1
|
Jo JY, Chae SJ, Ryu HJ. Update on Melasma Treatments. Ann Dermatol 2024; 36:125-134. [PMID: 38816973 PMCID: PMC11148313 DOI: 10.5021/ad.23.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/12/2024] [Accepted: 03/04/2024] [Indexed: 06/01/2024] Open
Abstract
Melasma is a prevalent hyperpigmentation condition known for its challenging treatment due to its resemblance to photoaged skin disorders. Numerous studies have shed light on the intricate nature of melasma, which often bears similarity to photoaging disorders. Various therapeutic approaches, encompassing topical and systemic treatments, chemical peeling, and laser therapy, have exhibited efficacy in managing melasma in previous research. However, melasma often reoccurs despite successful treatment, primarily due to its inherent photoaged properties. Given that melasma shares features with photoaging disorders, including disruptions in the basement membrane, solar elastosis, angiogenesis, and mast cell infiltration in the dermal layer, a comprehensive treatment strategy is imperative. Such an approach might involve addressing epidermal hyperpigmentation while concurrently restoring dermal components. In this article, we provide a comprehensive review of conventional treatment methods frequently employed in clinical practice, as well as innovative treatments currently under development for melasma management. Additionally, we offer an extensive overview of the pathogenesis of melasma.
Collapse
Affiliation(s)
- Ju Young Jo
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Su Ji Chae
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea.
| |
Collapse
|
2
|
Xu Z, Wang C, Xing X, Zhang C, Xiang LF. Efficacy and safety of the combination of oral tranexamic acid and intense pulsed light versus oral tranexamic acid alone in the treatment of refractory Riehl's melanosis: A prospective, comparative study. J Cosmet Dermatol 2024; 23:2049-2057. [PMID: 38456556 DOI: 10.1111/jocd.16257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND There is no standardized and effective treatment modality for Riehl's melanosis. AIMS To compare the efficacy and safety of oral tranexamic acid (TXA) combined with intense pulsed light (IPL) versus TXA alone in the treatment of refractory Riehl's melanosis. METHODS A prospective study of 28 subjects with refractory Riehl's melanosis and Fitzpatrick Skin Types III or IV was conducted. All subjects received oral TXA 500 mg daily and 11 of them were treated in combination with monthly IPL therapy for 6 months. The primary outcome measure was mean melanin index (MI), erythema index (EI) and acquired dermal macular hyperpigmentation area and severity index (DPASI). The Physician Global Assessment (PGA) and patient satisfaction scale were documented. RESULTS After treatment, DPASI, mean MI, and EI were significantly reduced in both groups. The group treated with combination therapy showed better improvement according to MI (p = 0.0032) and DPASI (p = 0.00468). PGA and patient satisfaction scale showed superior efficacy in the combination group. No significant difference was observed in treatment-related side effects. CONCLUSION The combination of oral TXA and IPL proves to be a safe and satisfactory treatment strategy for refractory Riehl's melanosis.
Collapse
Affiliation(s)
- Zhongyi Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Chen Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Xiaoxue Xing
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Leihong Flora Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, PR China
| |
Collapse
|
3
|
Zhang C, Song X, Ma C, Wang M, Deng H, Yuan M, Zhu W, Shen L, Li Y, Shi L. Hyaluronic acid dissolving microneedle patch loaded with tranexamic acid for melasma treatment. Int J Biol Macromol 2024; 270:132255. [PMID: 38729504 DOI: 10.1016/j.ijbiomac.2024.132255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/03/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Melasma is an acquired hypermelanotic condition characterized by the presence of irregular light-to-dark brown macules that primarily manifest on the sun-exposed areas of the skin, particularly the face. The management of melasma poses significant challenges, as it is often recalcitrant to treatment and tends to recur despite successful treatment. In this study, we explored a safe, easy, and effective melasma treatment strategy. A hyaluronic acid (HA)-based microneedle (MN) patch loaded with tranexamic acid (TXA) was designed to deliver the necessary medication for melasma treatment. The MN patch features uniform needles with adequate mechanical strength and effective penetration and solubility in the skin without cytotoxicity. Remarkably, these MNs substantially reduce the thickness of the epidermis of melasma mice, curtail melanin production, and diminish dopachrome tautomerase (DCT) expression.
Collapse
Affiliation(s)
- Cai Zhang
- The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xuejiao Song
- The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Chuan Ma
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, China
| | - Minjia Wang
- The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Hui Deng
- Department of Dermatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Miaomiao Yuan
- Shanghai Key Laboratory of Pancreatic Diseases, Precision Research Center for Refractory Diseases in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuyou Zhu
- Shanghai Foreign Language School Affiliated to Shanghai International Studies University, Shanghai, China
| | - Lingyue Shen
- Department of Oral & Maxillofacial-Head & Neck Oncology, Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yuzhen Li
- The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
| | - Leilei Shi
- Shanghai Key Laboratory of Pancreatic Diseases, Precision Research Center for Refractory Diseases in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
4
|
Ueda R, Hashimoto R, Fujii Y, Menezes JCJMDS, Takahashi H, Takeda H, Sawasaki T, Motokawa T, Tokunaga K, Fujita H. Membrane-Associated Ubiquitin Ligase RING Finger Protein 152 Orchestrates Melanogenesis via Tyrosinase Ubiquitination. MEMBRANES 2024; 14:43. [PMID: 38392670 PMCID: PMC10890620 DOI: 10.3390/membranes14020043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/24/2024]
Abstract
Lysosomal degradation of tyrosinase, a pivotal enzyme in melanin synthesis, negatively impacts melanogenesis in melanocytes. Nevertheless, the precise molecular mechanisms by which lysosomes target tyrosinase have remained elusive. Here, we identify RING (Really Interesting New Gene) finger protein 152 (RNF152) as a membrane-associated ubiquitin ligase specifically targeting tyrosinase for the first time, utilizing AlphaScreen technology. We observed that modulating RNF152 levels in B16 cells, either via overexpression or siRNA knockdown, resulted in decreased or increased levels of both tyrosinase and melanin, respectively. Notably, RNF152 and tyrosinase co-localized at the trans-Golgi network (TGN). However, upon treatment with lysosomal inhibitors, both proteins appeared in the lysosomes, indicating that tyrosinase undergoes RNF152-mediated lysosomal degradation. Through ubiquitination assays, we found the indispensable roles of both the RING and transmembrane (TM) domains of RNF152 in facilitating tyrosinase ubiquitination. In summary, our findings underscore RNF152 as a tyrosinase-specific ubiquitin ligase essential for regulating melanogenesis in melanocytes.
Collapse
Affiliation(s)
- Ryota Ueda
- Faculty of Pharmaceutical Sciences, Nagasaki International University, Sasebo 859-3298, Japan
| | - Rina Hashimoto
- Faculty of Pharmaceutical Sciences, Nagasaki International University, Sasebo 859-3298, Japan
| | - Yuki Fujii
- Faculty of Pharmaceutical Sciences, Nagasaki International University, Sasebo 859-3298, Japan
| | - José C J M D S Menezes
- Faculty of Pharmaceutical Sciences, Nagasaki International University, Sasebo 859-3298, Japan
- Esteem Industries Pvt Ltd., Bicholim 403529, Goa, India
| | | | - Hiroyuki Takeda
- Proteo-Science Center, Ehime University, Matsuyama 790-8577, Japan
| | - Tatsuya Sawasaki
- Proteo-Science Center, Ehime University, Matsuyama 790-8577, Japan
| | - Tomonori Motokawa
- Frontier Research Center, POLA Chemical Industries, Inc., Yokohama 244-0812, Japan
| | - Kenzo Tokunaga
- Department of Pathology, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Hideaki Fujita
- Faculty of Pharmaceutical Sciences, Nagasaki International University, Sasebo 859-3298, Japan
| |
Collapse
|
5
|
Sarkar R, Narayan R V, Vinay K, Lakhani R, Sinha S, Mysore V, Sendhil Kumaran M, Bhalla M, Das A, Swarnkar B, Mohan Thappa D, Podder I, Ojha Sharma R, Kumar Somani V, Barua S, Jagadeesan S, Dogra S. Prescribing practices of tranexamic acid for melasma: Delphi consensus from the Pigmentary Disorders Society. Indian J Dermatol Venereol Leprol 2024; 90:41-45. [PMID: 37609738 DOI: 10.25259/ijdvl_1157_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/22/2023] [Indexed: 08/24/2023]
Abstract
Introduction There is ambiguity regarding usage of tranexamic acid for melasma in India, be it in its pre-administration evaluation, administration route, dosing or monitoring. Hence, we conducted this study to understand various tranexamic-acid prescribing patterns and provide practical guidelines. Materials and methods A Google-form-based questionnaire (25-questions) was prepared based on the key areas identified by experts from the Pigmentary Disorders Society, India and circulated to practicing dermatologists across the country. In rounds 2 and 3, the questionnaire was re-presented to the same group of experts and their opinions were sought. The results of the practitioners' survey were denoted graphically alongside, to guide them. Consensus was deemed when at least 80% of respondents chose an option. Results The members agreed that history pertaining to risk factors for thromboembolism, cardiovascular and menstrual disorders should be sought in patients being started on oral tranexamic-acid. Baseline coagulation profile should be ordered in all patients prior to tranexamic-acid and more exhaustive investigations such as complete blood count, liver function test, protein C and S in patients with high risk of thromboembolism. The preferred oral dose was 250 mg orally twice daily, which can be used alone or in combination with topical hydroquinone, kojic acid and sunscreen. Repeated dosing of tranexamic-acid may be required for those relapsing with melasma following initial tranexamic-acid discontinuation. Coagulation profile should ideally be repeated at three monthly intervals during follow-up, especially in patients with clinically higher risk of thromboembolism. Treatment can be stopped abruptly post improvement and no tapering is required. Limitation This study is limited by the fact that open-ended questions were limited to the first general survey round. Conclusion Oral tranexamic-acid provides a valuable treatment option for melasma. Frequent courses of therapy may be required to sustain results and a vigilant watch is recommended for hypercoagulable states during the course of therapy.
Collapse
Affiliation(s)
- Rashmi Sarkar
- Department of Dermatology, Lady Hardinge Medical College and Hospitals, New Delhi, India
| | - Vignesh Narayan R
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ridhima Lakhani
- Department of Dermatology and Venereology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Surabhi Sinha
- Department of Dermatology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Venkataram Mysore
- Dermatology Section, Venkat Centre for Skin and Plastic Surgery, Bangalore, Karnataka, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Mala Bhalla
- Department of Dermatology, Skin Office, Government Medical College and Hospital, Chandigarh, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Bhavesh Swarnkar
- Dermatology Section, Swarnkar Superspeciality Center, Indore, Madhya Pradesh, India
| | | | - Indrashis Podder
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - Richa Ojha Sharma
- Dermatology Section, Twacha Skin Clinic, Road Opposite Bal Bharti School, Dwarka, Delhi, India
| | | | - Shyamanta Barua
- Department of Dermatology, Assam Medical College & Hospital, Dibrugarh, Assam, India
| | - Soumya Jagadeesan
- Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| |
Collapse
|
6
|
Pulumati A, Jaalouk D, Algarin YA, Nouri K. The role of 755-nm alexandrite picosecond laser in melasma management. Arch Dermatol Res 2023; 316:60. [PMID: 38151661 DOI: 10.1007/s00403-023-02794-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
Melasma is a skin dyspigmentation condition that disproportionately affects women, particularly those of Latino, Black, and Asian ethnicities, significantly impacting their quality of life. Efforts to identify effective treatment options have led to the exploration of picosecond laser technology which utilizes brief pulse durations to break down pigment while minimizing thermal damage to surrounding tissue. The 755-nm alexandrite picosecond laser, currently FDA approved for benign pigmented lesion removal, including melasma, is a promising solution. We aim to assess the efficacy and safety of the 755-nm alexandrite picosecond laser both as a stand-alone treatment for melasma and in combination with topical agents. We conducted a PubMed search using "755-nm picosecond" AND "melasma," "755-nm picosecond" AND "hydroquinone," and "755-nm picosecond" AND "tranexamic acid." English-written studies examining this laser as monotherapy or in combination with the topical agents were included. Those not meeting the criteria or lacking data related to melasma improvement were excluded. Monotherapy with the 755-nm picosecond laser led to a 50-75% improvement in melasma appearance in 40% of participants and a significant reduction in the average Melasma Area and Severity Index (MASI) score (p < 0.001) in all patients of one study. Notably, the use of topical tranexamic acid (TTA) in conjunction with the picosecond laser exhibited the most significant degree of improvement in hemi-MASI scores compared to the laser monotherapy group at one- and three-months post-treatment (p < 0.05). Patient satisfaction was also significantly higher for the combination group (p < 0.05). In contrast, combining hydroquinone (HQ) with the picosecond laser demonstrated no significant difference in outcomes compared to HQ alone, both of which were less effective than TTA with picosecond laser. The combination of the 755-nm picosecond laser with TTA proves promising, outperforming both laser monotherapy and laser with HQ. While monotherapy with the picosecond laser or topical agents is effective, literature favors combination therapy, especially the 755-nm picosecond laser with TTA, for superior benefits and minimal side effects. Ultimately, individualized regimens, considering factors like skin type, should be prioritized, given the heightened risk of postinflammatory hyperpigmentation, especially in skin of color patients.
Collapse
Affiliation(s)
- Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
| | - Dana Jaalouk
- Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
7
|
Hseu JH, Chan CI, Vadivalagan C, Chen SJ, Yen HR, Hseu YC, Yang HL, Wu PY. Tranexamic acid improves psoriasis-like skin inflammation: Evidence from in vivo and in vitro studies. Biomed Pharmacother 2023; 166:115307. [PMID: 37573659 DOI: 10.1016/j.biopha.2023.115307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/30/2023] [Accepted: 08/07/2023] [Indexed: 08/15/2023] Open
Abstract
The chronic disease psoriasis is associated with severe inflammation and abnormal keratinocyte propagation in the skin. Tranexamic acid (TXA), a plasmin inhibitor, is used to cure serious bleeding. We investigated whether TXA ointment mitigated Imiquimod (IMQ)-induced psoriasis-like inflammation. Furthermore, this study investigated the effect of noncytotoxic concentrations of TXA on IL-17-induced human keratinocyte (HaCaT) cells to determine the status of proliferative psoriatic keratinocytes. We found that TXA reduced IMQ-induced psoriasis-like erythema, thickness, scaling, and cumulative scores (erythema plus thickness plus scaling) on the back skin of BALB/c mice. Additionally, TXA decreased ear thickness and suppressed hyperkeratosis, hyperplasia, and inflammation of the ear epidermis in IMQ-induced BALB/c mice. Furthermore, TXA inhibited IMQ-induced splenomegaly in BALB/c mouse models. In IL-17-induced HaCaT cells, TXA inhibited ROS production and IL-8 secretion. Interestingly, TXA suppressed the IL-17-induced NFκB signaling pathway via IKK-mediated IκB degradation. TXA inhibited IL-17-induced activation of the NLRP3 inflammasome through caspase-1 and IL1β expression. TXA inhibited IL-17-induced NLRP3 inflammasome activation by enhancing autophagy, as indicated by LC3-II accumulation, p62/SQSTM1 expression, ATG4B inhibition, and Beclin-1/Bcl-2 dysregulation. Notably, TXA suppressed IL-17-induced Nrf2-mediated keratin 17 expression. N-acetylcysteine pretreatment reversed the effects of TXA on NFκB, NLRP3 inflammasomes, and the Nrf2-mediated keratin 17 pathway in IL-17-induced HaCaT cells. Results further confirmed that in the ear skin of IMQ-induced mice, psoriasis biomarkers such as NLRP3, IL1β, Nrf2, and keratin 17 expression were downregulated by TXA treatment. TXA improves IMQ-induced psoriasis-like inflammation in vivo and psoriatic keratinocytes in vitro. Tranexamic acid is a promising future treatment for psoriasis.
Collapse
Affiliation(s)
- Jhih-Hsuan Hseu
- Department of Dermatology, China Medical University Hospital, Taichung 404327, Taiwan
| | - Chon-I Chan
- Institute of Nutrition, College of health Care, China Medical University, Taichung 406040, Taiwan
| | - Chithravel Vadivalagan
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI 48109, United States
| | - Siang-Jyun Chen
- Institute of Nutrition, College of health Care, China Medical University, Taichung 406040, Taiwan
| | - Hung-Rong Yen
- Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan; Research Center of Chinese Herbal Medicine, China Medical University, Taichung 404333, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung 404333, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
| | - You-Cheng Hseu
- Department of Cosmeceutics, College of Pharmacy, China Medical University, Taichung 406040, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan; Research Center of Chinese Herbal Medicine, China Medical University, Taichung 404333, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung 413305, Taiwan.
| | - Hsin-Ling Yang
- Institute of Nutrition, College of health Care, China Medical University, Taichung 406040, Taiwan.
| | - Po-Yuan Wu
- Department of Dermatology, China Medical University Hospital, Taichung 404327, Taiwan; Department of Dermatology, School of Medicine, China Medical University, Taichung 404333, Taiwan.
| |
Collapse
|
8
|
Bazargan AS, Ziaeifar E, Abouie A, Mirahmadi S, Taheri A, Gheisari M. Evaluating the effect of tranexamic acid as mesotherapy on persistent post-acne erythema: A before and after study. J Cosmet Dermatol 2023; 22:2714-2720. [PMID: 37082869 DOI: 10.1111/jocd.15776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Acne vulgaris is a common skin disease that is more common in young population and it can be associated with some sequels after resolving the lesions. Post-inflammatory erythema is one of these complications that can be disturbing for patients and does not have any definite treatment. This study was aimed to evaluate the efficacy and safety of tranexamic acid (TA) as mesotherapy in treatment of post-acne erythema (PAE) treatment. METHOD This clinical trial study was performed in the dermatology clinic on 17 patients with persistent PAE (3 months after acne recovery). Two sessions of treatment were performed by a physician with 2-week intervals; TA was injected as mesotherapy into the right side of each patient's face as the case group, while the opposite side was used as the control group. A Visioface device was used to compare before and after treatment photographs of each side of the face in color mode with quantitative measures such as lesions count, area, and area percent. RESULTS Finally, 15 patients completed treatment sessions. There were statistically significant differences in right side lesions before and after treatment with p-values of 0.047, 0.002, and 0.035 for count, area, and area percent, respectively. There was no significant difference before and after treatment in terms of count, area. and area-percent on the left side. CONCLUSION According to the results of this study, TA injection as mesotherapy for resolving PAE can be effective. However, due to small sample size, further studies are needed.
Collapse
Affiliation(s)
| | - Elham Ziaeifar
- Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Abolfazl Abouie
- Department of Radiology, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sadegh Mirahmadi
- School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Amirmasoud Taheri
- General practitioner, Mazandaran University of Medical Sciensces, Sari, Iran
| | - Mehdi Gheisari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Lam T, Medcalf RL, Cloud GC, Myles PS, Keragala CB. Tranexamic acid for haemostasis and beyond: does dose matter? Thromb J 2023; 21:94. [PMID: 37700271 PMCID: PMC10496216 DOI: 10.1186/s12959-023-00540-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023] Open
Abstract
Tranexamic acid (TXA) is a widely used antifibrinolytic agent that has been used since the 1960's to reduce blood loss in various conditions. TXA is a lysine analogue that competes for the lysine binding sites in plasminogen and tissue-type plasminogen activator impairing its interaction with the exposed lysine residues on the fibrin surface. The presence of TXA therefore, impairs the plasminogen and tPA engagement and subsequent plasmin generation on the fibrin surface, protecting fibrin clot from proteolytic degradation. However, critical lysine binding sites for plasmin(ogen) also exist on other proteins and on various cell-surface receptors allowing plasmin to exert potent effects on other targets that are unrelated to classical fibrinolysis, notably in relation to immunity and inflammation. Indeed, TXA was reported to significantly reduce post-surgical infection rates in patients after cardiac surgery unrelated to its haemostatic effects. This has provided an impetus to consider TXA in other indications beyond inhibition of fibrinolysis. While there is extensive literature on the optimal dosage of TXA to reduce bleeding rates and transfusion needs, it remains to be determined if these dosages also apply to blocking the non-canonical effects of plasmin.
Collapse
Affiliation(s)
- Tammy Lam
- Australian Centre for Blood Diseases, Monash AMREP Building, Monash University, Level 1 Walkway, Via The Alfred Centre, 99 Commercial Rd, Melbourne, 3004, Australia
| | - Robert L Medcalf
- Australian Centre for Blood Diseases, Monash AMREP Building, Monash University, Level 1 Walkway, Via The Alfred Centre, 99 Commercial Rd, Melbourne, 3004, Australia
| | - Geoffrey C Cloud
- Department of Clinical Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital, Melbourne VIC, Australia
- Department of Anaesthesiology and Perioperative Medicine, Monash University, Melbourne VIC, Australia
| | - Charithani B Keragala
- Australian Centre for Blood Diseases, Monash AMREP Building, Monash University, Level 1 Walkway, Via The Alfred Centre, 99 Commercial Rd, Melbourne, 3004, Australia.
| |
Collapse
|
10
|
Song F, Wang Y, Wei XG, Yang N, Sun W, Li K, Ma H, Mu J. Proteomic Analysis of Two Different Methods to Induce Skin Melanin Deposition Models in Guinea Pigs. Clin Cosmet Investig Dermatol 2023; 16:2341-2356. [PMID: 37663883 PMCID: PMC10474869 DOI: 10.2147/ccid.s420501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/10/2023] [Indexed: 09/05/2023]
Abstract
Objective In this study, we analyzed the differential expression and key signaling pathways of proteins in the skin of guinea pigs with melanin deposition caused by two different modeling methods by utilizing proteomics techniques. Methods Guinea pig skin melanin deposition models were: (1) induced by ultraviolet (UV) irradiation alone (U group), (2) induced by UV combined with progesterone injection (P group), and guinea pigs treated without any treatment were used as blank group (B group). H&E staining and Masson staining were used to observe the extent of skin damage and melanin deposition in guinea pigs. The differentially expressed proteins (DEPs) in the skin tissues of melanin-deposited guinea pigs were screened by proteomic techniques, the functions of DEPs were analyzed, and a protein-protein interaction network (PPI) was constructed. Results There was a significant difference in grayscale between the U and P groups of guinea pig skin before and after modeling (P < 0.01). H&E and Masson staining showed that the U and P groups both exhibited incomplete keratinization of the stratum corneum, increased proliferation of epidermal cells with large nuclei and disordered arrangement, neovascularization of the dermis, and increased the number of melanin particles in the epidermis of the U and P groups of guinea pigs compared with the B group. Proteomics analysis showed that there were 171 DEPs between the U and P groups. These DEPs focused on biological processes such as fibrillar collagen trimer, extracellular matrix containing collagen proteins, metalloproteinase activity, and peroxidase activity. Conclusion The melanin pigmentation model induced solely by UV radiation negatively regulates biological processes such as extracellular matrix and collagen synthesis, while inducing significant skin photoaging. The combination of progesterone injections and UV radiation-induced melanin pigmentation model can cause abnormal protein expression in fatty acid and phospholipid metabolism, possibly being closer to the environment of melasma formation.
Collapse
Affiliation(s)
- Fei Song
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Key Laboratory of Modernization of Minority Medicine, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Yan Wang
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Xiao-ge Wei
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Key Laboratory of Modernization of Minority Medicine, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Nan Yang
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Wenjing Sun
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Kaiying Li
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Huisheng Ma
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Key Laboratory of Modernization of Minority Medicine, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Jing Mu
- College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| |
Collapse
|
11
|
Galache TR, Galache M, Sena MM, Pavani C. Amber photobiomodulation versus tranexamic acid for the treatment of melasma: protocol for a double-blind, randomised controlled trial. BMJ Open 2023; 13:e073568. [PMID: 37479524 PMCID: PMC10364183 DOI: 10.1136/bmjopen-2023-073568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Photobiomodulation (PBM) has been suggested as an alternative treatment for melasma. In vitro studies have shown PBM with amber light inhibits the tyrosinase enzyme, induces autophagy and reduces the melanin content, but randomised controlled clinical trials are still needed. This study aims to evaluate the efficacy of amber PBM (590 nm) in the treatment of melasma compared with liposomal tranexamic acid. METHODS AND ANALYSIS This study is a controlled, randomised, double-blind, non-inferiority trial. This study will be performed in two centres (Universidade Nove de Julho Facility, Campus Vergueiro, and Galache Odontology Clinic, São Caetano do Sul, both in São Paulo State, Brazil). The sample (54 participants) will be divided into two groups in a 1:1 ratio; one group will receive active PBM and a placebo cosmetic and the other will receive sham PBM and liposomal tranexamic acid. Women presenting facial melasma, aged 35-50 years, with skin phototypes II-IV, will be eligible for inclusion. Women who use oral contraceptives, intrauterine devices, hormone replacement or photosensitive drugs, those with autoimmune disease and those who have undergone facial treatments in the last 3 months will be excluded from the study. The participants will receive PBM weekly for 12 weeks and will use the cosmetic two times per day at home during this period. The severity of melasma will be evaluated through the Melasma Area and Severity Index (MASI) as the primary outcome; pigmentation of the epidermis evaluated by corneomelametry, the photographic records, the global diagnosis of the face and the quality-of-life questionnaire (Brazilian Portuguese version of the Melasma Quality of Life Questionnaire) will assessed as secondary outcomes. All assessments will be made before starting the study (week 0), mid-study at 6 weeks and at the completion of treatment (week 12). MASI will also be evaluated during follow-up (weeks 16 and 20). The data will be analysed based on the intention-to-treat analysis using a generalised mixed model, and α <0.05 will be considered statistically significant. ETHICS AND DISSEMINATION The protocol was approved by the Research Ethics Committee of Universidade Nove de Julho (5 332 384). All participants will fill out the patient informed consent form. The results obtained in this trial will be presented at conferences and submitted for publication. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT05326997).
Collapse
Affiliation(s)
- Thais Rodrigues Galache
- Postgraduate Program in Biophotonics Applied to the Health Sciences, , Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | | | - Michelle Mota Sena
- Postgraduate Program in Biophotonics Applied to the Health Sciences, , Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Christiane Pavani
- Postgraduate Program in Biophotonics Applied to the Health Sciences, , Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| |
Collapse
|
12
|
Hu Y, Chen Y, Zhao Y, Geng Q, Guan C, Xu J, Xie B, Song X. Tranexamic acid may promote melanocores clustering in keratinocytes through upregulation of Rab5b. Exp Dermatol 2023. [PMID: 36779692 DOI: 10.1111/exd.14767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/14/2023]
Abstract
Tranexamic acid (TXA) is a promising therapeutic agent in melasma that can act on multiple pathophysiologic mechanisms of melasma. However, it is unclear whether TXA affects melanin in keratinocytes. To explore the effect of TXA on melanocores in keratinocytes. The melanocore-incorporated keratinocytes were constructed by co-incubating normal human epidermal keratinocytes (NHEK) with melanocores. After being treated with TXA, autophagy- and melanin-related protein expressions were detected. Then, transcriptome sequencing was used to compare the genetic changes in melanocore-incorporated keratinocytes before and after TXA treatment and further verified the differentially expressed genes. At the same time, the distribution of melanocores in human keratinocytes was observed by transmission electron microscopy. We found that TXA does not promote melanin degradation in primary keratinocytes by inducing autophagy. Protein transport and intracellular protein transport-related genes were enriched after TXA treatment, and Rab5b was significantly upregulated. Transmission electron microscopy showed that the percentage of melanocores distributed in clusters increased after treatment with TXA, which was reduced after Rab5b silencing. In addition, results suggested that melanocores could colocalize with Rab5b and lysosome-associated membrane protein1 (LAMP1). Our study found that Rab5b may be involved in the melanocore distribution in keratinocytes. TXA may promote the clustering distribution of endocytic melanocores through upregulation of Rab5b, representing a potential mechanism of TXA treatment against melasma.
Collapse
Affiliation(s)
- Yebei Hu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Chen
- Department of Dermatology, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Zhao
- Department of Dermatology, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Qingwei Geng
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cuiping Guan
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinhui Xu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bo Xie
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiuzu Song
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
13
|
Simpson J, Peng L, Ting W. Evaluation of oral tranexamic acid as a novel treatment for melasma with a high benefit-risk ratio. J Cosmet Dermatol 2022; 21:6393-6399. [PMID: 35972476 DOI: 10.1111/jocd.15305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/25/2022] [Accepted: 08/12/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Melasma is an acquired melanogenesis dysfunction resulting in chronic hyperpigmentation commonly affecting the face and other frequently sun-exposed areas of the body. Melasma typically presents in women of reproductive age and can significantly impact self-esteem, negatively affecting one's quality of life. In the United States, melasma is often treated with application of topical agents that interfere with melanin synthesis, lasers, or chemical peels; however, in some East Asian countries, oral tranexamic acid (TXA) is widely administered to alleviate hyperpigmentation during and after childbirth. TXA is currently only FDA-approved to treat hypermenorrhea and reduce blood loss in surgery but may offer women in the United States an additional therapeutic option to treat melasma. AIMS The aim of this paper is to evaluate the safety and baseline efficacy of oral transmexic acid as a treatment for melasma. METHODS We retrospectively surveyed 42 patients of Fitzpatrick skin types III-VI that were prescribed 650 mg of TXA ½ tablet to be taken twice daily by mouth. RESULTS We found majority of patients saw noticeable improvement in their melasma. Of the 42 patients, only seven experienced side effects. The side effects noted were headaches, malaise and nausea, gastrointestinal upset, congestion, numbness in legs, hypomenorrhea, and hypermenorrhea. Patients who experienced unpleasant side effects discontinued taking oral TXA and were relieved of their symptoms. No long-term side effects were discovered, and the side effects experienced may be due to other confounding factors. CONCLUSION From this data, we concluded oral TXA is a safe and effective treatment option for patients with persistent melasma.
Collapse
Affiliation(s)
| | - Lucy Peng
- California Dermatology Care, San Ramon, California, USA
| | - William Ting
- California Dermatology Care, San Ramon, California, USA
| |
Collapse
|
14
|
Mechanism of Action of Topical Tranexamic Acid in the Treatment of Melasma and Sun-Induced Skin Hyperpigmentation. COSMETICS 2022. [DOI: 10.3390/cosmetics9050108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tranexamic acid (TXA) has anti-plasmin activity and has been shown when administered orally to be effective against melasma, for which it is considered first-line pharmacotherapy. Several studies have shown that topically applied TXA is also effective against melasma and skin hyperpigmentation caused by sunburn and inflammation. The TXA concentration in the epidermis and dermis/vasculature has been estimated from its distribution in the skin after closed application, and topically applied TXA has thus been shown to act on neutrophils and mast cells in the dermis and on the vascular system. It is unlikely that topically applied TXA acts on dermal neutrophils or mast cells or on the vascular system to form thrombi. As discussed in the present review, studies on the effects of topical TXA on the hyperpigmentation process indicate that the resulting skin-lightening mechanism involves the suppression of cytokine/chemical mediator production, which stimulates melanin production via the keratinocyte-derived urokinase-type plasminogen activator and plasminogen derived from dermal vascular in the basal layer of the epidermis, thereby suppressing the production of excessive melanin to prevent hyperpigmentation.
Collapse
|
15
|
Shining Light on Autophagy in Skin Pigmentation and Pigmentary Disorders. Cells 2022; 11:cells11192999. [PMID: 36230960 PMCID: PMC9563738 DOI: 10.3390/cells11192999] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/13/2022] [Accepted: 09/23/2022] [Indexed: 01/18/2023] Open
Abstract
Autophagy is a vital process for cell survival and it preserves homeostasis by recycling or disassembling unnecessary or dysfunctional cellular constituents. Autophagy ameliorates skin integrity, regulating epidermal differentiation and constitutive pigmentation. It induces melanogenesis and contributes to skin color through melanosome turnover. Autophagy activity is involved in skin phenotypic plasticity and cell function maintenance and, if altered, it concurs to the onset and/or progression of hypopigmentary and hyperpigmentary disorders. Overexpression of autophagy exerts a protective role against the intrinsic metabolic stress occurring in vitiligo skin, while its dysfunction has been linked to the tuberous sclerosis complex hypopigmentation. Again, autophagy impairment reduces melanosome degradation by concurring to pigment accumulation characterizing senile lentigo and melasma. Here we provide an updated review that describes recent findings on the crucial role of autophagy in skin pigmentation, thus revealing the complex interplay among melanocyte biology, skin environment and autophagy. Hence, targeting this process may also represent a promising strategy for treating pigmentary disorders.
Collapse
|
16
|
Prudovsky I, Kacer D, Zucco VV, Palmeri M, Falank C, Kramer R, Carter D, Rappold J. Tranexamic acid: Beyond antifibrinolysis. Transfusion 2022; 62 Suppl 1:S301-S312. [PMID: 35834488 DOI: 10.1111/trf.16976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/30/2022]
Abstract
Tranexamic acid (TXA) is a popular antifibrinolytic drug widely used in hemorrhagic trauma patients and cardiovascular, orthopedic, and gynecological surgical patients. TXA binds plasminogen and prevents its maturation to the fibrinolytic enzyme plasmin. A number of studies have demonstrated the broad life-saving effects of TXA in trauma, superior to those of other antifibrinolytic agents. Besides preventing fibrinolysis and blood loss, TXA has been reported to suppress posttraumatic inflammation and edema. Although the efficiency of TXA transcends simple inhibition of fibrinolysis, little is known about its mechanisms of action besides the suppression of plasmin maturation. Understanding the broader effects of TXA at the cell, organ, and organism levels are required to elucidate its potential mechanisms of action transcending antifibrinolytic activity. In this article, we provide a brief review of the current clinical use of TXA and then focus on the effects of TXA beyond antifibrinolytics such as its anti-inflammatory activity, protection of the endothelial and epithelial monolayers, stimulation of mitochondrial respiration, and suppression of melanogenesis.
Collapse
Affiliation(s)
- Igor Prudovsky
- Maine Medical Center Research Institute, Maine Medical Center, Scarborough, Maine, USA
| | - Doreen Kacer
- Maine Medical Center Research Institute, Maine Medical Center, Scarborough, Maine, USA
| | - Victoria Vieira Zucco
- Maine Medical Center Research Institute, Maine Medical Center, Scarborough, Maine, USA
| | - Monica Palmeri
- Maine Medical Center Cardiovascular Institute, Maine Medical Center, Portland, Maine, USA
| | - Carolyne Falank
- Department of Trauma, Maine Medical Center, Maine Medical Center, Portland, Maine, USA
| | - Robert Kramer
- Maine Medical Center Cardiovascular Institute, Maine Medical Center, Portland, Maine, USA
| | - Damien Carter
- Department of Trauma, Maine Medical Center, Maine Medical Center, Portland, Maine, USA
| | - Joseph Rappold
- Maine Medical Center Research Institute, Maine Medical Center, Scarborough, Maine, USA.,Department of Trauma, Maine Medical Center, Maine Medical Center, Portland, Maine, USA
| |
Collapse
|
17
|
Lee KW, Kim M, Lee SH, Kim KD. The Function of Autophagy as a Regulator of Melanin Homeostasis. Cells 2022; 11:cells11132085. [PMID: 35805169 PMCID: PMC9265842 DOI: 10.3390/cells11132085] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 12/18/2022] Open
Abstract
Melanosomes are melanocyte-specific organelles that protect cells from ultraviolet (UV)-induced deoxyribonucleic acid damage through the production and accumulation of melanin and are transferred from melanocytes to keratinocytes. The relatively well-known process by which melanin is synthesized from melanocytes is known as melanogenesis. The relationship between melanogenesis and autophagy is attracting the attention of researchers because proteins associated with autophagy, such as WD repeat domain phosphoinositide-interacting protein 1, microtubule-associated protein 1 light chain 3, autophagy-related (ATG)7, ATG4, beclin-1, and UV-radiation resistance-associated gene, contribute to the melanogenesis signaling pathway. Additionally, there are reports that some compounds used as whitening cosmetics materials induce skin depigmentation through autophagy. Thus, the possibility that autophagy is involved in the removal of melanin has been suggested. To date, however, there is a lack of data on melanosome autophagy and its underlying mechanism. This review highlights the importance of autophagy in melanin homeostasis by providing an overview of melanogenesis, autophagy, the autophagy machinery involved in melanogenesis, and natural compounds that induce autophagy-mediated depigmentation.
Collapse
Affiliation(s)
- Ki Won Lee
- PMBBRC, Gyeongsang National University, Jinju 52828, Korea;
| | - Minju Kim
- Division of Applied Life Science, Gyeongsang National University, Jinju 52828, Korea; (M.K.); (S.H.L.)
| | - Si Hyeon Lee
- Division of Applied Life Science, Gyeongsang National University, Jinju 52828, Korea; (M.K.); (S.H.L.)
| | - Kwang Dong Kim
- PMBBRC, Gyeongsang National University, Jinju 52828, Korea;
- Division of Applied Life Science, Gyeongsang National University, Jinju 52828, Korea; (M.K.); (S.H.L.)
- Correspondence: ; Tel.: +82-55-772-1365; Fax: +82-55-772-1359
| |
Collapse
|
18
|
Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid versus laser monotherapy for melasma and facial rejuvenation: a multicenter, randomized, double-blinded, split-face study in Chinese patients. Lasers Med Sci 2022; 37:2879-2887. [PMID: 35501519 DOI: 10.1007/s10103-022-03566-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/22/2022] [Indexed: 02/05/2023]
Abstract
To compare the efficacy and safety of 755-nm picosecond alexandrite laser and topical tranexamic acid (TTA) combination therapy with laser monotherapy, for the treatment of melasma and facial rejuvenation. This multicenter, randomized, double-blinded, split-face study enrolled 37 patients who presented with melasma and photoaging. Facial halves were randomized to receive either laser and TTA combination therapy or laser monotherapy. Three treatments were delivered at 4-5 weeks intervals. Patients were followed up for 1, 3, and 6 months post-final treatment and evaluated by blinded investigators for hemi-Melasma Area and Severity Index (hemi-MASI), facial dyschromia, skin texture, laxity, and rhytids. Daily diaries rating healing progress for 7 days posttreatment and satisfaction grading were performed by all patients. Adverse events were recorded. Thirty-six patients completed the follow-up. Compared with the baseline, hemi-MASI, dyschromia, and skin texture on both halves improved significantly through the follow-up (p = 0.000). A significant difference in hemi-MASI and dyschromia between combination therapy halves and monotherapy halves was noticed at 1- and 3-month follow-ups (p < 0.05). The laser monotherapy halves displayed significantly less redness and sensitivity during the 7-day posttreatment recovery period (p < 0.05). Patients' satisfaction ratings for the combination therapy halves were higher than the monotherapy halves at 1-month follow-up (p < 0.05). No severe adverse events were observed. The picosecond alexandrite laser and TTA combination therapy demonstrated synergistic efficacy for hemi-MASI and dyschromia improvements over laser monotherapy. The optimization of the picosecond laser and TTA combination regimen needs further investigation.
Collapse
|
19
|
Cassiano DP, Espósito ACC, Hassun KM, Lima MMDDA, Lima EVDA, Miot LDB, Miot HA, Bagatin E. Histological changes in facial melasma after treatment with triple combination cream with or without oral tranexamic acid and/or microneedling, a randomised clinical trial. Indian J Dermatol Venereol Leprol 2022; 88:761-770. [PMID: 35389028 DOI: 10.25259/ijdvl_126_2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 09/01/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Melasma is an acquired dyschromia with several histologic alterations in the epidermis, basement membrane and upper dermis. The treatment of melasma is challenging due to the irregular response and chronicity of the disease. To date, there are no curative strategies, largely due to the limited understanding of the intrinsic effects of each treatment. OBJECTIVES The objective of the study was to evaluate the histological changes promoted by triple combination cream, with or without complementary treatment with microneedling and oral tranexamic acid, in the treatment of melasma. METHODS A factorial, randomised, controlled and evaluator-blinded clinical trial was performed involving 64 women with facial melasma, divided in four groups, who underwent 60 days of treatment with triple combination cream alone (control group) or combined with two monthly microneedling sessions (microneedling group), TA 250 mg twice daily (tranexamic acid group), or both tranexamic acid group and microneedling group. The participants underwent biopsy of the area with melasma at inclusion (D1) and D60. The primary outcomes were the variation (D1 × D60) between the variables: Thickness of the epidermis and stratum corneum, stratum corneum compaction and solar elastosis; melanin density in the epidermis and upper dermis; proportion between the extension of the nonintact and intact basement membrane zone; mast cell count in the upper dermis; melanocyte count in the basal layer, pendulum melanocyte count and melanocyte area; immunostaining density of vascular endothelial growth factor; stem cell factor and keratinocyte growth factor. RESULTS One participant in the TG discontinued tranexamic acid due persistent headache; and herpes simplex occurred in three patients after microneedling. The groups showed a 24% (CI95%: 17-35%; P < 0.01) reduction in epidermal melanin density. There was no change in dermal melanin density or the area of melanocytes after treatment. There was an overall 25% (CI95%: 7-42%; P < 0.01) reduction in the number of pendulum melanocytes, especially in the microneedling and tranexamic acid group, that presented a 41% (CI95%: 7-73%; P < 0.01) reduction. The extension of the nonintact basal membrane relative to the intact basal membrane decreased after treatment, especially in microneedling group and microneedling and tranexamic acid group. There was an increase of 13% (CI95%: 5-21%; P = 0.02) in epidermal thickness and 6% (CI95%: 0-22%; P = 0.04) thinning of the stratum corneum in the groups. All groups showed stratum corneum compaction. Solar elastosis improved only in the microneedling group and microneedling and tranexamic acid group. Vascular endothelial growth factor immunostaining increased 14% (CI95%: 4-24%; P = 0.03) in the groups; and stem cell factor increased only in microneedling group. There was no change in the number of mast cells, CD34 and keratinocyte growth factor immunostaining. LIMITATIONS The site of biopsy may not represent all of the facial melasma and the immunohistochemical sensitivity of the cytokines does not have a stoichiometric relationship with proteins. CONCLUSION A greater thickness of the epidermis is associated with melasma bleaching. Dermal melanin seems to have no impact on melasma prognosis. Damage to the skin barrier and stimulus of angiogenesis should be avoided in the treatment of melasma. Microneedling complements the topical treatment of melasma by improving patterns of skin photoaging. Oral tranexamic acid complements the topical treatment of melasma by inhibiting the stem cell factor.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Hélio Amante Miot
- Departamento de Dermatologia e Radioterapia, Botucatu, São Paulo, Brazil
| | | |
Collapse
|
20
|
Implications of Oxidative Stress in the Pathogenesis and Treatment of Hyperpigmentation Disorders. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:7881717. [PMID: 35087618 PMCID: PMC8789419 DOI: 10.1155/2022/7881717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/19/2021] [Accepted: 12/31/2021] [Indexed: 01/19/2023]
Abstract
Oxidative stress represents an imbalance between the generation of reactive oxygen and nitrogen species and the ability of antioxidant systems to decompose those products. Oxidative stress is implicated in the pathogenesis of hyperpigmentation, hypopigmentation, melanoma, and other skin diseases. Regulatory networks involving oxidative stress and related pathways are widely represented in hypopigmentation diseases, particularly vitiligo. However, there is no complete review into the role of oxidative stress in the pathogenesis of hyperpigmentation disorders, especially regarding associations involving oxidative stress and cellular signaling pathways. Here, we review oxidative and antioxidant systems, oxidative stress-induced signal transduction mechanisms, and effects of antioxidant drugs used in preclinical and clinical settings in hyperpigmentation disorders.
Collapse
|
21
|
Skin Depigmenting Agents in Anti-Aging Cosmetics: A Medicinal Perspective on Emerging Ingredients. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020775] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Human skin aging results from intrinsic and extrinsic factors. Uneven pigmentation is one of the major changes of extrinsic aging. Many compounds have been tested for depigmenting activity but only a few are actually used by the cosmetic industry, which is continually looking for new ingredients. In this study, the trends in the use of skin depigmenting ingredients in a panel of anti-aging formulations commercialized in the Portuguese pharmacy market were analyzed, by comparing the composition of the products marketed in 2011 with products launched or reformulated in 2018 (59% and 74%, respectively). The analysis of the top 12 ingredients put forward three novelties for 2018: tranexamic acid, bakuchiol, and 4-butylresorcinol. Regarding their mechanisms of action, tranexamic acid inhibits melanin synthesis through inhibition of the plasminogen/plasmin system. Bakuchiol depigmenting efficacy was attributed to the ability to block both α-melanocyte-stimulating hormone and tyrosinase activation, while 4-butylresorcinol exerts its action through the inhibition of both tyrosinase and tyrosinase-related protein-1 (TRP-1). Industry-optimized and efficient synthetic methodologies that embrace green chemistry, reducing the environmental impact, are commonly used. This analysis aims to bring insights to both formulators, involved in the development of depigmenting cosmetic products, and chemists performing the synthesis of new and existing compounds intended for this purpose.
Collapse
|
22
|
Xing X, Xu Z, Chen L, Jin S, Zhang C, Xiang L. Tranexamic acid inhibits melanogenesis partially via stimulation of TGF-β1 expression in human epidermal keratinocytes. Exp Dermatol 2021; 31:633-640. [PMID: 34862827 DOI: 10.1111/exd.14509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/08/2021] [Accepted: 12/02/2021] [Indexed: 12/13/2022]
Abstract
Oral tranexamic acid (TA) has been an effective treatment for melasma with unclear mechanism. The present study aimed to demonstrate the effect of TA on melanogenesis via regulation of TGF-β1 expression in keratinocytes. We firstly determined the expression level of TGF-β1 in TA-treated keratinocyte-conditioned medium (KCM). Then, the mRNA and protein levels of microphthalmia-associated transcription factor (MITF), tyrosinase (TYR) and tyrosinase-related protein 1 (TRP-1) of human epidermal melanocytes (NHEMs) in the presence of TA-treated KCM were evaluated via RT-PCR and western blot analysis. Moreover, melanin content and tyrosinase activity were quantified. TGF-β1 gene was knocked down by small interfering RNA (siRNA) in keratinocytes. The mRNA and protein levels of TGF-β1 in keratinocytes were significantly increased after TA treatment. Melanin contents, tyrosinase activity, protein and mRNA levels of TYR, MITF and TRP-1 were downregulated in NHEMs in the presence of TA-treated KCM. Knockdown of TGF-β1 in keratinocytes could attenuate the inhibitory effect of TA-treated KCM on melanogenesis. TA could stimulate TGF-β1 expression in keratinocytes, which further inhibits melanogenesis through the paracrine signalling.
Collapse
Affiliation(s)
- Xiaoxue Xing
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongyi Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Chen
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shanglin Jin
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Leihong Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
23
|
Wang Y, Duan T, Hong M, Zhou Y, Huang H, Xiao X, Zheng J, Zhou H, Lu Z. Quantitative proteomic analysis uncovers inhibition of melanin synthesis by silk fibroin via MITF/tyrosinase axis in B16 melanoma cells. Life Sci 2021; 284:119930. [PMID: 34480938 DOI: 10.1016/j.lfs.2021.119930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 12/21/2022]
Abstract
AIMS Silk fibroin (SF), a natural product from silkworms, has been used to promote anti-inflammation, induce wound healing, and reduce melanin production. However, the underlying regulatory mechanism of SF on melanin production remains unknown. The aim of this study was to investigate the distinct regulatory mechanism of SF in B16 melanoma cells by applying quantitative proteomic approach. MATERIALS AND METHODS B16 melanoma cells were treated with PBS, KA or SF for 48 h, respectively. Cell viability, melanin content, and tyrosinase activity were examined. A label-free quantitative proteomic approach was utilized to investigate the regulatory mechanism of SF. The differentially expressed proteins and their related biological processes were subsequently identified by bioinformatics methods. Furthermore, the identified differentially expressed proteins were validated by western blot. KEY FINDINGS Both SF and KA were able to suppress the melanin synthesis of B16 melanoma cells without appreciable toxicity; yet, SF had a distinct effect on mushroom tyrosinase activity in vitro. Moreover, quantitative proteomic approach identified 141 proteins differentially expressed only in SF/Con group. Bioinformatic analysis of these proteins revealed that oxidation-reduction process, RNA processing, fatty acid degradation, as well as melanin biosynthetic process were enriched with SF treatment. The proteins associated with melanin biosynthetic process, including microphthalmia-associated transcription factor (MITF) and tyrosinase, were down-regulated in SF group, which was confirmed by western blot. SIGNIFICANCE SF inhibited melanin synthesis in B16 melanoma cells via down-regulation of MITF and tyrosinase expression, which provides a rationale for future utilization of SF.
Collapse
Affiliation(s)
- Yuqiu Wang
- School of Bioengineering, East China University of Science and Technology, Shanghai 200237, China; Department of Analytical Chemistry, CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Tianbi Duan
- Technology Center, Shanghai Inoherb Co. Ltd, 121 Chengyin Road, Shanghai 200083, China
| | - Minhua Hong
- Technology Center, Shanghai Inoherb Co. Ltd, 121 Chengyin Road, Shanghai 200083, China
| | - Yanting Zhou
- Department of Analytical Chemistry, CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Hui Huang
- Department of Analytical Chemistry, CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Xiao Xiao
- School of Bioengineering, East China University of Science and Technology, Shanghai 200237, China.
| | - Jing Zheng
- School of Bioengineering, East China University of Science and Technology, Shanghai 200237, China; School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China.
| | - Hu Zhou
- Department of Analytical Chemistry, CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China; University of Chinese Academy of Sciences, Number 19A Yuquan Road, Beijing 100049, China.
| | - Zhi Lu
- Technology Center, Shanghai Inoherb Co. Ltd, 121 Chengyin Road, Shanghai 200083, China.
| |
Collapse
|
24
|
Kim J, Choi H. The mucin protein MUCL1 regulates melanogenesis and melanoma genes in a manner dependent on threonine content. Br J Dermatol 2021; 186:532-543. [PMID: 34545566 PMCID: PMC9299140 DOI: 10.1111/bjd.20761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
Background The regulation of melanogenesis has been investigated as a long‐held aim for pharmaceutical manipulations with denotations for malignancy of melanoma. Mucins have a protective function in epithelial organs; however, in the most outer organ, the skin, the role of mucins has not been studied enough. Objectives Our initial hypothesis developed from the identification of correlations between pigmentation and expressions of skin mucins, particularly those existing in skin tissue. We aimed to investigate the action of mucins in human melanocytic cells. Materials and methods The expression of mucin proteins in human skin was investigated using microarray data from the Human Protein Atlas consortium (HPA) and the Genotype‐Tissue Expression consortium (GTEx) database. Mucin expression was measured at RNA and protein levels in melanoma cells. The findings were further validated and confirmed by analysis of independent experiments. Results We found that the several mucin proteins showed expression in human skin cells and among these, mucin‐like protein 1 (MUCL1) showed the highest expression and also clear negative correlation with melanogenesis in epidermal melanocytes. We confirmed the correlations between melanogenesis and MUCL1 by revealing negative correlations in melanocytes with different melanin production, resulting from increased composition of threonine, mucin‐conforming amino acid, and increased autophagy‐related forkhead‐box O signalling. Furthermore, threonine itself affects melanogenesis and metastatic activity in melanoma cells. Conclusions We identified a significant association between MUCL1 and threonine with melanogenesis and metastasis‐related genes in melanoma cells. Our results define a novel mechanism of mucin regulation, suggesting diagnostic and preventive roles of MUCL1 in cutaneous melanoma. Whatis already known about this topic? Despite considerable advances in radioactive therapeutics or chemotherapeutic approaches for the treatment of abnormal melanogenesis, there are still many caveats to delivery, effectiveness and safety, thus leaving a necessity for more immediate pharmaceutical targets. Mucins have protective and chemical barrier functions in epithelial organs; however, in the skin, mucin has scarce expression and is known only as a diagnostic aid in skin disorders such as mucinosis.
Whatdoes this study add? We provide detailed analysis demonstrating the potential of mucin‐like protein 1 (MUCL1), which showed negative correlations in melanocytes with different melanin production, resulting from increased composition of threonine and increased autophagy‐related forkhead‐box O signalling in epidermal melanocytes and melanoma cells. We established that through an alternative pathway for MUCL1 biosynthesis, threonine supplementation recovers MUCL1 levels in melanoma. Changes, brought on by the essential amino acid threonine, resulted in substantial modulations in melanogenesis and reduced metastasis‐related genes.
Whatis the translational message? This study demonstrates for the first time that the mucin protein of skin cells is compounded by distorted mucin homeostasis, with major effects on melanogenesis and metastasis‐related genes in melanoma. We anticipate that these novel findings will be of keen interest to the community of scientists and medical practitioners examining skin dysfunction.
Linked Comment: C. Casalou and D.J. Tobin. Br J Dermatol 2022; 186:388–389. Plain language summary available online
Collapse
Affiliation(s)
- J Kim
- Amorepacific R&D Center, 1920 Yonggu-daero, Giheung-gu, Gyeonggi-do, 17074, Korea
| | - H Choi
- Amorepacific R&D Center, 1920 Yonggu-daero, Giheung-gu, Gyeonggi-do, 17074, Korea
| |
Collapse
|
25
|
Zaky MS, Obaid ZM, Khalil EA, Elsaie ML. Microneedling-assisted topical tranexamic acid solution versus 4% hydroquinone for treating melasma: A split-face randomized study. J Cosmet Dermatol 2021; 20:4011-4016. [PMID: 34525492 DOI: 10.1111/jocd.14440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Melasma, also known as chloasma or mask of pregnancy, is a common, acquired, hyperpigmentary disorder usually affecting females. Tranexamic acid (TA), a derivative of amino acid lysine, has shown promising results over the past few years when used along with other therapies and when used as a stand-alone therapy. AIM OF THE WORK In this study, we aimed to evaluate and compare the effectiveness of topically applied tranexamic acid after microneedling versus topically applied hydroquinone (HQ) 4% alone in patients with melasma. PATIENTS AND METHODS Fifty selected patients were divided randomly according to the random number allocation method into two groups (25 patients each) of A (topical 4% hydroquinone, nightly application) and B (microneedling + topical 4% TA, every other week). RESULTS After eight weeks of treatment, the mean modified MASI score of the HQ treated side changed from 6.604 ± 4.02 to 3.032 ± 1.19 with a mean decrease percentage of 54.8% ± 19.4%. This reduction in modified MASI score was found to be statistically significant, (p < 0.001). MASI score of group B (TA +microneedling) changed from 6.348 ± 3.84 to 3.712 ± 1.19 with mean decrease percentage of 57.4% ± 23.4% which was also statistically significant, (p < 0.001). CONCLUSION We demonstrated safety and efficacy of both used modalities and with minimal side effects. Topical HQ application achieved minimal non-significant higher satisfactory results among raters and subjects.
Collapse
Affiliation(s)
- Mohamed S Zaky
- Department of Dermatology, Venereology and Andrology Damietta Faculty of Medicine, Al-Azhar University
| | - Zakaria M Obaid
- Department of Dermatology, Venereology and Andrology Damietta Faculty of Medicine, Al-Azhar University
| | - Eman A Khalil
- Department of Dermatology, Venereology and Andrology Damietta Faculty of Medicine, Al-Azhar University
| | | |
Collapse
|
26
|
Chen SJ, Hseu YC, Gowrisankar YV, Chung YT, Zhang YZ, Way TD, Yang HL. The anti-melanogenic effects of 3-O-ethyl ascorbic acid via Nrf2-mediated α-MSH inhibition in UVA-irradiated keratinocytes and autophagy induction in melanocytes. Free Radic Biol Med 2021; 173:151-169. [PMID: 34314818 DOI: 10.1016/j.freeradbiomed.2021.07.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/07/2021] [Accepted: 07/23/2021] [Indexed: 02/07/2023]
Abstract
3-O-ethyl ascorbic acid (EAA) is an ether-derivative of ascorbic acid, known to inhibit tyrosinase activity, and is widely used in skincare formulations. Nevertheless, the molecular mechanisms underlying the EAA's effects are poorly understood. Here, the anti-melanogenic activity of EAA was demonstrated through Nrf2-mediated α-MSH inhibition in UVA-irradiated keratinocytes (HaCaT) and autophagy induction and inhibition of α-MSH-stimulated melanogenesis in melanocytes (B16F10). EAA pretreatment increased the HaCaT cell viability but suppressed ROS-mediated p53/POMC/α-MSH pathways in UVA-irradiated cells. Further, the conditioned medium from EAA-pretreated and UVA-irradiated HaCaT cells suppressed the MITF-CREB-tyrosinase pathways leading to the inhibition of melanin synthesis in B16F10 cells. EAA treatment increased nuclear Nrf2 translocation via the p38, PKC, and ROS pathways leading to HO-1, γ-GCLC, and NQO-1 antioxidant expression in HaCaT cells. However, Nrf2 silencing reduced the EAA-mediated anti-melanogenic activity, evidenced by impaired antioxidant gene expression and uncontrolled ROS (H202) generation following UVA irradiation. In B16F10 cells, EAA-induced autophagy was shown by enhanced LC3-II levels, AVO formation, Beclin-1 upregulation, and activation of p62/SQSTM1. Further, EAA-induced anti-melanogenic activity was substantially decreased in autophagy inhibitor (3-MA) pretreated or LC3 knockdown B16F10 cells. Notably, transmission electron microscopy data showed increased melanosome-engulfing autophagosomes in EAA-treated B16F10 cells. Moreover, EAA also down-regulated MC1R, TRP-1/-2, tyrosinase expressions, and melanin synthesis by suppressing the cAMP-CREB-mediated MITF expression in B16F10 cells stimulated with α-MSH. In vivo studies on the zebrafish model further confirmed that EAA inhibited tyrosinase expression/activity and endogenous pigmentation. In conclusion, 3-O-ethyl ascorbic acid is an effective skin-whitening agent and could be used as a topical agent for cosmetic purposes.
Collapse
Affiliation(s)
- Siang-Jyun Chen
- Institute of Nutrition, College of Health Care, China Medical University, Taichung, 406040, Taiwan
| | - You-Cheng Hseu
- Department of Cosmeceutics, College of Pharmacy, China Medical University, Taichung, 406040, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, 413005, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung, 406040, Taiwan; Research Center of Chinese Herbal Medicine, China Medical University, Taichung, 406040, Taiwan.
| | | | - Yi-Ting Chung
- Department of Cosmeceutics, College of Pharmacy, China Medical University, Taichung, 406040, Taiwan
| | - Yan-Zhen Zhang
- Department of Life Sciences, China Medical University, Taichung, 406040, Taiwan
| | - Tzong-Der Way
- Department of Life Sciences, China Medical University, Taichung, 406040, Taiwan
| | - Hsin-Ling Yang
- Institute of Nutrition, College of Health Care, China Medical University, Taichung, 406040, Taiwan.
| |
Collapse
|
27
|
Espósito ACC, de Souza NP, Miot LDB, Miot HA. Deficit in autophagy: A possible mechanism involved in melanocyte hyperfunction in melasma. Indian J Dermatol Venereol Leprol 2021; 0:1-3. [PMID: 33871200 DOI: 10.25259/ijdvl_927_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
|
28
|
Lee AY. Skin Pigmentation Abnormalities and Their Possible Relationship with Skin Aging. Int J Mol Sci 2021; 22:ijms22073727. [PMID: 33918445 PMCID: PMC8038212 DOI: 10.3390/ijms22073727] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 12/13/2022] Open
Abstract
Skin disorders showing abnormal pigmentation are often difficult to manage because of their uncertain etiology or pathogenesis. Abnormal pigmentation is a common symptom accompanying aging skin. The association between skin aging and skin pigmentation abnormalities can be attributed to certain inherited disorders characterized by premature aging and abnormal pigmentation in the skin and some therapeutic modalities effective for both. Several molecular mechanisms, including oxidative stress, mitochondrial DNA mutations, DNA damage, telomere shortening, hormonal changes, and autophagy impairment, have been identified as involved in skin aging. Although each of these skin aging-related mechanisms are interconnected, this review examined the role of each mechanism in skin hyperpigmentation or hypopigmentation to propose the possible association between skin aging and pigmentation abnormalities.
Collapse
Affiliation(s)
- Ai-Young Lee
- Department of Dermatology, College of Medicine, Dongguk University Ilsan Hospital, 814 Siksa-dong, Ilsandong-gu, Goyang-si 410-773, Gyeonggi-do, Korea
| |
Collapse
|
29
|
Jeong D, Qomaladewi NP, Lee J, Park SH, Cho JY. The Role of Autophagy in Skin Fibroblasts, Keratinocytes, Melanocytes, and Epidermal Stem Cells. J Invest Dermatol 2021; 140:1691-1697. [PMID: 32800183 DOI: 10.1016/j.jid.2019.11.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 12/20/2022]
Abstract
Human skin acts as a barrier to protect our bodies from UV rays and external pathogens and to prevent water loss. Phenotypes of aging, or natural aging due to chronic damage, include wrinkles and the reduction of skin thickness that occur because of a loss of skin cell function. The dysregulation of autophagy, a lysosome-related degradation pathway, can lead to cell senescence, cancer, and various human diseases due to abnormal cellular homeostasis. Here, we discuss the roles and molecular mechanisms of autophagy involved in the anti-aging effects of autophagy and the relationship between autophagy and aging in skin cells.
Collapse
Affiliation(s)
- Deok Jeong
- Department of Integrative Biotechnology, Sungkyunkwan University, Suwon, Korea
| | | | - Jongsung Lee
- Department of Integrative Biotechnology, Sungkyunkwan University, Suwon, Korea; Department of Biocosmetics, Sungkyunkwan University, Suwon, Korea
| | - Sang Hee Park
- Department of Biocosmetics, Sungkyunkwan University, Suwon, Korea
| | - Jae Youl Cho
- Department of Integrative Biotechnology, Sungkyunkwan University, Suwon, Korea; Department of Biocosmetics, Sungkyunkwan University, Suwon, Korea.
| |
Collapse
|
30
|
Heissig B, Salama Y, Osada T, Okumura K, Hattori K. The Multifaceted Role of Plasminogen in Cancer. Int J Mol Sci 2021; 22:ijms22052304. [PMID: 33669052 PMCID: PMC7956603 DOI: 10.3390/ijms22052304] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 12/12/2022] Open
Abstract
Fibrinolytic factors like plasminogen, tissue-type plasminogen activator (tPA), and urokinase plasminogen activator (uPA) dissolve clots. Though mere extracellular-matrix-degrading enzymes, fibrinolytic factors interfere with many processes during primary cancer growth and metastasis. Their many receptors give them access to cellular functions that tumor cells have widely exploited to promote tumor cell survival, growth, and metastatic abilities. They give cancer cells tools to ensure their own survival by interfering with the signaling pathways involved in senescence, anoikis, and autophagy. They can also directly promote primary tumor growth and metastasis, and endow tumor cells with mechanisms to evade myelosuppression, thus acquiring drug resistance. In this review, recent studies on the role fibrinolytic factors play in metastasis and controlling cell-death-associated processes are presented, along with studies that describe how cancer cells have exploited plasminogen receptors to escape myelosuppression.
Collapse
Affiliation(s)
- Beate Heissig
- Immunological Diagnosis, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan;
- Correspondence: ; Tel.: +81-3-3813-3111
| | - Yousef Salama
- An-Najah Center for Cancer and Stem Cell Research, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus P.O. Box 7, Palestine;
| | - Taro Osada
- Department of Gastroenterology Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu-shi, Chiba 279-0021, Japan;
| | - Ko Okumura
- Immunological Diagnosis, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan;
| | - Koichi Hattori
- Center for Genomic & Regenerative Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan;
| |
Collapse
|
31
|
Kim AJ, Park JE, Cho YH, Lim DS, Lee JS. Effect of 7-Methylsulfinylheptyl Isothiocyanate on the Inhibition of Melanogenesis in B16-F1 Cells. Life (Basel) 2021; 11:life11020162. [PMID: 33672463 PMCID: PMC7923422 DOI: 10.3390/life11020162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/18/2022] Open
Abstract
Skin aging, characterized by hyperpigmentation, inflammation, wrinkles, and skin cancer, is influenced by intrinsic and extrinsic factors with synergistic effects. Autophagy maintains the homeostatic balance between the degradation, synthesis, and recycling of cellular proteins and organelles, and plays important roles in several cellular and biological processes, including aging. The compound 7-methylsulfinylheptyl isothiocyanate (7-MSI) is a sulfur-containing phytochemical produced by various plants, particularly cruciferous vegetables, with reported anti-inflammatory properties and a role in pathogen defense; however, its effects on skin whitening have not been studied in detail. The purpose of this study was to observe the effects of 7-MSI on skin whitening and autophagy in cultured murine melanoma (B16-F1) cells. Western blotting was used to evaluate the impact of 7-MSI on melanogenesis-, tyrosinase-, and autophagy-associated proteins. The levels of the melanogenesis-associated protein’s microphthalmia-associated transcription factor (MITF) and tyrosinase and tyrosinase-related protein-1 were decreased by treatment with 7-MSI under melanogenesis induction. Melanin synthesis also decreased by approximately 63% after treatment with 7-MSI for 73 h, compared with that non-treated controls. In addition, autophagosome formation and the expression levels of the autophagy-related proteins mTOR, p-mTOR, Beclin-1, Atg12, and LC3 were higher in 7-MSI-treated B16-F1 cells than in non-treated cells. These results indicate that 7-MSI can inhibit melanin synthesis in B16-F1 cells by suppressing melanogenesis and autophagy activation and thus can potentially be used as a novel multifunctional cosmetic agent.
Collapse
Affiliation(s)
- A-Ju Kim
- Department of Biomedical Science, College of Natural Sciences, Chosun University, Gwangju 61452, Korea; (A.-J.K.); (J.E.P.); (Y.H.C.); (D.S.L.)
| | - Jung Eun Park
- Department of Biomedical Science, College of Natural Sciences, Chosun University, Gwangju 61452, Korea; (A.-J.K.); (J.E.P.); (Y.H.C.); (D.S.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
| | - Yeong Hee Cho
- Department of Biomedical Science, College of Natural Sciences, Chosun University, Gwangju 61452, Korea; (A.-J.K.); (J.E.P.); (Y.H.C.); (D.S.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
| | - Do Sung Lim
- Department of Biomedical Science, College of Natural Sciences, Chosun University, Gwangju 61452, Korea; (A.-J.K.); (J.E.P.); (Y.H.C.); (D.S.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
| | - Jung Sup Lee
- Department of Biomedical Science, College of Natural Sciences, Chosun University, Gwangju 61452, Korea; (A.-J.K.); (J.E.P.); (Y.H.C.); (D.S.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
- Correspondence: ; Tel.: +82-62-230-6665
| |
Collapse
|
32
|
Yang HL, Lin CP, Vudhya Gowrisankar Y, Huang PJ, Chang WL, Shrestha S, Hseu YC. The anti-melanogenic effects of ellagic acid through induction of autophagy in melanocytes and suppression of UVA-activated α-MSH pathways via Nrf2 activation in keratinocytes. Biochem Pharmacol 2021; 185:114454. [PMID: 33545118 DOI: 10.1016/j.bcp.2021.114454] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/13/2022]
Abstract
Ellagic acid (EA) is a natural phenol antioxidant in different fruits, vegetables, and nuts. As a copper iron chelator from the tyrosinase enzyme's active site, EA was reported to inhibit melanogenesis in melanocytes. Here, we demonstrated the anti-melanogenic mechanisms of EA through autophagy induction in melanoma B16F10 cells and the role of Nrf2 and UVA (3 J/cm2)-activated α-melanocyte stimulating hormone (α-MSH) pathways in keratinocyte HaCaT cells. In vitro data showed that EA suppressed the tyrosinase activity and melanogenesis by suppressing cAMP-mediated CREB and MITF signaling mechanisms in α-MSH-stimulated B16F10 cells. ERK, JNK, and AKT pathways were involved in this EA-regulated MITF downregulation. Notably, EA induced autophagy in B16F10 cells was evidenced from increased LC3-II accumulation, p62/SQSTM1 activation, ATG4B downregulation, acidic vesicular organelle (AVO) formation, PI3K/AKT/mTOR inhibition, and Beclin-1/Bcl-2 dysregulation. Interestingly, 3-MA (an autophagy inhibitor) pretreatment or LC3 silencing (siRNA transfection) of B16F10 cells significantly reduced EA-induced anti-melanogenic activity. Besides this, in UVA-irradiated keratinocyte HaCaT cells, EA suppressed ROS production and α-MSH generation. Moreover, EA mediated the activation and nuclear translocation of Nrf2, leading to antioxidant γ-GCLC, HO-1, and NQO-1 protein expression in HaCaT cells. However, Nrf2 knockdown has significantly impaired this effect, and there was an uncontrolled ROS generation following UVA irradiation. JNK, PKC, and ROS pathways were involved in the activation of Nrf2 in HaCaT cells. In vivo experiments using the zebrafish model confirmed that EA inhibited tyrosinase activity and endogenous pigmentation. In conclusion, ellagic acid is an effective skin-whitening agent and might be used as a topical applicant.
Collapse
Affiliation(s)
- Hsin-Ling Yang
- Institute of Nutrition, College of Healthcare, China Medical University, Taichung 40402, Taiwan
| | - Chia-Pei Lin
- Department of Cosmeceutics, College of Pharmacy, China Medical University, Taichung 40402, Taiwan
| | | | - Pei-Jane Huang
- Department of Health and Nutrition Biotechnology, Asia University, Taichung 41354, Taiwan
| | - Wan-Lin Chang
- Department of Cosmeceutics, College of Pharmacy, China Medical University, Taichung 40402, Taiwan
| | - Sirjana Shrestha
- Institute of Nutrition, College of Healthcare, China Medical University, Taichung 40402, Taiwan
| | - You-Cheng Hseu
- Department of Cosmeceutics, College of Pharmacy, China Medical University, Taichung 40402, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung 41354, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan; Research Center of Chinese Herbal Medicine, China Medical University, Taichung 40402, Taiwan.
| |
Collapse
|
33
|
Anti-Melanogenic Effects of Ethanol Extracts of the Leaves and Roots of Patrinia villosa (Thunb.) Juss through Their Inhibition of CREB and Induction of ERK and Autophagy. Molecules 2020; 25:molecules25225375. [PMID: 33212959 PMCID: PMC7698407 DOI: 10.3390/molecules25225375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/16/2022] Open
Abstract
Patrinia villosa (Thunb.) Juss is a traditional herb commonly used in East Asia including Korea, Japan, and China. It has been administered to reduce and treat inflammation in Donguibogam, Korea. The mechanism for its anti-inflammatory effects has already been reported. In this study, we confirmed the efficacy of Patrinia villosa (Thunb.) Juss ethanol extract (Pv-EE) for inducing autophagy and investigate its anti-melanogenic properties. Melanin secretion and content were investigated using cells from the melanoma cell line B16F10. Pv-EE inhibited melanin in melanogenesis induced by α-melanocyte-stimulating hormone (α-MSH). The mechanism of inhibition of Pv-EE was confirmed by suppressing the mRNA of microphthalmia-associated transcription factor (MITF), decreasing the phosphorylation level of CREB, and increasing the phosphorylation of ERK. Finally, it was confirmed that Pv-EE induces autophagy through the autophagy markers LC3B and p62, and that the anti-melanogenic effect of Pv-EE is inhibited by the autophagy inhibitor 3-methyl adenine (3-MA). These results suggest that Pv-EE may be used as a skin protectant due to its anti-melanin properties including autophagy.
Collapse
|
34
|
Xing X, Chen L, Xu Z, Jin S, Zhang C, Xiang L. The efficacy and safety of topical tranexamic acid (liposomal or lotion with microneedling) versus conventional hydroquinone in the treatment of melasma. J Cosmet Dermatol 2020; 19:3238-3244. [PMID: 33091202 DOI: 10.1111/jocd.13810] [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] [Received: 07/19/2020] [Revised: 09/21/2020] [Accepted: 10/09/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Robust evidence regarding the efficacy of topical tranexamic acid (TA) on melasma in Chinese population is lacking. OBJECTIVE To evaluate the efficacy and safety of 1.8% liposomal TA and microneedling with 5% TA solution on melasma. METHODS Sixty melasma patients were enrolled and randomized to receive 1.8% liposomal TA twice daily, microneedling with 5% TA solution weekly or 2% hydroquinone every night. Objective and subjective assessments were obtained at baseline, 4, 8, and 12 weeks. RESULTS 27.8% of patients of liposomal TA group, 33.3% of microneedling with TA solution group, and 30.0% of hydroquinone group were recognized as "more than 50% improvement." At the endpoint, the melanin index (MI) in all treatment groups was significantly decreased, while the improvement of MI in microneedling with TA solution group and hydroquinone group is higher than liposomal TA group. The erythema index (EI) was significantly diminished in liposomal TA group and microneedling with TA solution group. Dermatoscopy and reflectance confocal microscopy revealed decreased brown granules in all groups and reduced telangiectasia in liposomal TA group and microneedling with TA solution group. CONCLUSION 1.8% liposomal TA and microneedling with 5% TA solution are both effective and safe on melasma.
Collapse
Affiliation(s)
- Xiaoxue Xing
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Chen
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongyi Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shanglin Jin
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Leihong Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
35
|
Tian X, Cui Z, Liu S, Zhou J, Cui R. Melanosome transport and regulation in development and disease. Pharmacol Ther 2020; 219:107707. [PMID: 33075361 DOI: 10.1016/j.pharmthera.2020.107707] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023]
Abstract
Melanosomes are specialized membrane-bound organelles that synthesize and organize melanin, ultimately providing color to the skin, hair, and eyes. Disorders in melanogenesis and melanosome transport are linked to pigmentary diseases, such as Hermansky-Pudlak syndrome, Chediak-Higashi syndrome, and Griscelli syndrome. Clinical cases of these pigmentary diseases shed light on the molecular mechanisms that control melanosome-related pathways. However, only an improved understanding of melanogenesis and melanosome transport will further the development of diagnostic and therapeutic approaches. Herein, we review the current literature surrounding melanosomes with particular emphasis on melanosome membrane transport and cytoskeleton-mediated melanosome transport. We also provide perspectives on melanosome regulatory mechanisms which include hormonal action, inflammation, autophagy, and organelle interactions.
Collapse
Affiliation(s)
- Xiaoyu Tian
- Institute of Biomedical Sciences, Shandong Provincial Key Laboratory of Animal Resistance Biology, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan 250014, China
| | - Ziyong Cui
- Harvard College, Cambridge, MA 02138, United States of America
| | - Song Liu
- Institute of Biomedical Sciences, Shandong Provincial Key Laboratory of Animal Resistance Biology, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan 250014, China
| | - Jun Zhou
- Institute of Biomedical Sciences, Shandong Provincial Key Laboratory of Animal Resistance Biology, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan 250014, China; State Key Laboratory of Medicinal Chemical Biology, College of Life Sciences, Nankai University, Tianjin 300071, China.
| | - Rutao Cui
- Skin Disease Research Institute, The 2nd Hospital, Zhejiang University, Hangzhou 310058, China.
| |
Collapse
|
36
|
Nakanishi S, Kurihara K, Denda M. Glutathione Counteracts the Effects of Japanese Cedar (Cryptomeria japonica) Pollen Allergen Cry j1. Biol Pharm Bull 2020; 43:1591-1594. [PMID: 32999169 DOI: 10.1248/bpb.b20-00264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Japanese cedar (Cryptomeria japonica) pollen allergen Cry j1 increases the intracellular calcium concentration in human keratinocytes, and also impairs the epidermal barrier function. Here, we show that reduced glutathione (GSH) blocks both thrombin activation and the Cry j1-induced intracellular calcium elevation in cultured human keratinocytes, and also prevents the Cry j1-induced decrease of barrier function in ex vivo human skin.
Collapse
|
37
|
Lim GE, Park JE, Cho YH, Lim DS, Kim AJ, Moh SH, Lee JH, Lee JS. Alpha-neoendorphin can reduce UVB-induced skin photoaging by activating cellular autophagy. Arch Biochem Biophys 2020; 689:108437. [PMID: 32526201 DOI: 10.1016/j.abb.2020.108437] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/13/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
Skin aging is influenced by several genetic, physiological, and environmental factors. In particular, ultraviolet (UV) exposure is an important factor involved in inducing skin photoaging. Autophagy controlling homeostatic balance between the synthesis, degradation, and recycling of cellular organelles and proteins plays important regulatory roles in several biological processes, including aging. The opioid neuropeptide α-neoendorphin (named NEP) is an endogenous decapeptide (N-YGGFLRKYPK-C) that activates the kappa opioid receptor and exhibits certain anti-aging and anti-wrinkling effects on skin cells; however, its action mechanism has not yet been elucidated. Therefore, the aim of this study was to determine the effects of NEP on anti-skin aging and autophagy activation in human dermal fibroblast cells. Western blot results showed that NEP down-regulates the production of phospho-mammalian target of rapamycin (p-mTOR), whereas increases the expression of key autophagy-related molecules such as Beclin-1, Atg5-Atg12, and LC3-II. The immunocytochemical analysis performed with anti-LC3-II antibody also showed that the autophagic indicators, autophagosomes are formed by NEP. These results suggest that NEP can activate cellular autophagy through mTOR-Beclin-1-mediated signaling pathway. It was also revealed by CM-H2DCF-DA assay and Western blottings that NEP can reduce the production of ultraviolet B (UVB)-induced reactive oxygen species (ROS) like with N-acetylcysteine (NAC), resulting in decreasing the expression levels of skin aging-related proteins, such as phospho-ERK (p-ERK), phospho-p38 (p-p38), and phospho-JNK (p-JNK). Furthermore, NEP could increase the type I procollagen production, while decreasing MMP-1, MMP-2, and MMP-9 activities. Taken together, the results demonstrate that NEP can reduce UVB-induced photoaging by activating autophagy.
Collapse
Affiliation(s)
- Ga-Eun Lim
- Department of Biomedical Science, BK21-plus Research Team for Bioactive Control Technology, National Research Center for Dementia, College of Natural Sciences, Chosun University, Gwangju, 61452, Republic of Korea
| | - Jung Eun Park
- Department of Biomedical Science, BK21-plus Research Team for Bioactive Control Technology, National Research Center for Dementia, College of Natural Sciences, Chosun University, Gwangju, 61452, Republic of Korea
| | - Yeong Hee Cho
- Department of Biomedical Science, BK21-plus Research Team for Bioactive Control Technology, National Research Center for Dementia, College of Natural Sciences, Chosun University, Gwangju, 61452, Republic of Korea
| | - Do Sung Lim
- Department of Biomedical Science, BK21-plus Research Team for Bioactive Control Technology, National Research Center for Dementia, College of Natural Sciences, Chosun University, Gwangju, 61452, Republic of Korea
| | - A-Ju Kim
- Department of Biomedical Science, BK21-plus Research Team for Bioactive Control Technology, National Research Center for Dementia, College of Natural Sciences, Chosun University, Gwangju, 61452, Republic of Korea
| | - Sang Hyun Moh
- Anti-aging Research Institute of BIO-FD&C Co. Ltd., Incheon, 21990, Republic of Korea
| | - Jeong Hun Lee
- Anti-aging Research Institute of BIO-FD&C Co. Ltd., Incheon, 21990, Republic of Korea
| | - Jung Sup Lee
- Department of Biomedical Science, BK21-plus Research Team for Bioactive Control Technology, National Research Center for Dementia, College of Natural Sciences, Chosun University, Gwangju, 61452, Republic of Korea.
| |
Collapse
|
38
|
Beclin 1 controls pigmentation by changing the nuclear localization of melanogenic factor MITF. Biochem Biophys Res Commun 2020; 528:719-725. [PMID: 32513537 DOI: 10.1016/j.bbrc.2020.05.118] [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] [Received: 04/24/2020] [Accepted: 05/15/2020] [Indexed: 11/21/2022]
Abstract
The primary contributor for the determination of skin color is melanin, a pigment that is produced in specialized cells called melanocytes. At cellular level, melanin synthesis occurs through several enzymes like tyrosinase (TYR) and tyrosinase related proteins and the expression of these proteins are regulated transcriptionally by microphthalmia associated transcription factor (MITF). Melanin pigmentation is a complex process finely regulated by different transcription factors, structural proteins and enzymes. In recent times, several autophagic genes have been implicated in the regulation of pigmentation. Though previous report observed a visible loss of coat-color in heterozygous Beclin 1 mice, the role of this protein in pigmentation is yet to study in details. In this present work we intend to study the role of Beclin 1, a central autophagic factor, in pigmentation. Using human melanoma cells and primary melanocytes, we showed that Beclin 1 downregulation significantly decreased the melanin content, tyrosinase activity and the expression of TYR and tyrosinase related protein 1 (TYRP1). These effects were recapitulated in a Beclin 1 knockdown in vivo model of zebrafish. Most importantly, re-expression of Beclin 1 rescued the pigmentation-associated defects both in cellular and in organismal level indicating the specificity. Surprisingly, Beclin 1 knockdown cells did not show significant changes in MITF expression but the nuclear localization of MITF was altered. Together, these data suggest that indeed Beclin 1 is associated with melanogenesis and this effect is more likely exerted through the subcellular distribution rather than the change in expression of MITF.
Collapse
|
39
|
Wuttikul K, Boonme P, Thammarat C, Khongkow P. N-acetylglucosamine microemulsions: Assessment of skin penetration, cytotoxicity, and anti-melanogenesis. J Cosmet Dermatol 2020; 20:304-309. [PMID: 32368847 DOI: 10.1111/jocd.13431] [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] [Received: 10/01/2019] [Revised: 01/15/2020] [Accepted: 04/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND N-acetylglucosamine (NAG) is an amino sugar which can reduce melanin production. NAG has previously been formulated for topical use in many nanocarrier systems, excluding microemulsions (MEs). In this study, NAG was prepared in the form of MEs and assessed in terms of skin permeability, cytotoxicity, and effectiveness for cosmetic applications. AIMS To investigate the skin penetration, cytotoxicity, and anti-melanogenesis of N-acetylglucosamine loaded microemulsions (NAG-MEs). METHODS Two NAG-MEs (NME1 and NME2) were prepared. The in vitro penetration study of NAG-MEs was evaluated by modified Franz diffusion cells using full-thickness porcine ear skin as the membrane. The optimized formula was then selected for further assessment of cytotoxicity and efficiency. In vitro cytotoxicity was examined using human keratinocytes (HaCaT cells) and B16 melanoma cells. Anti-melanogenic activity was investigated by determination of melanin production of B16 melanoma cells. RESULTS The cumulative amounts of NAG from NME1 and NME2 in the receptor fluid at 24 hours were 1010.46 ± 31.63 and 1260.99 ± 100.19 µg/cm2 and those accumulated in the skin membrane were 155.59 ± 19.19 and 181.11 ± 20.38 µg/cm2 , respectively. NME2 and its blank counterpart (Blank-ME2) showed no adverse effects on the viability of both HaCaT and B16 melanoma cells. The anti-melanogenic activity data showed that the NME2 treated B16 cells exhibited a significant melanin reduction. CONCLUSIONS NAG-MEs could allow NAG penetrate through and accumulate in full-thickness porcine ear skin. NME2 was safe for both normal human keratinocytes and melanoma cells. It also showed effectiveness on anti-melanogenic activity in B16 melanoma cells.
Collapse
Affiliation(s)
- Krisada Wuttikul
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand.,Drug Delivery System Excellence Center, Prince of Songkla University, Songkhla, Thailand
| | - Prapaporn Boonme
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand.,Drug Delivery System Excellence Center, Prince of Songkla University, Songkhla, Thailand
| | - Chayanee Thammarat
- Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pasarat Khongkow
- Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| |
Collapse
|
40
|
Lee JY, Lee J, Min D, Kim J, Kim HJ, No KT. Tyrosinase-Targeting Gallacetophenone Inhibits Melanogenesis in Melanocytes and Human Skin-Equivalents. Int J Mol Sci 2020; 21:ijms21093144. [PMID: 32365630 PMCID: PMC7246559 DOI: 10.3390/ijms21093144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 12/19/2022] Open
Abstract
Demands for safe depigmentation compounds are constantly increasing in the pharmaceutical and cosmetic industry, since the numerous relevant compounds reported to date have shown undesirable side effects or low anti-melanogenic effects. In this study, we reported three novel inhibitors of tyrosinase, which is the key enzyme in melanogenesis, identified using docking-based high throughput virtual screening of an in-house natural compound library followed by mushroom tyrosinase inhibition assay. Of the three compounds, gallacetophenone showed high anti-melanogenic effect in both human epidermal melanocytes and a 3D human skin model, MelanoDerm. The inhibitory effect of gallacetophenone on tyrosinase was elucidated by computational molecular modeling at the atomic level. Binding of gallacetophenone to the active site of tyrosinase was found to be stabilized by hydrophobic interactions with His367, Ile368, and Val377; hydrogen bonding with Ser380 and a water molecule bridging the copper ions. Thus, our results strongly suggested gallacetophenone as an anti-melanogenic ingredient that inhibits tyrosinase.
Collapse
Affiliation(s)
- Ji Young Lee
- Amorepacific Corporation R&D Center, Yongin City, Gyunggi-do 17074, Korea; (J.Y.L.); (D.M.); (J.K.)
- Department of Bioengineering, Yonsei University, Seoul 03722, Korea
| | - Jooyun Lee
- Bioinformatics and Molecular Design Research Center (BMDRC), Yonsei University, Incheon 21983, Korea;
| | - Daejin Min
- Amorepacific Corporation R&D Center, Yongin City, Gyunggi-do 17074, Korea; (J.Y.L.); (D.M.); (J.K.)
| | - Juewon Kim
- Amorepacific Corporation R&D Center, Yongin City, Gyunggi-do 17074, Korea; (J.Y.L.); (D.M.); (J.K.)
| | - Hyoung-June Kim
- Amorepacific Corporation R&D Center, Yongin City, Gyunggi-do 17074, Korea; (J.Y.L.); (D.M.); (J.K.)
- Correspondence: (H.-J.K.); (K.T.N.); Tel.: +82-31-280-5827 (H.-J.K.); +82-2-2123-5882 (K.T.N.)
| | - Kyoung Tai No
- Department of Bioengineering, Yonsei University, Seoul 03722, Korea
- Bioinformatics and Molecular Design Research Center (BMDRC), Yonsei University, Incheon 21983, Korea;
- Correspondence: (H.-J.K.); (K.T.N.); Tel.: +82-31-280-5827 (H.-J.K.); +82-2-2123-5882 (K.T.N.)
| |
Collapse
|
41
|
Zhao N, Su X, Wang Y, Chen J, Zhuang W. Traditional Chinese Herbal Medicine for Whitening. Nat Prod Commun 2020. [DOI: 10.1177/1934578x20905148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Melanin is the chief pigment responsible for the pigmentation of human skin. Increasing evidence indicates that traditional Chinese drugs with skin-whitening effects are attracting the attention of consumers and researchers because they are perceived to be milder, safer, and healthier than synthetic alternatives. This commentary summarizes the current research on Chinese herbal medicines that inhibit melanin and their biological activities. The findings presented in this study suggest that these traditional Chinese herbal medicines might be potential candidates for novel skin-whitening agents.
Collapse
Affiliation(s)
- Na Zhao
- Department of Molecular Biology Test Technique, College of Medical Technology, Beihua University, Jilin, China
| | - Xiaoming Su
- Department of Molecular Biology Test Technique, College of Medical Technology, Beihua University, Jilin, China
| | - Yueyang Wang
- Department of Molecular Biology Test Technique, College of Medical Technology, Beihua University, Jilin, China
| | - Jianguang Chen
- Department of Pharmacology, College of Pharmacy, Beihua University, Jilin, China
| | - Wenyue Zhuang
- Department of Molecular Biology Test Technique, College of Medical Technology, Beihua University, Jilin, China
| |
Collapse
|
42
|
Zhu JW, Ni YJ, Tong XY, Guo X, Wu XP, Lu ZF. Tranexamic Acid Inhibits Angiogenesis and Melanogenesis in Vitro by Targeting VEGF Receptors. Int J Med Sci 2020; 17:903-911. [PMID: 32308543 PMCID: PMC7163366 DOI: 10.7150/ijms.44188] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/06/2020] [Indexed: 01/08/2023] Open
Abstract
Melasma is a common but complex skin condition concerning cosmetic problems. Tranexamic acid (TA) has been proved to be effective in treatment of melasma with still unclear mechanisms. Here, we show that VEGF165 enhanced the expression of VEGF receptors (VEGFRs, including VEGFR-1, VEGFR-2 and NRP-1) in human umbilical vein endothelial cells (HUVECs), which was attenuated by TA. VEGF165 also promoted tyrosine phosphorylation of VEGFR-1 and VEGFR-2 in HUVECs, which was again abolished by TA. TA further showed similar effects to neutralization of VEGFR-1 and VEGFR-2 in inhibiting cell proliferation, migration, invasion and tube formation of HUVECs induced by VEGF165, suggesting that TA could inhibit angiogenesis by targeting VEGFRs in HUVECs. In addition, VEGF165 enhanced the expression of VEGFRs and promoted tyrosine phosphorylation of VEGFR-1 and VEGFR-2 in normal human melanocytes, which were also attenuated by TA. Furthermore, TA showed similar effects to neutralization of VEGFR-1 and VEGFR-2 in inhibiting tyrosinase activity, melanin production and even melanogenic proteins induced by VEGF165, suggesting that TA could reduce melanogenesis via inhibiting activation of VEGFRs and subsequent expression of melanogenic proteins in melanocytes. Taken together, we demonstrate that TA can inhibit angiogenesis and melanogenesis in vitro at least in part by targeting VEGFRs, which may offer a new understanding of the pathogenesis of melasma as well as the molecular mechanism for TA in treatment of the disease.
Collapse
Affiliation(s)
- Jian-Wei Zhu
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Ya-Jie Ni
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Xiao-Yun Tong
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Xia Guo
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Xiao-Ping Wu
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Zhong-Fa Lu
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88, Jiefang Rd., Hangzhou, 310009, Zhejiang Province, China
| |
Collapse
|
43
|
Santi MD, Peralta MA, Puiatti M, Cabrera JL, Ortega MG. Melanogenic inhibitory effects of Triangularin in B16F0 melanoma cells, in vitro and molecular docking studies. Bioorg Med Chem 2019; 27:3722-3728. [DOI: 10.1016/j.bmc.2019.06.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/04/2019] [Accepted: 06/26/2019] [Indexed: 12/16/2022]
|
44
|
Abstract
This year, many publications have focused on understanding, avoiding and treating vascular complications when injecting fillers. New protocols for the use of hyaluronidase have shown their effectiveness in preventing skin necrosis or blindness after vascular embolism when injecting hyaluronic acid. Other areas of interventional dermatology have been well documented: myomodulation is an interesting concept that describes the impact of the injection depth of a filler on muscle forces in order to correct the balances between the lowering and elevators during congenital or acquired defcits with aging. Treatment of melasma remains diffcult but the prescription of oral tranexamic acid could be useful. Botulinum toxin is expanding its feld of activity for both aesthetic and medical treatments. Pulsed dye laser remains the reference treatment for port wine stains, but the rate of recurrence by post laser neo-angiogenesis justifes the need of reliable and effective adjuvant treatments.
Collapse
Affiliation(s)
- C Raimbault
- Dermatologue libérale, 30, rue des Clercs, 57000 Metz, France, présidente du Groupe de dermatologie esthétique et correctrice (gDEC) de la Société française de dermatologie, past présidente de l'Association de dermatologie esthétique et laser de l'Est (ADELE).
| |
Collapse
|
45
|
WIPI1, BAG1, and PEX3 Autophagy-Related Genes Are Relevant Melanoma Markers. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:1471682. [PMID: 30622661 PMCID: PMC6304818 DOI: 10.1155/2018/1471682] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/09/2018] [Indexed: 01/07/2023]
Abstract
ROS and oxidative stress may promote autophagy; on the other hand, autophagy may help reduce oxidative damages. According to the known interplay of ROS, autophagy, and melanoma onset, we hypothesized that autophagy-related genes (ARGs) may represent useful melanoma biomarkers. We therefore analyzed the gene and protein expression of 222 ARGs in human melanoma samples, from 5 independent expression databases (overall 572 patients). Gene expression was first evaluated in the GEO database. Forty-two genes showed extremely high ability to discriminate melanoma from nevi (63 samples) according to ROC (AUC ≥ 0.85) and Mann-Whitney (p < 0.0001) analyses. The 9 genes never related to melanoma before were then in silico validated in the IST online database. BAG1, CHMP2B, PEX3, and WIPI1 confirmed a strong differential gene expression, in 355 samples. A second-round validation performed on the Human Protein Atlas database showed strong differential protein expression for BAG1, PEX3, and WIPI1 in melanoma vs control samples, according to the image analysis of 80 human histological sections. WIPI1 gene expression also showed a significant prognostic value (p < 0.0001) according to 102 melanoma patients' survival data. We finally addressed in Oncomine database whether WIPI1 overexpression is melanoma-specific. Within more than 20 cancer types, the most relevant WIPI1 expression change (p = 0.00002; fold change = 3.1) was observed in melanoma. Molecular/functional relationships of the investigated molecules with melanoma and their molecular/functional network were analyzed via Chilibot software, STRING analysis, and gene ontology enrichment analysis. We conclude that WIPI1 (AUC = 0.99), BAG1 (AUC = 1), and PEX3 (AUC = 0.93) are relevant novel melanoma markers at both gene and protein levels.
Collapse
|
46
|
Nakanishi S, Kumamoto J, Denda M. Tranexamic acid blocks the thrombin-mediated delay of epidermal permeability barrier recovery induced by the cedar pollen allergen, Cry j1. Sci Rep 2018; 8:15610. [PMID: 30353092 PMCID: PMC6199325 DOI: 10.1038/s41598-018-33898-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/05/2018] [Indexed: 11/09/2022] Open
Abstract
We previously demonstrated that Cry j1, the major pollen allergen of Cryptomeria japonica (Japanese cedar), transiently increases protease activity and intracellular Ca2+ concentration in cultured human keratinocytes, and delays recovery after stratum corneum barrier disruption in human skin ex vivo. Topical application of tranexamic acid or trypsin-type serine protease inhibitors accelerates barrier recovery. We hypothesized that tranexamic acid might prevent the transient protease activity increase and the barrier recovery delay induced by Cry j1. Here, we tested this hypothesis and examined the mechanism involved. In cultured human keratinocytes, knock-down of protease-activated receptor 1 (PAR-1) reduced the transient increase of calcium induced by Cry j1, whereas knock-down of PAR-2 did not. Knock-down of thrombin significantly reduced the transient increases of calcium concentration and protease activity. Tranexamic acid, soybean trypsin inhibitor, or bivalirudin (a thrombin inhibitor) also reduced the calcium elevation induced by Cry j1 and/or thrombin. Co-application of tranexamic acid or bivalirudin with Cry j1 to human skin ex vivo blocked the delay of barrier recovery. These results suggest that thrombin and PAR-1 or PAR-1-like receptor might mediate the adverse effects of Cry j1 on human epidermal keratinocytes, and could open up a new strategy for treating inflammatory skin diseases.
Collapse
Affiliation(s)
| | - J Kumamoto
- Research Institute for Electronic Science, Hokkaido University, Sapporo, Japan
| | - M Denda
- Shiseido Research Center, Yokohama, Japan
| |
Collapse
|
47
|
Xu Z, Xing X, Zhang C, Chen L, Flora Xiang L. A pilot study of oral tranexamic acid and Glycyrrhizin compound in the treatment of recalcitrant Riehl’s melanosis. J Cosmet Dermatol 2018; 18:286-292. [PMID: 30341831 DOI: 10.1111/jocd.12797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/20/2018] [Accepted: 09/17/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Zhongyi Xu
- Department of Dermatology Huashan Hospital, Fudan University Shanghai China
| | - Xiaoxue Xing
- Department of Dermatology Huashan Hospital, Fudan University Shanghai China
| | - Chengfeng Zhang
- Department of Dermatology Huashan Hospital, Fudan University Shanghai China
| | - Li Chen
- Department of Dermatology Huashan Hospital, Fudan University Shanghai China
| | | |
Collapse
|
48
|
Nahhas AF, Abdel-Malek ZA, Kohli I, Braunberger TL, Lim HW, Hamzavi IH. The potential role of antioxidants in mitigating skin hyperpigmentation resulting from ultraviolet and visible light-induced oxidative stress. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 35:420-428. [PMID: 30198587 DOI: 10.1111/phpp.12423] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/10/2018] [Accepted: 09/02/2018] [Indexed: 01/03/2023]
Abstract
Oxidative stress is an integral element that influences a variety of biochemical reactions throughout the body and is known to play a notable role in melanogenesis. Exogenous triggers of oxidative stress, such as ultraviolet radiation (UVR) and visible light (VL), lead to pigment formation through somewhat different pathways, but both share a common endpoint-the potential to generate cosmetically undesirable hyperpigmentation. Though organic and inorganic sunscreens are available to protect against the UVR portion of the electromagnetic spectrum, coverage is lacking to protect against the VL spectrum. In this manuscript, we review the phases of tanning, pathways of melanogenesis triggered by UVR and VL, and the associated impact of oxidative stress. We also discuss the known intrinsic mechanisms and paracrine regulation of melanocytes that influence their response to UVR. Understanding these mechanisms and their role in UVR-induced hyperpigmentation should potentially lead to identification of useful targets that can be coupled with antioxidant therapy to alleviate this effect.
Collapse
Affiliation(s)
- Amanda F Nahhas
- Department of Dermatology, Beaumont-Farmington Hills, Farmington Hills, Michigan.,Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - Indermeet Kohli
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | |
Collapse
|