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It has been demonstrated that in some cases of oral mucosal melanoma, there is loss of the integrity of the melanosomal membrane with leakage into the cytoplasm and nucleoplasm of the melanocytes, of toxic melanin particles, intermediates of melanogenesis and reactive oxygen species, with consequent DNA damage and increase in the risk of genetic mutations [59]
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The mechanism for bronchospasm remains speculative but may involve NO-mediated bronchiolar smooth-muscle relaxation tipping into paradoxical constriction in susceptible individuals
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For some people, ischaemia with non-obstructive coronary arteries - particularly where coronary microvascular dysfunction is present - may also sit alongside other long-term conditions affecting vascular, metabolic, inflammatory or renal health
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