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Shahid A, Yeung S, Miwalian R, Mercado A, Andresen BT, Huang Y. Mitigation of Nitrogen Mustard-Induced Skin Injury by the β-Blocker Carvedilol and Its Enantiomers. J Pharmacol Exp Ther 2024; 388:495-505. [PMID: 37827703 PMCID: PMC10801755 DOI: 10.1124/jpet.123.001663] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023] Open
Abstract
The chemical warfare agent sulfur mustard and its structural analog nitrogen mustard (NM) cause severe vesicating skin injuries. The pathologic mechanisms for the skin injury following mustard exposure are poorly understood; therefore, no effective countermeasure is available. Previous reports demonstrated the protective activity of carvedilol, a US Food and Drug Administration (FDA)-approved β-blocker, against UV radiation-induced skin damage. Thus, the current study evaluated the effects of carvedilol on NM-induced skin injuries in vitro and in vivo. In the murine epidermal cell line JB6 Cl 41-5a, β-blockers with different receptor subtype selectivity were examined. Carvedilol and both of its enantiomers, R- and S-carvedilol, were the only tested ligands statistically reducing NM-induced cytotoxicity. Carvedilol also reduced NM-induced apoptosis and p53 expression. In SKH-1 mice, NM increased epidermal thickness, damaged skin architecture, and induced nuclear factor κB (NF-κB)-related proinflammatory genes as assessed by RT2 Profiler PCR (polymerase chain reaction) Arrays. To model chemical warfare scenario, 30 minutes after exposure to NM, 10 μM carvedilol was applied topically. Twenty-four hours after NM exposure, carvedilol attenuated NM-induced epidermal thickening, Ki-67 expression, a marker of cellular proliferation, and multiple proinflammatory genes. Supporting the in vitro data, the non-β-blocking R-enantiomer of carvedilol had similar effects as racemic carvedilol, and there was no difference between carvedilol and R-carvedilol in the PCR array data, suggesting that the skin protective effects are independent of the β-adrenergic receptors. These data suggest that the β-blocker carvedilol and its enantiomers can be repurposed as countermeasures against mustard-induced skin injuries. SIGNIFICANCE STATEMENT: The chemical warfare agent sulfur mustard and its structural analog nitrogen mustard cause severe vesicating skin injuries for which no effective countermeasure is available. This study evaluated the effects of US Food and Drug Administration (FDA)-approved β-blocker carvedilol on nitrogen mustard-induced skin injuries to repurpose this cardiovascular drug as a medical countermeasure.
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Affiliation(s)
- Ayaz Shahid
- Department of Biotechnology and Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Steven Yeung
- Department of Biotechnology and Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Rita Miwalian
- Department of Biotechnology and Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Angela Mercado
- Department of Biotechnology and Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Bradley T Andresen
- Department of Biotechnology and Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Ying Huang
- Department of Biotechnology and Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
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Jia S, Wang X, Wang G, Wang X. Mechanism and application of β-adrenoceptor blockers in soft tissue wound healing. Med Res Rev 2024; 44:422-452. [PMID: 37470332 DOI: 10.1002/med.21984] [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: 07/03/2022] [Revised: 06/01/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023]
Abstract
Soft tissue damage stimulates sympathetic nerves to release large amounts of catecholamine hormones which bind to β-adrenergic receptors (β-ARs) on the cell membrane surface. It activates the downstream effector molecules and impairs soft tissue wound healing. β-blockers specifically inhibit β-ARs activation in acute/chronic skin lesions and ulcerative hemangiomas. They also accelerate soft tissue wound healing by shortening the duration of inflammation, speeding keratinocyte migration and reepithelialization, promoting wound contraction and angiogenesis, and inhibiting bacterial virulence effects. In addition, β-blockers shorten wound healing periods in patients with severe thermal damage by reducing the hypermetabolic response. While β-blockers promote/inhibit corneal epithelial cell regeneration and restores limbal stem/progenitor cells function, it could well accelerate/delay corneal wound healing. Given these meaningful effects, a growing number of studies are focused on examining the efficacy and safety of β-blockers in soft tissue wound repair, including acute and chronic wounds, severe thermal damage, ulcerated infantile hemangioma, corneal wounds, and other soft tissue disorders. However, an intensive investigation on their acting mechanisms is imperatively needed. The purpose of this article is to summerize the roles of β-blockers in soft tissue wound healing and explore their clinical applications.
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Affiliation(s)
- Shasha Jia
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China
- School of Stomatology, Qingdao University, Qingdao, Shandong, People's Republic of China
| | - Xueya Wang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China
- School of Stomatology, Qingdao University, Qingdao, Shandong, People's Republic of China
| | - Guowei Wang
- Department of Stomatology, No. 971 Hospital of the Chinese Navy, Qingdao, Shandong, People's Republic of China
| | - Xiaojing Wang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China
- School of Stomatology, Qingdao University, Qingdao, Shandong, People's Republic of China
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Llamas-Molina JM, Ayén-Rodríguez Á, De la Torre-Gomar FJ. [Translated article] RF-Carvedilol and Its Applications in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T896-T898. [PMID: 37678634 DOI: 10.1016/j.ad.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/26/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- J M Llamas-Molina
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain.
| | - Á Ayén-Rodríguez
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
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Llamas-Molina JM, Ayén-Rodríguez Á, De la Torre-Gomar FJ. RF - Carvedilol and Its Applications in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:896-898. [PMID: 37356542 DOI: 10.1016/j.ad.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/26/2023] [Indexed: 06/27/2023] Open
Affiliation(s)
- J M Llamas-Molina
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España.
| | - Á Ayén-Rodríguez
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
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The β-Blocker Carvedilol Prevents Benzo(a)pyrene-Induced Lung Toxicity, Inflammation and Carcinogenesis. Cancers (Basel) 2023; 15:cancers15030583. [PMID: 36765542 PMCID: PMC9913110 DOI: 10.3390/cancers15030583] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/05/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
The current study evaluated the effects of the β-blocker carvedilol on benzo(a)pyrene (B(a)P) and its active metabolite benzo(a)pyrene diol epoxide (BPDE)-induced lung toxicity, inflammation and carcinogenesis and explored the potential mechanisms. Carvedilol blocked the BPDE-induced malignant transformation of human bronchial epithelial cells BEAS-2B. In BEAS-2B cells, B(a)P strongly activated ELK-1, a transcription factor regulating serum response element (SRE) signaling, which was attenuated by carvedilol. Carvedilol also inhibited the B(a)P-induced AhR/xenobiotic responsive element (XRE) and mRNA expression of CYP1A1 and attenuated B(a)P-induced NF-κB activation. In a B(a)P-induced acute lung toxicity model in CD-1/IGS mice, pretreatment with carvedilol for 7 days before B(a)P exposure effectively inhibited the B(a)P-induced plasma levels of lactate dehydrogenase and malondialdehyde, inflammatory cell infiltration and histopathologic abnormalities in the lung, and upregulated the expression of GADD45α, caspase-3 and COX-2 in the lung. In a B(a)P-induced lung carcinogenesis model in A/J mice, carvedilol treatment for 20 weeks did not affect body weight but significantly attenuated tumor multiplicity and volume. These data reveal a previously unexplored role of carvedilol in preventing B(a)P-induced lung inflammation and carcinogenesis by inhibiting the cross-talk of the oncogenic transcription factors ELK-1, AhR and NF-κB.
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Pihl C, Togsverd-Bo K, Andersen F, Haedersdal M, Bjerring P, Lerche CM. Keratinocyte Carcinoma and Photoprevention: The Protective Actions of Repurposed Pharmaceuticals, Phytochemicals and Vitamins. Cancers (Basel) 2021; 13:cancers13153684. [PMID: 34359586 PMCID: PMC8345172 DOI: 10.3390/cancers13153684] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Keratinocyte carcinoma is the most common type of cancer. Sun exposure and ultraviolet radiation are significant contributors to the development of carcinogenesis, mediated by DNA damage, increased oxidative stress, inflammation, immunosuppression and dysregulated signal transduction. Photoprevention involves using different compounds to delay or prevent ultraviolet radiation-induced skin cancer. In this review, we look at new avenues for systemic photoprevention that are based on pharmaceuticals, plant-derived phytochemicals and vitamins. We also investigate the mechanisms underlying these strategies for preventing the onset of carcinogenesis. Abstract Ultraviolet radiation (UVR) arising from sun exposure represents a major risk factor in the development of keratinocyte carcinomas (KCs). UVR exposure induces dysregulated signal transduction, oxidative stress, inflammation, immunosuppression and DNA damage, all of which promote the induction and development of photocarcinogenesis. Because the incidence of KCs is increasing, better prevention strategies are necessary. In the concept of photoprevention, protective compounds are administered either topically or systemically to prevent the effects of UVR and the development of skin cancer. In this review, we provide descriptions of the pathways underlying photocarcinogenesis and an overview of selected photoprotective compounds, such as repurposed pharmaceuticals, plant-derived phytochemicals and vitamins. We discuss the protective potential of these compounds and their effects in pre-clinical and human trials, summarising the mechanisms of action involved in preventing photocarcinogenesis.
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Affiliation(s)
- Celina Pihl
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
- Correspondence:
| | - Katrine Togsverd-Bo
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Flemming Andersen
- Department of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark; (F.A.); (P.B.)
- Private Hospital Molholm, 7100 Vejle, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Peter Bjerring
- Department of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark; (F.A.); (P.B.)
| | - Catharina Margrethe Lerche
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark; (K.T.-B.); (M.H.); (C.M.L.)
- Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
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Liang S, Shamim MA, Shahid A, Chen M, Cleveland KH, Parsa C, Orlando R, Andresen BT, Huang Y. Prevention of Skin Carcinogenesis by the Non-β-blocking R-carvedilol Enantiomer. Cancer Prev Res (Phila) 2021; 14:527-540. [PMID: 33648941 DOI: 10.1158/1940-6207.capr-20-0609] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/22/2021] [Accepted: 02/25/2021] [Indexed: 11/16/2022]
Abstract
Skin cancer is the most common malignancy worldwide and is rapidly rising in incidence, representing a significant public health challenge. The β-blocker, carvedilol, has shown promising effects in preventing skin cancer. However, as a potent β-blocker, repurposing carvedilol to an anticancer agent is limited by cardiovascular effects. Carvedilol is a racemic mixture consisting of equimolar S- and R-carvedilol, whereas the R-carvedilol enantiomer does not possess β-blocking activity. Because previous studies suggest that carvedilol's cancer preventive activity is independent of β-blockade, we examined the skin cancer preventive activity of R-carvedilol compared with S-carvedilol and the racemic carvedilol. R- and S-carvedilol were equally effective in preventing EGF-induced neoplastic transformation of the mouse epidermal JB6 Cl 41-5a (JB6 P+) cells and displayed similar attenuation of EGF-induced ELK-1 activity. R-carvedilol appeared slightly better than S-carvedilol against UV-induced intracellular oxidative stress and release of prostaglandin E2 from the JB6 P+ cells. In an acute UV-induced skin damage and inflammation mouse model using a single irradiation of 300 mJ/cm2 UV, topical treatment with R-carvedilol dose dependently attenuated skin edema and reduced epidermal thickening, Ki-67 staining, COX-2 protein, and IL6 and IL1β mRNA levels similar to carvedilol. In a chronic UV (50-150 mJ/cm2) induced skin carcinogenesis model in mice with pretreatment of test agents, topical treatment with R-carvedilol, but not racemic carvedilol, significantly delayed and reduced skin squamous cell carcinoma development. Therefore, as an enantiomer present in an FDA-approved agent, R-carvedilol may be a better option for developing a safer and more effective preventive agent for skin carcinogenesis. PREVENTION RELEVANCE: In this study, we demonstrated the skin cancer preventive activity of R-carvedilol, the non-β-blocking enantiomer present in the racemic β-blocker, carvedilol. As R-carvedilol does not have β-blocking activity, such a preventive treatment would not lead to common cardiovascular side effects of β-blockers.
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Affiliation(s)
- Sherry Liang
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Md Abdullah Shamim
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Ayaz Shahid
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Mengbing Chen
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Kristan H Cleveland
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Cyrus Parsa
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California.,Department of Pathology, Beverly Hospital, Montebello, California
| | - Robert Orlando
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California.,Department of Pathology, Beverly Hospital, Montebello, California
| | - Bradley T Andresen
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California
| | - Ying Huang
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, California.
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Topical Delivery of Carvedilol Loaded Nano-Transfersomes for Skin Cancer Chemoprevention. Pharmaceutics 2020; 12:pharmaceutics12121151. [PMID: 33260886 PMCID: PMC7761092 DOI: 10.3390/pharmaceutics12121151] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 02/07/2023] Open
Abstract
The β-blocker carvedilol has been shown to prevent skin carcinogenesis in vitro and in vivo. Since systemic absorption of the β-blocker may cause cardiovascular disturbance, we developed a carvedilol loaded transfersome for skin-targeted delivery. Transfersomes were prepared using phospholipids and surfactants at various ratios and characterized. One formulation (F18) selected for further analysis was composed of carvedilol, soy phosphatidylcholine, and Tween-80 at a ratio of 1:3:0.5, which had a particle size of 115.6 ± 8.7 nm, a zeta potential of 11.34 ± 0.67 mV, and an encapsulation efficiency of 93.7 ± 5.1%. F18 inhibited EGF-induced neoplastic transformation of mouse epidermal JB6 P+ cells at non-toxic concentrations, while only high concentrations induced cytotoxicity in JB6 P+ and human keratinocytes HaCaT. Compared to the free drug, F18 released through the dialysis membrane and permeated through the porcine ear skin at a slower rate, but similarly depositing the drug in the epidermis and dermis of the skin. Consistently, surface application of F18 on reconstructed full-thickness human skin showed slower drug permeation, while it suppressed ultraviolet-induced DNA damage, inflammatory gene expression, and apoptosis. These data indicate that transfersome is a promising topical delivery system of carvedilol for preventing ultraviolet-induced skin damage and carcinogenesis.
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Choi ME, Yoo H, Lee HR, Moon IJ, Lee WJ, Song Y, Chang SE. Carvedilol, an Adrenergic Blocker, Suppresses Melanin Synthesis by Inhibiting the cAMP/CREB Signaling Pathway in Human Melanocytes and Ex Vivo Human Skin Culture. Int J Mol Sci 2020; 21:ijms21228796. [PMID: 33233731 PMCID: PMC7699935 DOI: 10.3390/ijms21228796] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/02/2022] Open
Abstract
Catecholamines function via G protein-coupled receptors, triggering an increase in intracellular levels of 3′,5′-cyclic adenosine monophosphate (cAMP) in various cells. Catecholamine biosynthesis and the β-adrenergic receptor exist in melanocytes; thus, catecholamines may play critical roles in skin pigmentation. However, their action and mechanisms mediating melanogenesis in human skin have not yet been investigated. Therefore, we examined the potential anti-melanogenetic effect of carvedilol, a nonselective β-blocker with weak α1-blocking activities. Carvedilol reduced melanin content and cellular tyrosinase activity without compromising cellular viability in normal human melanocytes as well as in mel-Ab immortalized mouse melanocytes. Carvedilol downregulated microphthalmia-associated transcription factor (MITF), tyrosinase, tyrosinase-related protein (TRP)-1, and TRP-2. Carvedilol treatment led to the downregulation of phosphor-cAMP response element-binding protein (CREB). Moreover, the increase in cAMP levels upon treatment with forskolin reversed the anti-melanogenic action of carvedilol. In addition, carvedilol remarkably reduced the melanin index in ultraviolet-irradiated human skin cultures. Taken together, our results indicate that carvedilol effectively suppresses melanogenesis in human melanocytes and ex vivo human skin by inhibiting cAMP/protein kinase A/CREB signaling. The anti-melanogenic effects of carvedilol have potential significance for skin whitening agents.
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Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea; (M.E.C.); (H.Y.); (I.J.M.); (W.J.L.)
| | - Hanju Yoo
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea; (M.E.C.); (H.Y.); (I.J.M.); (W.J.L.)
- Bio-Medical Institute of Technology (BMIT), University of Ulsan College of Medicine, Ulsan 05505, Korea;
| | - Ha-Ri Lee
- Bio-Medical Institute of Technology (BMIT), University of Ulsan College of Medicine, Ulsan 05505, Korea;
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
| | - Ik Joon Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea; (M.E.C.); (H.Y.); (I.J.M.); (W.J.L.)
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea; (M.E.C.); (H.Y.); (I.J.M.); (W.J.L.)
| | - Youngsup Song
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
- Correspondence: (Y.S.); (S.E.C.); Tel.: +82-2-3010-2089 (Y.S.); +82-2-3010-3460 (S.E.C.)
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea; (M.E.C.); (H.Y.); (I.J.M.); (W.J.L.)
- Correspondence: (Y.S.); (S.E.C.); Tel.: +82-2-3010-2089 (Y.S.); +82-2-3010-3460 (S.E.C.)
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