Inhibition of Ultraviolet Radiation-Induced Skin Tumors in Hairless Mice by Topical Application of the Sunscreen 2-Ethyl Hexyl-P-Methoxycinnamate

Does Photosensitivity Predict Photococarcinogenicity?

Assessment of short-term and long-term effects of light (pho—totesting) is part of the safety evaluation of drugs. Results are incorporated into drug package inserts to advise patients and health care providers about the use of drug products on sun—exposed skin. We undertook an exhaustive literature search and a search of archived studies at the Center for Drug Evaluation and Research (CDER), Food and Drug Administration (FDA), in order to evaluate the potential of short—term photoassays to predict long—term effects of drugs used in sunlight (280–700 nm). The correlation between the findings from the photococarcinogenicity assays in mice that used exposure to simulated sunlight and those from photogenotoxicity and photosensitivity studies was examined. Results indicated that photosensitivity and photogenotoxicity assays did not necessarily predict effects in photococarcinogenicity studies in mice. Effects of drugs on skin that are not due to photoactivation of drug can be important factors in enhancement of UV—induced skin carcinogenesis.

Human Safety and Efficacy of Ultraviolet Filters and Sunscreen Products

Ultraviolet (UV) filters are the active ingredients in sunscreens. The concentration and combination of UV filters determine the efficacy of sunscreens as measured by sun protection factor. The safety of individual UV filters, and, more generally, sunscreen products, is a matter of a few related components: objective toxicologic evaluation, phototoxicologic potential, and human health consequences of using products that may reduce some but not all of the solar UV. Of 16 UV filters approved by the US Food and Drug Administration, 9 are used in different combinations in the most currently marketed sunscreens. Most of these compounds are considered safe and effective alone or in combination with other UV filters based on extensive toxicologic/phototoxicologic evaluations and market history. The benefits from proper use of sunscreens outweigh real or perceived human health concerns, establishing a favorable benefit-to-risk ratio. Future UV filters will require complete human safety evaluations alone and in combination with select benchmark ingredients.

Sunscreens Inadequately Protect Against Ultraviolet-A-Induced Free Radicals in Skin: Implications for Skin Aging and Melanoma?

Sunscreens are employed to mitigate the adverse effects of sunlight on skin but are primarily designed to prevent ultraviolet-B-associated burning and damage. The increasingly recognized role of ultraviolet A in aging, and possibly melanoma, highlights the need to include ultraviolet A screens; however, validation remains difficult. We have used a novel method to establish the efficacy of sunscreens, by measuring ultraviolet-A-induced free-radical production (thought to contribute towards ultraviolet-A-related aging and malignant change). Electron spin resonance spectroscopy was used to detect free radicals directly in human Caucasian skin during irradiation with levels of ultraviolet comparable to solar intensities. Using this system the protection afforded by three high factor sunscreens (sun protection factor 20+) that claim ultraviolet A protection was examined. Each sunscreen behaved similarly: at recommended application levels (> or = 2 mg per cm2) the ultraviolet-induced free radicals were reduced by only about 55%, and by about 45% at 0.5-1.5 mg per cm (0.5 mg per cm2 reported for common usage). A "free-radical protection factor" calculated on the basis of these results was only 2 at the recommended application level, which contrasts strongly with the erythema-based sun protection factors (mainly indicative of ultraviolet B protection) quoted by the manufacturers (20+). The disparity between these protection factors suggests that prolonged sunbathing (encouraged by use of these creams) would disproportionately increase exposure to ultraviolet A and consequently the risk of ultraviolet-A-related skin damage.

Inhibition of solar simulator-induced p53 mutations and protection against skin cancer development in mice by sunscreens

We demonstrated previously that p53 mutations can be detected in ultraviolet B-irradiated mouse skin months before the gross appearance of skin tumors and that applying sun protection factor 15 sunscreens to mouse skin before each Kodacel-filtered FS40 sunlamp irradiation resulted in the reduction of such mutations. To determine whether there is an association between reduction of ultraviolet-induced p53 mutations by sunscreens and protection against skin cancer using an environmentally relevant light source, we applied sunscreens (sun protection factors 15-22) on to the shaved dorsal skin of C3H mice 30 min before each exposure to 4.54 kJ ultraviolet B (290-400 nm) radiation per m2 from a solar simulator. Control mice were treated 5 d per wk with ultraviolet only or vehicle plus ultraviolet. p53 mutation analysis indicated that mice exposed to ultraviolet only or vehicle plus ultraviolet for 16 wk (cumulative exposure to 359 kJ ultraviolet B per m2) developed p53 mutations at a frequency of 56%-69%, respectively, but less than 5% of mice treated with sunscreens plus ultraviolet showed evidence of p53 mutations. More importantly, 100% of mice that received a cumulative dose of 1000 kJ ultraviolet B per m2 only, or vehicle plus ultraviolet B developed skin tumors, whereas, the probability of tumor development in all the mice treated with the sunscreens plus 1000 kJ ultraviolet B per m2 was 2% and mice treated with sunscreens plus 1500 kJ ultraviolet B per m2 was 15%. These results demonstrate that the sunscreens used in this study not only protect mice against ultraviolet-induced p53 mutations, but also against skin cancers induced with solar-simulated ultraviolet. Because of this association, we conclude that inhibition of p53 mutations is a useful early biologic endpoint of photoprotection against an important initiating event in ultraviolet carcinogenesis.

Sunscreen protection against ultraviolet radiation-induced pyrimidine dimers in mouse epidermal DNA

Pyrimidine dimers were measured in epidermal DNA of SKH:HR1 mice following exposure to solar-simulated UV radiation (SSUV, 290-400 nm) or to UVA (320-400 nm). Mice were exposed to SSUV or UVA after topical application (2 mg/cm2) of vehicle, a UVB absorber (5% 2-ethylhexyl p-methoxycinnamate [2-EHMC]), or a broad-spectrum UVA absorber (5% Mexoryl SX). The rates of induction of pyrimidine dimers in untreated animals were 5.4 +/- 0.57 x 10(-4) (mean +/- SEM) and 7.6 +/- 0.95 x 10(-6) dimers per 10(8) Da of epidermal DNA per J/m2 of SSUV and UVA, respectively. Topical application of Mexoryl SX reduced the rate of induction of pyrimidine dimers in SSUV-exposed animals to 4.7 +/- 0.44 x 10(-5) dimers per 10(8) Da per J/m2 for a dimer induction protection factor (PF) of 11.5 (5.4 x 10(-4)/4.7 x 10(-5). The rate of dimer induction in Mexoryl SX-treated, UVA-exposed mice was 0.95 +/- 0.2 x 10(-6) dimers per 10(8) Da per J/m2 (PF = 8.0). The 2-EHMC at a concentration of 5% (wt/wt) was significantly less effective than Mexoryl SX in preventing the induction of pyrimidine dimers in animals exposed to either SSUV or UVA. The rates of dimer induction in 2-EHMC-treated mice were 8.2 +/- 1.1 x 10(-5) and 3.8 +/- 0.33 x 10(-6) dimers per Da per J/m2 of SSUV (PF = 6.6) and UVA (PF = 2.0), respectively. Upon normalizing to the efficacy for edema induction, UVA induced approximately one-fourth the number of pyrimidine dimers per equivalent edematous response when compared to SSUV.

Sunscreen lotions prevent ultraviolet radiation-induced suppression of antitumor immune responses

Exposure to subcarcinogenic doses of ultraviolet (UV) radiation suppresses tumor immunity, thus permitting the emergence and growth of highly immunogenic skin cancers in mice. Sunscreens prevent UV carcinogenesis; however, there are conflicting reports regarding their ability to block UV-induced tumor immune suppression. In this study we critically evaluated the effects of UV spectrum and dose on the tumor immune protective capacity of 4 marketed sunscreen lotions with labeled sun protection factors (SPF) 8-45. Effective tumor immune suppression doses (TISD), i.e., the lowest dose tested to induce outgrowth of transplanted nonmelanoma skin tumors in 100% of UV-exposed C3H mice, were established for 3 different UV sources. TISD were significantly lower for unfiltered (FS) and Kodacel-filtered (KFS) UVB-type FS20 sunlamps compared with a filtered xenon arc lamp solar simulator. Sunscreen tumor immune protection levels matched those predicted by their labeled SPF when sunscreen-protected mice were exposed to a fixed TISD of solar simulator UV radiation. SPF 30 and 45 sunscreens also blocked activation of tumor antigen-specific suppressor T-lymphocytes in mice exposed to solar simulator UV radiation. In comparison, sunscreens with SPF > or = 15 provided partial to complete protection, as measured by tumor incidence, for mice exposed to UV radiation from KFS. All sunscreens tested reduced tumor growth rates in KFS UV-exposed mice. None of the sunscreens tested provided measurable tumor immune protection for mice exposed to FS UV radiation. Thus, sunscreen lotions provide an extent of tumor immune protection consistent with their labeled SPF when appropriate testing conditions are employed.

Mexoryl SX protects against solar-simulated UVR-induced photocarcinogenesis in mice

The aim of this study was to determine, for regulatory purposes, the potential of Mexoryl SX, a broad UVA absorber that also absorbs to some extent in the UVB, to modify the UV radiation (UVR)-induced murine skin tumor development and growth. Skh-hr1 mice were exposed to solar-simulated UVR 5 days per week for 40 weeks. Two control groups were irradiated without topical application, three groups received a sunscreen preparation containing either the UVA absorber, Mexoryl SX at 5 or 10% concentration, or a filter that absorbs principally in the UVB, 2-ethylhexyl-p-methoxycinnamate (2-EHMC) at 5% concentration, introduced as a comparator test article. Sunscreen application was performed before UVR exposure 3 days per week and after UVR exposure on the other 2 days (consistent with the design of a standard photocarcinogenesis safety test). Two different weekly UVR doses were administrated: the lower dose was given to one group of unprotected animals, whereas the higher dose was administrated to the other unprotected group and to the three sunscreen-treated groups. The two UVR control groups demonstrated a UVR-dependent response for cumulative tumor prevalence, tumor yield and median latent period. Neither concentration of Mexoryl SX increased the probability of tumor development; consistent with the principles for safety testing, this provides evidence in that it is safe for use in sunlight. Although this study was explicitly designed as a safety test, the results also provide some clues about the efficacy of Mexoryl SX in decreasing the probability of tumor development. Topical administration of Mexoryl SX, at both concentrations, resulted in a 6 week delay in the median latent period compared to high UVR controls, whereas 5% 2-EHMC delayed the median latent periods only by 2 weeks. Tumor prevalence and yield show the same efficacy differences between the two sunscreen ingredients. Tumor protection factors were calculated from these results and found to be equal to 2.4 for the two preparations containing Mexoryl SX and to 1.3 for the 5% 2-EHMC preparation. These findings illustrate the efficacy of Mexoryl SX in preventing UVR-induced carcinogenesis.

Sunscreens protect from UV-promoted squamous cell carcinoma in mice chronically irradiated with doses of UV radiation insufficient to cause edema

Previously we reported that the broad-spectrum sunscreen microfine titanium dioxide (MTD) could completely protect C3H/HeJ mice from UV radiation-induced immunosuppression to a contact sensitizer. In contrast, 2-ethylhexyl p-methoxycinnamate (2-EHMC), a UVB-absorbing sunscreen, only partially protected the skin immune system. In this study we investigated further this differential protection of the skin immune system by comparing the ability of 2-EHMC and MTD to protect these mice from the promotion phase of tumorigenesis. The mice were initiated using a single subcarcinogenic dose of 7,12-dimethylbenz(alpha)anthracene (DMBA) followed by promotion with chronic low-dose solar-simulated UV radiation for 32 weeks. We used doses of UV insufficient to cause edema in order to simulate daily human exposure to solar UV radiation. Mice were observed for the appearance of squamous cell carcinomas for 48 weeks. The DMBA-initiation alone and DMBA-initiated, sunscreen-treated groups did not develop tumors. Ultra-violet alone induced the appearance of tumors in 46% of mice at week 48 and therefore some tumors were initiated by UV. Initiation with DMBA prior to UV irradiation enhanced tumorigenesis such that 87% of mice at week 48 had tumors. Both 2-EHMC and MTD completely protected these mice from UV-induced promotion as well as from complete carcinogenesis despite the different UV-absorption spectra of the sunscreens and their differential abilities to protect from UV-induced immuno-suppression. Furthermore, we have shown that, if UV exposure is not increased to compensate for tolerance to edema, protection from tumorigenesis is afforded by sunscreens.

Relationship between the ability of sunscreens containing 2-ethylhexyl-4'-methoxycinnamate to protect against UVR-induced inflammation, depletion of epidermal Langerhans (Ia+) cells and suppression of alloactivating capacity of murine skin in vivo

The UVB sunscreen 2-ethylhexyl-4'-methoxycinnamate was evaluated in hairless albino mouse skin for its ability to inhibit UVR-induced (i) oedema, (ii) epidermal Langerhans cell (Ia+) depletion and (iii) suppression of the alloactivating capacity of epidermal cells (mixed epidermal cell-lymphocyte reaction, MECLR). The sunscreen, prepared at 9% in ethanol or a cosmetic lotion, was applied prior to UVB/UVA irradiation. In some experiments there was a second application halfway through the irradiation. Single applications in both vehicles gave varying degrees of protection from oedema and Langerhans cell depletion but afforded no protection from suppression of MECLR. When the sunscreens were applied twice there was improved protection from oedema and Langerhans cell depletion and complete protection was afforded from suppression of MECLR. There was a clear linear relationship between Langerhans cell numbers and oedema with and without sunscreen application. The relationship between Langerhans cell numbers and MECLR was more complex. These data confirm published discrepancies between protection from oedema (a model for human erythema) and endpoints with immunological significance, but show that 2-ethylhexyl-4'-methoxycinnamate can afford complete immunoprotection, although protection is dependent on the application rate and vehicle.

UV-A-mediated activity of p-methoxymethylcinnamate

Methyl esters of hydroxycinnamic acids are photobiologically active. Cis(Z) and trans(E) p-methoxymethyl-cinnamate photosensitize Escherichia coli and Chinese hamster ovary cells. They also produce sister chromatid exchanges. Photosensitization is oxygen independent, and the cinnamates are not genetically active in the absence of light in the Ames Salmonella typhimurium test.