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      Silibinin and non-melanoma skin cancers

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          Abstract

          Skin is the largest human organ that shields the inner body from contact with xenobiotic and genotoxic agents, and in this process, the skin’s cellular genome faces continuous stress due to direct exposure to these noxious factors. Accumulation of genetic stress results in genomic alterations leading to undesirable gene or protein alteration/expression in skin cells, which eventually causes the formation of non-melanoma skin cancers (NMSCs). Ultraviolet B (UVB) radiation from sun is the most prominent factor contributing to ∼5 million skin cancer cases (which are mostly NMSCs) in the United States (US) and western countries. UVB exposure causes aberrations in a range of biochemical and molecular pathways such as: thymine dimer formation, DNA damage, oxidative stress, inflammatory responses, altered cellular signaling, which ultimately contribute to the development of NMSCs. The focus of this review is to summarize the protective and preventive potential of silymarin and/or silibinin against UVB-induced NMSC in pre-clinical skin cancer studies. Over two decades of research has shown the strong potential of silibinin, a biologically active flavonolignan (crude form Silymarin) derived from milk thistle plant, against a wide range of cancers, including NMSCs. Silibinin protects against UVB-induced thymine dimer formation and in turn promotes DNA repair and/or initiates apoptosis in damaged cells via an increase in p53 levels. Additionally, silibinin has shown strong efficacy against NMSCs via its potential to target aberrant signaling pathways, and induction of anti-inflammatory responses. Overall, completed comprehensive studies suggest the potential use of silibinin to prevent and/or manage NMSCs in humans.

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          Highlights

          • Silibinin shows strong efficacy against all stages of photocarcinogenesis in NMSCs.

          • It also protects UVB-induced genomic instability, tumor growth and Progression.

          • Silibinin targets inflammatory and oxidative stress signaling to prevent BCC/SCC.

          • It induced apoptosis by targeting p53, MAPK, PI3K-Akt and other survival pathways.

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          Most cited references55

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          Mutational landscape of aggressive cutaneous squamous cell carcinoma.

          Aggressive cutaneous squamous cell carcinoma (cSCC) is often a disfiguring and lethal disease. Very little is currently known about the mutations that drive aggressive cSCC.
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            Squamous Cell Cancers: A Unified Perspective on Biology and Genetics.

            Squamous cell carcinomas (SCCs) represent the most frequent human solid tumors and are a major cause of cancer mortality. These highly heterogeneous tumors arise from closely interconnected epithelial cell populations with intrinsic self-renewal potential inversely related to the stratified differentiation program. SCCs can also originate from simple or pseudo-stratified epithelia through activation of quiescent cells and/or a switch in cell-fate determination. Here, we focus on specific determinants implicated in the development of SCCs by recent large-scale genomic, genetic, and epigenetic studies, and complementary functional analysis. The evidence indicates that SCCs from various body sites, while clinically treated as separate entities, have common determinants, pointing to a unified perspective of the disease and potential new avenues for prevention and treatment.
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              Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches

              Skin cancer, including both melanoma and non-melanoma, is the most common type of malignancy in the Caucasian population. Firstly, we review the evidence for the observed increase in the incidence of skin cancer over recent decades, and investigate whether this is a true increase or an artefact of greater screening and over-diagnosis. Prevention strategies are also discussed. Secondly, we discuss the complexities and challenges encountered when diagnosing and developing treatment strategies for skin cancer. Key case studies are presented that highlight the practic challenges of choosing the most appropriate treatment for patients with skin cancer. Thirdly, we consider the potential risks and benefits of increased sun exposure. However, this is discussed in terms of the possibility that the avoidance of sun exposure in order to reduce the risk of skin cancer may be less important than the reduction in all-cause mortality as a result of the potential benefits of increased exposure to the sun. Finally, we consider common questions on human papillomavirus infection.
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                Author and article information

                Contributors
                Journal
                J Tradit Complement Med
                J Tradit Complement Med
                Journal of Traditional and Complementary Medicine
                Elsevier
                2225-4110
                06 February 2020
                May 2020
                06 February 2020
                : 10
                : 3
                : 236-244
                Affiliations
                [a ]Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO, 80045, USA
                [b ]Department of Pharmaceutical Sciences, South Dakota State University, Brookings, SD, 57007, USA
                [c ]University of Colorado Comprehensive Cancer Center, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO, 80045, USA
                Author notes
                []Corresponding author. Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, 12850 E. Montview Blvd, C238, Room V20-2118, Aurora, CO, 80045, USA. Rajesh.Agarwal@ 123456cuanschutz.edu
                Article
                S2225-4110(20)30069-9
                10.1016/j.jtcme.2020.02.003
                7340873
                32670818
                0355394b-da3b-437c-a987-93b9ad7dfe17
                © 2020 Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 21 January 2020
                : 4 February 2020
                : 5 February 2020
                Categories
                Non-Melanoma Skin Cancers (NMSC)

                squamous cell carcinoma,basal cell carcinoma,photocarcinogenesis,hedgehog pathway,cyclobutane pyrimidine dimers

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