Pierce Ellen S, Jindal Charulata, Choi Yuk Ming, Cassidy Kaitlin, Efird Jimmy T
Independent Physician Researcher, Spokane Valley, Washington, USA.
School of Medicine and Public Health, University of Sydney, Sydney, New South Wales, Australia.
MedComm Oncol. 2024 Jun;3(2). doi: 10.1002/mog2.72. Epub 2024 May 12.
Infectious etiologies have previously been proposed as causes of both melanoma and non-melanoma skin cancer. This exploratory overview explains and presents the evidence for the hypothesis that a microorganism excreted in infected ruminant animal feces, subspecies (MAP), is the cause of some cases of cutaneous melanoma (CM). Occupational, residential, and recreational contact with MAP-contaminated feces, soil, sand, and natural bodies of water may confer a higher rate of CM. Included in our hypothesis are possible reasons for the differing rates and locations of CM in persons with white versus nonwhite skin, why CM develops underneath nails and in vulvar skin, why canine melanoma is an excellent model for human melanoma, and why the Bacille Calmette-Guérin (BCG) vaccine has demonstrated efficacy in the prevention and treatment of CM. The pathogenic mechanisms and etiologic aspects of MAP, as a transmittable agent underlying CM risk, are carefully deliberated in this paper. Imbalances in gut and skin bacteria, genetic risk factors, and vaccine prevention/therapy are also discussed, while acknowledging that the evidence for a causal association between MAP exposure and CM remains circumstantial.
传染性病因此前已被提出是黑色素瘤和非黑色素瘤皮肤癌的病因。本探索性综述解释并呈现了以下假说的证据：一种存在于受感染反刍动物粪便中的微生物——副结核分枝杆菌亚种（MAP），是某些皮肤黑色素瘤（CM）病例的病因。与受MAP污染的粪便、土壤、沙子和天然水体的职业性、居住性及娱乐性接触，可能会使CM发病率升高。我们的假说包括了以下几个方面的可能原因：白种人与非白种人皮肤人群中CM发病率和发病部位不同的原因；CM为何会在指甲下和外阴皮肤处发生；犬黑色素瘤为何是人类黑色素瘤的极佳模型；以及卡介苗（BCG）疫苗为何在CM的预防和治疗中显示出疗效。本文仔细探讨了MAP作为CM风险潜在传播因子的致病机制和病因学方面。同时也讨论了肠道和皮肤细菌失衡、遗传风险因素以及疫苗预防/治疗等问题，不过也承认MAP暴露与CM之间存在因果关联的证据仍然是间接的。
