Retinol and α-Tocopherol Levels in the Serum and Subcutaneous Adipose Tissue of Newly Diagnosed Basal Cell Carcinoma Patients
Background: Nonmelanoma skin cancers are the most frequently occurring skin cancers. Vitamin A is involved in epithelial cell differentiation and may control skin tumor development. Vitamin E is a powerful lipophilic antioxidant that can quench and scavenge reactive oxygen species. However, there is little consistent evidence considering micronutrients and the development of basal cell carcinoma (BCC). Therefore, we aimed to investigate the possible difference between retinol and α-tocopherol in BCC patients and controls in Iranian population.
Methods: This case-control study was conducted on adults with newly diagnosed BCC referred to Razi Hospital, Tehran, Iran in 2015. Serum and subcutaneous fat tissue retinol and α-tochopherol were measured by HPLC method.
Results: Overall, serum retinol level was lower significantly in BCC patients (0.237±0.01 µg/ml) in comparison with control group (0.27±0.02 µg/ml, P-value: 0.038). However serum ɑ-tocopherol level was not significantly different between BCC patients (4.41±0.33 µg/ml) and control subjects (4.06±0.35 µg/ml, P-value=0.18). Subcutaneous adipose tissue retinol was lower significantly in BCC patients (38.60±3.30 ng/mg) compared with control group (54.78±3.49 ng/mg, P-value=0.002). Furthermore, results revealed lower subcutaneous adipose tissue ɑ-tocopherol in BCC patients (4.41±0.33 µg/ml) in comparison with control group (4.06±0.35 µg/ml, P-value=0.18).
Conclusion: Skin tissue concentration of retinol and ɑ-tocopherol and serum retinol level was lower in BCC patients in comparison with control group but serum ɑ-tocopherol was not different between groups.
2. Apalla Z, Nashan D, Weller RB et al (2017). Skin cancer: Epidemiology, disease bur-den, pathophysiology, diagnosis, and therapeutic approaches. Dermatol Ther (Heidelb), 7(1): 5-19.
3. Keyghobadi N, Rafiemanesh H, Moham-madian-Hafshejani A et al (2015). Epi-demiology and trend of cancers in the province of Kerman: southeast of Iran. Asian Pac J Cancer Prev, 16(4): 1409-13.
4. Rahrovani F, Javanbakht MH, Ehsani A-H et al (2018). Erythrocyte membrane satu-rated fatty acids profile in newly diag-nosed Basal Cell Carcinoma patients. Clin Nutr ESPEN, 23:107-111.
5. McNaughton SA, Marks GC, Gaffney P et al (2005). Antioxidants and basal cell car-cinoma of the skin: A nested case–control study. Cancer causes and control, 16(5): 609-18.
6. van Dam RM, Huang Z, Giovannucci E et al (2000). Diet and basal cell carcinoma of the skin in a prospective cohort of men. Am J Clin Nutr, 71(1): 135-41.
7. Hallaji Z, Rahimi H, Mirshams-Shahshahani M (2011). Comparison of risk factors of single basal cell carcinoma with multiple basal cell carcinomas. Indian J Dermatol, 56(4): 398-402.
8. McNaughton SA, Marks GC, Green AC (2005). Role of dietary factors in the de-velopment of basal cell cancer and squa-mous cell cancer of the skin. Cancer Epi-demiol Biomarkers Prev, 14(7): 1596-607.
9. Kohen R, Gati I (2000). Skin low molecular weight antioxidants and their role in ag-ing and in oxidative stress. Toxicology, 148(2): 149-57.
10. Fung TT, Spiegelman D, Egan KM et al (2003). Vitamin and carotenoid intake and risk of squamous cell carcinoma of the skin. Int J Cancer, 103(1): 110-15.
11. Asgari MM, Brasky TM, White E (2012). Association of vitamin A and carotenoid intake with melanoma risk in a large pro-spective cohort. J Investig Dermatol, 132(6): 1573-82.
12. Pal A, Alam S, Singhal J et al (2013). Protec-tive Effect of Topical Application of α-Tocopherol and/or N-Acetyl Cysteine on Argemone Oil/Alkaloid-Induced Skin Tumorigenesis in Mice. Nutr Cancer, 65(sup1): 78-87.
13. van der Pols JC, Heinen MM, Hughes MC et al (2009). Serum antioxidants and skin cancer risk: an 8-year community-based follow-up study. Cancer Epidemiol Bi-omarkers Prev, 18(4): 1167-73.
14. Moon TE, Levine N, Cartmel B et al (1997). Effect of retinol in preventing squamous cell skin cancer in moderate-risk subjects: a randomized, double-blind, controlled trial. Southwest Skin Cancer Prevention Study Group. Cancer Epidemiol Biomarkers Prev, 6(11): 949-56.
15. Davies T, Treasure F, Welch A et al (2002). Diet and basal cell skin cancer: results from the EPIC–Norfolk cohort. Br J Dermatol, 146(6): 1017-22.
16. Klarod K, Hongsprabhas P, Khampitak T et al (2011). Serum antioxidant levels and nutritional status in early and advanced stage lung cancer patients. Nutrition, 27(11): 1156-60.
17. Shim E, Yeum K-J, Tang G et al (2012). Retinoids, carotenoids, and tocopherols in breast adipose tissue and serum of be-nign breast disease and breast cancer pa-tients. Nutr Cancer, 64(7): 956-63.
18. Jenab M, Riboli E, Ferrari P et al (2006). Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gas-tric adenocarcinomas in the European prospective investigation into cancer and nutrition. Br J Cancer, 95(3): 406-15.
19. Clouser MC, Roe DJ, Foote JA et al (2010). Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence. Nutr Cancer, 62(8): 1058-66.
20. Okuno M, Kojima S, Matsushima-Nishiwaki R et al (2004). Retinoids in cancer chem-oprevention. Curr Cancer Drug Targets, 4(3): 285-98.
21. Payette MJ, Whalen J, Grant-Kels JM (2010). Nutrition and nonmelanoma skin can-cers. Clin Dermatol, 28(6): 650-62.
22. Fung TT, Hunter DJ, Spiegelman D et al (2002). Vitamins and carotenoids intake and the risk of basal cell carcinoma of the skin in women (United States). Cancer Causes & Control, 13(3): 221-30.
23. Werninghaus K, Meydani M, Bhawan J et al (1994). Evaluation of the photoprotective effect of oral vitamin E supplementation. AMA Arch Derm, 130(10): 1257-61.
24. Chinem VP, Miot HA (2011). Epidemiology of basal cell carcinoma. An Bras Dermatol, 86(2): 292-305.
25. Lear W, Dahlke E, Murray CA (2007). Basal cell carcinoma: review of epidemiology, pathogenesis, and associated risk factors. J Cutan Med Surg, 11(1):19-30.
26. Hunter DJ, Colditz GA, Stampfer MJ et al (1992). Diet and risk of basal cell carci-noma of the skin in a prospective cohort of women. Ann Epidemiol, 2(3): 231-39.
27. Clark LC, Combs GF, Turnbull BW et al (1996). Effects of selenium supplementa-tion for cancer prevention in patients with carcinoma of the skin: a randomized controlled trial. JAMA, 276(24): 1957-63.
28. Naska A, Lagiou A, Lagiou P (2017). Dietary assessment methods in epidemiological research: current state of the art and fu-ture prospects. F1000Res, 6:926.
29. Sander CS, Chang H, Salzmann S et al (2002). Photoaging is associated with protein oxidation in human skin in vivo. J Investig Dermatol, 118(4): 618-25.
30. Pandel R, Poljšak B, Godic A et al (2013). Skin photoaging and the role of antioxi-dants in its prevention. ISRN dermatol, 2013:930164.
31. Diaconu RE, Macarie AE, Orãsan R (2014). Analysis of oxidative stress in sun-exposed and unexposed skin. Human & Veterinary Med, 6(3).
32. Grammenandi K, Kyriazi M, Katsarou-Katsari A et al (2016). Low-Molecular-Weight Hydrophilic and Lipophilic Anti-oxidants in Nonmelanoma Skin Carci-nomas and Adjacent Normal-Looking Skin. Skin Pharmacol Physiol, 29(6): 324-31.
33. Abu Teir MM AAI, Darwish SM, MM A-H ( 2014). Study of the interaction of hy-drophobic vitamins (vitamin E and vita-min D) with HAS using spectroscopic techniques. Int J Curr Res, 6.
34. Kabat G, Kim M, Sarto G et al (2012). Re-peated measurements of serum carote-noid, retinol and tocopherol levels in rela-tion to colorectal cancer risk in the Wom-en's Health Initiative. Eur J Clin Nutr, 66(5): 549-54.
35. Zhang M, Tao Y, Zhou W et al (2014). All‐trans retinoic acid induces cell‐cycle arrest in human cutaneous squamous carcino-ma cells by inhibiting the mitogen‐activated protein kinase–activated protein 1 pathway. Clin Exp Dermatol, 39(3): 354-60.
36. Wright ME, Lawson KA, Weinstein SJ et al (2006). Higher baseline serum concentra-tions of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Clin Nutr, 84(5): 1200-07.