Treatment of recalcitrant facial verrucae vulgares with sinecatechins (greentea catechins) ointment

Injectable catechin-based supramolecular hydrogel for highly efficient application in HPV-associated OSCC

Catechins are a group of natural polyphenols extracted from green tea. Notably, they have been proven to have excellent anti-HPV and anti-tumour properties and to be effective against some HPV-related diseases, showing great potential in the treatment of HPV-associated oral squamous cell carcinoma (HPV⁺ OSCC). However, the poor bioavailability, short half-lives, and stability issues of catechins hamper their clinical application. To overcome these shortcomings of catechins, we innovatively synthesised an injectable supramolecular hydrogel, namely catechin-phenylenebisboronic acid-isoguanosine (CPBisoG), with catechin (one of the simplest catechins) and isoguanosine (isoG), another natural product with self-assembly ability, via dynamic phenylborate diester bonds. The biodegradation and sustained-release time of the CPBisoG hydrogel in mice lasted up to 72 h. This supramolecular hydrogel not only functioned as a good local drug delivery platform with good stability, injectability, self-healing properties, biocompatibility, biodegradability, but also exhibited therapeutic effects toward HPV⁺ OSCC in vitro and in vivo. And interestingly, it also showed selective inhibition against HPV⁺ OSCC cells. In all, these results demonstrate that this catechin-based hydrogel could sustainedly and highly effectively treat HPV⁺ OSCC topically, which could also provide a promising strategy for the management of other HPV-associated diseases in the future.

Efficacy and Safety of Oral Green Tea Preparations in Skin Ailments: A Systematic Review of Clinical Studies

Green-tea-based products and their polyphenols, especially epigallocatechin-3-gallate, have attracted great attention over the years as possible nutraceuticals, due to their promising bioactivities, especially antioxidant and anti-inflammatory, which could be exploited in several diseases, including skin ailments. In this context, the present study aimed at reviewing clinical evidence about the benefits of the oral administration of green tea preparations and its polyphenols to relieve skin disorders, to point out the current knowledge, and to suggest possible novel strategies to effectively exploit the properties of green tea, also managing safety risks. To this end, a systematic review of the existing literature was carried out, using the PRISMA method. Few studies, including five focused on UV-induced erythema and skin alterations, three on photoaging, two on antioxidant skin defenses, and one on acne and genodermatosis, were retrieved. Despite several benefits, clinical evidence only supports the use of oral green tea preparations to protect skin from damage induced by ultraviolet radiation; in other cases, conflicting results and methodological limits of clinical trials do not allow one to clarify their efficacy. Therefore, their application as adjuvant or alternative sunscreen-protective interventions could be encouraged, in compliance with the safety recommendations.

Intralesional Immunotherapy with Measles-Mumps-Rubella Vaccine for Recalcitrant Facial Warts: A Report of Two Cases

Warts are common benign skin tumors caused by human papilloma viruses. Recalcitrant facial warts tend to be cosmetically embarrassing to patients and difficult to treat for doctors. Recently, intralesional immunotherapy by antigens like Bacille Calmette-Guerin vaccine, candida antigen, and measles, mumps, and rubella (MMR) vaccine has shown promising efficacy. Here, we report two cases of Omani men who presented with recalcitrant facial warts that resolved completely with a single intralesional injection of the MMR vaccine.

Applications of a Standardized Green Tea Catechin Preparation for Viral Warts and Human Papilloma Virus-Related and Unrelated Cancers

Most cell-based and animal experiments have shown that green tea catechins (GTC) exhibit various health benefits. In human experimental and epidemiological studies, there are conflicting results, and more precise investigations are required. One of the most effective ways to prove beneficial health effects in humans might be clinical intervention studies. Polyphenon^®E was developed as a standardized GTC preparation, which was approved by Food and Drug Administration of US in 2006 as a medication to treat genital warts (Veregen^® or sinecatechins). Positive efficacy of Polyphenon^®E/sinecatechins/Veregen^® (PSV) on anogenital warts has been demonstrated in several epidemiological studies and there have been several case reports to show the clinical effectiveness of PSV. In addition, several studies have provided evidence to suggest that PSV is effective in other human papillomavirus (HPV)-related diseases, although some studies failed to show such effects. Since (−)-epigallocatechin gallate (EGCG) is the major component of PSV, the mechanism of the action of PSV might be deduced from that of EGCG. The microarray analysis of the biopsy samples from the patients suggested that apoptosis induction and the downregulation of inflammation are involved in the mechanism of the action of PSV in the clearance of anogenital warts. Cell-based and animal experiments using PSV also demonstrated effects similar to those elicited by EGCG, explaining how PSV works to induce apoptosis and exert anti-inflammatory actions in HPV-related diseases. Future studies would clarify what kinds of diseases respond effectively to PSV, showing health benefits of GTC and EGCG in humans.

Sinecatechins ointment for the treatment of warts in children

BACKGROUND

Sinecatechins ointment, a green tea derivative, is a novel agent approved for the treatment of anogenital warts in immunocompetent adults and has been reported to be effective in treating extragenital warts as well. Data are lacking in children. We sought to determine the efficacy and tolerability of sinecatechins ointment for treating warts in children.

METHODS

A retrospective cohort study was conducted of children with anogenital and/or extragenital warts treated with sinecatechins ointment for at least 1 month. The primary outcome was frequency of complete response (total resolution of warts at follow-up). Secondary outcomes included frequency of partial response (reduction in number and/or size of warts) and adverse events. There was no control group for comparison.

RESULTS

Of 24 patients who met the inclusion criteria, 14 (58.3%) had anogenital warts, 7 (29.2%) had extragenital warts, and 3 (12.5%) had both anogenital and extragenital warts. Mean age at treatment initiation was 8.0 years (SD = 3.9). Median duration of warts at treatment initiation was 1.2 years (range 0.09-12.62). Sixteen patients (66.7%) experienced a reduction in the number and/or size of the warts. Four patients (16.7%) had complete resolution. Median treatment duration was 4.5 months (range 0.6-21.8) overall. Median time to complete resolution was 2.9 months (range 1.3-7.7). Fifty-four percent of patients used sinecatechins ointment as prescribed. Adverse events were limited to mild local irritation (7 patients; 29.2%).

CONCLUSION

Sinecatechins ointment is a promising therapy for warts in children, and its use should be evaluated in prospective controlled clinical trials.

Efficacy and Tolerability of Topical Green Tea Extract (Polyphenon E) Application in a "Therapy-Resistant" Plantar Wart

Plantar warts account for 30% of all cutaneous warts. These lesions could be very painful, especially if the lesion is located over pressure sites such as the metatarsal head. Plantar wart treatment remains a challenging therapeutic problem. A 67-year-old immunocompetent nonsmoking man presented with a large mosaic plantar wart on his right foot. The lesion had been present for 5 years. Several cryotherapy sessions (a total of 6 procedures) had been performed with no success. The lesion was therefore treated with a 5-fluorouracil (5-FU) regimen and then with a topical combination of 5-FU and salicylic acid, but also these approaches failed. At the initial visit, a large (16 cm²) mosaic wart lesion was present. Treatment with topical Polyphenon E, 10%, twice daily was prescribed and started. After 3 months of treatment, the lesion completely disappeared. Interestingly, no curettage or mechanical pickling of the hyperkeratotic parts of the lesion were performed before the start of the treatment. Local tolerability was evaluated as very good by the patient.