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Vitamin D Plays Role in Melanocytic Lesions

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BYDGOSZCZ, Poland—Results from a recent Polish study found a reduction or absence of vitamin D receptor is linked to progression of melanocytic lesions, and its lack affects survival of melanoma patients, and melanogenesis can attenuate receptor expression (Hum Pathol. 2011 Feb 1). 1,25-dihydroxyvitamin D3 affects proliferation, differentiation and apoptosis, and protects DNA against oxidative damage with a net tumorostatic and anti-carcinogenic effect. It acts through a specific nuclear receptor that is widely distributed through the body. Although a beneficial role of vitamin D in melanoma patients has been suggested, there is lack of information on the changes in the expression pattern of vitamin D receptor during progression of pigmented lesions. Using immunohistochemistry, researchers analyzed the expression of vitamin D receptor in 140 samples obtained form 82 patients, including 25 benign nevi, 70 primary cutaneous melanomas, 35 metastases, 5 re-excisions and 5 normal skin biopsies.

The strongest expression was observed in normal skin that significantly decreased in melanocytic proliferations with the following order of expression: normal skin > melanocytic nevi > melanomas = metastases. The vitamin D receptor expression in skin surrounding nevi and melanoma was also significantly reduced as compared to normal skin. Tumor-infiltrating and lymph node lymphocytes retained high levels of vitamin D receptor. There was negative correlation between tumor progression and vitamin D receptor expression with a remarkable decrease of the immunoreactivity in nuclei of melanoma cells at vertical versus radial growth phases and with metastatic melanomas showing the lowest cytoplasmic receptor staining. Furthermore, lack of the receptor expression in primary melanomas and metastases was related to shorter overall patients' survival. In addition, the receptor expression decreased in melanized melanoma cells in comparison to amelanotic or poorly pigmented cells. The researchers concluded changes in vitamin D receptor expression pattern can serve as important variables for diagnosis, predicting clinical outcome of melanogenesis and/or as a guidance for novel therapy of melanomas based on use of vitamin D or its derivatives.

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