Vitamina D e Melanoma

João Maia Silva; Catarina de Sousa Teixeira; Miguel Correia

doi:10.29021/spdv.75.1.716

João Maia Silva Dermatologista/Consultant of Dermatology; Clinica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Universidade de Lisboa; Centro de Dermatologia, Hospital CUF Descobertas, Lisboa, Portugal
Catarina de Sousa Teixeira Interna do Ano Comum de Dermatologia e Venereologia/Resident of the 1st year of Dermatology
Miguel Correia Dermatologista/Consultant of Dermatology; Centro de Dermatologia, Hospital CUF Descobertas, Lisboa, Portugal

DOI: https://doi.org/10.29021/spdv.75.1.716

Palavras-chave: Luz Solar, Melanoma, Neoplasias da Pele, Vitamina D.

Resumo

A vitamina D participa na homeostasia do cálcio e mineralização óssea. Recentemente, a vitamina D foi implicada na patogénese do cancro e, mais especificamente, do melanoma. A deficiência sérica de 25(OH)D3, o precursor da forma ativa da vitamina D, tem sido associado ao aumento da incidência e a pior prognóstico do melanoma. Em modelos in vitro de vários tumores, a suplementação de vitamina D tem ação anti-inflamatória e promove a apoptose, induz a diferenciação, inibe a proliferação e sensibiliza as células tumorais para terapias anti-tumorais. Também a modulação da expressão dos recetores da vitamina D (VDR) parece estar implicada no efeito anti-tumoral da vitamina D. A relação entre a vitamina D e o melanoma torna-se mais controversa quando a obtenção de vitamina D através da exposição à radiação ultra-violeta pode estar associado ao aumento do risco de melanoma. Neste artigo é efetuada revisão da literatura e dadas sugestões de atuação no que se refere à exposição solar, níveis séricos de vitamina D e redução da incidência e gravidade do melanoma.

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Referências

Sondak VK, McIver B, Kanetsky PA. Vitamin D and Melanoma:

What Do We Tell Our Patients? J Clin Oncol.

; 34:1713-14.

Bade B, Zdebik A, Wagenpfeil S, Stefan Gräber, Geisel

J, Vogt T, Reichrath J. Low serum 25-hydroxyvitamin D

concentrations are associated with increased risk for melanoma

and unfa-vourable prognosis. PLoS One. 2014;

: e112863.

Burns EM, Elmets CA, Yusuf N. Vitamin D and skin cancer.

Photochem Photobiol. 2015; 91:201-9.

Tang JY, Fu T, Lau C, Oh DH, Bikle DD, Asgari MM. Vitamin

D in cutaneous carcinogenesis: part I. J Am Acad

Dermatol 2012; 67:803.

Bikle DD, Nemanic MK, Gee E, Elias P. 1,25-Dihydroxyvitamin

D3 production by human keratinocytes. Kinetics

and regulation. J Clin Investig. 1986; 78:557-66.

Bikle DD, Nemanic MK, Whitney JO, Elias PW. Neonatal

human foreskin keratinocytes produce 1,25-dihydroxyvitamin

D3. Biochemistry. 1986; 25:1545-8.

Fawzi MM, Mahmoud SB, Ahmed SF, Shaker OG. Assessment

of vitamin D receptors in alope-cia areata

and androgenetic alopecia. J Cosmet Dermatol. 2016;

:318-23.

Binkley N, Novotny R, Krueger D, Kawahara T, Daida

YG, Lensmeyer G, et al. Low vitamin D status despite

abundant sun exposure. J Clin Endocrinol Metab. 2007;

:2130-5.

IARC Working Group Reports. Vitamin D and cancer.

[accessed May 2016]. Available from: https://www.

iarc.fr/en/publications/pdfs-online/wrk/wrk5/Report_

VitD.pdf10.

Schuster I. Cytochromes P450 are essential players in

the vitamin D signaling system. Biochim Biophys Acta.

;1814:186-99.

Trochoutsou AI, Kloukina V, Samitas K, Xanthou G. Vitamin-

D in the Immune System: Ge-nomic and Non-Genomic

Actions. Mini Rev Med Chem. 2015; 15:953-63.

Cranney A, Weiler HA, O’Donnell S, Puil L. Summary

of evidence-based review on vitamin D ef-ficacy and

safety in relation to bone health. Am J Clin Nutr. 2008;

:513S-9S.

Holick MF, Chen TC, Lu Z, Sauter E. Vitamin D and skin

physiology: A D-lightful story. J Bone Miner Res. 2007; 22

(Suppl 2);V28-V33.

Winston WT. Malignant Melanoma. Medscape 2016. [accessed

May 2016]. Available from: http://emedicine.medscape.

com/article/280245-overview

Matos D, Alves J, António AM, Bártolo E. Melanoma maligno:

análise retrospetiva 2006-2013. Rev Soc Port Dermatol

Venereol. 2015; 71: 321-28.

Berwick M, Erdei O. Vitamin D and melanoma incidence

and mortality. Pigment Cell Melanoma Res. 2013; 26:9-

D’Orazio J, Jarrett S, Amaro-Ortiz A, Scott T. UV Radiation

and the Skin. Int J Mol Sci. 2013; 14: 12222-48.

Gandini S, Sera F, Cattaruzza MS, Pasquini P, Picconi O,

Picconi O, Boyle P, et al. Meta-analysis of risk factors for

cutaneous melanoma: II. Sun exposure. Eur J Cancer.

; 41:45-60.

Chakraborti C. Vitamin D as a promising anticancer

agent. Indian J Pharmacol. 2011; 43:113-20.

Field S, Newton-Bishop JA. Melanoma and vitamin D.

Mol Oncol. 2011; 5:197-214.

Osborne, JE, Hutchinson PE. Vitamin D and systemic cancer:

Is this relevant to malignant mela-noma? Br J Dermatol.

; 147:197-213.

Bouillon R, Carmeliet G, Daci E, Segaert S, Verstuyf A.

Vitamin D metabolism and action. Osteoporos Int. 1998;

Suppl 2:S13-9.23.

Tang JY, Fu T, Leblanc E, Manson JE, Feldman D, Linos E,

et al. Calcium plus vitamin D sup-plementation and the

risk of nonmelanoma and melanoma skin cancer: post

hoc analyses of the Women’s Health Initiative Randomized

Controlled Trial. J Clin Oncol. 2011; 29:3078-84.

Kavitha K, Reddy. The role of vitamin D in melanoma

prevention: Evidence and hyperbole. J Am Acad Dermatol.

; 71:1005.

Major JM, Kiruthu C, Weinstein SJ, Horst RL, Syder K, Virtamo

J, et al. Pre-diagnostic circulating vitamin D and risk

of melanoma in men. PLoS ONE. 2012; 7, e35112.

Mason RS, Sequeira VB, Dixon KM, Gordon-Thomson

C, Pobre K, Dilley A, et al. Photoprotection by 1alpha,

-dihydroxyvitamin D and analogs: Further studies on

mechanisms and implications for UV-damage. J Steroid

Biochem Mol Biol. 2010; 121:164-8.

Dixon KM, Deo SS, Norman AW, Bishop JE, Halliday GM,

Reeve VE, et al. In vivo relevance for photoprotection by

the vitamin D rapid response pathway. J Steroid Biochem

Mol Biol. 2007; 103:451-6.

Nurnberg B, Graber S, Gartner B, Geisel J, Pfohler C,

Schadendorf D, et al. Reduced serum 25-hydroxyvitamin

D levels in stage IV melanoma patients. Anticancer Res.

; 29: 3669-74.

Rosso S, Sera F, Segnan N, Zanetti R. Sun exposure prior

to diagnosis is associated with im-proved survival in melanoma

patients: results from a long-term follow-up study

of Italian pa-tients. Eur J Cancer. 2008; 44:1275-81.

Shipman AR, Clark AB, Levell NJ. Sunnier European countries

have lower melanoma mortality. Clin Exp Dermatol.

; 36:544-7.

Gandini S, De Vries E, Tosti G, Botteri E, Spadola G, Maisonneuve

P, et al. Sunny holidays be-fore and after melanoma

diagnosis are respectively associated with lower

breslow thickness and lower relapse rates in Italy. PLoS

ONE. 2013; 8:e78820.

Gandini S, Montella M, Ayala F, Benedetto L, Rossi CR,

Vecchiato A, et al. Sun exposure and melanoma prognostic

factors. Oncol Lett. 2016; 11:2706-14.

Institute of Medicine, Food and Nutrition Board. Dietary

reference intakes for calcium and vit-amin D. Washington:

National Academic Press; 2010.

Ovesen L, Brot C, Jakobsen J. Food contents and biological

activity of 25-hydroxyvitamin D: a vitamin D metabolite

to be reckoned with? Ann Nutr Metab. 2003;

:107-13.

Dawson-Hughes B, Mithal A, BonjourJP, Boonen S, Burckhardt

P, Fuleihan GE, et al. IOF posi-tion statement:

vitamin D recommendations for older adults. Osteoporos

Int. 2010; 21:1151-4.