Basic questions on toxicology and pharmacology of anthralin

Anthralin/dithranol in dermatology

Anthralin (1,8-dihydroxy-9anthrone, dithranol) was first synthesized as a derivative of chrysarobin, prepared from the araroba tree in Brazil over a century ago. Drawbacks to the use of anthralin include irritation and discoloration of the skin. This property of the molecule prompted workers to investigate details of its pharmacology, mode of action, and indications. The major point of this article is to highlight and revisit these aspects for pertinent future use. Therefore, it is worthwhile to consider that the drug is relatively innocuous, yet effective, and is devoid of any systemic side effects in contrast to a wide variety of systemic and topical therapies available for psoriasis and other dermatoses.

Antipsoriatic anthrones: aspects of oxygen radical formation, challenges and prospects

1. Antipsoriatic anthrones are among the most commonly used topical agents for the treatment of psoriasis. 2. These drugs generate reactive oxygen species during their auto-oxidation under physiological conditions. 3. Recent studies have indicated that activation of molecular oxygen by anthrones may play a critical role in their mechanism of action at the molecular level. 4. This article summarizes the evidence pointing toward the significance of oxygen activation and radical formation in the antipsoriatic action and induction of skin inflammation of anthrones. 5. Also, the role of oxygen radical formation in the development of novel anthrones devoid of inflammatory and staining properties is discussed.

Modification of DNA bases by anthralin and related compounds

Modification of bases in calf thymus DNA by treatment with the antipsoriatic drug anthralin was studied. The products of DNA bases were identified and their yields measured by gas chromatography-mass spectrometry with selected ion monitoring. Treatment of calf thymus DNA with anthralin significantly enhanced the amount of modified bases above control levels. Purine bases were modified to products identical with those known to be typical of DNA damage induced by hydroxyl radicals. The yields of Fapy-adenine, 8-hydroxyadenine, Fapy-guanine, and 8-hydroxyguanine were maximally increased at an anthralin concentration of 75 microM. A variety of structural analogues of anthralin were also tested at 75 microM were either weaker or stronger hydroxylating agents. It is likely that damage to DNA bases induced by anthrones contributes to their antiproliferative activity. The pharmacological implications of these characteristics of the action of anthralin on DNA bases are discussed.

Kinetic studies on anthralin photooxidation

The photooxidation of the antipsoriatic drug anthralin (1,8-dihydroxy-9-anthrone) has been studied by several kinetic techniques, including direct observation of 1O2 (1 delta g) luminescence at 1.27 microns. The rate of deactivation of 1O2 increases at higher pH, demonstrating that the trihydroxyanthracene anion is the reactive species. Direct determination of the rate constant of 1O2 deactivation (kR + kQ) in deuterated buffer systems by luminescence quenching gave a value of 3.0 x 10(8) M-1 s-1 for the anion; the neutral anthrone is unreactive. The rate constant for the neutral anthrone in benzene-d6 is 2.8 x 10(4) M-1 s-1. Competition experiments with tetramethylethylene in acetonitrile gave a rate constant for reaction alone (kR) of 2.1 x 10(8) M-1 s-1 for the anion.

Ligand-specific and non-specific in vivo modulation of human epidermal cellular retinoic acid binding protein (CRABP)

Retinoic acid (RA) is bound intracellularly by a specific, low molecular weight protein (CRABP), that is unrelated to its nuclear receptor and whose function and regulation are still unknown. In the present study we were able to obtain an in vivo modulation of CRABP by different stimuli in one of the major target organs of RA: the human skin. We found increased CRABP after daily application during 4 days of natural or synthetic retinoids (RA, acitretin, isotretinoin, Ro137410, retinol), that have either a high affinity to CRABP or can be transformed into RA. Only Ro150778 with no affinity and no reported transformation had no effect. No macro- or microscopical changes could be observed with any of the tested compounds. Induction of inflammatory and hyperproliferative changes in the skin by topical dithranol treatment, UVB irradiation or scotch tape stripping also induced a significant increase of CRABP 3 days after exposure. Topical diflucortolone showed not only a tendancy to decrease intrinsic CRABP levels, but significantly reduced the retinoid stimulated rise of CRABP. Thus we conclude that the increase of CRABP in a fully differentiated adult tissue seems to be a biological phenomenon following processes of inflammation and proliferation with a lag of several days, while retinoids seem to be able to induce such a rise independently of, or before, the appearance of such processes. Corticosteroids seem to be inhibitors of this reaction. We discuss the hypothesis that CRABP might function as an intracellular 'buffer' in the case of RA overload.

A microspectrofluorometric study of the effect of anthralin, an antipsoriatic drug, on cellular structures and metabolism

The microspectrofluorometric approach has been used to investigate in single living cells in culture fundamental questions raised by the use of anthralin, a potent antipsoriatic drug. This method allows fluorescence determinations on the intracellular fate of the drug as well as the recognition of structural and metabolic alterations induced by the drug. In the absence of demonstrable adduct formation with DNA, the antipsoriatic, i.e. antiproliferative effect of anthralin, has been attributed to its action at the level of mitochondria or at the level of glucose-6-phosphate dehydrogenase which initiates the pentose phosphate shunt (cf. its prominent role in nucleic acid synthesis). Upon addition of 2.3 to 23 microM anthralin to the L cell culture, the characteristic structure of the anthralin anion fluorescence spectrum is recognized almost immediately in the cytoplasm (much weaker in the nucleus) but disappears within minutes. The vital mitochondrial fluorescence probe dimethylaminostyryl-pyridinium-methyl-iodine reveals striking structural alterations of the mitochondria within 15 min after addition of the drug. At the same time, there is a stimulation of the transient NAD(P)+ reduction observed upon microinjection into the L cell of the Krebs' cycle substrate malate, or the pentose cycle substrate 6-phosphogluconate. Specially, the injection of the latter to anthralin-treated cells suggests that upon release of the mitochondrial control, there is a tremendous disruption of metabolic activity which could have profound consequences on the proliferative activity of the cell. These findings, while they open new possibilities for the intracellular evaluation of therapeutic agents, create also a challenge in understanding the complex and dynamic interrelationships between intracellular organelles and bioenergetic or biosynthetic pathways.

Anthralin inhibition of mouse epidermal arachidonic acid lipoxygenase in vitro

Epidermal strips, free of sebaceous gland and hair follicle contamination, were prepared from mouse tail skin. Epidermal homogenates synthesized prostaglandins and 12-hydroxy-5,8,10,14-eicosatetraenoic acid (12-HETE) from exogenously added [1-14C]arachidonic acid. The effects of pH, assay time, substrate concentration, and several selective inhibitors upon the lipoxygenase and cyclooxygenase pathways were determined. Ultracentrifugation of the crude homogenate at 105,000 g sedimented both activities, and pellet 12-HETE synthesis increased 2-fold relative to the crude homogenate. Recombination of the 105,000 g pellet and supernatant gave yields of prostaglandins and 12-HETE essentially equivalent to that of crude homogenate. When tested in homogenate with 4.5 microM arachidonic acid, anthralin specifically inhibited 12-HETE production with IC50 of 50.0 microM; no significant effect against cyclooxygenase was observed over the dose range of 2-200 microM. 1,8-Dihydroxy-9,10-anthraquinone (DHAQ) also specifically inhibited 12-HETE synthesis, but the dose response curve was flatter and maximum inhibition was only 55% at 200 microM. 6-Chloro-2,3-dihydroxy-1,4-naphthoquinone (CDNQ), an agent with topical antipsoriatic activity, also inhibited 12-HETE synthesis with an IC50 of 25 microM, but simultaneously stimulated prostaglandin production, up to 2.5-fold at 200 microM. When tested with washed human platelets, anthralin again specifically inhibited 12-HETE production with an IC50 of 10 microM, while DHAQ inhibited lipoxygenase activity by only 40% at 25 microM. When tested in platelets, CDNQ gave 33% inhibition of 12-HETE production at 200 microM, although prostaglandin synthesis was stimulated over the range of 25-200 microM. It is proposed that certain antipsoriatic agents may exert their action through modulation of arachidonic acid metabolism.

Anthralin: historical and current perspectives

Anthralin was first synthesized in 1916. Earlier, a natural product, chrysarobin, originally derived from the South American araroba tree, had been used to treat psoriasis. Anthralin was first used in Germany, and later in the Ingram regimen in Britain, but it has never been popular with American dermatologists. This is probably due to the side effects of staining and irritation of the skin. Attempts to reduce these using low concentration, short contact therapy, and concomitant steroid therapy, have been only partially successful. It may be that better instruction of patients and physicians will lead to wider use of this effective topical agent for the treatment of psoriasis. The mode of action of anthralin is thought to be either through its effect on deoxyribonucleic acid (DNA), probably mitochondrial DNA, which reduces cell turnover, or through its effects on various enzyme systems, including those of polyamine synthesis and respiration. The aims of this review are to discuss historical aspects of anthralin and to update its chemistry, pharmacology, and clinical usage.