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Ren J, Zhu Q, Wang S, Li X, Sun Z, Li N, Feng J, Ding H, Dong S, Wang H. Clinical efficacy and safety of using calcipotriol-betamethasone compounding agent for psoriasis treatment: a systematic review and meta-analysis. Arch Dermatol Res 2021; 314:633-641. [PMID: 34417633 DOI: 10.1007/s00403-021-02272-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/15/2021] [Accepted: 08/13/2021] [Indexed: 11/26/2022]
Abstract
The main objective is to evaluate clinical efficacy and safety of using calcipotriol-betamethasone compounding agent for psoriasis treatment through a systematic review and meta-analysis. We searched MEDLINE, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), and WanFang Data from inception till July 31, 2020. Efficacy was evaluated based on primary outcome indicators including skin lesion improvement and overall adverse reaction rate. Secondary outcome indicators included degree of life quality improvement, clinical effectiveness rate, and specific adverse reaction rates. RevMan5.3 was used to perform the meta-analysis. 22 studies finally met our inclusion criteria for the meta-analysis. The results indicated that for short-term treatment, a sequential therapy that uses calcipotriol betamethasone compounding agent and calcipotriol improves PASI score (MD = -0.94, 95% CI - 1.38 ~ - 0.49, P < 0.0001, I2 = 49%), comparing with using only calcipotriol. From a drug safety perspective, the difference in overall adverse reaction rate is not significant between the calcipotriol group and the sequential treatment group (RR = 0.50, 95% CI 0.22 ~ 1.14, P = 0.10, I2 = 33%). Calcipotriol betamethasone compounding agent may be more effective in plaque psoriasis treatment compared to use only calcipotriol, with no significant difference in adverse reaction rate between the two groups. Although the data were collected from 13 comparison groups, each group may not have sufficient data for a thorough and comprehensive analysis. Further research may be necessary for a more detailed evaluation of effectiveness of using calcipotriol betamethasone compounding agent for plaque psoriasis treatment.
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Affiliation(s)
- Junrong Ren
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Qi Zhu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Siyao Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaolong Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhen Sun
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Nan Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jian Feng
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Haining Ding
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Sitong Dong
- Systematic Review Solutions Ltd, The Ingenuity Centre, Triumph Road, Nottingham, NG7 2TU, UK
| | - Hongmei Wang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China.
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Fixed-Combination Halobetasol Propionate and Tazarotene in the Treatment of Psoriasis: Narrative Review of Mechanisms of Action and Therapeutic Benefits. Dermatol Ther (Heidelb) 2021; 11:1157-1174. [PMID: 34106439 PMCID: PMC8322240 DOI: 10.1007/s13555-021-00560-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Indexed: 12/14/2022] Open
Abstract
Psoriasis is a lifelong disease associated with cycles of remission and relapse. Topical treatments are the front line of psoriasis therapy for most patients and have antiproliferative, anti-inflammatory, and immunosuppressive mechanisms of action. Novel fixed-dose combinations of topical therapeutic agents are becoming increasingly available, leveraging multiple mechanisms of action to improve safety and efficacy with formulations that are easier to use and may allow for the use of lower doses of active ingredients. A fixed-combination lotion containing the potent-to-superpotent corticosteroid halobetasol propionate (HP) and the retinoid tazarotene (HP 0.01%/TAZ 0.045%) was recently developed using polymeric emulsion technology. This new formulation technology allows for more uniform and efficient delivery of the active ingredients at lower doses than conventional monotherapy formulations of either ingredient while providing enhanced hydration and moisturization. This review provides an up-to-date overview of the therapeutic mechanisms of action of HP and TAZ, the rationale behind the development of HP 0.01%/TAZ 0.045% lotion, and clinical trials data on the efficacy, safety and tolerability, and maintenance of therapeutic effect with HP 0.01%/TAZ 0.045% lotion in the treatment of moderate-to-severe plaque psoriasis.
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Gao Y, Lu J, Bao X, Yi X, Peng C, Chen W, Zhen T, Shi Y, Xing K, Zhu S, Ding Y. Inhibition of phospholipases suppresses progression of psoriasis through modulation of inflammation. Exp Biol Med (Maywood) 2021; 246:1253-1262. [PMID: 33641447 PMCID: PMC8371307 DOI: 10.1177/1535370221993424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Abnormal lipid metabolism is regarded as a crucial cause of psoriasis. The specific mechanism of how phospholipase PLA2G4B mediates local immune dysfunction and skin lesions remains unclear. The aim of this study was to explore the mechanisms of anti-psoriasis and immune suppression effect by inhibiting PLA2G4B in psoriasis progression. We successfully transfected si-PLA2G4B in a murine keratinocyte cell-line PAM212 to verify the effect of progression by PLA2G4B. The Imiquimod psoriasis mouse model was then successfully constructed, followed by emulsion wrapped PLA2G4B-siRNA applied to the skin lesions. The phenotype, pathology, immunofluorescence staining of PLA2G4B, IL17, CD3, and CD1b, and bulk transcriptome analysis were performed to decipher the effect and mechanism of si-PLA2G4B. Interfering with PLA2G4B significantly inhibited the proliferation and migration of PAM212. The interference of PLA2G4B in vivo showed a therapeutic effect on psoriasis, comparable to that of betamethasone. The phenotype and pathology revealed reduced keratinocytes in the si-PLA2G4B group compared to the model mice. Immunofluorescence showed that CD1b, CD3+ T cells, and IL17 were suppressed in the skin lesions. RNA-seq and deconvolution revealed that immune cells such as myeloid dendritic cell and T cell CD8+ naive were inactivated. Th17 reduce the release of inflammatory factors such as IL17 and IL36. Pathway analysis revealed the potential therapeutic mechanism involved in the inhibition of sphingolipid or ceramide secretion. This study verified the anti-psoriatic effect of using si-PLA2G4B. The immune response was alleviated after administration. This phospholipase inhibition-based therapy sheds light on the pharmaceutical potential against psoriasis.
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Affiliation(s)
- Yunlu Gao
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Jiajing Lu
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Xunxia Bao
- Cinoasia Institute, Shanghai 200438, China
| | - Xuemei Yi
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Chen Peng
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Wenjuan Chen
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | | | - Yong Shi
- Cinoasia Institute, Shanghai 200438, China
| | | | - Sibo Zhu
- School of Life Sciences, Fudan University, Shanghai 200438, China
| | - Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
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Barbati F, Giovannini M, Oranges T, Lodi L, Barni S, Novembre E, Baldo E, Cristofolini M, Stagi S, Ricci S, Mori F, Filippeschi C, Azzari C, Indolfi G. Netherton Syndrome in Children: Management and Future Perspectives. Front Pediatr 2021; 9:645259. [PMID: 34041207 PMCID: PMC8141839 DOI: 10.3389/fped.2021.645259] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/08/2021] [Indexed: 11/13/2022] Open
Abstract
Netherton syndrome (NS) is a genetic, multisystemic disease classically distinguished by a triad of clinical manifestations: congenital ichthyosiform erythroderma, hair shaft abnormalities, and immune dysregulation. Due to the complex pathogenesis of the disease, there are no specific therapies currently accessible for patients with NS. An early diagnosis is crucial to start the correct management of these patients. A multidisciplinary approach, including specialists in immunology, allergology, and dermatology, is necessary to set up the best therapeutic pathway. We conducted a review with the aim to summarize the different therapeutic strategies currently accessible and potentially available in the future for children with NS. However, given the limited data in the literature, the best-tailored management should be decided upon the basis of the specific clinical characteristics of the patients with this rare clinical condition. Further comprehension of the pathophysiology of the disease could lead to more efficacious specific therapeutic options, which could allow a change in the natural history of NS.
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Affiliation(s)
- Federica Barbati
- Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Teresa Oranges
- Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Lorenzo Lodi
- Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Ermanno Baldo
- “Giovan Battista Mattei” Research Institute, Stenico, Italy
| | | | - Stefano Stagi
- Endocrinology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Silvia Ricci
- Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Cesare Filippeschi
- Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Chiara Azzari
- Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giuseppe Indolfi
- Pediatric and Liver Unit, Meyer Children's University Hospital, Florence, Italy
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Didona D, Scarsella L, Fehresti M, Solimani F, Juratli HA, Göbel M, Mühlenbein S, Holiangu L, Pieper J, Korff V, Schmidt T, Sitaru C, Eming R, Hertl M, Pollmann R. Autoreactive Peripheral Blood T Helper Cell Responses in Bullous Pemphigoid and Elderly Patients With Pruritic Disorders. Front Immunol 2021; 12:569287. [PMID: 33841390 PMCID: PMC8027500 DOI: 10.3389/fimmu.2021.569287] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 03/08/2021] [Indexed: 12/17/2022] Open
Abstract
Bullous pemphigoid (BP) is a prototypic autoimmune disorder of the elderly, characterized by serum IgG autoantibodies, namely anti-BP180 and anti-BP230, directed against components of the basal membrane zone that lead to sub-epidermal loss of adhesion. Pruritus may be indicative of a pre-clinical stage of BP, since a subset of these patients shows serum IgG autoantibodies against BP230 and/or BP180 while chronic pruritus is increasingly common in the elderly population and is associated with a variety of dermatoses. Clinical and experimental evidence further suggests that pruritus of the elderly may be linked to autoimmunity with loss of self-tolerance against cutaneous autoantigens. Thus, the objective of this study was to determine autoreactive T cell responses against BP180 in elderly patients in comparison to patients with BP. A total of 22 elderly patients with pruritic disorders, 34 patients with bullous or non-bullous BP and 34 age-matched healthy controls were included in this study. The level of anti-BP180 and anti-BP230 IgG serum autoantibodies, Bullous Pemphigoid Disease Area Index (BPDAI), and pruritus severity were assessed for all patients and controls. For characterization of the autoreactive T cell response, peripheral blood mononuclear cells were stimulated ex vivo with recombinant BP180 proteins (NH2- and COOH-terminal domains) and the frequencies of BP180-specific T cells producing interferon-γ, interleukin (IL)-5 or IL-17 were subsequently determined by ELISpot assay. Patients with BP showed a mixed Th1/Th2 response against BP180 while autoreactive Th1 cells were identified in a minor subset of elderly patients with pruritic disorders. Furthermore, our T cell characterization revealed that therapeutic application of topical clobetasol propionate ointment in BP patients significantly reduced peripheral blood BP180-specific T cells, along with clinically improved symptoms, strongly suggesting a systemic immunosuppressive effect of this treatment.
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Affiliation(s)
- Dario Didona
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Luca Scarsella
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Milad Fehresti
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Farzan Solimani
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hazem A. Juratli
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Manuel Göbel
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Stefan Mühlenbein
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Lily Holiangu
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Josquin Pieper
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Vera Korff
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Thomas Schmidt
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Cassian Sitaru
- Department of Dermatology and Allergology, Universität Freiburg, Freiburg, Germany
| | - Rüdiger Eming
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Robert Pollmann
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
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56
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Purvis CG, Balogh EA, Heron CE, Feldman SR. Topical calcipotriol plus betamethasone dipropionate for the treatment of plaque psoriasis: a drug evaluation. Expert Opin Pharmacother 2021; 22:1107-1118. [PMID: 33745399 DOI: 10.1080/14656566.2021.1900825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Psoriasis is an inflammatory skin disease affecting approximately 3.2% of adults in the United States. The mainstay treatment for mild-to-moderate plaque psoriasis (the most common subtype and severity) is topical therapy.Areas covered:The fixed combination calcipotriol plus betamethasone dipropionate (BD) is an effective topical treatment for plaque psoriasis. Two therapies with separate actions - a Vitamin D analog and a high-potency topical corticosteroid - combined into a single medication allows for better efficacy and patient adherence. The treatment is available in ointment, gel, suspension, foam, and cream formulations. The authors elaborate on this and provide their expert perspectives.Expert opinion: Combination calcipotriol/BD offers several advantages over its separate product monotherapies, including better efficacy, safety, and ease of use. Newer calcipotriol/BD formulations include less messy vehicles, thus promoting improved adherence. Further data are needed on whether combination calcipotriol/BD will be cost-effective and whether insurers will place it in the treatment coverage algorithm. Due to its higher price, calcipotriol/BD will likely remain a second-line treatment option after generic topical corticosteroids.
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Affiliation(s)
- Caitlin G Purvis
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Esther A Balogh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Courtney E Heron
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States.,Wake Forest School of Medicine, Winston-Salem, North Carolina, United States.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
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57
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Pegoraro NS, Camponogara C, Cruz L, Oliveira SM. Oleic acid exhibits an expressive anti-inflammatory effect in croton oil-induced irritant contact dermatitis without the occurrence of toxicological effects in mice. JOURNAL OF ETHNOPHARMACOLOGY 2021; 267:113486. [PMID: 33091495 DOI: 10.1016/j.jep.2020.113486] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cutaneous inflammatory diseases, such as irritant contact dermatitis, are usually treated with topical corticosteroids, which cause systemic and local adverse effects limiting their use. Thus, the discovery of new therapeutic alternatives able to effectively treat skin inflammatory disorders, without causing adverse effects, is urgently needed. AIM OF THE STUDY To investigate the topical anti-inflammatory effect of oleic acid (OA), a monounsaturated fatty acid, into Pemulen® TR2-based semisolid dosage forms, employing a croton oil-induced irritant contact dermatitis model in mice. MATERIALS AND METHODS Male Swiss mice were submitted to skin inflammation protocols by acute and repeated applications of croton oil. The anti-inflammatory activity of Pemulen® TR2 hydrogels containing OA was evaluated by assessing oedema, inflammatory cell infiltration, and pro-inflammatory cytokine IL-1β levels. The mechanisms of action of OA were evaluated using cytokine IL-1β application or pretreatment with the glucocorticoid antagonist mifepristone. Possible toxic effects of OA were also assessed. RESULTS Pemulen® TR2 3% OA inhibited the acute ear oedema [maximal inhibition (Imax) = 76.41 ± 5.69%], similarly to dexamethasone (Imax = 84.94 ± 2.16%), and also inhibited ear oedema after repeated croton oil application with Imax = 85.75 ± 3.08%, similar to dexamethasone (Imax = 81.03 ± 4.66%) on the day 7 of the experiment. Croton oil increased myeloperoxidase activity, which was inhibited by Pemulen® TR2 3% OA (Imax = 71.37 ± 10.97%) and by 0.5% dexamethasone (Imax = 96.31 ± 3.73%). Pemulen® TR2 3% OA also prevented the increase in pro-inflammatory cytokine IL-1β levels induced by croton oil (Imax = 94.18 ± 12.03%), similar to 0.5% dexamethasone (Imax = 87.21 ± 10.58%). Besides, both Pemulen® TR2 3% OA and 0.5% dexamethasone inhibited IL-1β-induced ear oedema with an Imax of 80.58 ± 2.45% and 77.46 ± 1.92%, respectively. OA and dexamethasone anti-inflammatory effects were prevented by 100% and 91.43 ± 5.43%, respectively, after pretreatment with mifepristone. No adverse effects were related to Pemulen® TR2 3% OA administration. CONCLUSIONS OA demonstrated anti-inflammatory efficacy similar to dexamethasone, clinically used to treat skin inflammatory conditions, without presenting adverse effects.
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Affiliation(s)
- Natháli Schopf Pegoraro
- Graduate Program in Biological Sciences: Biochemistry Toxicology, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Camila Camponogara
- Graduate Program in Biological Sciences: Biochemistry Toxicology, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Letícia Cruz
- Graduate Program in Pharmaceutical Sciences, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Sara Marchesan Oliveira
- Graduate Program in Biological Sciences: Biochemistry Toxicology, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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58
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Shu PP, Li LX, He QM, Pan J, Li XL, Zhu M, Yang Y, Qu Y. Identification and quantification of oleanane triterpenoid saponins and potential analgesic and anti-inflammatory activities from the roots and rhizomes of Panax stipuleanatus. J Ginseng Res 2021; 45:305-315. [PMID: 33841011 PMCID: PMC8020355 DOI: 10.1016/j.jgr.2020.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Panax stipuleanatus represents a folk medicine for treatment of inflammation. However, lack of experimental data does not confirm its function. This article aims to investigate the analgesic and anti-inflammatory activities of triterpenoid saponins isolated from P. stipuleanatus. METHODS The chemical characterization of P. stipuleanatus allowed the identification and quantitation of two major compounds. Analgesic effects of triterpenoid saponins were evaluated in two models of thermal- and chemical-stimulated acute pain. Anti-inflammatory effects of triterpenoid saponins were also evaluated using four models of acetic acid-induced vascular permeability, xylene-induced ear edema, carrageenan-induced paw edema, and cotton pellet-induced granuloma in mice. RESULTS Two triterpenoid saponins of stipuleanosides R1 (SP-R1) and R2 (SP-R2) were isolated and identified from P. stipuleanatus. The results showed that SP-R1 and SP-R2 significantly increased the latency time to thermal pain in the hot plate test and reduced the writhing response in the acetic acid-induced writhing test. SP-R1 and SP-R2 caused a significant decrease in vascular permeability, ear edema, paw edema, and granuloma formation in inflammatory models. Further studies showed that the levels of inflammatory mediators, nitric oxide, malondialdehyde, tumor necrosis factor-α, and interleukin 6 in paw tissues were downregulated by SP-R1 and SP-R2. In addition, the rational harvest of three- to five-year-old P. stipuleanatus was preferable to obtain a higher level of triterpenoid saponins. SP-R2 showed the highest content in P. stipuleanatus, which had potential as a chemical marker for quality control of P. stipuleanatus. CONCLUSION This study provides important basic information about utilization of P. stipuleanatus resources for production of active triterpenoid saponins.
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Affiliation(s)
- Pan-Pan Shu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Yunnan Provincial Key Laboratory of Panax notoginseng, Kunming, 650500, China
| | - Lu-Xi Li
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Yunnan Provincial Key Laboratory of Panax notoginseng, Kunming, 650500, China
| | - Qin-Min He
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Jun Pan
- Yunnan Provincal Academy of Agricultural Sciences, Kunming, 650231, China
| | - Xiao-Lei Li
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Min Zhu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Ye Yang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Yunnan Provincial Key Laboratory of Panax notoginseng, Kunming, 650500, China
| | - Yuan Qu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Yunnan Provincial Key Laboratory of Panax notoginseng, Kunming, 650500, China
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59
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Said Z, Murdoch C, Hansen J, Siim Madsen L, Colley HE. Corticosteroid delivery using oral mucosa equivalents for the treatment of inflammatory mucosal diseases. Eur J Oral Sci 2021; 129:e12761. [PMID: 33645844 PMCID: PMC8048628 DOI: 10.1111/eos.12761] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
Oral lichen planus (OLP) is an immune‐mediated disease of the oral mucosa with idiopathic aetiology. It is frequently treated with topical corticosteroids (applied as gels, mouthwashes, or sprays); however, the mucosal exposure times of topical corticosteroids are short because of removal by the constant flow of saliva and mechanical forces. In this study we used cell monolayers, as well as oral mucosal equivalents (OMEs) containing activated T‐cells, to examine corticosteroid potency and delivery of clobetasol‐17‐propionate from a novel electrospun mucoadhesive patch. The OMEs displayed tight junctions, desmosomes, hemidesmosomes, and an efficient permeability barrier. Following application of corticosteroids to cells cultured as monolayers, the degree of cytotoxicity measured correlated to the level of potency recognized for each corticosteroid; by contrast, OMEs were largely unaffected by corticosteroid treatment. Permeation of clobetasol‐17‐propionate into and through the OMEs was time‐ and dose‐dependent, regardless of whether this corticosteroid was delivered in liquid form or from a mucoadhesive patch, and both liquid‐ and patch‐delivered clobetasol‐17‐propionate significantly reduced the secretion of interleukin‐2 by activated T‐cells. This study confirms that OMEs are more suitable models than cell monolayers for evaluating toxicity and drug delivery. After topical exposure, clobetasol‐17‐propionate accumulated in OMEs at a higher level than betamethasone‐17‐valerate and hydrocortisone‐17‐valerate, and exerted its immunosuppressive actions following application via the patch delivery system, highlighting the efficacy of this mode of drug delivery to treat OLP.
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Affiliation(s)
- Zulfahmi Said
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.,Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Craig Murdoch
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | | | - Helen E Colley
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Stein Gold L, Bhatia N, Tallman AM, Rubenstein DS. A phase 2b, randomized clinical trial of tapinarof cream for the treatment of plaque psoriasis: Secondary efficacy and patient-reported outcomes. J Am Acad Dermatol 2021; 84:624-631. [DOI: 10.1016/j.jaad.2020.04.181] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/09/2023]
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61
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Cingi C, Bayar Muluk N, Mitsias DI, Papadopoulos NG, Klimek L, Laulajainen-Hongisto A, Hytönen M, Toppila-Salmi SK, Scadding GK. The Nose as a Route for Therapy: Part 1. Pharmacotherapy. FRONTIERS IN ALLERGY 2021; 2:638136. [PMID: 35387039 PMCID: PMC8974766 DOI: 10.3389/falgy.2021.638136] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/08/2021] [Indexed: 12/30/2022] Open
Abstract
This article reviews nasal structure and function in the light of intranasal pharmacotherapy. The nose provides an accessible, fast route for local treatment of nose and sinus diseases, with lower doses than are necessary systemically and few adverse effects. It can also be used for other medications as it has sufficient surface area protected from local damage by mucociliary clearance, absence of digestive enzymes, responsive blood flow, and provides a rapid route to the central nervous system.
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Affiliation(s)
- Cemal Cingi
- Department of Otolaryngology, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Nuray Bayar Muluk
- Department of Otolaryngology, Kirikkale University, Kirikkale, Turkey
| | - Dimitrios I Mitsias
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.,Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Ludger Klimek
- Centre for Rhinology and Allergology, Wiesbaden, Germany
| | - Anu Laulajainen-Hongisto
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Maija Hytönen
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Sanna Katriina Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.,Faculty of Medicine, The Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Glenis Kathleen Scadding
- University College London Hospitals NHS Foundation Trust, London, United Kingdom.,Royal National Throat Nose and Ear Hospital, London, United Kingdom
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62
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Lebwohl M, Stein Gold L, Papp K, Han G, Pariser D, Lin T, Harris S, Jacobson A. Long‐term safety and efficacy of a fixed‐combination halobetasol propionate 0.01%/tazarotene 0.045% lotion in moderate‐to‐severe plaque psoriasis: phase 3 open‐label study. J Eur Acad Dermatol Venereol 2021; 35:1152-1160. [DOI: 10.1111/jdv.17113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M.G. Lebwohl
- Icahn School of Medicine at Mount Sinai New York NY USA
| | | | - K. Papp
- Probity Medical Research and K. Papp Clinical Research Waterloo ON Canada
| | - G. Han
- Icahn School of Medicine at Mount Sinai New York NY USA
| | - D.M. Pariser
- Eastern Virginia Medical School and Virginia Clinical Research, Inc. Norfolk VA USA
| | - T. Lin
- Ortho Dermatologics† Bridgewater NJ USA
| | - S. Harris
- Bausch Health US, LLC† Bridgewater NJ USA
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Nanostructured Non-Ionic Surfactant Carrier-Based Gel for Topical Delivery of Desoximetasone. Int J Mol Sci 2021; 22:ijms22041535. [PMID: 33546426 PMCID: PMC7913730 DOI: 10.3390/ijms22041535] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 12/22/2022] Open
Abstract
Psoriasis is a chronic autoimmune skin disease impacting the population globally. Pharmaceutical products developed to combat this condition commonly used in clinical settings are IV bolus or oral drug delivery routes. There are some major challenges for effectively developing new dosage forms for topical use: API physicochemical nature, the severity of the disease state, and low bioavailability present challenges for pharmaceutical product developers. For non-severe cases of psoriasis, topical drug delivery systems may be preferred or used in conjunction with oral or parenteral therapy to address local symptoms. Elastic vesicular systems, termed “niosomes”, are promising drug delivery vehicles developed to achieve improved drug delivery into biological membranes. This study aimed to effectively incorporate a corticosteroid into the niosomes for improving the drug bioavailability of desoximetasone, used to treat skin conditions via topical delivery. Niosomes characterization measurements were drug content, pH, spreadability, specific gravity, content uniformity, rheology, and physicochemical properties. Formulations used a topical gelling agent, Carbomer 980 to test for in vitro skin permeation testing (IVPT) and accelerated stability studies. The developed niosomal test gel provided approximately 93.03 ± 0.23% to 101.84 ± 0.11% drug content with yield stresses ranging from 16.12 to 225.54 Pa. The permeated amount of desoximetasone from the niosomal gel after 24 h was 9.75 ± 0.44 µg/cm2 compared to 24.22 ± 4.29 µg/cm2 released from the reference gel tested. Furthermore, a drug retention study compared the test gel to a reference gel, demonstrating that the skin retained 30.88 ng/mg of desoximetasone while the reference product retained 26.01 ng/mg. A controlled drug release profile was obtained with a niosomal formulation containing desoximetasone for use in a topical gel formulation showing promise for potential use to treat skin diseases like psoriasis.
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64
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Natural Compound Mixture, Containing Emodin, Genipin, Chlorogenic Acid, Cimigenoside, and Ginsenoside Rb1, Ameliorates Psoriasis-Like Skin Lesions by Suppressing Inflammation and Proliferation in Keratinocytes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9416962. [PMID: 33149756 PMCID: PMC7603578 DOI: 10.1155/2020/9416962] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/16/2020] [Accepted: 10/07/2020] [Indexed: 01/13/2023]
Abstract
Herbal combinations of Rhei Radix et Rhizoma, Gardeniae Fructus, Cimicifugae Rhizoma, and Ginseng Radix have been used in traditional formulas to treat the symptoms of heat and dryness. This study investigated the therapeutic effects of a natural compound mixture (PSM) of these herbal combinations, containing emodin, genipin, chlorogenic acid, cimigenoside, and ginsenoside Rb1, for the treatment of psoriasis and its underlying molecular mechanisms. PSM was applied topically to the dorsal skin lesions of imiquimod- (IMQ-) induced C57BL/6 mice, and the expression of the proinflammatory mediators was investigated. The topical application of 1% PSM reduced psoriasis-like symptoms in IMQ-induced C57BL/6 mice significantly. PSM also attenuated the production of IFN-γ, IL-1β, and IL-6 in skin lesions. Histological analysis showed that PSM had antipsoriatic effects by reducing the lesional epidermal thickness. Either M5 (IL-1α, IL-17A, IL-22, oncostatin M, and TNF-α, 10 ng/ml each) or IL-22- (100 ng/ml) stimulated HaCaT cells were used to examine the efficacy and underlying mechanism of PSM. In M5-stimulated HaCaT cells, PSM inhibited the production of C-X-C motif chemokine ligand (CXCL) 10 and C-C motif chemokine ligand (CCL) 20 effectively. Moreover, compared to the use of a single compound, it had synergistic inhibitory effects in CXCL8 production. PSM suppressed the phosphorylation of ERK1/2, p38, and STAT3 signaling pathways in M5-stimulated HaCaT cells. Furthermore, PSM reduced the proliferation rate and K16 and K17 expressions in IL-22-stimulated HaCaT cells by inhibiting the Akt/mTOR signaling pathway. These results suggest that PSM may have a therapeutic potential in the treatment of psoriasis lesions.
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65
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Cretu S, Salavastru CM, Tiplica GS. Treatment of psoriatic erythroderma using systemic corticosteroids: A timeless option? Dermatol Ther 2020; 33:e14222. [PMID: 32820848 DOI: 10.1111/dth.14222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/06/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Stefana Cretu
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Carmen Maria Salavastru
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Pediatric Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - George Sorin Tiplica
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Second Dermatology Clinic, Colentina Clinical Hospital, Bucharest, Romania
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Pinto NDCC, Maciel MDSF, Rezende NDS, Duque APDN, Mendes RDF, da Silva JB, Evangelista MDR, Monteiro LC, da Silva JM, da Costa JDC, Scio E. Preclinical studies indicate that INFLATIV, an herbal medicine cream containing Pereskia aculeata, presents potential to be marketed as a topical anti-inflammatory agent and as adjuvant in psoriasis therapy. J Pharm Pharmacol 2020; 72:1933-1945. [PMID: 32846458 DOI: 10.1111/jphp.13357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/03/2020] [Accepted: 07/25/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES A previous study reported that the hexane fraction (HF) obtained from Pereskia aculeata leaves showed promising topical anti-inflammatory activity. Intending its future use in clinical practice, a herbal medicine cream named INFLATIV was developed. Its anti-inflammatory and antipsoriatic potential were investigated. INFLATIV was subjected to preliminary accelerated stability tests and to a degradation profile assessment. METHODS INFLATIV was prepared at 6% and 12%. The anti-inflammatory activity was assessed by croton oil single and multiple application challenge in mice. Mouse tail test was used for antipsoriatic potential investigation. Cutaneous atrophy test was performed. Preliminary accelerated stability tests were performed together with a degradation profile by GC-MS analysis. KEY FINDINGS The anti-inflammatory activity shown by INFLATIV was comparable to dexamethasone. However, the skin atrophy caused by that drug was not observed. INFLATIV modified skin parakeratotic differentiation into orthokeratosis, which revealed its antipsoriatic potential. The ingredients used were suitable to carry the bioactives as they were well permeated by the skin. The preliminary accelerated stability tests indicated that INFLATIV 6% is more stable than 12%. CONCLUSIONS The results demonstrated the relevant therapeutic and marketing potentials of INFLATIV, which is likely to be further evaluated in clinical trials for drug registration process with regulatory agencies.
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Affiliation(s)
- Nícolas de Castro Campos Pinto
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Mariana de Souza Ferreira Maciel
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Nathalia Dos Santos Rezende
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Ana Paula do Nascimento Duque
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Renata de Freitas Mendes
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Jucélia Barbosa da Silva
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Monique de Rezende Evangelista
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Luana Cahon Monteiro
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Josiane Mello da Silva
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Juliana de Carvalho da Costa
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Elita Scio
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
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67
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Sachdeva S, Arora P, Kulhari A, Sardana K. Iatrogenic Cushing's syndrome due to topical steroid abuse in a child with Psoriasis presenting as septicaemia. Dermatol Ther 2020; 33:e13514. [DOI: 10.1111/dth.13514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/25/2020] [Accepted: 04/29/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Soumya Sachdeva
- Department of Dermatology, Venereology and Leprosy Dr. Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences New Delhi Delhi India
| | - Pooja Arora
- Department of Dermatology, Venereology and Leprosy Dr. Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences New Delhi Delhi India
| | - Anita Kulhari
- Department of Dermatology, Venereology and Leprosy Dr. Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences New Delhi Delhi India
| | - Kabir Sardana
- Department of Dermatology, Venereology and Leprosy Dr. Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences New Delhi Delhi India
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Lu YT, Guan R, Zheng JR, Hang TJ, Song M. Determination of clobetasol propionate, tazarotene and tazarotenic acid in Bama mini-pig skin by UPLC-MS/MS: Application to pharmacokinetic and drug-drug interaction studies. J Pharm Biomed Anal 2020; 186:113322. [DOI: 10.1016/j.jpba.2020.113322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 11/26/2022]
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69
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Benezeder T, Painsi C, Patra V, Dey S, Holcmann M, Lange-Asschenfeldt B, Sibilia M, Wolf P. Dithranol targets keratinocytes, their crosstalk with neutrophils and inhibits the IL-36 inflammatory loop in psoriasis. eLife 2020; 9:e56991. [PMID: 32484435 PMCID: PMC7266641 DOI: 10.7554/elife.56991] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/18/2020] [Indexed: 12/18/2022] Open
Abstract
Despite the introduction of biologics, topical dithranol (anthralin) has remained one of the most effective anti-psoriatic agents. Serial biopsies from human psoriatic lesions and both the c-Jun/JunB and imiquimod psoriasis mouse model allowed us to study the therapeutic mechanism of this drug. Top differentially expressed genes in the early response to dithranol belonged to keratinocyte and epidermal differentiation pathways and IL-1 family members (i.e. IL36RN) but not elements of the IL-17/IL-23 axis. In human psoriatic response to dithranol, rapid decrease in expression of keratinocyte differentiation regulators (e.g. involucrin, SERPINB7 and SERPINB13), antimicrobial peptides (e.g. ß-defensins like DEFB4A, DEFB4B, DEFB103A, S100 proteins like S100A7, S100A12), chemotactic factors for neutrophils (e.g. CXCL5, CXCL8) and neutrophilic infiltration was followed with much delay by reduction in T cell infiltration. Targeting keratinocytes rather than immune cells may be an alternative approach in particular for topical anti-psoriatic treatment, an area with high need for new drugs.
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Affiliation(s)
| | - Clemens Painsi
- State Hospital KlagenfurtKlagenfurt am WörtherseeAustria
| | - VijayKumar Patra
- Department of Dermatology, Medical University of GrazGrazAustria
| | - Saptaswa Dey
- Department of Dermatology, Medical University of GrazGrazAustria
| | - Martin Holcmann
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of ViennaViennaAustria
| | | | - Maria Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of ViennaViennaAustria
| | - Peter Wolf
- Department of Dermatology, Medical University of GrazGrazAustria
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70
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Wang W, Shu GF, Lu KJ, Xu XL, Sun MC, Qi J, Huang QL, Tan WQ, Du YZ. Flexible liposomal gel dual-loaded with all-trans retinoic acid and betamethasone for enhanced therapeutic efficiency of psoriasis. J Nanobiotechnology 2020; 18:80. [PMID: 32448273 PMCID: PMC7245867 DOI: 10.1186/s12951-020-00635-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/12/2020] [Indexed: 12/22/2022] Open
Abstract
Background Psoriasis is a chronic immune-mediated inflammatory skin disease without effective treatment. The utilization of all trans-retinoic acid (TRA) and betamethasone (BT) for the treatment of psoriasis is still facing difficulties, due to their relatively poor stability, limited skin permeation, and systemic side effects. Flexible liposomes are excellent in deeper skin permeation and reducing the side effects of drugs, which is promising for effective treatment of skin disorders. This work aimed to establish dual-loaded flexible liposomal gel for enhanced therapeutic efficiency of psoriasis based on TRA and BT. Results Flexible liposomes co-loaded with TRA and BT were successfully prepared in our study. The characterization examination revealed that flexible liposomes featured nano-sized particles (around 70 nm), high drug encapsulation efficiency (> 98%) and sustained drug release behaviors. Flexible liposomes remarkably increased the drug skin permeation and retention as compared with free drugs. Results on HaCaT cells suggested that flexible liposomes were nontoxic, and its cellular uptake has a time-dependent manner. In vivo studies suggested the topical application of TRA and BT dual-loaded liposomal gel had the best ability to reduce the thickness of epidermal and the level of cytokines (TNF-α and IL-6), largely alleviating the symptoms of psoriasis. Conclusions Flexible liposomal gel dual-loaded with TRA and BT exerted a synergistic effect, which is a promising topical therapeutic for the treatment of psoriasis.![]()
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Affiliation(s)
- Wei Wang
- Department of Pharmacy, The Third People's Hospital of Hangzhou, 38 West Lake Avenue, Hangzhou, 310009, China
| | - Gao-Feng Shu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Kong-Jun Lu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Xiao-Ling Xu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Min-Cheng Sun
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Jing Qi
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Qiao-Ling Huang
- Department of Pharmacy, The Third People's Hospital of Hangzhou, 38 West Lake Avenue, Hangzhou, 310009, China.
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, China.
| | - Yong-Zhong Du
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China.
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Topical Anti-Inflammatory Activity of Essential Oils of Alpinia calcarata Rosc., Its Main Constituents, and Possible Mechanism of Action. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2035671. [PMID: 32419793 PMCID: PMC7204338 DOI: 10.1155/2020/2035671] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/10/2020] [Indexed: 01/04/2023]
Abstract
This study aimed at investigating the anti-inflammatory potential of essential oil from rhizome and leaf of Alpinia calcarata Rosc. (ACEO) with the focus of its topical anti-inflammatory activity along with its dominant compounds 1,8-cineole and α-terpineol using mouse ear edema model. ACEOs were analyzed by GC-MS. The anti-inflammatory activity was determined by studying the inhibition of overproduction of proinflammatory mediators-nitric oxide, reactive oxygen species, prostaglandins, cyclooxygenases, and cytokines induced by lipopolysaccharides in murine macrophages. Topical anti-inflammatory and antinociceptive activity was studied by 12-O-tetradecanoylphorbol-13-acetate (TPA) induced skin inflammation and formalin-induced pain model in mice, respectively. Rhizome oil has 1,8-cineole (31.08%), α-terpineol (10.31%), and fenchyl acetate (10.73%) as major compounds whereas the ACEO from leaves has 1,8-cineole (38.45%), a-terpineol (11.62%), and camphor (10%). ACEOs reduced the production of inflammatory mediators in vitro in a concentration-dependent manner. Further, ACEO and its major compounds reduced ear thickness, weight, myeloperoxidase, and cytokines significantly (p < 0.01) in mouse ear. Dose-dependent reduction in flinching and licking in both the phases of pain sensation concludes the topical analgesic effect. Our findings suggest the potency of topical use of ACEOs for inflammatory disease conditions.
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Amat-Samaranch V, Puig L. Safety of calcipotriene and betamethasone dipropionate foam for the treatment of psoriasis. Expert Opin Drug Saf 2020; 19:423-432. [PMID: 32243212 DOI: 10.1080/14740338.2020.1749594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Psoriasis vulgaris is a chronic inflammatory skin disease characterized by well-demarcated red and scaly plaques. Most patients have mild disease that is usually controlled with topical treatment. Calcipotriene 0.05% and betamethasone dipropionate 0.064% (Cal/BD) in aerosol foam (Enstilar®) is a novel formulation, which has shown promising results in terms of efficacy and safety.Areas covered: This review evaluates the safety profile of Cal/BD aerosol foam and also the key points regarding its efficacy. A literature search was performed in PubMed in November 2019 from the start of records. Additional references were searched and retrieved manually.Expert opnion: Cal/BD aerosol foam has proven its efficacy, safety, and tolerability in several clinical trials and real clinical practice. It has also demonstrated higher efficacy than the ointment and gel formulations of the fixed combination. It has a low incidence of adverse events; nasopharyngitis and site application pain were the most frequently reported. Moreover, it is devoid of changes in calcium homeostasis and hypothalamic-pituitary-adrenal axis. As a result of its unique formulation, it is easily spread, is rapidly absorbed, and has a rapid onset of action. These features upgrade patient's satisfaction and they may increase adherence to topical therapy.
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Affiliation(s)
- Victoria Amat-Samaranch
- Department of Dermatology, Hospital De La Santa Creu I Sant Pau. Universitat Autònoma De Barcelona, Barcelona, Catalonia, Spain
| | - Lluís Puig
- Department of Dermatology, Hospital De La Santa Creu I Sant Pau. Universitat Autònoma De Barcelona, Barcelona, Catalonia, Spain
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74
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Gerdes S, Velasco M, Wu JJ, Hubo M, Veverka KA. Calcipotriol/betamethasone dipropionate aerosol foam for the treatment of psoriasis vulgaris: a review of real-world evidence (RWE). J DERMATOL TREAT 2020; 32:883-893. [PMID: 31986945 DOI: 10.1080/09546634.2020.1717417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Randomized controlled trials (RCTs) demonstrated the advantages of an aerosol foam formulation of calcipotriol/betamethasone dipropionate (Cal/BD) in patients with psoriasis. In this review, we investigated whether such benefits could also be obtained in real-world clinical practice.Methods: PubMed was searched for studies reporting real-world data in patients with psoriasis treated with Cal/BD aerosol foam.Results: Three large real-world studies with Cal/BD aerosol foam were identified: a prospective non-interventional study from Germany, a medical chart review from the US, and a retrospective non-interventional study from Spain. Some key findings included the following: high levels of adherence to treatment (82-93%); after 4 weeks, about 50% of patients achieved complete/almost complete responses; at final assessment, 85-95% of patients were extremely satisfied/very satisfied/satisfied with Cal/BD aerosol foam; all healthcare providers were satisfied or somewhat satisfied with the efficacy of Cal/BD foam and they reported similar findings for symptom improvements (itch, pain, erythema/redness, flaking, and plaque thickness). Global ratings by investigators/healthcare providers for symptom control, overall efficacy and the emotional status of patients were also very high (75-100%).Conclusion: The results from real-world studies undertaken in diverse healthcare systems reinforce the positive findings reported in RCTs with Cal/BD aerosol foam in patients with psoriasis.
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Affiliation(s)
- Sascha Gerdes
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | | | - Jashin J Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
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Super Critical Fluid Extracted Fatty Acids from Withania somnifera Seeds Repair Psoriasis-Like Skin Lesions and Attenuate Pro-Inflammatory Cytokines (TNF-α and IL-6) Release. Biomolecules 2020; 10:biom10020185. [PMID: 31991752 PMCID: PMC7072271 DOI: 10.3390/biom10020185] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Withania somnifera Dunal (Ashwagandha) is a widely used medicinal herb in traditional medicinal systems with extensive research on various plant parts. Surprisingly, seeds of W. somnifera have never been investigated for their therapeutic potential. (2) Methods: W. somnifera seeds were extracted for fatty acids (WSSO) using super critical fluid extraction, and was analyzed by gas chromatography. Its therapeutic potential in psoriasis-like skin etiologies was investigated using a 12-O tetradecanoyl phorbol 13-acetate (TPA)-induced psoriatic mouse model. Psoriatic inflammation along with psoriatic lesions and histopathological scores were recorded. WSSO was also tested on murine macrophage (RAW264.7), human epidermoid (A431), and monocytic (THP-1) cells, stimulated with TPA or lipo poly-saccharide (LPS) to induce pro-inflammatory cytokine (IL-6 and TNF-α) release. NFκB promoter activity was also measured by luciferase reporter assay. (3) Results: Topical application of WSSO with concurrent oral doses significantly reduced inflammation-induced edema, and repaired psoriatic lesions and associated histopathological scores. Inhibition of pro-inflammatory cytokines release was observed in WSSO-treated A431 and THP-1 cells, along with reduced NFκB expression. WSSO also inhibited reactive nitrogen species (RNS) in LPS-stimulated RAW264.7 cells. (4) Conclusion: Here we show that the fatty acids from W. somnifera seeds have strong anti-inflammatory properties, along with remarkable therapeutic potential on psoriasis-like skin etiologies.
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Wu S, Zhao M, Sun Y, Xie M, Le K, Xu M, Huang C. The potential of Diosgenin in treating psoriasis: Studies from HaCaT keratinocytes and imiquimod-induced murine model. Life Sci 2020; 241:117115. [DOI: 10.1016/j.lfs.2019.117115] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/11/2019] [Accepted: 11/27/2019] [Indexed: 12/21/2022]
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77
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Dolz-Pérez I, Sallam MA, Masiá E, Morelló-Bolumar D, Pérez Del Caz MD, Graff P, Abdelmonsif D, Hedtrich S, Nebot VJ, Vicent MJ. Polypeptide-corticosteroid conjugates as a topical treatment approach to psoriasis. J Control Release 2019; 318:210-222. [PMID: 31843640 DOI: 10.1016/j.jconrel.2019.12.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/18/2019] [Accepted: 12/11/2019] [Indexed: 12/19/2022]
Abstract
Topical treatment of mild-to-moderate psoriasis with corticosteroids suffers from challenges that include reduced drug bioavailability at the desired site of action. The retention of therapeutics within the epidermis can safely treat skin inflammation, scaling, and erythema associated with psoriasis while avoiding possible side effects associated with systemic treatments. We successfully synthesized and characterized a pH-responsive biodegradable poly-L-glutamic acid (PGA)-fluocinolone acetonide (FLUO) conjugate that allows the controlled release of the FLUO to reduce skin inflammation. Additionally, the application of a hyaluronic acid (HA)-poly-L-glutamate cross polymer (HA-CP) vehicle boosted skin permeation. During in vitro and ex vivo analyses, we discovered that PGA-FLUO inhibited pro-inflammatory cytokine release, suggesting that polypeptidic conjugation fails to affect the anti-inflammatory activity of FLUO. Additionally, ex vivo human skin permeation studies using confocal microscopy revealed the presence of PGA-FLUO within the epidermis, but a minimal presence in the dermis, thereby reducing the likelihood of FLUO entering the systemic circulation. Finally, we demonstrated that PGA-FLUO applied within HA-CP effectively reduced psoriasis-associated phenotypes in an in vivo mouse model of human psoriasis while also lowering levels of pro-inflammatory cytokines in tissue and serum. Overall, our experimental results demonstrate that PGA-FLUO within an HA-CP penetration enhancer represents an effective topical treatment for psoriasis.
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Affiliation(s)
- Irene Dolz-Pérez
- Polymer Therapeutics Laboratory, Centro de Investigación Príncipe Felipe, Av. Eduardo Primo Yúfera 3, Valencia 46012, Spain
| | - Marwa A Sallam
- Department of Industrial Pharmacy, Faculty of Pharmacy, Alexandria University, El Sultan Hussein St Azarita, Egypt; John A. Paulson school of engineering and applied sciences and Wyss institute for biologically inspired engineering, Harvard University, 52 Oxford St, Cambridge, MA 02138, USA
| | - Esther Masiá
- Polymer Therapeutics Laboratory, Centro de Investigación Príncipe Felipe, Av. Eduardo Primo Yúfera 3, Valencia 46012, Spain; Screening Platform, Centro de Investigación Príncipe Felipe, Av. Eduardo Primo Yúfera 3, Valencia 46012, Spain
| | - Daniel Morelló-Bolumar
- Polypeptide Therapeutic Solutions S.L. C/ Benjamin Franklin 19 (Paterna), Valencia 46980, Spain
| | - M Dolores Pérez Del Caz
- Servicio de cirugía plástica, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell 106, Valencia 46026, Spain
| | - Patrick Graff
- Institute of Pharmacy (Pharmacology and Toxicology), Freie Universität Berlin, Königin-Luise Str. 2+4, Berlin 14195, Germany
| | - Doaa Abdelmonsif
- Department of Medical Biochemistry, Faculty of Medicine, Alexandria University, El Sultan Hussein St Azarita, Egypt
| | - Sarah Hedtrich
- Institute of Pharmacy (Pharmacology and Toxicology), Freie Universität Berlin, Königin-Luise Str. 2+4, Berlin 14195, Germany; Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, Canada
| | - Vicent J Nebot
- Polypeptide Therapeutic Solutions S.L. C/ Benjamin Franklin 19 (Paterna), Valencia 46980, Spain.
| | - María J Vicent
- Polymer Therapeutics Laboratory, Centro de Investigación Príncipe Felipe, Av. Eduardo Primo Yúfera 3, Valencia 46012, Spain; Screening Platform, Centro de Investigación Príncipe Felipe, Av. Eduardo Primo Yúfera 3, Valencia 46012, Spain.
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Psomadakis CE, Han G. New and Emerging Topical Therapies for Psoriasis and Atopic Dermatitis. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2019; 12:28-34. [PMID: 32038762 PMCID: PMC7002051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Psoriasis and atopic dermatitis represent two of the most common skin conditions seen by both primary care and specialist dermatology. The prevalence of psoriasis in North America is 2 to 4 percent, and it is estimated to cost more than $3 billion per year to treat this condition. Atopic dermatitis has an estimated 15 to 30 percent lifetime prevalence in children and an 8 to 10 percent lifetime prevalence in adults. Both diseases have a significant impact on patient quality of life, as well as associated psychological, social, and economic consequences. While systemic therapies are available for both, the majority of patients with each condition are treated with topical therapies alone, with varying degrees of efficacy and patient satisfaction. As such, there is both need and an incentive to develop new treatments for these two conditions. In this paper, we review new and emerging topical therapies for psoriasis and atopic dermatitis.
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Affiliation(s)
- Corinna E Psomadakis
- Drs. Psomadakis and Han are with the Department of Dermatology, Mount Sinai Medical Center in New York, New York
| | - George Han
- Drs. Psomadakis and Han are with the Department of Dermatology, Mount Sinai Medical Center in New York, New York
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79
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Günther C, Kowal K, Schmidt T, Jambrecina A, Toner F, Nave R. Comparison of In Vitro and In Vivo Percutaneous Absorption Across Human Skin Using BAY1003803 Formulated as Ointment and Cream. Clin Pharmacol Drug Dev 2019; 9:582-592. [PMID: 31647607 PMCID: PMC7383986 DOI: 10.1002/cpdd.736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/05/2019] [Indexed: 01/06/2023]
Abstract
Direct comparisons between skin absorption data and clinical pharmacokinetic data are rare. Here we use the lipophilic nonsteroidal selective glucocorticoid receptor agonist BAY1003803 to make such a comparison. The objective is to find the extent to which measurements of skin permeation in vitro can be used to predict the corresponding permeation in vivo for human pharmacokinetics of topically applied substances. BAY1003803 was prepared in various formulations: ointment, hydrophilic cream, lipophilic cream, and milk. Its ability to permeate healthy human skin was measured in vitro in static diffusion cells, and percutaneous absorption as well as dermal delivery was measured thereafter, for 2 selected formulations, in vivo in healthy volunteers. Absorption in vivo comparing ointment and lipophilic cream was correlated with expectation based on the dermal delivery obtained in vitro. A 2.17-fold higher systemic exposure to BAY1003803 was achieved by the ointment formulation. This is well in line with the predicted exposure difference of 2.74 based on the in vitro data. In conclusion, in vitro skin absorption studies using human skin are suitable for the prediction of systemic exposure and formulation effects in vivo; they can therefore be applied to guide the design of clinical investigations of dermatological preparations.
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Affiliation(s)
- Clemens Günther
- Bayer AG, Pharmaceuticals, Translational Sciences, Berlin, Germany
| | - Kristin Kowal
- Bayer AG, Pharmaceuticals, Translational Sciences, Berlin, Germany
| | - Timm Schmidt
- Bayer AG, Pharmaceuticals, Launch Management, Berlin, Germany
| | | | - Frank Toner
- Charles River Laboratories Edinburgh Ltd, Edinburgh, United Kingdom
| | - Rüdiger Nave
- Bayer AG, Pharmaceuticals, Translational Sciences, Berlin, Germany
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80
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Anderko M, Navarro Triviño FJ, Sharples CL. Calcipotriol Plus Betamethasone Dipropionate Aerosol Foam For Scalp Psoriasis. Clin Cosmet Investig Dermatol 2019; 12:699-705. [PMID: 31571970 PMCID: PMC6756148 DOI: 10.2147/ccid.s221078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/04/2019] [Indexed: 11/23/2022]
Abstract
This article presents real-world experience of the effectiveness of calcipotriol (50 µg/g)/betamethasone dipropionate (0.5 mg/g) (Cal/BD) aerosol foam formulation in three cases of scalp psoriasis, and briefly reviews the literature relating to Cal/BD topical therapy in adults with scalp psoriasis. Patients had long histories of scalp psoriasis and reported negative impacts on their lives (e.g. clothing choices, psychological well-being, employment status). Previous treatments had provided inadequate or only temporary relief. Cal/BD aerosol foam relieved itching in the first few days and was associated with visible improvement of flaky patches on the scalp at the end of the recommended 4-week treatment period. Controlled clinical trials in patients with scalp psoriasis are rare. There have been several trials in adults with scalp psoriasis involving Cal/BD gel or suspension scalp formulations, which have proven more effective and well tolerated compared with the individual components or vehicle alone. The Cal/BD aerosol formulation has enhanced skin penetration and higher bioavailability compared with the older formulations; studies show improved efficacy with Cal/BD aerosol foam, compared with older formulations, in patients with plaque psoriasis. The present cases confirm the benefits of Cal/BD aerosol foam in adults with scalp psoriasis, treated in real-world settings.
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81
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Sevilla LM, Pérez P. Glucocorticoids and Glucocorticoid-Induced-Leucine-Zipper (GILZ) in Psoriasis. Front Immunol 2019; 10:2220. [PMID: 31572404 PMCID: PMC6753639 DOI: 10.3389/fimmu.2019.02220] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/02/2019] [Indexed: 12/20/2022] Open
Abstract
Psoriasis is a prevalent chronic inflammatory human disease initiated by impaired function of immune cells and epidermal keratinocytes, resulting in increased cytokine production and hyperproliferation, leading to skin lesions. Overproduction of Th1- and Th17-cytokines including interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-23, IL-17, and IL-22, is a major driver of the disease. Glucocorticoids (GCs) represent the mainstay protocol for treating psoriasis as they modulate epidermal differentiation and are potent anti-inflammatory compounds. The development of safer GC-based therapies is a high priority due to potentially severe adverse effects associated with prolonged GC use. Specific efforts have focused on downstream anti-inflammatory effectors of GC-signaling such as GC-Induced-Leucine-Zipper (GILZ), which suppresses Th17 responses and antagonizes multiple pro-inflammatory signaling pathways involved in psoriasis, including AP-1, NF-κB, STAT3, and ROR-γt. Here we review evidence regarding defective GC signaling, GC receptor (GR) function, and GILZ in psoriasis. We discuss seemingly contradicting data on the loss- and gain-of-function of GILZ in the imiquimod-induced mouse model of psoriasis. We also present potential therapeutic strategies aimed to restore GC-related pathways.
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Affiliation(s)
- Lisa M Sevilla
- Animal Models of Skin Pathologies Unit, Instituto de Biomedicina de Valencia (IBV)-CSIC, Valencia, Spain
| | - Paloma Pérez
- Animal Models of Skin Pathologies Unit, Instituto de Biomedicina de Valencia (IBV)-CSIC, Valencia, Spain
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82
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Abstract
Introduction: Generalized pustular psoriasis (GPP) is a rare, severe relapsing/remitting, multisystem disease that can be difficult to treat. Recent clinical, histological, and genetic evidence suggests that GPP is a distinct clinical entity from plaque psoriasis and requires a separate diagnosis. The interleukin-36 pathway appears to be central to GPP pathogenesis. As no therapeutic agents have been approved for GPP to date in the United States or Europe, the introduction of anti-IL-36 therapies may change disease management. Areas covered: Using PubMed and Google Scholar, we reviewed the literature for articles related to GPP, psoriasis, and the genetics, pathogenesis, and treatment thereof. Expert opinion: New therapeutic options and updated guidelines for GPP treatment are needed. Ideal agents would have rapid onset of action and rapid time to achieve disease clearance, have the ability to prevent acute flares and avert recurrence, and possess a favorable safety profile. Such therapies should be readily accessible via approval or listing on formularies. Scoring systems to establish GPP disease burden and objective outcome measures could also help with further evaluation of therapies and treatment access issues. IL-36 remains a promising target, as supported by early phase data suggesting efficacy and safety for a novel anti-IL-36 therapy.
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Affiliation(s)
- Melinda J Gooderham
- SKiN Centre for Dermatology, Probity Medical Research, Queen's University , Peterborough , ON , Canada
| | - Abby S Van Voorhees
- Department of Dermatology, Eastern Virginia Medical School , Norfolk , VA , USA
| | - Mark G Lebwohl
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York , NY , USA
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83
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Bhattacharjee O, Ayyangar U, Kurbet AS, Ashok D, Raghavan S. Unraveling the ECM-Immune Cell Crosstalk in Skin Diseases. Front Cell Dev Biol 2019; 7:68. [PMID: 31134198 PMCID: PMC6514232 DOI: 10.3389/fcell.2019.00068] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 04/09/2019] [Indexed: 01/06/2023] Open
Abstract
The extracellular matrix (ECM) is a complex network of proteins and proteoglycans secreted by keratinocytes, fibroblasts and immune cells. The function of the skin ECM has expanded from being a scaffold that provides structural integrity, to a more dynamic entity that is constantly remodeled to maintain tissue homeostasis. The ECM functions as ligands for cell surface receptors such as integrins, dystroglycans, and toll-like receptors (TLRs) and regulate cellular signaling and immune cell dynamics. The ECM also acts as a sink for growth factors and cytokines, providing critical cues during epithelial morphogenesis. Dysregulation in the organization and deposition of ECMs lead to a plethora of pathophysiological conditions that are exacerbated by aberrant ECM-immune cell interactions. In this review, we focus on the interplay between ECM and immune cells in the context of skin diseases and also discuss state of the art therapies that target the key molecular players involved.
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Affiliation(s)
- Oindrila Bhattacharjee
- School of Chemical and Biotechnology, Sastra University, Thanjavur, India.,Institute for Stem Cell Biology and Regenerative Medicine, GKVK Campus, Bangalore, India
| | - Uttkarsh Ayyangar
- School of Chemical and Biotechnology, Sastra University, Thanjavur, India.,Institute for Stem Cell Biology and Regenerative Medicine, GKVK Campus, Bangalore, India
| | - Ambika S Kurbet
- School of Chemical and Biotechnology, Sastra University, Thanjavur, India.,Institute for Stem Cell Biology and Regenerative Medicine, GKVK Campus, Bangalore, India
| | - Driti Ashok
- Institute for Stem Cell Biology and Regenerative Medicine, GKVK Campus, Bangalore, India
| | - Srikala Raghavan
- Institute for Stem Cell Biology and Regenerative Medicine, GKVK Campus, Bangalore, India
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84
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Watts AM, Cripps AW, West NP, Cox AJ. Modulation of Allergic Inflammation in the Nasal Mucosa of Allergic Rhinitis Sufferers With Topical Pharmaceutical Agents. Front Pharmacol 2019; 10:294. [PMID: 31001114 PMCID: PMC6455085 DOI: 10.3389/fphar.2019.00294] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/11/2019] [Indexed: 12/14/2022] Open
Abstract
Allergic rhinitis (AR) is a chronic upper respiratory disease estimated to affect between 10 and 40% of the worldwide population. The mechanisms underlying AR are highly complex and involve multiple immune cells, mediators, and cytokines. As such, the development of a single drug to treat allergic inflammation and/or symptoms is confounded by the complexity of the disease pathophysiology. Complete avoidance of allergens that trigger AR symptoms is not possible and without a cure, the available therapeutic options are typically focused on achieving symptomatic relief. Topical therapies offer many advantages over oral therapies, such as delivering greater concentrations of drugs to the receptor sites at the source of the allergic inflammation and the reduced risk of systemic side effects. This review describes the complex pathophysiology of AR and identifies the mechanism(s) of action of topical treatments including antihistamines, steroids, anticholinergics, decongestants and chromones in relation to AR pathophysiology. Following the literature review a discussion on the future therapeutic strategies for AR treatment is provided.
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Affiliation(s)
- Annabelle M. Watts
- Menzies Health Institute Queensland, School of Medical Science, Griffith University, Southport, QLD, Australia
| | - Allan W. Cripps
- Menzies Health Institute Queensland, School of Medicine, Griffith University, Southport, QLD, Australia
| | - Nicholas P. West
- Menzies Health Institute Queensland, School of Medical Science, Griffith University, Southport, QLD, Australia
| | - Amanda J. Cox
- Menzies Health Institute Queensland, School of Medical Science, Griffith University, Southport, QLD, Australia
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85
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Bhoir SS, Vishwapathi V, Singh KK. Antipsoriatic potential of Annona squamosa seed oil: An in vitro and in vivo evaluation. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 54:265-277. [PMID: 30668377 DOI: 10.1016/j.phymed.2018.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 06/09/2018] [Accepted: 07/13/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Corticosteroids remains compound of choice for topical treatment of psoriasis. Several side effects associated with chronic application of corticosteroids limit its uses. Hence, there is a need to find a safe and effective alternative agent for psoriasis treatment. PURPOSE The study aimed to investigate the in vitro and in vivo efficacy of petroleum ether extract of Annona squamosa seeds (ASO) as an antipsoriatic agent. The toxicity profile of ASO and its effect on psoriasis-induced inflammation has also been determined. METHODS Physicochemical characterization was performed to determine constituents of ASO. Anti-proliferative activity of ASO was studied by Sulforhodamine B (SRB) assay using HaCaT cell lines. Oxazolone-induced psoriasis in female Balb/C mice was used as an animal model for investigating in vivoefficacy of ASO. Inflammatory markers were analyzed by immunohistochemical staining of mice ears. Safety profile of ASO was confirmed by performing acute dose dermal toxicity and repeated dose dermal toxicity testing. RESULTS Predominant presence of polyunsaturated fatty acids viz. linoleic acid and oleic acid in ASO was confirmed by 1H NMR, 13C NMR and GC-MS analysis. The petroleum ether extract of Annona squamosa seeds showed inhibition of cell proliferation of keratinocytes (HaCaT cells). The growth inhibitory property of ASO was significantly higher than that was observed in presence of corticosteroid, clobetasol propionaste (CP). Application of ASO to the ears of Balb/C mice with oxazolone induced psoriasis showed marked reduction in erythema and edema, which was comparable to treatment with 0.05% CP cream. The increased levels of cytokines IL6, IL17, TNF-α, INF-γ, GMCSF, and infiltration of CD4 T cells observed in psoriasis lesions were decreased upon application of ASO. Acute and repeated dermal toxicity studies of ASO did not reveal any adverse events affirming the safety of ASO. CONCLUSION The present data has demonstrated that ASO is a safe and effective anti-psoriatic agent when tested in animal models. The efficacy of ASO in preclinical studies could further be exploited for the development of potential novel topical antipsoriatic agent for therapy in humans.
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Affiliation(s)
- Sandeepa S Bhoir
- C. U. Shah College of Pharmacy, S.N. D. T. Women's University, Santacruz (W), Mumbai 400049, India
| | - Vinod Vishwapathi
- School of Pharmacy and Biomedical Sciences, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Kamalinder K Singh
- School of Pharmacy and Biomedical Sciences, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, United Kingdom.
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86
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Extra-adrenal glucocorticoid synthesis at epithelial barriers. Genes Immun 2019; 20:627-640. [PMID: 30692606 DOI: 10.1038/s41435-019-0058-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/02/2019] [Indexed: 01/08/2023]
Abstract
Epithelial barriers play an important role in the exchange of nutrients, gases, and other signals between our body and the outside world. However, they protect it also from invasion by potential pathogens. Defective epithelial barriers and associated overshooting immune responses are the basis of many different inflammatory disorders of the skin, the lung, and the intestinal mucosa. The anti-inflammatory activity of glucocorticoids has been efficiently used for the treatment of these diseases. Interestingly, epithelia in these tissues are also a rich source of endogenous glucocorticoids, suggesting that local glucocorticoid synthesis is part of a tissue-specific regulatory circuit. In this review, we summarize current knowledge about the extra-adrenal glucocorticoid synthesis at the epithelial barriers of the intestine, lung and the skin, and discuss their relevance in the pathogenesis of inflammatory diseases and as therapeutic targets.
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87
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Pinter A, Thormann H, Angeletti F, Jalili A. Calcipotriol/betamethasone dipropionate aerosol foam for the treatment of psoriasis vulgaris: case series and review of the literature. Clin Cosmet Investig Dermatol 2018; 11:451-459. [PMID: 30349342 PMCID: PMC6183653 DOI: 10.2147/ccid.s180698] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
An aerosol foam formulation of a once-daily, fixed-dose combination of a synthetic vitamin D3 analog/synthetic corticosteroid (calcipotriol [Cal] 50 µg/g and betamethasone dipropionate [BD] 0.5 mg/g) has recently been introduced for the topical treatment of plaque psoriasis in adults. Data from several sources - randomized controlled trials, case reports (as highlighted in this review), and real-world evidence (RWE) - underscore the considerable and rapid clinical response, effectiveness, and favorable safety and tolerability of Cal/BD aerosol foam in mild-to-moderate psoriatic patients previously treated with class 3 or 4 topical corticosteroids, in patients unsatisfied with ongoing phototherapy in combination with topical therapy and in patients with moderate-to-severe psoriasis. In addition, our case series, considered together with other RWE, highlights that Cal/BD aerosol foam is more effective and with greater levels of patient preference and acceptability than comparator preparations. Thus, Cal/BD aerosol foam offers several treatment advantages, including relief of itch, and is an appropriate first-line topical therapy for consideration in patients with psoriasis of any severity.
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Affiliation(s)
- Andreas Pinter
- Department of Dermatology, Venereology, and Allergology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany,
| | | | - Flavia Angeletti
- Department of Dermatology, Venereology, and Allergology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany,
| | - Ahmad Jalili
- Department of Dermatology, Bürgenstock Medical Center, Obbürgen, Switzerland
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Kim HK, Bae MJ, Lim S, Lee W, Kim S. A Water-Soluble Extract from Actinidia arguta Ameliorates Psoriasis-Like Skin Inflammation in Mice by Inhibition of Neutrophil Infiltration. Nutrients 2018; 10:nu10101399. [PMID: 30279326 PMCID: PMC6213123 DOI: 10.3390/nu10101399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/12/2018] [Accepted: 09/28/2018] [Indexed: 01/31/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease with complex etiology involving multiple factors. Current treatment methods are highly limited and there is a strong need for the development of safer and efficacious agents. We have previously shown that a water-soluble extract derived from hardy kiwifruit Actinidia arguta, called PG102, shows potent anti-inflammatory effects. Based on its reported biological activities, the effects of PG102 were examined on imiquimod-induced psoriasis-like skin inflammation. Our results showed that topical application of PG102 ameliorates clinical symptoms of psoriasis, reducing skin thickness and Interleukin (IL)-17A level in draining lymph nodes without causing any adverse effects. Treatment with PG102 on cytokine-stimulated HaCaT cells suppressed hyperproliferation and downregulated the expression of various chemokines and antimicrobial peptides known to induce neutrophil infiltration. These anti-inflammatory activities of PG102 were mediated via inhibition of NF-κB and signal transducer of activation (STAT) signaling. We also found decreased neutrophil chemotaxis both in vitro and in vivo. Taken together, PG102 has potential as a safe and effective reagent for the treatment of psoriasis.
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Affiliation(s)
- Hyun-Keun Kim
- School of Biological Sciences, Seoul National University, Seoul 151-742, Korea.
| | - Min Jung Bae
- ViroMed Co. Ltd., Building 203, Seoul National University, Seoul 151-742, Korea.
| | - Seonung Lim
- School of Biological Sciences, Seoul National University, Seoul 151-742, Korea.
| | - Wonwoo Lee
- ViroMed Co. Ltd., Building 203, Seoul National University, Seoul 151-742, Korea.
| | - Sunyoung Kim
- School of Biological Sciences, Seoul National University, Seoul 151-742, Korea.
- ViroMed Co. Ltd., Building 203, Seoul National University, Seoul 151-742, Korea.
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89
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Implication of Topical Steroids in the Onset of Osteoporosis. Case Rep Pediatr 2018; 2018:4802172. [PMID: 30245900 PMCID: PMC6136575 DOI: 10.1155/2018/4802172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 07/30/2018] [Indexed: 11/18/2022] Open
Abstract
The systemic bioavailability of steroids has long been implicated as a cause for osteoporosis (OP); however, much less is known about the effect of topical steroids on bone homeostasis. This is a case of an 11-year-old male who is a known case of generalised pustular psoriasis for 8-year duration with frequent exacerbations controlled with topical betamethasone dipropionate. He presented with generalised progressive bone pain and positive history of bone fracture. The diagnosis of OP was established on the results of DEXA, which were -2.7 SD and -2.4 SD for the lumbar spine and whole body, respectively. Although the cutoff value is the same (<-2 SD) in children, the definition of OP is more reliant on the densitometry Z score, as opposed to adults, who are approached using the T score. The element of psoriasis poses a risk for the development of OP due to the presence of a chronic inflammatory disease state that increases bone turnover. Furthermore, the compromised skin barrier and associated vasodilation seen in psoriasis enhance the absorption of topically applied agents and increase their bioavailability. Children are a targeted risk group as they are more vulnerable to the manifestation of systemic adverse affects of topically applied steroids as a result of their increased ratio of total surface area relative to their body weight and slower drug metabolism. We recommend that children undergoing long-term topical steroid therapy be screened for OP with the consideration of instituting prophylactic treatment especially in those suffering from chronic inflammatory disease states.
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90
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Serafino A, Nicotera G, Andreola F, Giovannini D, Zonfrillo M, Sferrazza G, Calcaterra A, De Angelis C, Camponeschi C, Pierimarchi P. Synergistic antiproliferative and differentiating effect of 2,4-monofurfurylidene-tetra-O-methylsorbitol and 4,6-dimethyl-2-(3,4,5-trimethoxyphenylamino)pyrimidine on primary and immortalized keratinocytes. Biomed Pharmacother 2018; 107:155-167. [PMID: 30086462 DOI: 10.1016/j.biopha.2018.07.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022] Open
Abstract
Psoriasis is one of the most common chronic autoinflammatory skin disease, associated with hyperproliferation and abnormal differentiation of keratinocytes, inflammation, and angiogenesis. The available treatments for psoriasis are not curative and may have numerous side effects, and topical administration is preferred over systemic therapy due to the reduced systemic burden of the drug. Thus, novel and more efficacious formulations of anti-inflammatory and/or differentiating compounds for topical application could be very useful for the disease management and for improving the quality of life of the patients. Here we evaluated the potential as anti-psoriatic of an equimolar mixture of two compounds, 2,4-Monofurfurylidene-tetra-O-methylsorbitol (Compound A) and 4,6-dimethyl-2-(3,4,5-trimethoxyphenylamino)pyrimidine (Compound B), that, used individually, are known to possess immunomodulating properties (Compound A) and keratolitic and anti-inflammatory activity (Compound B). Human immortalized keratinocyte cell line (HaCaT cells) and primary human keratinocyte cells from adult donor (HEKa) were used as in vitro experimental models. We show that the mix A + B exhibits antiproliferative activity and induces terminal differentiation more efficiently than compounds A and B used individually. We confirm that the compound B is the active ingredient of the mixture and the mainly responsible for anti-psoriatic activity, but the mix A + B is more effective and possesses lower cytotoxicity than the compound B alone. This could be ascribable to the association with compound A, that is known to possess, in addition to the immunomodulating ability, antioxidant and antiradical action. Our results indicate that mix A + B could be a suitable candidate for a new cosmeceutical formulation for topical treatment of psoriasis.
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Affiliation(s)
- Annalucia Serafino
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy.
| | - Giuseppe Nicotera
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Federica Andreola
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Daniela Giovannini
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Manuela Zonfrillo
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Gianluca Sferrazza
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Andrea Calcaterra
- University of Rome "La Sapienza", Department of Chemistry and Technology of Drugs, Rome, Italy
| | | | | | - Pasquale Pierimarchi
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
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91
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Fernández‐Mayola M, Betancourt L, Molina‐Kautzman A, Palomares S, Mendoza‐Marí Y, Ugarte‐Moreno D, Aguilera‐Barreto A, Bermúdez‐Álvarez Y, Besada V, González LJ, García‐Ojalvo A, Mir‐Benítez AJ, Urquiza‐Rodríguez A, Berlanga‐Acosta J. Growth hormone-releasing peptide 6 prevents cutaneous hypertrophic scarring: early mechanistic data from a proteome study. Int Wound J 2018; 15:538-546. [PMID: 29464859 PMCID: PMC7949743 DOI: 10.1111/iwj.12895] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/05/2018] [Indexed: 12/13/2022] Open
Abstract
Hypertrophic scars (HTS) and keloids are forms of aberrant cutaneous healing with excessive extracellular matrix (ECM) deposition. Current therapies still fall short and cause undesired effects. We aimed to thoroughly evaluate the ability of growth hormone releasing peptide 6 (GHRP6) to both prevent and reverse cutaneous fibrosis and to acquire the earliest proteome data supporting GHRP6's acute impact on aesthetic wound healing. Two independent sets of experiments addressing prevention and reversion effects were conducted on the classic HTS model in rabbits. In the prevention approach, the wounds were assigned to topically receive GHRP6, triamcinolone acetonide (TA), or vehicle (1% sodium carboxy methylcellulose [CMC]) from day 1 to day 30 post-wounding. The reversion scheme was based on the infiltration of either GHRP6 or sterile saline in mature HTS for 4 consecutive weeks. The incidence and appearance of HTS were systematically monitored. The sub-epidermal fibrotic core area of HTS was ultrasonographically determined, and the scar elevation index was calculated on haematoxylin/eosin-stained, microscopic digitised images. Tissue samples were collected for proteomics after 1 hour of HTS induction and treatment with either GHRP6 or vehicle. GHRP6 prevented the onset of HTS without the untoward reactions induced by the first-line treatment triamcinolone acetonide (TA); however, it failed to significantly reverse mature HTS. The preliminary proteomic study suggests that the anti-fibrotic preventing effect exerted by GHRP6 depends on different pathways involved in lipid metabolism, cytoskeleton arrangements, epidermal cells' differentiation, and ECM dynamics. These results enlighten the potential success of GHRP6 as one of the incoming alternatives for HTS prevention.
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Affiliation(s)
- Maday Fernández‐Mayola
- Wound Healing and Cytoprotection Group, Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Lázaro Betancourt
- Mass Spectrometry and Bioinformatics Group, Department of Proteomics. Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Alicia Molina‐Kautzman
- Wound Healing and Cytoprotection Group, Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Sucel Palomares
- Mass Spectrometry and Bioinformatics Group, Department of Proteomics. Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Yssel Mendoza‐Marí
- Wound Healing and Cytoprotection Group, Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | | | - Ana Aguilera‐Barreto
- Pharmaceutical Formulations Department, Technological Development DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Yilian Bermúdez‐Álvarez
- Pharmaceutical Formulations Department, Technological Development DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Vladimir Besada
- Mass Spectrometry and Bioinformatics Group, Department of Proteomics. Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Luis J. González
- Mass Spectrometry and Bioinformatics Group, Department of Proteomics. Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Ariana García‐Ojalvo
- Wound Healing and Cytoprotection Group, Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
| | - Ana J. Mir‐Benítez
- Plastic and Reconstructive Surgery Department“Joaquín Albarrán” HospitalHavanaCuba
| | | | - Jorge Berlanga‐Acosta
- Wound Healing and Cytoprotection Group, Biomedical Research DirectionCenter for Genetic Engineering and BiotechnologyHavanaCuba
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92
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Carrer V, Alonso C, Oliver MA, Coderch L. In vitro penetration through the skin layers of topically applied glucocorticoids. Drug Test Anal 2018; 10:1528-1535. [PMID: 29788546 DOI: 10.1002/dta.2412] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/26/2018] [Accepted: 05/14/2018] [Indexed: 11/08/2022]
Abstract
Corticoids are actives widely used in the treatment of skin diseases. This work aims to study the penetration of 3 corticoids (betamethasone, clobetasol, and flurandrenolide), their relationship with their Log D values and the effects of the vehicles. The 3 compounds were applied on a Franz-type diffusion cell in propylene glycol solution and their respective commercial creams and ointments. The active amounts found in the stratum corneum, epidermal, and dermal layers of the skin were investigated. Their diffusions were greatly affected by the formulation; moreover higher amounts of substance in the epidermis and dermis were detected in ointments than in creams. The enhancement effect of propylene glycol was also observed. The differences between the 3 substances could be related to their lipophilicity, molecular structure, and molecular weight. The more hydrophobic compounds (clobetasol and betamethasone) are present in higher amounts in the epidermis and dermis, while the hydrophilic compound (flurandrenolide) is mostly present in the receptor fluid.
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Affiliation(s)
- Victor Carrer
- Advanced Chemical Institute of Catalonia (IQAC-CSIC), Barcelona, Spain
| | - Cristina Alonso
- Advanced Chemical Institute of Catalonia (IQAC-CSIC), Barcelona, Spain
| | - Marc Adrià Oliver
- Advanced Chemical Institute of Catalonia (IQAC-CSIC), Barcelona, Spain
| | - Luisa Coderch
- Advanced Chemical Institute of Catalonia (IQAC-CSIC), Barcelona, Spain
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93
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Motta ACF, Zhan Q, Larson A, Lerman M, Woo SB, Soiffer RJ, Murphy GF, Treister NS. Immunohistopathological characterization and the impact of topical immunomodulatory therapy in oral chronic graft-versus-host disease: A pilot study. Oral Dis 2018; 24:580-590. [PMID: 29197137 PMCID: PMC5902645 DOI: 10.1111/odi.12813] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 11/11/2017] [Accepted: 11/26/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To characterize the immunohistopathological features of oral chronic graft-versus-host disease (cGVHD), and the impact of topical immunomodulatory therapy on the infiltrating cells. MATERIAL AND METHODS Paired oral cGVHD biopsies obtained before (n = 12) and 1 month after treatment (n = 12) with topical dexamethasone (n = 8) or tacrolimus (n = 4) were characterized by immunohistochemistry using a panel of CD1a, CD3, CD4, CD8, CD20, CD31, CD62E, CD103, CD163, c-kit, and FoxP3. Controls included acute GVHD (aGVHD; n = 3), oral lichen planus (OLP; n = 5), and normal tissues (n = 5). RESULTS Oral cGVHD specimens prior to treatment were mainly characterized by basal cell squamatization, lichenoid inflammation, sclerosis, apoptosis, and lymphocytic exocytosis. The infiltrating cells in oral cGVHD primarily consisted of CD3+ , CD4+ , CD8+ , CD103+ , CD163+ , and FoxP3+ cells, which were higher than in normal tissues. Topical dexamethasone or tacrolimus reduced neutrophilic exocytosis, basal cell squamatization, and lichenoid inflammation in oral cGVHD, and dexamethasone reduced the number of CD4+ and CD103+ cells. CONCLUSION The high expression of CD3, CD4, CD8, CD103, CD163, and FoxP3 confirms that oral cGVHD is largely T-cell-driven with macrophage participation. The impact of topical immunomodulatory therapy was variable, reducing histological inflammatory features, but with a weak clinicopathological correlation. Topical dexamethasone reduced the expression of CD4 and CD103, which may offer novel therapeutic targets.
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Affiliation(s)
- Ana Carolina F. Motta
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Qian Zhan
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Allison Larson
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Mark Lerman
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Boston, MA, USA
| | - Robert J. Soiffer
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA, USA
| | - George F. Murphy
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Nathaniel S. Treister
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Boston, MA, USA
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94
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Shields CW, White JP, Osta EG, Patel J, Rajkumar S, Kirby N, Therrien JP, Zauscher S. Encapsulation and controlled release of retinol from silicone particles for topical delivery. J Control Release 2018; 278:37-48. [PMID: 29604311 DOI: 10.1016/j.jconrel.2018.03.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/11/2018] [Accepted: 03/23/2018] [Indexed: 01/07/2023]
Abstract
Retinol, a derivative of vitamin A, is a ubiquitous compound used to treat acne, reduce wrinkles and protect against conditions like psoriasis and ichthyosis. While retinol is used as the primary active ingredient (AI) in many skin care formulations, its efficacy is often limited by an extreme sensitivity to degrade and toxicity at high concentrations. While microencapsulation is an appealing method to help overcome these issues, few microencapsulation strategies have made a major translational impact due to challenges with complexity, cost, limited protection of the AI and poor control of the release of the AI. We have developed a class of silicone particles that addresses these challenges for the encapsulation, protection and controlled release of retinol and other hydrophobic compounds. The particles are prepared by the sol-gel polymerization of silane monomers, which enables their rapid and facile synthesis at scale while maintaining a narrow size distribution (i.e., CV < 20%). We show that our particles can: (i) encapsulate retinol with high efficiency (>85%), (ii) protect retinol from degradation (yielding a half-life 9× greater than unencapsulated retinol) and (iii) slowly release retinol over several hours (at rates from 0.14 to 0.67 μg cm-2 s-1/2). To demonstrate that the controlled release of retinol from the particles can reduce irritation, we performed a double blind study on human subjects and found that formulations containing our particles were 12-23% less irritating than identical formulations containing Microsponge® particles (an industry standard by Amcol, Inc.). To show that the silicone particles can elicit a favorable biological response, similar to the Microsponge® particles, we applied both formulations to reconstructed human epidermal tissues and found an upregulation of keratin 19 (K19) and a downregulation of K10, indicating that the reduced irritation observed in the human study was not caused by reduced activity. We also found a decrease in the production of interleukin-1α (IL-1α) compared to formulations containing the Microsponge particles, suggesting lower irritation levels and supporting the findings from the human study. Finally, we show that the silicone particles can encapsulate other AIs, including betamethasone, N, N-diethyl-meta-toluamide (DEET), homosalate and ingenol mebutate, establishing these particles as a true platform technology.
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Affiliation(s)
- C Wyatt Shields
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA; Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC 27708, USA.
| | - John P White
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA; Department of Chemistry, Duke University, Durham, NC 27708, USA
| | - Erica G Osta
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA; NSF Partnerships for Research and Education in Materials, Texas State University, San Marcos, TX 78666, USA
| | - Jerishma Patel
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA; Department of Chemistry, Duke University, Durham, NC 27708, USA
| | - Shashank Rajkumar
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA; Department of Chemistry, Duke University, Durham, NC 27708, USA
| | - Nickolas Kirby
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA
| | | | - Stefan Zauscher
- NSF Research Triangle Materials Research Science and Engineering Center, Duke University, Durham, NC 27708, USA; Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC 27708, USA; Department of Chemistry, Duke University, Durham, NC 27708, USA.
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95
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Verallo-Rowell VM, Katalbas SS, Evangelista MTP, Dayrit JF. Review Update on Topical Therapy for Psoriasis. CURRENT DERMATOLOGY REPORTS 2018. [DOI: 10.1007/s13671-018-0209-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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96
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97
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Patel NU, Gowda A, Grammenos A, Onikoyi O, Feldman SR. Six week evaluation of the potential for topical desoximetasone 0.25% spray to induce photoallergic skin reaction. J DERMATOL TREAT 2017; 29:269-271. [PMID: 29098900 DOI: 10.1080/09546634.2017.1395803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Desoximetasone 0.25% topical spray is a novel formulation that has not been tested or approved for safety and efficacy. The primary objective was to determine the potential of desoximetasone 0.25 and 0.05% topical sprays, as well as a vehicle to induce photoallergic skin reaction after repeated topical application and irradiation to the skin using a controlled photopatch testing procedure. MATERIALS AND METHODS 53 subjects completed the study, each with six application sites (two of each treatment), three of which were irradiated and three non-irradiated, for an induction period of three weeks and then challenge period at week 6. RESULTS Desoximetasone 0.25 and 0.05%, as well as vehicle showed no evidence of potential to induce photosensitization. There was statistically significantly greater irritation at the vehicle irradiated site in comparison to the irradiated treatment area of desoximetasone 0.25% (p = .005) and the irradiated treatment area of desoximetasone 0.05% (p = .008). CONCLUSION Our results suggest that regular treatment with desoximetasone 0.25 and 0.05% spray, followed by UV light exposure does not induce photosensitization or photo-irritation. These findings increase confidence for the use of this topical spray in eczema or psoriasis patients who may also be receiving UV light therapy and may contribute to the clinical management of these patients.
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Affiliation(s)
- Nupur U Patel
- a Center for Dermatology Research, Department of Dermatology , Wake Forest University School of Medicine , Winston-Salem , NC , USA
| | - Asha Gowda
- a Center for Dermatology Research, Department of Dermatology , Wake Forest University School of Medicine , Winston-Salem , NC , USA
| | - Alexandra Grammenos
- b Department of Pathology , Wake Forest University School of Medicine , Winston-Salem , NC , USA
| | - Omobola Onikoyi
- c Department of Public Health Sciences , Wake Forest University School of Medicine , Winston-Salem , NC , USA
| | - Steven R Feldman
- a Center for Dermatology Research, Department of Dermatology , Wake Forest University School of Medicine , Winston-Salem , NC , USA.,b Department of Pathology , Wake Forest University School of Medicine , Winston-Salem , NC , USA.,c Department of Public Health Sciences , Wake Forest University School of Medicine , Winston-Salem , NC , USA
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98
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Gupta S, Tewatia P, Misri J, Singh R. Molecular Modeling of Cloned Bacillus subtilis Keratinase and Its Insinuation in Psoriasis Treatment Using Docking Studies. Indian J Microbiol 2017; 57:485-491. [PMID: 29151650 DOI: 10.1007/s12088-017-0677-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/19/2017] [Indexed: 12/13/2022] Open
Abstract
Present study demonstrated the expression of cloned Bacillus subtilis RSE163 keratinase gene and in silico binding affinities of deduced protein with psoriasis topical drugs for systemic absorption and permeation through skin. The ker gene expressed in E. coli showed significantly higher keratinase activity 450 ± 10.43 U representing 1342 bp nucleotides encoding 447 amino acids with molecular weight of 46 kDa. The modeled structure was validated using ramachandran's plot showing 305 residues (84.3%) in most favoured region. Docking studies using extra precision (XP) method of Glide showed optimum binding affinities with the drugs Acitretin (- 39.62 kcal/mol), Clobetasol propionate (- 37.90 kcal/mol), Fluticasone (- 38.53 kcal/mol), Desonide (- 32.23 kcal/mol), Anthralin (- 38.04 kcal/mol), Calcipotreine (- 21.55 kcal/mol) and Mometasone (- 28.40 kcal/mol) in comparison to other psoriasis drugs. The results can further be correlated with in vitro enzymatic experiments using keratinase as an effective drug mediator through skin to serve the unmet need of industries.
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Affiliation(s)
- Sonali Gupta
- Amity Institute of Microbial Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, U.P. India
| | - Parul Tewatia
- School of Computer Science and Communication, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Jyoti Misri
- Division of Animal Science, Indian Council of Agricultural Research, Krishi Bhavan, New Delhi, 110114 India
| | - Rajni Singh
- Amity Institute of Microbial Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, U.P. India
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Segaert S, Shear NH, Chiricozzi A, Thaçi D, Carrascosa JM, Young H, Descamps V. Optimizing Anti-Inflammatory and Immunomodulatory Effects of Corticosteroid and Vitamin D Analogue Fixed-Dose Combination Therapy. Dermatol Ther (Heidelb) 2017; 7:265-279. [PMID: 28785924 PMCID: PMC5574747 DOI: 10.1007/s13555-017-0196-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Indexed: 12/02/2022] Open
Abstract
Abstract Fixed-dose combination topical therapy with corticosteroid and vitamin D analog provides effective treatment and possible long-term management of psoriasis. The anti-inflammatory and immunomodulatory effects of corticosteroids and vitamin D analogs in treating psoriasis are well investigated; their complementary effects lead to the disruption of the inflammatory feedback loop underlying psoriasis pathogenesis. Recent preclinical data showed that combination therapy is more effective than monotherapies of the active ingredients in preventing activation of resting pro-inflammatory cells, inducing immunomodulation, reducing inflammatory responses by regulating T cell production, and normalizing keratinocytes. The increased understanding of the mechanism of action of fixed-dose combination therapy from preclinical studies is supported by several clinical studies. As the efficacy of topical therapy is correlated with the skin penetration of the active ingredients, new drug delivery systems have been developed. The fixed-dose combination Cal/BD aerosol foam creates a modified supersaturated formulation when applied to the skin, which is maintained for at least 26 h in the laboratory setting. Clinical studies have demonstrated superior efficacy of fixed-dose combination calcipotriol (Cal) 50 µg/g and betamethasone dipropionate (BD) 0.5 mg/g aerosol foam compared with monotherapies of the active ingredients. Furthermore, Cal/BD aerosol foam has shown significantly improved efficacy compared with more traditional formulations, such as Cal/BD ointment and gel, in other studies. Calcipotriol also mitigates risks associated with betamethasone dipropionate and vice versa, resulting in the favorable safety profile observed with fixed-dose combination treatment. Recent data also suggest that fixed-dose combination treatment could provide long-term management of psoriasis, although further clinical investigations are needed. Overall, these data support the value of fixed-dose combination therapy of corticosteroid and vitamin D analog and highlight the added potential of innovative drug delivery for the treatment of psoriasis. Funding LEO Pharma.
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Affiliation(s)
- Siegfried Segaert
- Dermatology Department, University Hospital Leuven, Leuven, Belgium.
| | - Neil H Shear
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center and University of Toronto, Toronto, Canada
| | | | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - Jose-Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma of Barcelona, Badalona, Spain
| | - Helen Young
- Division of Musculoskeletal and Dermatological Sciences, The Dermatology Research Centre, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Vincent Descamps
- Department of Dermatology, Bichat-Claude Bernard Hospital, Paris 7 Denis Diderot University, Paris, France
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100
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Calcipotriene betamethasone dipropionate aerosol foam in the treatment of plaque psoriasis: a review of the literature. Ther Deliv 2017; 8:737-746. [PMID: 28659016 DOI: 10.4155/tde-2017-0058] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Psoriasis is a common chronic immune-mediated skin disease which has a significant impact on patients' quality of life, and is associated with numerous comorbidities (i.e., psoriatic arthritis, Crohn's disease and cardiovascular disease). A greater understanding of its immunopathogenesis has guided the development of novel, more targeted therapies. Nonetheless, traditional treatment with topical agents, phototherapy and systemic medications is used in the management of the majority of psoriasis patients. Mainstay topical treatments include corticosteroids and vitamin D derivatives. Calcipotriene/betamethasone dipropionate aerosol foam is a novel single product combination, which seeks to provide superior therapeutic efficacy in addition to enhanced cosmetic properties. This article reviews the literature on the pharmacology and clinical data in terms of safety, efficacy and patient satisfaction of this topical medication.
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