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Ramos SC, Macfarlane MJ, Polton G. Isotretinoin treatment of 12 dogs with epitheliotropic lymphoma. Vet Dermatol 2022; 33:345-e80. [PMID: 35637167 DOI: 10.1111/vde.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Epitheliotropic lymphoma is an uncommon cutaneous malignancy of T lymphocytes. Limited information is available regarding the treatment and outcome of dogs with this disease. OBJECTIVES To evaluate the treatment outcome and toxicity profile of isotretinoin in dogs with epitheliotropic lymphoma. ANIMALS Twelve dogs with a diagnosis of epitheliotropic lymphoma were included. MATERIALS AND METHODS A medical database was searched for dogs diagnosed with epitheliotropic lymphoma and treated with isotretinoin between 2010 and 2021. Diagnosis, treatment details and tumour response were recorded for 12 dogs. RESULTS All lesions resolved in four of 12 (33%) treated dogs. Lesions visibly improved in a further three dogs, giving a response rate of 58%. Two dogs' lesions remained unchanged and three progressed despite therapy. Adverse effects occurred in three dogs (25%), all of which were rapidly resolving or not affecting quality of life. CONCLUSION Isotretinoin treatment was a well-tolerated and effective treatment for canine epitheliotropic lymphoma.
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Affiliation(s)
- Sofia Chichorro Ramos
- North Downs Specialist Referrals, 3 & 4 The Brewerstreet Dairy Business Park, Bletchingley, UK
| | - Michael John Macfarlane
- North Downs Specialist Referrals, 3 & 4 The Brewerstreet Dairy Business Park, Bletchingley, UK
| | - Gerry Polton
- North Downs Specialist Referrals, 3 & 4 The Brewerstreet Dairy Business Park, Bletchingley, UK
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2
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Ayhan E, Aslan Ö, Araç E. Effect of isotretinoin (13-cis-retinoic acid) on levels of soluble VEGF receptors (sVEGFR1, sVEGFR2, sVEGFR3) in patients with acne vulgaris. J DERMATOL TREAT 2020; 32:936-940. [PMID: 32043381 DOI: 10.1080/09546634.2020.1729331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background/aim: The effect of isotretinoin on soluble VEGFRs has not been previously investigated. This study evaluate the effects of isotretinoin (13-cis-retinoic acid) on soluble VEGFR1 (sVEGFR1), soluble VEGFR2 (sVEGFR2) and soluble VEGFR3 (sVEGFR3).Methods: The study included 38 patients (28 females, 10 males) receiving systemic isotretinoin treatment and 38 healthy individuals (28 females, 10 males) with similar age and gender characteristics. The blood samples of the patient group at third months and blood samples of the control group were compared in terms of sVEGFR1, sVEGFR2 and sVEGFR3 concentrations.Results: It was significant that sVEGFR1 was low and sVEGFR3 was high in patients receiving isotretinoin (p: .038, p: .021, respectively). There was no significant change in sVEGFR2 levels between the groups (p: .519).Conclusions: We think that the effect of isotretinoin on sVEGFR1, sVEGFR2 and sVEGFR3 may be secondary to its effects on the VEGF family. However, after clarifying the effect of isotretinoin on the VEGF family, we think that it can be used in some tumors and vascular diseases.
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Affiliation(s)
- Erhan Ayhan
- Department of Dermatology, University of Health Sciences Gazi Yaşargil Trainning and Research Hospital, Diyarbakır, Turkey
| | - Özgür Aslan
- Department of Biochemistry, University of Health Sciences Gazi Yaşargil Trainning and Research Hospital, Diyarbakır, Turkey
| | - Eşref Araç
- Department of Internal Medicine, University of Health Sciences Gazi Yaşargil Trainning and Research Hospital, Diyarbakır, Turkey
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3
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Peterson E, Weed J, Lo Sicco K, Latkowski JA. Cutaneous T Cell Lymphoma: A Difficult Diagnosis Demystified. Dermatol Clin 2020; 37:455-469. [PMID: 31466586 DOI: 10.1016/j.det.2019.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cutaneous T cell lymphoma (CTCL) represents a heterogeneous group of extranodal non-Hodgkin lymphomas in which monoclonal T lymphocytes infiltrate the skin. The mechanism of CTCL development is not fully understood, but likely involves dysregulation of various genes and signaling pathways. A variety of treatment modalities are available, and although they can induce remission in most patients, the disease may recur after treatment cessation. Owing to relatively low incidence and significant chronicity of disease, and the high morbidity of some therapeutic regimens, further clinical trials are warranted to better define the ideal treatment option for each subtype of CTCL.
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Affiliation(s)
- Erik Peterson
- The Ronald O. Perelman Department of Dermatology, 240 East 38th Street, 11th Floor, New York, New York 10016, USA
| | - Jason Weed
- The Ronald O. Perelman Department of Dermatology, 240 East 38th Street, 11th Floor, New York, New York 10016, USA
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, 240 East 38th Street, 11th Floor, New York, New York 10016, USA
| | - Jo-Ann Latkowski
- The Ronald O. Perelman Department of Dermatology, 240 East 38th Street, 11th Floor, New York, New York 10016, USA; New York Harbor VA Healthcare System, Dermatology Residency Training Program.
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4
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Iwahashi Y, Kasa Y, Uno H, Nakada T. Pseudolymphoma successfully treated by etretinate. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2019. [DOI: 10.1002/cia2.12074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Yuriko Iwahashi
- Department of Dermatology Showa University Fujigaoka Hospital Yokohama Kanagawa Japan
| | - Yurina Kasa
- Department of Dermatology Showa University Fujigaoka Hospital Yokohama Kanagawa Japan
| | - Hirokazu Uno
- Department of Dermatology Showa University Fujigaoka Hospital Yokohama Kanagawa Japan
| | - Tokio Nakada
- Department of Dermatology Showa University Fujigaoka Hospital Yokohama Kanagawa Japan
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Lee GW, Song SB, Kang MH, Park HM. Clinical response to isotretinoin and interferon-α of two dogs with cutaneous epitheliotropic T-cell lymphoma: a case report. BMC Vet Res 2018; 14:382. [PMID: 30514314 PMCID: PMC6278019 DOI: 10.1186/s12917-018-1710-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no specific therapy for cutaneous epitheliotropic T-cell lymphoma (CETL). The administration of retinoids in conjunction with interferon-α (IFN-α) in CETL has not been reported in dogs. CASE PRESENTATION Two dogs (Shih tzu and Miniature pinscher) presented with multiple nodular skin lesions. Histopathological examination revealed diffuse infiltrations of lymphocytes in the epidermis and dermis, with a CD3-positive immunophenotypic profile. Based on the clinical and histopathological examination, CETL was diagnosed. Both dogs were treated with isotretinoin in combination with IFN-α and showed clinical improvement with complete or partial remission. The disease in these dogs was well-controlled for more than 264 days of overall median survival time without any additional clinical signs after initiation of the treatment. In both the cases, the dogs were followed up for 27 months, and 10 months without any evidence of recurrence or metastasis, respectively. CONCLUSIONS We describe the clinical efficacy of isotretinoin combined with IFN-α in 2 dogs with CETL. Long-term management with isotretinoin combined with IFN-α was effective in treating CETL in these cases.
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Affiliation(s)
- Ga-Won Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, # 1 Hwayang-dong, Gwang-jin-gu, Seoul, 143-701 South Korea
| | - Su-Bin Song
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, # 1 Hwayang-dong, Gwang-jin-gu, Seoul, 143-701 South Korea
| | - Min-Hee Kang
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, # 1 Hwayang-dong, Gwang-jin-gu, Seoul, 143-701 South Korea
| | - Hee-Myung Park
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, # 1 Hwayang-dong, Gwang-jin-gu, Seoul, 143-701 South Korea
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6
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Gray GM, Ma N, Wagner CE, van der Vaart A. Molecular dynamics simulations and molecular flooding studies of the retinoid X-receptor ligand binding domain. J Mol Model 2017; 23:98. [PMID: 28251414 DOI: 10.1007/s00894-017-3260-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 01/30/2017] [Indexed: 02/04/2023]
Abstract
Bexarotene is an FDA approved retinoid X-receptor (RXR) agonist for the treatment of cutaneous T-cell lymphoma, and its use in other cancers and Alzheimer's disease is being investigated. The drug causes serious side effects, which might be reduced by chemical modifications of the molecule. To rationalize known agonists and to help identify sites for potential substitutions we present molecular simulations in which the RXR ligand-binding domain was flooded with a large number of drug-like molecules, and molecular dynamics simulations of a series of bexarotene-like ligands bound to the RXR ligand-binding domain. Based on the flooding simulations, two regions of interest for ligand modifications were identified: a hydrophobic area near the bridgehead and another near the fused ring. In addition, positional fluctuations of the phenyl ring were generally smaller than fluctuations of the fused ring of the ligands. Together, these observations suggest that the fused ring might be a good target for the design of higher affinity bexarotene-like ligands, while the phenyl ring is already optimized. In addition, notable differences in ligand position and interactions between the RXRα and RXRβ were observed, as well as differences in hydrogen bonding and solvation, which might be exploited in the development of subspecies-specific ligands.
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Affiliation(s)
- Geoffrey M Gray
- Department of Chemistry, University of South Florida, 4202 E. Fowler Ave. CHE 205, Tampa, FL, 33620, USA
| | - Ning Ma
- Department of Chemistry, University of South Florida, 4202 E. Fowler Ave. CHE 205, Tampa, FL, 33620, USA
| | - Carl E Wagner
- School of Mathematical and Natural Sciences, New College of Interdisciplinary Arts & Sciences, Arizona State University, 4701 W. Thunderbird Rd., Glendale, AZ, 85306, USA
| | - Arjan van der Vaart
- Department of Chemistry, University of South Florida, 4202 E. Fowler Ave. CHE 205, Tampa, FL, 33620, USA.
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7
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Huen AO, Kim EJ. The Role of Systemic Retinoids in the Treatment of Cutaneous T-Cell Lymphoma. Dermatol Clin 2015; 33:715-29. [PMID: 26433844 DOI: 10.1016/j.det.2015.05.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Retinoids are natural and synthetic vitamin A analogs with effects on cell proliferation, differentiation, and apoptosis. They have significant activity in hematologic malignancies and have been studied extensively in cutaneous T-cell lymphoma. Retinoids bind to nuclear receptors and exert their effects through moderation of gene expression. Retinoic acid receptor and retinoic X receptor exert regulatory activity in vivo, binding to distinct ligands. Studies investigating systemic retinoids as monotherapy and in combination with other agents active against cutaneous lymphoma are reviewed. Side effects associated with retinoids include teratogenicity, dyslipidemias, and hypothyroidism, which should be carefully monitored in patients receiving treatment.
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Affiliation(s)
- Auris O Huen
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Suite 330S, Philadelphia, PA 19104, USA
| | - Ellen J Kim
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Suite 330S, Philadelphia, PA 19104, USA.
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8
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Sokołowska-Wojdyło M, Ługowska-Umer H, Maciejewska-Radomska A. Oral retinoids and rexinoids in cutaneous T-cell lymphomas. Postepy Dermatol Alergol 2013; 30:19-29. [PMID: 24278042 PMCID: PMC3834697 DOI: 10.5114/pdia.2013.33375] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 06/30/2012] [Accepted: 09/23/2012] [Indexed: 12/26/2022] Open
Abstract
Retinoids are biologically active derivatives of vitamin A modulating cell proliferation, differentiation, apoptosis and altering the immune response. They have been used for years in therapy of cutaneous T-cell lymphomas (CTCL) but the exact mechanism of retinoids' action is unclear. It is based on the presence of specific receptors' families, mediating the biological effects of retinoids on the tumor cells: retinoic acid receptor (RAR) and retinoic X receptor (RXR). Orally administrated bexarotene, the first synthetic selective RXR retinoid, was revealed to be active against the cutaneous manifestation of CTCL. The toxicity profile caused by bexarotene seems to be more limited to laboratory values and better tolerated than classical retinoids, but generally associated with more severe grades of toxicity. Both selective retinoic acid receptor- and retinoic X receptor-mediated retinoids have modest objective response rates and, therefore, most likely will have limited impact as monotherapeutic agents. However, the immunomodulatory effects of RAR and RXR retinoids provide a rational basis for using retinoids in combination with other biologic immune response modifiers, phototherapy and radiotherapy. The authors reviewed the literature on the results of the use of retinoids and rexinoids in patients with mycosis fungoides and Sézary syndrome.
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Affiliation(s)
- Małgorzata Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Poland. Head: Prof. Roman Nowicki MD, PhD
| | - Hanna Ługowska-Umer
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Poland. Head: Prof. Roman Nowicki MD, PhD
| | - Agata Maciejewska-Radomska
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Varmia and Masuria, Olsztyn, Poland. Head: Prof. Waldemar Placek MD, PhD
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9
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Coors EA, von den Driesch P. Treatment of 2 patients with mycosis fungoides with alitretinoin. J Am Acad Dermatol 2012; 67:e265-7. [DOI: 10.1016/j.jaad.2012.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 05/02/2012] [Accepted: 05/08/2012] [Indexed: 11/25/2022]
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10
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Trautinger F. Phototherapy of mycosis fungoides. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2011; 27:68-74. [PMID: 21392108 DOI: 10.1111/j.1600-0781.2011.00559.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND/PURPOSE Among the primary cutaneous T-cell lymphomas, mycosis fungoides (MF) is the most common disease entity. Recently, an improved understanding of the pathology, clinical presentation, and prognosis of MF has lead to the development of new and practically useful classification and staging systems. In most patients, MF presents with patches and plaques and remains confined to the skin for years and decades, making it an ideal target for phototherapy. However, treatment schedules vary widely and this review describes the current knowledge about phototherapy of MF focusing mainly on narrow- and broadband UVB and 8-methoxypsoralen plus UVA, its indications, practical aspects, and clinical outcome. METHODS Review and summary of the pertinent literature. RESULTS AND CONCLUSIONS Since 1976, when the first report on phototherapy for MF was published, sufficient evidence has accumulated to make narrowband UVB and PUVA safe and effective treatment options for early stages of the disease. In refractory cases or more advanced stages, combination of phototherapy with systemic treatments including mainly interferons and retinoids might be valuable. Additional research is required to further define the optimal treatment schedules and the role of maintenance.
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Affiliation(s)
- Franz Trautinger
- Karl Landsteiner Institute for Dermatological Research, St. Pölten, Austria.
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11
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Abstract
AbstractThe most common subtypes of primary cutaneous T-cell lymphomas are mycosis fungoides (MF) and Sézary syndrome (SS). The majority of patients have indolent disease; and given the incurable nature of MF/SS, management should focus on improving symptoms and cosmesis while limiting toxicity. Management of MF/SS should use a “stage-based” approach; treatment of early-stage disease (IA-IIA) typically involves skin directed therapies that include topical corticosteroids, phototherapy (psoralen plus ultraviolet A radiation or ultraviolet B radiation), topical chemotherapy, topical or systemic bexarotene, and radiotherapy. Systemic approaches are used for recalcitrant early-stage disease, advanced-stage disease (IIB-IV), and transformed disease and include retinoids, such as bexarotene, interferon-α, histone deacetylase inhibitors, the fusion toxin denileukin diftitox, systemic chemotherapy including transplantation, and extracorporeal photopheresis. Examples of drugs under active investigation include new histone deacetylase inhibitors, forodesine, monoclonal antibodies, proteasome inhibitors, and immunomodulatory agents, such as lenalidomide. It is appropriate to consider patients for novel agents within clinical trials if they have failed front-line therapy and before chemotherapy is used.
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12
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Williams LE, Rassnick KM, Power HT, Lana SE, Morrison-Collister KE, Hansen K, Johnson JL. CCNU in the Treatment of Canine Epitheliotropic Lymphoma. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb02833.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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Kempf W, Kettelhack N, Duvic M, Burg G. Topical and systemic retinoid therapy for cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 2003; 17:1405-19. [PMID: 14710892 DOI: 10.1016/s0889-8588(03)00107-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Because curative therapies for CTCL are not yet available, short of TSEB in patients who have early-stage disease and allogeneic bone marrow transplantation in patients who have more advanced disease, the goal of current therapies is to prevent progression of MF and to preserve quality of life. The overall conclusion drawn from the studies reported in the literature, is that retinoids as monotherapy, or in combination with other nonaggressive treatment modalities, represent a low-risk treatment alternative that is especially suitable for controlling early stages of MF and other CTCL. A combination of therapies may be more effective in controlling CTCL as shown with IFN-alpha plus retinoids, and, recently, IFN-alpha with bexarotene and other modalities. For example, isotretinoin, followed by TSEB (for stage I to II disease) or preceded by chemotherapy (for stage II and IV disease) and bexarotene plus PUVA or photopheresis plus IFN, gave overall response rates of 82% and 69% in patients who had MF and SS, respectively. Retinoids as monotherapy may induce complete remissions, but usually these responses are of short duration and relapses are common. Clinical response is not identical to histologic clearance. Even in cases with clinically complete clearance of skin lesions, lymphoid infiltrates persisted, which are most likely the source of recurrences. The new generation of retinoids, the RXR selective agonists like bexarotene, represent a promising approach for refractory or persistent MF that is unresponsive to first-line therapies. Individual differences in response to retinoids may be due to different expression of retinoid receptors, functional polymorphisms in metabolizing retinoids, or resistance to some retinoids. In the future, pharmacogenomic studies are needed to clarify the mechanisms that underlie the differing response rates of patients who have CTCL to retinoids. In addition, new agonists of RAR and RXR, either selective or pan agonists, will become available and will enlarge the spectrum of vitamin A analogs that have antitumoral properties.
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Affiliation(s)
- Werner Kempf
- Department of Dermatology, University Hospital, Gloriastrasse 31, CH-8091, Zürich, Switzerland
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14
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Kanduc D, Capuano F, Capurso SA, Geliebter J, Guercia D, Lucchese A, Mittelman A, Simone SM, Sinha AA, Tiwari R, Farber E. Cancer prevention and therapy: strategies and problems. JOURNAL OF EXPERIMENTAL THERAPEUTICS AND ONCOLOGY 2003; 3:108-14. [PMID: 14641817 DOI: 10.1046/j.1359-4117.2003.01086.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
During the next years, molecular diagnostic science and the pharmaceutical industry will face increasing demand for personalized medicine. Therapeutic treatments should be tailored to the needs of individual patient. Patients will inquire for information about potential tumor detection at an early stage when disease can be more likely to be arrested or cured with specific regimens of drug therapy. To respond to this demand, science and industry need to modulate therapeutic approaches to the continuous development of cancer. Now more than ever, it is necessary to fill the knowledge hiatus between the "beginning" and the "end" of cancer development, i.e we need to critically analyze the extensive multi-step process of cancer development that still remains poorly understood.
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Affiliation(s)
- Darja Kanduc
- Department of Biochemistry and Molecular Biology, University of Bari, Via Orabona 4, 70126, Italy.
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15
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Schmuth M, Elias PM, Feingold KR. Nukleäre Hormonrezeptoren: Interventionsmöglichkeiten jenseits von Glukokortikoiden, Retinoiden und Vitamin D. J Dtsch Dermatol Ges 2003; 1:352-62. [PMID: 16285300 DOI: 10.1046/j.1610-0387.2003.03001.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Nuclear hormone receptors are ligand-dependent transcription factors. The class of nuclear hormone receptors that form heterodimers with retinoid X receptor includes members that are well established targets of current dermatological therapeutics such as the retinoic acid receptor (RAR) and the vitamin D receptor (VDR) as well as more recently discovered receptors including the peroxisome proliferator-activated receptors (PPAR) and the liver X receptor (LXR). After ligand activation (often lipid metabolites), these intracellular receptors exert their functions by binding to specific response elements in regulatory sequences of target genes, preferentially those involved in differentiation, energy expenditure and lipid metabolism. A number of selective activators has been developed by combinational chemistry, initially for their anti-diabetic and lipid lowering properties as well as their ability to regulate bile acid and drug metabolism. However, these activators also have marked effects on cutaneous homeostasis. Therefore, these compounds have important implications for dermatological therapy. In this review, the clinical implications of the more recently discovered members of the nuclear hormone receptor family are discussed.
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Affiliation(s)
- Matthias Schmuth
- Universitätsklinik für Dermatologie und Venerologie Karl-Franzens-Universität Innsbruck.
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16
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Sardana K, Sehgal VN. Retinoids: fascinating up-and-coming scenario. J Dermatol 2003; 30:355-80. [PMID: 12773802 DOI: 10.1111/j.1346-8138.2003.tb00402.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2002] [Accepted: 02/04/2003] [Indexed: 11/28/2022]
Abstract
Retinoids have been in sharp focus ever since their introduction 30 years ago. They include any drug (s) that bind to retinoid receptors and elicit a biological response. Enormous information on the subject seems to embroil the recent literature. Practically it is impossible to clearly comprehend the undercurrents. The meticulously dispensing text envisages surmounting the perspective reader's predicaments. Accordingly, retinoids and their related facets namely retinoid receptors, classification, mode of action, and the pharmacological diversity have been precisely defined. Commonly used systemic retinoids too have been given a substantial fresh look along with their monitoring. Overall, adverse effects and relative and absolute contraindications have been scrupulously incorporated. Human immuno deficiency virus (HIV) and isoretinoid for acne, in particular, have been highlighted. Micronized isotretinoin formulations have also been taken care so also commonly used topical retinoids. Tretinoin and their newer formulation have also been accounted for along with tretinoin polymer cream. Adapalene, a new chemical entity possessing a unique physico-chemical activity similar to that of tretinoin has also been dealt with. Newer retinoids are likely to be a subject of intrigue. A focus on future potentials of retinoids is its special ingredient. The inclusion of details of rexinoid the most recent introduction in their purview is likely to invoke interest to further consolidate its reckoning in future. All in all the text of the paper should provide an insight into the current rumbling around retinoids.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology and Venereology, Lady Hardinge Medical College, New Delhi, India
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17
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Abstract
Peripheral (post-thymic) T-cell lymphoma consists of a wide spectrum of disorders with marked differences in biology and behavior. Proper classification is pivotal for evaluating treatment results, and most studies performed a decade ago lump together different disease entities and cannot be interpreted. With improved use of immunophenotyping and molecular methods for these disorders, their exact nature is better defined in the Revised European-American Lymphoma and subsequent World Health Organization (WHO) classifications. The WHO classification of post- thymic T/natural killer (NK)-cell lymphoma consists of 15 entities, including about 30% that are unclassified cases. A wide range in incidence exists between different populations, but it is likely to be lower than previously estimated. Certain entities, like nasal/nasal-type T/NK-cell lymphoma and human T-cell leukemia/lymphoma virus 1, are much more prevalent in certain racial groups and show exquisite viral association. In these entities as a group, prognosis and treatment seem inferior to those of their B-cell counterparts, but treatment must be tailored to the exact pathologic diagnosis and prognostic index. Aggressive combination chemotherapy appears to be curative for certain entities (eg, anaplastic lymphoma kinase-positive), whereas purine analogues may be useful for low-grade entities. The role of autologous and allogeneic stem cell transplantation is still poorly defined. Specific antibody-based therapy is also on the horizon.
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Affiliation(s)
- Wing Y Au
- University Department of Medicine, Queen Mary Hospital, 4/F Professorial Block, Pokfulam Road, Hong Kong SAR, China.
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18
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Gorgun G, Foss F. Immunomodulatory effects of RXR rexinoids: modulation of high-affinity IL-2R expression enhances susceptibility to denileukin diftitox. Blood 2002; 100:1399-403. [PMID: 12149223 DOI: 10.1182/blood-2002-01-0300] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Rexinoids binding to both the retinoic acid receptor (RAR) and retinoid X receptor (RXR) families of rexinoid receptors have demonstrated clinical activity in hematologic malignancies and have been shown to mediate genes associated with both growth and differentiation. RXR rexinoids have demonstrated efficacy in the treatment of cutaneous T-cell lymphomas, but the mechanism of action is unclear. We explored the immunomodulatory effects of RAR and RXR rexinoids in human T- and B-cell leukemia cells and demonstrated that RXR rexinoids are capable of up-regulating high-affinity interleukin-2 receptor (IL-2R) expression. Exposure to 10(-6) to 10(-10) M bexarotene or Panretin for 48 hours was associated with increased expression of both the p55 and p75 subunits of the IL-2R in T-cell leukemias and p75 in B-cell leukemias. Furthermore, rexinoid exposure enhanced susceptibility of the cells to denileukin diftitox fusion toxin-targeting and -intoxicating cells expressing high-affinity IL-2R. These results suggest a rationale for combining rexinoids with IL-2R-targeted therapies in lymphoid malignancies as well as possibly in autoimmune diseases.
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MESH Headings
- Adjuvants, Immunologic/pharmacology
- Alitretinoin
- Antineoplastic Agents/therapeutic use
- B-Lymphocytes/drug effects
- Bexarotene
- Diphtheria Toxin/therapeutic use
- Gene Expression Regulation/drug effects
- Humans
- Interleukin-2/therapeutic use
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia-Lymphoma, Adult T-Cell/metabolism
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Receptors, Interleukin-2/drug effects
- Receptors, Interleukin-2/genetics
- Receptors, Retinoic Acid/drug effects
- Receptors, Retinoic Acid/physiology
- Recombinant Fusion Proteins/therapeutic use
- Retinoid X Receptors
- Retinoids/pharmacology
- T-Lymphocytes/drug effects
- Tetrahydronaphthalenes/pharmacology
- Transcription Factors/drug effects
- Transcription Factors/physiology
- Tretinoin/pharmacology
- Tumor Cells, Cultured
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Affiliation(s)
- Gullu Gorgun
- Department of Hematology Oncology and Experimental Therapeutics, Tufts New England Medical Center, Boston, MA 02111, USA
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