and alpha-MSH with MC1R; PDZK1 upregulation in both melanocytes and keratinocytes; increased SCF from dermalfibroblasts; reduced WIF-1 in dermalfibroblasts as well as epidermal keratinocytes; reduced H19 in keratinocytes are involved in stimulation of melanogenesis and melanosome transfer in hyperpigmented lesional skin compared to normally pigmented skin of melasma patients. miR-675, a microRNA of H19 RNA, is released from keratinocytes as exosomes, and delivered to neighboring melanocytes orfibroblasts, regulating pigmentation via a direct target, such as MITF. miR-675 inhibits melanogenesis by targeting MITF. The melanogenic response of each skin cell type (melanocytes, keratinocytes, fibroblasts) and cell-to-cell interaction in response to UV exposure, female sex hormones, and stress could be different in different individuals. cAMP ¼3 0,50-cyclic adenosine monophosphate; MAPK¼mitogen-activated protein kinase; MC1R¼melanocortin-1 receptor; MITF¼microphthalmia-associated transcription factor; MSH¼melanocyte stimulating hormone; NGF¼nerve growth factor; PAR-2¼protease-activated receptor-2; PDZK1¼PDZ domain containing 1; PKA¼protein kinase A; PKC¼protein kinase C; SCF¼stem cell factor; UVR¼UV radiation; WIF-1¼Wnt inhibitory factor-1.