Biochemical effects of unsaponifiable lipidic components of avocado and soya bean administered percutaneously on the connective tissue components of hairless rat skin

Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

Vulvar lichen sclerosus (VLS) is a chronic, distressing, inflammatory disease with an enormous impact on quality of life. Treatment goals are relieving symptoms, reversing signs and preventing anatomical changes. Despite the availability of numerous therapeutic options, treatment outcome may not be entirely satisfactory and a definitive cure does not exist. This may be due to the fact that the exact VLS etiopathogenesis remains unknown. The objectives of this paper were to review the most up-to-date knowledge on VLS etiopathogenesis and to consider the available therapies through the lens of a plausible pathogenetic model. An electronic search on both VLS etiopathogenesis and its treatment was performed using the National Library of Medicine PubMed database. Based on current knowledge, it is conceivable that various, heterogeneous environmental factors acting on a genetic background trigger an autoimmune, Th-1 response, which leads to a chronic inflammatory state. This, in turn, can determine both tissue and micro-vascular injury and activation of signaling pathways involved in fibroblast and collagen metabolism. This pathogenetic sequence may explain the effectiveness of anti-inflammatory treatments, mostly topical corticosteroids, in improving VLS clinical-pathological changes. Further deepening of the disease pathways will presumably allow key mediators to become new therapeutic targets and optimize the available treatments.

Avocado and soybean extracts as active principles in the treatment of mild-to-moderate vulvar lichen sclerosus: results of efficacy and tolerability

OBJECTIVE

Limited evidence is available on the effectiveness of treatments alternative to corticosteroids for vulvar lichen sclerosus (VLS). The present study aimed to assess the efficacy and tolerability of avocado and soybean extracts (ASE) as active principles of both a topical product and a nutritional supplement in the treatment of active mild-to-moderate VLS.

MATERIALS AND METHODS

Twenty-three patients were enrolled. Treatment consisted of a topical product containing ASE and other lenitive and anti-oxidant principles administered twice daily for 24 weeks, in association with a dietary supplement containing ASE, vitamin E and para-aminobenzoic acid for the first 12 weeks. The primary efficacy endpoint was the rate of patients achieving an improvement from baseline in global subjective score (GSS) and global objective score (GOS) of ≥ 75%. Secondary efficacy endpoint was the rate of patients achieving GSS50 and GOS50. Tertiary efficacy endpoint was the mean reduction in subjective and objective scores throughout the treatment.

RESULTS

By the end of the 24-week treatment, 12 (70.5% of symptomatic patients) and 13 patients (72.2%) achieved an improvement of at least 75% in subjective and objective global scores, respectively; 100% and 88.9% reached GSS50 and GOS50, respectively. Mean symptom and sign scores decreased significantly after treatment. The treatment was well tolerated.

CONCLUSIONS

Our results provide evidence that the topical and dietary supplements used in the study, which contain active principles exerting anti-inflammatory, anti-fibrotic, emollient and lenitive actions, are effective alternatives in the treatment of symptoms and signs of mild-to-moderate VLS.

Management of Osteoarthritis with Avocado/Soybean Unsaponifiables

Osteoarthritis (OA) is a painful and life-altering disease that severely limits the daily activity of millions of Americans, and is one of the most common causes of disability in the world. With obesity on the rise and the world's population living longer, the prevalence of OA is expected to increase dramatically in the coming decades, generating burdensome socioeconomic costs. This review summarizes current pharmaceutical, non-pharmaceutical, and prospective new treatments for OA, with primary focus on the dietary supplement Avocado/Soybean Unsaponifiables (ASU). ASU modulates OA pathogenesis by inhibiting a number of molecules and pathways implicated in OA. Anticatabolic properties prevent cartilage degradation by inhibiting the release and activity of matrix metalloproteinases (MMP-2,3,13) and increasing tissue inhibitors of these catabolic enzymes (TIMP-1). ASU also inhibits fibrinolysis by stimulating the expression of plasminogen activator inhibitor (PAI-1). Anabolic properties promote cartilage repair by stimulating collagen and aggrecan synthesis via inhibition of inflammatory cytokines such as IL1, IL6, IL8, TNF, ERK, and PGE2. Chondroprotective effects are mediated by correcting growth factor abnormalities, increasing TGFβ while decreasing vascular endothelial growth factor (VEGF) in synovial fluid. ASU also inhibits cholesterol absorption and endogenous cholesterol biosynthesis, which mediate reactive oxygen species pathology in chondrocytes. At the clinical level, ASU reduces pain and stiffness while improving joint function, resulting in decreased dependence on analgesics.

Effects of avocado and soya bean lipidic non-saponifiables on the components of skin connective tissue after topical application in the hairless rat: biophysical and biomechanical determination

Synopsis The non-saponifiable lipidic fractions of avocado and soya bean applied percutaneously to hairless rats for 15 days had been shown to produce biochemical modifications of dermal connective tissue components: increases of soluble collagen and of the ratio soluble collagen/insoluble collagen. In this present study, we tried to show whether these biochemical modifications could be confirmed by biophysical analytical methods and could affect the biochemical properties of the skin. The experiments were carried out on three groups of rats treated by application to the dorsal skin, either with 0.9% NaCl (control), or sweet almond oil (vehicle), or with a mixture of 2/3 soya bean and 1/3 avocado in solution at 5% of sweet almond oil (treated group). After 15 days treatment, the rats were killed and the skin of the treated area dissected. X-ray diffraction diagrams were recorded by varying the position of previously dried samples in controlled conditions. Results indicated that the vehicle decreased the orientation degree of collagen fibres, acting on their reticulation. The addition of the non-saponifiable fraction did not significantly add to the vehicle effect. The study of thermostability of the cutaneous collagen by differential scanning calorimetry showed that non-saponifiables increased the slope of the rise of temperature of denaturation. The quantity of heat absorbed during the denaturation (enthalpy variation) reached around 0.04 J mg(-1) of collagen in the control groups and did not exceed 0.03 J mg(-1) of collagen in the treated ones. Taken in conjunction with previous work it is probable that the non-saponifiables increase the proportion of soluble collagen. The elasticity of whole skin, determined by a static method using an Instron exten-siometer was significantly modified by treatment with non-saponifiables. They produced a decrease of the elasticity module. These results correspond to a decrease of collagen reticulation degree.

Non-saponifiable fraction of cocoa shell butter: effect on rat and human skin fibroblasts

Synopsis Non-saponifiable lipid fraction (ICSB) extracted from cocoa shell butter was solubilized in dimethylformamide (DMF) and analysed for its biological activity on growth of rat and human fibroblasts. Non-saponifiables (10 mug ml(-1)) partially protected cells from toxicity of DMF (1%) and allowed the growth of fibroblasts cultivated in optimal conditions (10% fetal calf serum-FCS, 37 degrees C) or improved the survival of cells maintained in altered conditions (2.5% FCS, 35 degrees C). At higher concentration (ICSB 50 mug ml(-1), DMF 1%), the protective effect was suppressed. ICSB was fractionated by chromatography into four compounds: sterols, terpenic alcohols, tocopherols and hydrocarbons +/- carotenoids. We found that biological activity of ICSB was mostly due to the major fraction containing sterols.

The effect of various avocado oils on skin collagen metabolism

The effects of various avocado oils on collagen metabolism in skin were studied in growing rats fed diets containing 10% (w/w) of the tested oils. Rats fed the unrefined avocado oil extracted with hexane from the intact fruit, its unsaponifiables or the avocado seed oil, showed significant increases in soluble collagen content in skin, though total collagen content was not affected. The increased soluble collagen content appears to be a consequence of the inhibition of lysyl oxidase activity. The active factor was found to be present in the unrefined avocado oil and probably originated from the avocado seed, since collagen metabolism was affected only by fractions which contained lipids fraction from the seed. In comparison rats fed the refined or unrefined soybean oils showed no effects.