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encefalopsina ou panopsina &#40;OPN3&#41; &#233; um fotorreceptor acoplado &#224; prote&#237;na G&#44; que promove melanog&#234;nese induzida pela luz azul &#40;420&#8208;490<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; Na retina&#44; foram descritas OPN&#160;1&#160;a&#160;5&#44; por&#233;m a OPN3 &#233; a forma mais expressa na pele&#44; que induz a fosforila&#231;&#227;o do fator de transcri&#231;&#227;o associado &#224; microftalmia &#40;MITF&#41; nos melan&#243;citos&#44; resultando na ativa&#231;&#227;o da tirosinase&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> At&#233; o momento&#44; n&#227;o foi investigada a express&#227;o diferencial de OPN3 na pele com melasma em compara&#231;&#227;o com a pele adjacente&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Neste estudo&#44; ap&#243;s aprova&#231;&#227;o no Comit&#234; de &#201;tica&#44; 20 mulheres com melasma facial &#40;diagnosticado clinicamente por dermatologista experiente&#41;&#44; sem tratamento h&#225; mais de 30 dias &#40;exceto filtro solar&#41; foram submetidas a duas bi&#243;psias &#40;3<span class="elsevierStyleHsp" style=""></span>mm&#41;&#58; pele com melasma e pele adjacente n&#227;o afetada &#40;&#60; 2<span class="elsevierStyleHsp" style=""></span>cm de dist&#226;ncia&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Os 40 esp&#233;cimes foram submetidos &#224; imunofluoresc&#234;ncia de tripla marca&#231;&#227;o pelos anticorpos prim&#225;rios e dilui&#231;&#245;es padronizadas&#58; anti&#8208;OPN3 <span class="elsevierStyleItalic">rabbit</span> &#40;ab228748&#8208;Abcam&#44; Cambridge&#8208;MA&#44; EUA&#41; 1&#58;150&#59; anti&#8208;vimentina <span class="elsevierStyleItalic">mouse</span> &#40;ab8978&#8208;Abcam&#44; Cambridge&#8208;MA&#44; EUA&#41; 1&#58;100&#44; que se expressa em melan&#243;citos e nos filamentos intermedi&#225;rios dos fibroblastos&#59; e pelo DAPI &#40;4&#8242;&#44;6&#8208;diamidino&#8208;2&#8208;phenylindole&#41;&#44; para marca&#231;&#227;o dos n&#250;cleos celulares&#46; Para os anticorpos secund&#225;rios &#40;crom&#243;foros&#41; e as dilui&#231;&#245;es para o OPN3&#58; AlexaFluor 594&#44; 1&#58;500&#160;&#40;vermelho&#41;&#59; e&#44; para a vimentina&#58; AlexaFluor 488&#44; 1&#58;500&#160;&#40;verde&#41;&#46; Todas as rea&#231;&#245;es foram testadas para seus controles positivos e negativos&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Tr&#234;s &#225;reas de maior imunomarca&#231;&#227;o das l&#226;minas de cada topografia &#40;melasma e pele n&#227;o afetada&#41; foram fotografadas por microscopia confocal a laser LEICA TCS&#8208;SP8&#46; Utilizando o canal do laser vermelho &#40;crom&#243;foro do OPN3&#41;&#44; orientado pela colocaliza&#231;&#227;o de pontos verdes citoplasm&#225;ticos&#44; e fora da colocaliza&#231;&#227;o azul nuclear&#44; as intensidades m&#233;dias dos histogramas de imagem &#40;varia&#231;&#227;o de&#160;0&#160;a&#160;255&#41; foram estimadas pelo <span class="elsevierStyleItalic">software</span> ImageJ&#44; 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pele adjacente s&#227; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">N&#227;o houve diferen&#231;a da contagem de melan&#243;citos e fibroblastos na derme superior por campo de grande aumento &#40;400<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#41; entre as duas topografias&#46; Entretanto&#44; a pele com melasma apresentou maior densidade de melan&#243;citos em p&#234;ndulo &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Os resultados deste estudo sugerem que a express&#227;o de OPN3 n&#227;o justifica a diferen&#231;a de pigmenta&#231;&#227;o cut&#226;nea no melasma em rela&#231;&#227;o &#224; pele adjacente n&#227;o afetada&#46; Caso a LV apresente um papel importante em sua patog&#234;nese&#44; ela n&#227;o o exerce em fun&#231;&#227;o da express&#227;o de OPN3&#46; De fato&#44; pacientes com melasma facial n&#227;o apresentaram piora das les&#245;es ap&#243;s exposi&#231;&#227;o &#224; tela de computador &#40;8<span class="elsevierStyleHsp" style=""></span>h&#47;dia&#44; cinco&#160;dias consecutivos&#41;&#44; a uma dist&#226;ncia de 20<span class="elsevierStyleHsp" style=""></span>cm&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> Al&#233;m disso&#44; a express&#227;o das OPN&#160;1&#160;a&#160;5 na pele sabidamente n&#227;o apresenta diferen&#231;a de acordo com os fototipos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">H&#225; um efeito sin&#233;rgico entre LV e RUV do tipo&#160;A1 &#40;UVA1&#58;&#160;340&#8208;400<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; Quando indiv&#237;duos de fototipo IV a V s&#227;o irradiados com LV isolada&#44; a pigmenta&#231;&#227;o ocorre de maneira n&#227;o linear com a dose irradiada&#46; J&#225; quando UVA1 &#233; associada &#224; LV&#44; h&#225; pigmenta&#231;&#227;o mais intensa e a resposta &#233; diretamente proporcional &#224; dose utilizada&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> O sinergismo de LV com UVA1 na pigmenta&#231;&#227;o diferencial do melasma precisa ser explorado com desenhos experimentais espec&#237;ficos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A ocorr&#234;ncia de OPN3 em tecidos humanos fora da retina &#233; chamada express&#227;o &#8220;n&#227;o visual&#8221;&#44; cujas fun&#231;&#245;es n&#227;o s&#227;o totalmente esclarecidas&#46; Na pele&#44; al&#233;m da modula&#231;&#227;o da melanog&#234;nese&#44; promove diferencia&#231;&#227;o de queratin&#243;citos e ativa&#231;&#227;o de metaloproteinases &#40;MMP&#8208;1&#44; &#8208;2&#44; &#8208;3 e &#8208;9&#41; pelos fibroblastos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> A OPN3 tamb&#233;m pode ser induzida na pele ap&#243;s irradia&#231;&#227;o por luz azul em modelos de reparo cicatricial&#44; sugerindo que exer&#231;a papel na cicatriza&#231;&#227;o cut&#226;nea&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Melan&#243;citos em p&#234;ndulo s&#227;o melan&#243;citos da camada basal que se projetam em dire&#231;&#227;o &#224; derme superior e s&#227;o caracter&#237;sticos da pele com melasma&#44; apesar de serem encontradas em menor propor&#231;&#227;o na pele fotoagredida adjacente&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Seu significado fisiopatol&#243;gico n&#227;o &#233; claro&#44; mas sua ocorr&#234;ncia parece estar relacionada ao aumento de MMP&#8208;2 e fragmenta&#231;&#227;o da membrana basal&#46; O maior n&#250;mero na pele com melasma refor&#231;a o papel da RUV na fisiopatologia da doen&#231;a&#44; j&#225; que UVA promove um microambiente inflamat&#243;rio na derme superior&#44; com aumento da atividade das MMP &#40;especialmente MMP&#8208;2 e &#8208;9&#41; e degrada&#231;&#227;o da membrana basal&#44; o que facilita a protus&#227;o dos melan&#243;citos em dire&#231;&#227;o &#224; derme&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Este estudo apresenta limita&#231;&#245;es ligadas &#224; t&#233;cnica de investiga&#231;&#227;o semiquantitativa <span class="elsevierStyleItalic">in situ</span>&#44; que n&#227;o identifica diferentes isoformas &#40;<span class="elsevierStyleItalic">splicing</span>&#41; dos fotorreceptores ou detecta altera&#231;&#245;es funcionais de sua via&#46; Existem outras c&#233;lulas fusiformes na derme superior al&#233;m dos fibroblastos &#40;p&#46; ex&#46;&#44; c&#233;lulas dendr&#237;ticas indiferenciadas mesenquimais CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#41; que&#44; apesar de menos numerosas&#44; n&#227;o s&#227;o distingu&#237;veis &#224; morfologia nem &#224; marca&#231;&#227;o pela vimentina&#46; Ainda&#44; as demais OPN &#40;OPN&#8208;1&#44; &#8208;2&#44; &#8208;4 e &#8208;5&#41; n&#227;o foram exploradas&#44; apesar de menos expressas na pele normal&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; n&#227;o h&#225; express&#227;o diferencial de OPN3 nos queratin&#243;citos&#44; melan&#243;citos ou fibroblastos no melasma facial em compara&#231;&#227;o com a pele adjacente n&#227;o afetada&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0070" class="elsevierStylePara elsevierViewall">FUNADERSP &#8211; Fundo de Apoio &#224; Dermatologia de S&#227;o Paulo &#8211; Sebasti&#227;o Sampaio&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0075" class="elsevierStylePara elsevierViewall">Ana Cl&#225;udia Cavalcante Esp&#243;sito&#58; Participa&#231;&#227;o na concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Nath&#225;lia Pereira de Souza&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Luciane Donida Bartoli Miot&#58; Concep&#231;&#227;o e planejamento do estudo&#59; interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Participa&#231;&#227;o na concep&#231;&#227;o e planejamento do estudo&#59; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0095" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Como citar este artigo&#58; Esp&#243;sito ACC&#44; Souza NP&#44; Miot LDB&#44; Miot HA&#46; Expression of OPN3 in fibroblasts&#44; melanocytes&#44; and keratinocytes of skin with facial melasma in comparison with unaffected adjacent skin<span class="elsevierStyleItalic">&#46;</span> An Bras Dermatol&#46; 2021&#59;96&#58;367&#8211;9&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Trabalho realizado no Departamentos de Dermatologia e de Patologia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil&#46;</p>"
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          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Imagem de sobreposi&#231;&#227;o da imunofluoresc&#234;ncia de tripla marca&#231;&#227;o na pele com melasma&#46; Marca&#231;&#227;o em verde &#40;vimentina&#41;&#44; vermelho &#40;Opsina&#8208;3&#41;&#44; azul &#40;n&#250;cleos celulares&#41;&#46; Seta com contorno branco&#58; melan&#243;citos na camada basal&#46; Seta branca cheia&#58; melan&#243;citos em p&#234;ndulo&#46; Elipses tracejadas&#58; fibroblastos da derme superior&#46;</p>"
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Carta ‐ Investigação
Expressão de OPN3 em fibroblastos, melanócitos e queratinócitos da pele com melasma facial em comparação com a pele adjacente não afetada
Ana Cláudia Cavalcante Espósito
Autor para correspondência
anaclaudiaesposito@gmail.com

Autor para correspondência.
, Nathália Pereira de Souza, Luciane Donida Bartoli Miot, Hélio Amante Miot
Departamentos de Dermatologia e de Patologia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
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          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Imagem de sobreposi&#231;&#227;o da imunofluoresc&#234;ncia de tripla marca&#231;&#227;o na pele com melasma&#46; Marca&#231;&#227;o em verde &#40;vimentina&#41;&#44; vermelho &#40;Opsina&#8208;3&#41;&#44; azul &#40;n&#250;cleos celulares&#41;&#46; Seta com contorno branco&#58; melan&#243;citos na camada basal&#46; Seta branca cheia&#58; melan&#243;citos em p&#234;ndulo&#46; Elipses tracejadas&#58; fibroblastos da derme superior&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Melasma &#233; uma discromia cr&#244;nica adquirida frequente que acomete &#225;reas fotoexpostas&#44; especialmente em mulheres em idade f&#233;rtil&#46; A radia&#231;&#227;o ultravioleta &#40;RUV&#41; &#233; o principal est&#237;mulo ambiental na indu&#231;&#227;o da pigmenta&#231;&#227;o do melasma&#59; entretanto&#44; o papel da luz vis&#237;vel &#40;LV&#58; 400&#8208;700<span class="elsevierStyleHsp" style=""></span>nm&#41; em sua patog&#234;nese ainda &#233; incerto&#46; A LV compreende cerca de 44&#37; da irradia&#231;&#227;o solar e promove pigmenta&#231;&#227;o mais duradoura &#40;superior a duas semanas&#41; que a UVA &#8211; no entanto&#44; apenas em fototipos mais elevados &#40;IV&#160;a&#160;VI&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Opsina&#8208;3&#44; encefalopsina ou panopsina &#40;OPN3&#41; &#233; um fotorreceptor acoplado &#224; prote&#237;na G&#44; que promove melanog&#234;nese induzida pela luz azul &#40;420&#8208;490<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; Na retina&#44; foram descritas OPN&#160;1&#160;a&#160;5&#44; por&#233;m a OPN3 &#233; a forma mais expressa na pele&#44; que induz a fosforila&#231;&#227;o do fator de transcri&#231;&#227;o associado &#224; microftalmia &#40;MITF&#41; nos melan&#243;citos&#44; resultando na ativa&#231;&#227;o da tirosinase&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> At&#233; o momento&#44; n&#227;o foi investigada a express&#227;o diferencial de OPN3 na pele com melasma em compara&#231;&#227;o com a pele adjacente&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Neste estudo&#44; ap&#243;s aprova&#231;&#227;o no Comit&#234; de &#201;tica&#44; 20 mulheres com melasma facial &#40;diagnosticado clinicamente por dermatologista experiente&#41;&#44; sem tratamento h&#225; mais de 30 dias &#40;exceto filtro solar&#41; foram submetidas a duas bi&#243;psias &#40;3<span class="elsevierStyleHsp" style=""></span>mm&#41;&#58; pele com melasma e pele adjacente n&#227;o afetada &#40;&#60; 2<span class="elsevierStyleHsp" style=""></span>cm de dist&#226;ncia&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Os 40 esp&#233;cimes foram submetidos &#224; imunofluoresc&#234;ncia de tripla marca&#231;&#227;o pelos anticorpos prim&#225;rios e dilui&#231;&#245;es padronizadas&#58; anti&#8208;OPN3 <span class="elsevierStyleItalic">rabbit</span> &#40;ab228748&#8208;Abcam&#44; Cambridge&#8208;MA&#44; EUA&#41; 1&#58;150&#59; anti&#8208;vimentina <span class="elsevierStyleItalic">mouse</span> &#40;ab8978&#8208;Abcam&#44; Cambridge&#8208;MA&#44; EUA&#41; 1&#58;100&#44; que se expressa em melan&#243;citos e nos filamentos intermedi&#225;rios dos fibroblastos&#59; e pelo DAPI &#40;4&#8242;&#44;6&#8208;diamidino&#8208;2&#8208;phenylindole&#41;&#44; para marca&#231;&#227;o dos n&#250;cleos celulares&#46; Para os anticorpos secund&#225;rios &#40;crom&#243;foros&#41; e as dilui&#231;&#245;es para o OPN3&#58; AlexaFluor 594&#44; 1&#58;500&#160;&#40;vermelho&#41;&#59; e&#44; para a vimentina&#58; AlexaFluor 488&#44; 1&#58;500&#160;&#40;verde&#41;&#46; Todas as rea&#231;&#245;es foram testadas para seus controles positivos e negativos&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Tr&#234;s &#225;reas de maior imunomarca&#231;&#227;o das l&#226;minas de cada topografia &#40;melasma e pele n&#227;o afetada&#41; foram fotografadas por microscopia confocal a laser LEICA TCS&#8208;SP8&#46; Utilizando o canal do laser vermelho &#40;crom&#243;foro do OPN3&#41;&#44; orientado pela colocaliza&#231;&#227;o de pontos verdes citoplasm&#225;ticos&#44; e fora da colocaliza&#231;&#227;o azul nuclear&#44; as intensidades m&#233;dias dos histogramas de imagem &#40;varia&#231;&#227;o de&#160;0&#160;a&#160;255&#41; foram estimadas pelo <span class="elsevierStyleItalic">software</span> ImageJ&#44; para os diferentes tipos celulares&#44; de forma cega em rela&#231;&#227;o &#224; topografia&#46; A intensidade m&#233;dia de fluoresc&#234;ncia em cada grupo celular foi comparada entre as topografias pelo teste&#8208;<span class="elsevierStyleItalic">t</span> de Student &#40;dados dependentes&#41;&#46; Foram tamb&#233;m estimadas as contagens celulares entre as topografias&#46; Considerou&#8208;se significativo p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#44; bicaudal&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Receptores de OPN3 foram identificados em todas as c&#233;lulas estudadas&#58; queratin&#243;citos&#44; melan&#243;citos da camada basal&#44; melan&#243;citos em p&#234;ndulo e fibroblastos da derme superior &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; N&#227;o houve express&#227;o diferencial em nenhum grupo celular ao se comparar a pele com melasma em rela&#231;&#227;o &#224; pele adjacente s&#227; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">N&#227;o houve diferen&#231;a da contagem de melan&#243;citos e fibroblastos na derme superior por campo de grande aumento &#40;400<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#41; entre as duas topografias&#46; Entretanto&#44; a pele com melasma apresentou maior densidade de melan&#243;citos em p&#234;ndulo &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Os resultados deste estudo sugerem que a express&#227;o de OPN3 n&#227;o justifica a diferen&#231;a de pigmenta&#231;&#227;o cut&#226;nea no melasma em rela&#231;&#227;o &#224; pele adjacente n&#227;o afetada&#46; Caso a LV apresente um papel importante em sua patog&#234;nese&#44; ela n&#227;o o exerce em fun&#231;&#227;o da express&#227;o de OPN3&#46; De fato&#44; pacientes com melasma facial n&#227;o apresentaram piora das les&#245;es ap&#243;s exposi&#231;&#227;o &#224; tela de computador &#40;8<span class="elsevierStyleHsp" style=""></span>h&#47;dia&#44; cinco&#160;dias consecutivos&#41;&#44; a uma dist&#226;ncia de 20<span class="elsevierStyleHsp" style=""></span>cm&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> Al&#233;m disso&#44; a express&#227;o das OPN&#160;1&#160;a&#160;5 na pele sabidamente n&#227;o apresenta diferen&#231;a de acordo com os fototipos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">H&#225; um efeito sin&#233;rgico entre LV e RUV do tipo&#160;A1 &#40;UVA1&#58;&#160;340&#8208;400<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; Quando indiv&#237;duos de fototipo IV a V s&#227;o irradiados com LV isolada&#44; a pigmenta&#231;&#227;o ocorre de maneira n&#227;o linear com a dose irradiada&#46; J&#225; quando UVA1 &#233; associada &#224; LV&#44; h&#225; pigmenta&#231;&#227;o mais intensa e a resposta &#233; diretamente proporcional &#224; dose utilizada&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> O sinergismo de LV com UVA1 na pigmenta&#231;&#227;o diferencial do melasma precisa ser explorado com desenhos experimentais espec&#237;ficos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A ocorr&#234;ncia de OPN3 em tecidos humanos fora da retina &#233; chamada express&#227;o &#8220;n&#227;o visual&#8221;&#44; cujas fun&#231;&#245;es n&#227;o s&#227;o totalmente esclarecidas&#46; Na pele&#44; al&#233;m da modula&#231;&#227;o da melanog&#234;nese&#44; promove diferencia&#231;&#227;o de queratin&#243;citos e ativa&#231;&#227;o de metaloproteinases &#40;MMP&#8208;1&#44; &#8208;2&#44; &#8208;3 e &#8208;9&#41; pelos fibroblastos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> A OPN3 tamb&#233;m pode ser induzida na pele ap&#243;s irradia&#231;&#227;o por luz azul em modelos de reparo cicatricial&#44; sugerindo que exer&#231;a papel na cicatriza&#231;&#227;o cut&#226;nea&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Melan&#243;citos em p&#234;ndulo s&#227;o melan&#243;citos da camada basal que se projetam em dire&#231;&#227;o &#224; derme superior e s&#227;o caracter&#237;sticos da pele com melasma&#44; apesar de serem encontradas em menor propor&#231;&#227;o na pele fotoagredida adjacente&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Seu significado fisiopatol&#243;gico n&#227;o &#233; claro&#44; mas sua ocorr&#234;ncia parece estar relacionada ao aumento de MMP&#8208;2 e fragmenta&#231;&#227;o da membrana basal&#46; O maior n&#250;mero na pele com melasma refor&#231;a o papel da RUV na fisiopatologia da doen&#231;a&#44; j&#225; que UVA promove um microambiente inflamat&#243;rio na derme superior&#44; com aumento da atividade das MMP &#40;especialmente MMP&#8208;2 e &#8208;9&#41; e degrada&#231;&#227;o da membrana basal&#44; o que facilita a protus&#227;o dos melan&#243;citos em dire&#231;&#227;o &#224; derme&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Este estudo apresenta limita&#231;&#245;es ligadas &#224; t&#233;cnica de investiga&#231;&#227;o semiquantitativa <span class="elsevierStyleItalic">in situ</span>&#44; que n&#227;o identifica diferentes isoformas &#40;<span class="elsevierStyleItalic">splicing</span>&#41; dos fotorreceptores ou detecta altera&#231;&#245;es funcionais de sua via&#46; Existem outras c&#233;lulas fusiformes na derme superior al&#233;m dos fibroblastos &#40;p&#46; ex&#46;&#44; c&#233;lulas dendr&#237;ticas indiferenciadas mesenquimais CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#41; que&#44; apesar de menos numerosas&#44; n&#227;o s&#227;o distingu&#237;veis &#224; morfologia nem &#224; marca&#231;&#227;o pela vimentina&#46; Ainda&#44; as demais OPN &#40;OPN&#8208;1&#44; &#8208;2&#44; &#8208;4 e &#8208;5&#41; n&#227;o foram exploradas&#44; apesar de menos expressas na pele normal&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; n&#227;o h&#225; express&#227;o diferencial de OPN3 nos queratin&#243;citos&#44; melan&#243;citos ou fibroblastos no melasma facial em compara&#231;&#227;o com a pele adjacente n&#227;o afetada&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0070" class="elsevierStylePara elsevierViewall">FUNADERSP &#8211; Fundo de Apoio &#224; Dermatologia de S&#227;o Paulo &#8211; Sebasti&#227;o Sampaio&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0075" class="elsevierStylePara elsevierViewall">Ana Cl&#225;udia Cavalcante Esp&#243;sito&#58; Participa&#231;&#227;o na concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Nath&#225;lia Pereira de Souza&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Luciane Donida Bartoli Miot&#58; Concep&#231;&#227;o e planejamento do estudo&#59; interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Participa&#231;&#227;o na concep&#231;&#227;o e planejamento do estudo&#59; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0095" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Imagem de sobreposi&#231;&#227;o da imunofluoresc&#234;ncia de tripla marca&#231;&#227;o na pele com melasma&#46; Marca&#231;&#227;o em verde &#40;vimentina&#41;&#44; vermelho &#40;Opsina&#8208;3&#41;&#44; azul &#40;n&#250;cleos celulares&#41;&#46; Seta com contorno branco&#58; melan&#243;citos na camada basal&#46; Seta branca cheia&#58; melan&#243;citos em p&#234;ndulo&#46; Elipses tracejadas&#58; fibroblastos da derme superior&#46;</p>"
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                  \t\t\t\t">17&#44;3 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;031&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Contagem m&#233;dia &#40;desvio&#8208;padr&#227;o&#41; de c&#233;lulas &#40;melan&#243;citos&#44; melan&#243;citos em p&#234;ndulo e fibroblastos&#41; por campo de grande aumento &#40;400<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#41;</p>"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Visible light in photodermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Narla"
                            1 => "I&#46; Kohli"
                            2 => "I&#46;H&#46; Hamzavi"
                            3 => "H&#46;W&#46; Lim"
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                      "doi" => "10.1039/c9pp00425d"
                      "Revista" => array:6 [
                        "tituloSerie" => "Photochem Photobiol Sci&#46;"
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                        "volumen" => "19"
                        "paginaInicial" => "99"
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                  "contribucion" => array:1 [
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                      "titulo" => "Illuminating insights into opsin 3 function in the skin"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;E&#46; Olinski"
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                    0 => array:2 [
                      "doi" => "10.1016/j.jbior.2019.100668"
                      "Revista" => array:5 [
                        "tituloSerie" => "Adv Biol Regul&#46;"
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                        "volumen" => "75"
                        "paginaInicial" => "100668"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31653550"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short&#8208;term exposure to blue light emitted by electronic devices does not worsen melasma"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Duteil"
                            1 => "C&#46; Queille-Roussel"
                            2 => "J&#46;P&#46; Lacour"
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                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2019.12.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
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                        "volumen" => "83"
                        "paginaInicial" => "913"
                        "paginaFinal" => "914"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31887321"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Synergistic effects of long&#8208;wavelength ultraviolet A1 and visible light on pigmentation and erythema"
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "T&#46;F&#46; Mohammad"
                            3 => "C&#46;L&#46; Nicholson"
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                      "doi" => "10.1111/bjd.15940"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol&#46;"
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                        "volumen" => "178"
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                        "paginaFinal" => "1180"
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                      "titulo" => "Does blue light restore human epidermal barrier function via activation of Opsin during cutaneous wound healing&#63;"
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                          "autores" => array:6 [
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                            3 => "B&#46; Raafs"
                            4 => "V&#46;A&#46; Botchkarev"
                            5 => "M&#46;J&#46; Thornton"
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ISSN: 26662752
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