Autophagy: The Potential Link between SARS-CoV-2 and Cancer

COVID-19 infection survivors suffer from a constellation of symptoms referred to as post-acute COVID-19 syndrome. However, in the wake of recent evidence highlighting the long-term persistence of SARS-CoV-2 antigens in tissues and emerging information regarding the interaction between SARS-CoV-2 proteins and various components of the host cell macroautophagy/autophagy machinery, the unforeseen long-term consequences of this infection, such as increased risk of malignancies, should be explored. Although SARS-CoV-2 is not considered an oncogenic virus, the possibility of increased risk of cancer among COVID-19 survivors cannot be ruled out. Herein, we provide an overview of the possible mechanisms leading to cancer development, particularly obesity-related cancers (e.g., colorectal cancer), resulting from defects in autophagy and the blockade of the autophagic flux, and also immune escape in COVID-19 survivors. We also highlight the potential long-term implications of COVID-19 infection in the prognosis of patients with cancer and their response to different cancer treatments. Finally, we consider future directions for further investigations on this matter.

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Human papillomavirus-driven immune deviation: challenge and novel opportunity for immunotherapy

Therapeutic Advances in Vaccines ◽

10.1177/2051013617717914 ◽

2017 ◽

Vol 5 (3) ◽

pp. 69-82 ◽

Cited By ~ 25

Author(s):

Sigrun Smola ◽

Connie Trimble ◽

Peter L. Stern

Keyword(s):

Human Papillomavirus ◽

Immune System ◽

Immune Escape ◽

Hpv Vaccination ◽

Suppressor Cells ◽

Clinical Problem ◽

Hpv Infection ◽

Treatment Protocols ◽

Increased Risk ◽

Risk Of Cancer

It is now recognized that the immune system can be a key component of restraint and control during the neoplastic process. Human papillomavirus (HPV)-associated cancers of the anogenital tract and oropharynx represent a significant clinical problem but there is a clear opportunity for immune targeting of the viral oncogene expression that drives cancer development. However, high-risk HPV infection of the target epithelium and the expression of the E6/E7 oncogenes can lead to early compromise of the innate immune system (loss of antigen-presenting cells) facilitating viral persistence and increased risk of cancer. In these circumstances, a succession of interacting and self-reinforcing events mediated through modulation of different immune receptors, chemokine and cytokine responses (CCL20; CCL2; CCR2; IL-6; CCR7; IL-12) further promote the generation of an immune suppressive microenvironment [increased levels of Tregs, Th17, myeloid-derived suppressor cells (MDSCs) and PD-L1]. The overexpression of E6/E7 expression also compromises the ability to repair cellular DNA, leading to genomic instability, with the acquisition of genetic changes providing for the selection of advantaged cancer cells including additional strategies for immune escape. Therapeutic vaccines targeting the HPV oncogenes have shown some encouraging success in some recent early-phase clinical trials tested in patients with HPV-associated high-grade anogenital lesions. A significant hurdle to success in more advanced disease will be the local and systemic immune suppressive factors. Interventions targeting the different immunosuppressive components can provide opportunity to release existing or generate new and effective antitumour immunity. Treatments that alter the protumour inflammatory environment including toll-like receptor stimulation, inhibition of IL-6-related pathways, immune-checkpoint inhibition, direct modulation of MDSCs, Tregs and macrophages could all be useful in combination with therapeutic HPV vaccination. Future progress in delivering successful immunotherapy will depend on the configuration of treatment protocols in an insightful and timely combination.

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Frostbite and Hypothermia

10.2310/em.4357 ◽

2015 ◽

Author(s):

Jeffrey I. Schneider

Keyword(s):

Body Temperature ◽

Heat Loss ◽

Pleural Cavity ◽

The Body ◽

Ice Crystals ◽

Homeless Population ◽

Outdoor Sports ◽

Increased Risk ◽

Long Term Consequences

Frostbite and hypothermia are becoming increasingly common as the popularity of extreme and outdoor sports rises and the homeless population increases. Advanced age is also associated with an increased risk of frostbite and hypothermia; thus, their incidence will likely continue to increase as the population ages. Frostbite occurs when there is sufficient heat loss to produce ice crystals within either superficial or deep flesh. Hypothermia is defined as an involuntary drop in body temperature to below 35°C, but a useful functional definition is a decrease in temperature that results in an inability of the body to maintain its natural functions. This review details the assessment and stabilization, diagnosis, and treatment and disposition for frostbite and hypothermia. Figures show factors that may predispose individuals to developing frostbite, long-term consequences of severe frostbite, and an approach for pleural cavity lavage. Tables list factors that increase the risk of frostbite, degrees of frostbite, three phases of frostbite, and staging of hypothermia. This review contains 3 highly rendered figures, 4 tables, and 71 references.

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Preventing Venous Thromboembolism in Ambulatory Patients with Cancer: A Narrative Review

Cancers ◽

10.3390/cancers12030612 ◽

2020 ◽

Vol 12 (3) ◽

pp. 612 ◽

Cited By ~ 1

Author(s):

Anne Rossel ◽

Helia Robert-Ebadi ◽

Christophe Marti

Keyword(s):

Venous Thromboembolism ◽

Cancer Patients ◽

Absolute Risk ◽

Narrative Review ◽

Relative Reduction ◽

Number Needed To Treat ◽

Chemotherapeutic Regimen ◽

Patients With Cancer ◽

Increased Risk ◽

Risk Of Cancer

Venous thromboembolism (VTE) is frequent among patients with cancer. Ambulatory cancer patients starting chemotherapy have a 5% to 10% risk of cancer associated thrombosis (CAT) within the first year after cancer diagnosis. This risk may vary according to patient characteristics, cancer location, cancer stage, or the type of chemotherapeutic regimen. Landmark studies evaluating thrombophrophylaxis with low molecular weight heparin (LMWH) for ambulatory cancer patients have shown a relative reduction in the rate of symptomatic VTE of about one half. However, the absolute risk reduction is modest among unselected patients given a rather low risk of events resulting in a number needed to treat (NNT) of 40 to 50. Moreover, this modest benefit is mitigated by a trend towards an increased risk of bleeding, and the economic and patient burden due to daily injections of LMWH. For these reasons, routine thromboprophylaxis is not recommended by expert societies. Advances in VTE risk stratification among cancer patients, and growing evidence regarding efficacy and safety of direct oral anticoagulants (DOACs) for the treatment and prevention of CAT have led to reconsider the paradigms of this risk–benefit assessment. This narrative review aims to summarize the recent evidence provided by randomized trials comparing DOACs to placebo in ambulatory cancer patients and its impact on expert recommendations and clinical practice.

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Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff

International Archives of Occupational and Environmental Health ◽

10.1007/s00420-020-01580-z ◽

2020 ◽

Author(s):

Vanessa Rentrop ◽

Johanna Sophie Schneider ◽

Alexander Bäuerle ◽

Florian Junne ◽

Nora Dörrie ◽

...

Keyword(s):

Medical Staff ◽

Online Training ◽

University Hospital ◽

High Psychological Distress ◽

Increased Risk ◽

Psychosocial Emergency ◽

Low Threshold ◽

Long Term Consequences ◽

The University

Abstract Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de.

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Risks of Skin, Hair, and Nail Supplements

Dermatology Practical & Conceptual ◽

10.5826/dpc.1004a89 ◽

2020 ◽

pp. e2020089

Author(s):

Emily K. Burns ◽

Ariadna Perez-Sanchez ◽

Rajani Katta

Keyword(s):

Allergic Reactions ◽

Post Marketing Surveillance ◽

Increased Risk ◽

Surveillance Programs ◽

Post Marketing ◽

Potential Risks ◽

High Doses ◽

Risk Of Cancer ◽

Very High

Skin, hair, and nail supplements, sometimes referred to as “beauty supplements” or “ingestible skin care”, are a large and growing industry. These products may contain vitamins and minerals, sometimes in very high doses. They may also contain herbs, hormones, microbes, or animal derivatives such as fish oils and collagen powders. Dietary supplements are regulated as foods, not drugs, by the U.S. Food and Drug Administration. Therefore, manufacturers do not need to provide any proof of safety, efficacy, or quality prior to sale. This is of serious concern, as many adverse effects due to supplement components have been reported. The potential risks cover multiple categories. These include acute toxicities such as choking, as well as chronic toxicities, such as increased risk of diabetes. Teratogenicity and interaction with drugs and laboratory testing have been documented in research studies. Other risks include potentially increased risk of cancer with long-term use, allergic reactions, and others. It is vital that physicians educate their patients on these risks. As no post-marketing surveillance programs are required for supplements, our understanding of supplement risks is incomplete. Physicians should be wary of these risks and encourage further research and regulation.

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Increased risk of chronic fatigue and hair loss following COVID-19 in individuals with hypohidrotic ectodermal dysplasia

10.21203/rs.3.rs-529105/v1 ◽

2021 ◽

Author(s):

Verena Hennig ◽

Wolfgang Schuh ◽

Antje Neubert ◽

Dirk Mielenz ◽

Hans-Martin Jäck ◽

...

Keyword(s):

Hair Loss ◽

Ectodermal Dysplasia ◽

Genetic Disorder ◽

Control Group ◽

Hypohidrotic Ectodermal Dysplasia ◽

Control Subjects ◽

Eccrine Glands ◽

Increased Risk ◽

Long Term Consequences

Abstract Background Hypohidrotic ectodermal dysplasia (HED) is a group of genodermatoses in which deficient ectodysplasin A signalling leads to maldevelopment of skin appendages, various eccrine glands, and teeth. Individuals with HED often have disrupted epithelial barriers and, therefore, were suspected to be more susceptible to coronavirus infection. Methods 56 households with at least one member who had coronavirus disease of 2019 (COVID-19) were enrolled in a longitudinal study to compare the course of illness, immune responses, and long-term consequences of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection in HED patients (n = 15, age 9–52 years) and control subjects of the same age group (n = 149). Results In 14 HED patients, mild or moderate typical COVID-19 symptoms were observed that lasted for 4–45 days. Fever during the first days sometimes required external cooling measures. The course of COVID-19 was similar to that in control subjects if patients developed antibodies blocking the SARS-CoV-2 spike protein. Five out of six HED patients with completely abrogated ectodysplasin A signalling (83%) suffered from chronic, in two cases very severe fatigue following COVID-19, while only 25% of HED patients with residual activity of this pathway and 21% of control subjects recovering from COVID-19 experienced postinfectious fatigue. Hair loss after COVID-19 was also more frequent among HED patients (64%) than in the control group (13%). Conclusions HED appears to be associated with an increased risk of long-term consequences of a SARS-CoV-2 infection. Preventive vaccination against COVID-19 should be recommended for individuals affected by this rare genetic disorder.

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Understanding acute burn injury as a chronic disease

Burns & Trauma ◽

10.1186/s41038-019-0163-2 ◽

2019 ◽

Vol 7 ◽

Cited By ~ 10

Author(s):

Lucy W. Barrett ◽

Vanessa S. Fear ◽

Jason C. Waithman ◽

Fiona M. Wood ◽

Mark W. Fear

Keyword(s):

Chronic Disease ◽

Burn Injury ◽

Gastrointestinal Disease ◽

Improve Patient Care ◽

Burn Care ◽

Increased Risk ◽

Wide Range ◽

Initial Injury ◽

Risk Of Cancer

Abstract While treatment for burn injury has improved significantly over the past few decades, reducing mortality and improving patient outcomes, recent evidence has revealed that burn injury is associated with a number of secondary pathologies, many of which arise long after the initial injury has healed. Population studies have linked burn injury with increased risk of cancer, cardiovascular disease, nervous system disorders, diabetes, musculoskeletal disorders, gastrointestinal disease, infections, anxiety and depression. The wide range of secondary pathologies indicates that burn can cause sustained disruption of homeostasis, presenting new challenges for post-burn care. Understanding burn injury as a chronic disease will improve patient care, providing evidence for better long-term support and monitoring of patients. Through focused research into the mechanisms underpinning long-term dysfunction, a better understanding of burn injury pathology may help with the development of preventative treatments to improve long-term health outcomes. The review will outline evidence of long-term health effects, possible mechanisms linking burn injury to long-term health and current research into burns as a chronic disease.

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Risk of cancer among sarcoidosis patients with biopsy-verified non-necrotizing granulomatous inflammation: Population-based cohort study

The Journal of Rheumatology ◽

10.3899/jrheum.210588 ◽

2021 ◽

pp. jrheum.210588

Author(s):

Mikkel Faurschou ◽

Lars H. Omland ◽

Niels Obel ◽

Jesper Lindhardsen ◽

Bo Baslund

Keyword(s):

Solid Tumors ◽

Granulomatous Inflammation ◽

Population Based ◽

Risk Difference ◽

Increased Risk ◽

Incidence Functions ◽

Risk Of Cancer ◽

Population Controls

Objective To assess the long-term risk of hematologic cancers, invasive solid tumors, and nonmelanoma skin cancer (NMSC) among sarcoidosis patients with biopsy-verified non-necrotizing granulomatous inflammation. Methods We used Danish administrative registers with nationwide coverage to construct a cohort of 3892 sarcoidosis patients and an age- and gender-matched comparison cohort of 38.920 population-controls. For all patients, a biopsy demonstrating non-necrotizing granulomatous inflammation had been obtained from the lower respiratory tract at time of diagnosis. Study outcome was time to diagnosis of cancer. Follow-up began at time of sarcoidosis diagnosis and continued for up to 10 years. We calculated hazard ratios (HRs) as estimates of the cancer risk among the sarcoidosis patients relative to that among the population-controls and used cumulative incidence functions to calculate absolute 10-year risk estimates. Results We observed an increased long-term risk of hematologic cancers (HR during the first 2 years of follow-up: 2.71 (95% CI: 1.18-6.25); HR after >2 years of follow-up: 2.12 (95% CI: 1.29-3.47)) and NMSC (HR after >2 years of follow-up: 1.82 (95% CI: 1.43-2.32)) among the sarcoidosis patients. An increased risk of invasive solid tumors was only observed during the first 2 years (HR: 1.55 (95% CI: 1.18-2.04)). Compared with the population-controls, the sarcoidosis patients had an increased absolute 10-year risk of hematologic cancers (risk difference: 0.56% (95% CI: 0.11%-1.01%)) and NMSC (risk difference: 1.58% (95% CI: 0.70%-2.47%)). Conclusion Sarcoidosis patients with biopsy-verified non-necrotizing granulomatous inflammation have an increased long-term risk of hematologic cancers and NMSC compared with the general population.

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Optimizing Social Support in Oncology with Digital Platforms (Preprint)

10.2196/preprints.36258 ◽

2022 ◽

Author(s):

Dimos Katsaros ◽

James Hawthorne ◽

Jay Patel ◽

Kaitlin Pothier ◽

Timothy Aungst ◽

...

Keyword(s):

Social Support ◽

Survival Rates ◽

Support Programs ◽

Cancer Treatments ◽

Digital Platforms ◽

Treatment Regimens ◽

Patients With Cancer ◽

Coping With Cancer ◽

Social Support Systems

UNSTRUCTURED Increased cancer prevalence and survival rates coupled with earlier patient discharges from hospitals has created a larger need for social support. Cancer care is both short-term and long-term, requiring acute treatments, treatments for remission, and long-term screenings and treatment regimens. Healthcare systems are already overwhelmed and often struggle to provide social support systems for everyone. Caregivers are limited in number, and even when they are available, they often lack necessary information, skills, or resources to meet the needs of patients with cancer. The act of caregiving presents various challenges, and caregivers themselves often need social support as well. Despite these needs, most social support programs are targeted toward patients alone. Given the prevalence of cancer and known needs of these patients and their caregivers, the ability to identify those who need social support is crucial. Further, the scalability and overall availability of social support programs is vital for successful patient care. This paper establishes the benefits of social support for both patients and caregivers coping with cancer treatments, explores innovative ways of identifying patients who may need social support using digital tools, and reviews potential advantages of digital social support programs.

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