Cancer risk in psoriatic patients

A new study published in February 2020 in the journal JAMA Dermatology reports that there is a 21% increased risk of cancer in patients with psoriasis, but not with psoriatic arthritis alone.

What is psoriasis?

Psoriasis is a chronic inflammatory disease that affects the skin and the joints, mediated by the T immune cells. The skin cells typically travel from the basal layer of the epidermis, where they are generated to the most superficial layer. By the time they reach the top layer, they have differentiated completely and are dead skin cells or keratinocytes, filled with the skin protein called keratin.
However, in psoriasis, the basal cells speed up on their journey to the top layer, and as a result, they reach it in an immature state, pushing the mature keratinocytes off. The skin, therefore, appears red, tender, cracked, and peeling.

Earlier studies have found that patients with psoriasis are at an increased risk of cancer compared to people without the condition or the general population. Psoriasis is also associated with smoking and drinking; two factors also linked to cancer risk. It is already known that lymphomas and keratinocyte cancers are present at a higher rate in patients with psoriasis.

Psoriasis on elbow.

Secondly, several new biologic drugs have been introduced for the treatment of psoriasis, but biologic agents have a risk of cancer. However, whether these agents confer a risk of cancer independent of the disease itself is an unanswered question.

The study

The current study is a systematic review and meta-analysis to find the risk of cancer in two conditions, namely, psoriasis and psoriatic arthritis, in addition to the risk of specific cancers. The researchers also aimed at finding the risk of cancer in psoriasis patients who are on biologic agents rather than conventional drugs.

The researchers looked at 112 studies in which over 2 million patients with psoriasis or psoriatic arthritis were involved, and in which cancer outcomes were reported. They analyzed the risk of cancer overall, and certain cancers specifically.

The findings

The study showed an almost 4.8% prevalence of cancer in psoriasis patients, with an incidence rate (IR) of nearly 11.8 per 1000 person-years. If keratinocyte cancer is excluded, the prevalence and IR are 4% and 7.6, respectively.

Eight studies showed a higher and two studies at a lower risk of cancer in psoriasis patients. The overall risk was 20% higher, or 14% higher after excluding keratinocyte cancer.

Keratinocyte cancer occurred in 2.5% of patients with psoriasis, with an IR of 4.4. The risk for this cancer was more than 2.28 times higher in psoriasis patients compared to others. For melanoma, lymphoma, and non-Hodgkin lymphoma, the risk was 13%, 56%, and 48% higher, respectively. For Hodgkin lymphoma, the risk was 87% higher.

Concerning breast cancer and colorectal cancer, the risk was not higher in these patients. However, psoriasis patients were at a 26% higher risk of lung cancer.

Overall, there was no significant change in the risk of cancer for patients on biological agents, nor when keratinocyte cancer or lymphomas were considered. The same was the case with psoriatic arthritis as well, except for breast cancer, which was significantly higher in three studies.

Implications

The current study includes over twice the number of studies as the last comprehensive review in 2013, including newer studies with a more significant number of participants. Yet the findings remain the same overall, supporting the existence of an association between psoriasis and cancer, but not psoriatic arthritis.

Keratinocyte cancer is linked to sunlight exposure, and the risk is significantly increased in patients with psoriasis who are on PUVA therapy, involving exposure to ultraviolet rays. The highest risk is for squamous cell carcinoma. Other factors that have been suggested are more extended periods spent in the sunlight and treatment with UVB irradiation and with coaltar, which are both risk factors for keratinocyte cancer.

The increased risk of lymphoma may be due to the higher risk of cutaneous T-cell lymphoma, which is markedly more common in people with severe psoriasis. This might be due to chronic activation of the immune system, the authors speculate.

Lifestyle factors like alcohol and smoking are also linked to the higher risk of psoriasis and also of cancer in these patients. However, other factors are also involved, and these need to be identified.

With many different types of cancer occurring at a higher rate in patients with psoriasis, it is essential that doctors who treat such patients be aware that such risks exist. Especially in the case of lymphomas, any therapy for psoriasis which activates the immune system could also result in increased lymphoma activity. More research is required to assess the risk with the use of biologic agents and in psoriatic arthritis.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement 

How Sunlight Affects Your Mental Health

One factor that has an impact on mental health is sunlight. That’s the conclusion of a recent study which looked at the links between weather and depression.  Mental health data from more than 16,000 young University students was used whereby assessments had been filled out several times by each person over the course of six years. The assessments were then matched to local weather data. 

Within the study, 19 different environmental factors including solar irradiance (the amount of sunlight that reaches the Earth), cloud cover, rain, wind chill, barometric pressure and smog levels were accounted for.  However, it was discovered that what mattered most was the amount of time between sunrise and sunset. The other factors didn’t seem to have a significant association with emotional distress, provided that there was enough sunlight.

The results shouldn’t come as a surprise. It’s been estimated that as many as 20% of Americans are affected by SAD (Seasonal Affective Disorder) each winter, suffering from the blues, fatigue and in some cases, depression. 

Another noteworthy benefit of sun exposure is Vitamin D. But when we talk about sun exposure to optimize vitamin D production, we’re really only looking at a small portion of the action spectrum of light, because ultraviolet B radiation is the only portion able to photosynthesize vitamin D in your skin. 

Furthermore, according to a paper published  the sunlight has the ability to influence your mood. Consider this example: Your body uses the near infrared light spectrum to produce mitochondrial energy and maintain systemic equilibrium. Near infrared also primes the cells in your retina for repair and regeneration.  With near-infrared playing such an important role in your body’s energy production, conclusions have been made that if you’re running low on adenosine triphosphate (ATP) due to insufficient amounts of sunlight exposure, you may feel sluggish and tired, and possibly depressed. 

It is a known fact that when it’s dark your melatonin levels increase which is why you may feel tired when the sun starts to set. During the winter months this may be as early as 4pm. In addition to this, research has also determined that UV light also stimulates epidermal cells known as keratinocytes to make beta-endorphins, which have a mood-boosting effect.

Also, it is a well-known fact that serotonin is released in response to sunlight – a hormone which helps elevate your mood and your energy. UVA generates nitric oxide (NO) in your skin, which has a number of beneficial effects on your body. In fact, it stimulates up to 60% of your blood to flow to your skin capillaries where they absorb this energy and infrared radiation. UVA also helps kill any infections in your blood while the infrared recharges your cellular battery.

Vitamin D Deficiency Predisposes You to Depression

Vitamin D appears to improve depression, possibly due to the fact that it’s a potent anti-inflammatory. Moreover, there’s ample evidence to suggest that vitamin D plays an important role in mental health. So, if you tend to feel blue over the fall and winter months, you’d be wise to get your levels of vitamin D checked out. If results show that your vitamin D levels are below 40 ng/mL, a vitamin D supplement will be advisable. 

In a 2006 study, seniors with vitamin D levels below 20 ng/ml were found to be more prone to depression than those with higher levels. Furthermore, a 2007 study suggested that vitamin D deficiency is responsible for symptoms of depression and anxiety in patients with fibromyalgia. Adding to this, vitamin D deficiency is also a well-recognized cause in SAD. In fact, in a 2011 study, the authors pointed out that ‘effective detection and treatment of inadequate vitamin D levels in persons with depression and other mental disorders may be an easy and cost-effective therapy which could improve patients' long-term health outcomes as well as their quality of life. 

It has been discovered that the optimal range for general physical and mental health appears to be between 40 and 70 ng/ml. So if you’re feeling depressed, get your vitamin D levels checked. 

One other noteworthy point to keep in mind is that when taking a vitamin D supplement, you also need to take vitamin K2 and magnesium as these nutrients work in tandem. And since vitamin D is fat-soluble, taking it with some form of healthy fat will help optimize absorption. 

Tips for Beating the Winter Blues

As mentioned above, light is a major factor in overcoming SAD and depression, as insufficient vitamin D levels. However, you can also help boost your mood naturally during the dark, cold winter with these tips: 

1. Exercising: Exercise has been found to work better than antidepressant drugs. It works by normalizing your insulin levels while simultaneously boosting the ‘feel good’ hormones in your brain. 

2. Going to sleep early: There is a link between depression and lack of sleep. Statistics show that of the approximately 18 million Americans with depression, more than half of them struggle with insomnia. While it was believed that insomnia was a symptom of depression, it now seems that insomnia may precede depression in some cases. As a general rule, aim for about 8 hours of sleep per night. You may also want to use a sleep tracker to help motivate you to get to bed earlier. 

3. Avoiding processed foods: Your diet should not be a factor that is overlooked. Foods can have an immense impact on your mood. So opt for a diet that consists of fresh, whole foods to support your mental health. 

4. Optimize your gut health: Fermented foods play an important role in optimal mental health and are vital for optimizing gut health. It’s important as your gut actually produces more mood-regulating serotonin than your brain does. 

5. Increase high quality and animal-based omega-3 fats: This may be the most important nutrient for optimal brain function. In addition, vitamin B12 deficiency may also contribute to depression, so it is worth getting checked out.

The Role of Vitamin D in Disease Prevention

Vitamin D plays a crucial role in disease prevention and maintaining optimal health. There are about 30,000 genes in the body, 3000 of which are affected by vitamin D. In one large-scale study it was found that optimal vitamin D can slash your risk of cancer by as much as 60%. So keeping your levels opitimized can help prevent at least 16 different types of cancer, including pancreatic, lung, ovarian, prostate and skin cancers. 

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                                         PS- THOSE INTERESTED IN RECIPES ARE FREE TO VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/   

FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                                           https:// kneereplacement-stickclub.blogspot.com/                              

FOR CROCHET DESIGNS                                                                                                                                                                                                                                         https://my crochet creations.blogspot.com/ 

Why wounds take longer to heal with age decoded

Wounds take longer to heal in older people because of disruption in communication between skin cells and the immune system with age, a new study has found.

Researchers explored this physiological puzzle by examining molecular changes in ageing mouse skin.

"Within days of an injury, skin cells migrate in and close the wound, a process that requires coordination with nearby immune cells," said Elaine Fuchs from the Rockefeller University in the US.

"Our experiments have shown that, with ageing, disruptions to communication between skin cells and their immune cells slow down this step," said Fuchs.

"This discovery suggests new approaches to developing treatments that could speed healing among older people," Fuchs added.

Whenever a wound occurs, the body needs to repair it quickly to restore its protective skin barrier.

Both skin cells and immune cells contribute to this elaborate process, which begins with the formation of a scab.

New skin cells known as keratinocytes later travel in as a sheet to fill in the wound under the scab.

Researchers focused on this latter step in healing in two-month-old versus 24-month-old mice-roughly equivalent to 20- and 70-year-old humans.

They found that among the older mice, keratinocytes were much slower to migrate into the skin gap under the scab and as a result, wounds often took days longer to close.

Wound healing is known to require specialised immune cells that reside in the skin.

The researcher's new experiments showed that following an injury, the keratinocytes at the wound edge talk to these immune cells by producing proteins known as Skints that appear to tell the immune cells to stay around and assist in filling the gap.

In older mice, the keratinocytes failed to produce these immune signals.

To see if they could enhance Skint signalling in older skin, the researchers turned to a protein that resident immune cells normally release after injury.

When they applied this protein to young and old mouse skin tissue in a petri dish, they saw an increase in keratinocyte migration, which was most pronounced in the older skin. In effect, the old keratinocytes behaved more youthfully.

The scientists hope the same principle could be applied to developing treatments for age-related delays in healing.

"Our work suggests it may be possible to develop drugs to activate pathways that help ageing skin cells to communicate better with their immune cell neighbours, and so boost the signals that normally decline with age," said Fuchs.

The study appears in the journal Cell.

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.

https://gscrochetdesigns.blogspot.com. one can see my crochet creations

https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes

https://kneereplacement-stickclub.blogspot.com. for info on knee replacement