预防皮肤癌:健康的阳光照射和间歇性强烈的阳光照射不需要防晒霜光老化理论受到质疑和新策略

W. L. Chiou
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引用次数: 0

摘要

目前,FDA对阳光照射采取零容忍政策,以防止皮肤癌和皮肤过早老化(光老化)。这显然是基于一种经典概念,即阳光(一种致癌物)的损害是累积的,不可修复的。这一概念在理论上和现实中都存在明显的缺陷。为了在我们的日常生活中实现身体健康和外貌的基因组稳定性,大自然的设计要求我们几乎完全修复日常暴露在非燃烧阳光下的DNA和其他组织成分的损伤。换句话说,ENS通常不会导致皮肤癌和光老化。例如,这种观点可以通过以下事实得到证明:世界范围内皮肤癌发病率较低,严重的晒伤是皮肤癌的主要病因,内在衰老是皮肤老化的主要原因。由于ENS可以提供许多健康益处,这种暴露可以被视为健康的阳光照射,并用于帮助预防皮肤癌。由于意外的晒伤效果,强烈建议在强烈的间歇性暴露中使用防晒霜。由于光老化与皮肤癌可能密切相关,因此也提出了一些与传统光老化理论和实践相关的问题。其中包括:舒斯特1975年的开创性研究;加速老化理论的失效;皱纹和老年斑的病因理论问题Fisher对金属蛋白酶的研究大剂量辐照与恒定剂量辐照;作为抗光老化/抗癌剂的保湿剂;皮肤老化外泌体中血液和水分的包涵;风效果;各国防晒霜使用模式评价差异替换晒黑床中的UVA。
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Prevention of Skin Cancer: Healthy Sun Exposure and No sunscreen for Intense Intermittent Exposure; Photoaging Theories Questioned and New Strategies
Currently the FDA adopts a zero-tolerance policy toward sun exposure in order to prevent skin cancer and premature skin aging (photoaging). This is apparently based on classical concept that damage from sunlight, a carcinogen, is cumulative and un-reparable. Such concept is apparently flawed both theoretically and in reality. The nature’s design to achieve genomic stability of body health and appearance for smooth passage of generations in our normal daily lives would require virtually complete repair of damages of DNA and other tissue components from daily Exposure to Non-Burning Sunlight (ENS). In other words, ENS is generally not expected to cause skin cancer and photoaging. Such notion is evidenced by, for example, low worldwide skin-cancer incidences, severe sunburn as overwhelming skin-cancer etiology, and intrinsic aging as overwhelming skin aging. Since ENS can provide numerous health benefits, such exposure can be regarded as healthy sun exposure and used to help prevent skin cancer. Due to unintended sunburn effect, use of sunscreens for intense intermittent exposure is strongly discouraged. As photoaging and skin cancer may be closely related, some questions related to conventional theories and practices in photoaging are also raised. They include the following: Schuster’s pioneering study in 1975; invalidation of accelerated aging theory; questionable theory on etiology of wrinkles and age spots; Fisher’s studies on metalloproteinases; bolus doing vs constant-rate dosing in irradiation; moisturizers as anti-photoaging/anti-cancer agents; inclusion of blood and water in skin-aging exosome; wind effect; differences in usage pattern between countries in sunscreen evaluation; replacement of UVA in tanning beds.
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