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1.
J Eur Acad Dermatol Venereol ; 37 Suppl 5: 18-26, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37092275

RESUMO

BACKGROUND: Moderate to severe AD can be successfully managed by systemic treatments. Current guidelines also recommend emollients or emollients 'plus' and eudermic cleansers for all AD patients to improve the skin barrier and provide anti-irritant and anti-pruritic effects. OBJECTIVES: To investigate the efficacy of skin care (in addition to systemic treatment) with an Emollient 'plus' balm designed to improve the skin barrier and skin microbiome plus a corresponding syndet compared to usual commercial emollients and cleansers. METHODS: In a randomized controlled multicenter study, patients with moderate to severe AD (Severity scoring of atopic dermatitis [SCORAD] score ≥ 40) receiving systemic treatment (cyclosporin A, dupilumab or a Janus kinase inhibitor) were randomized 1:1 to apply twice daily for 10 weeks Emollient 'plus' after pre-cleaning with the syndet (Emollient 'plus' group) or to continue with their usual emollient and cleanser (Control group). Assessments included SCORAD, pruritus on a Visual Analog Scale, Dermatology quality of life questionnaire (DLQI), efficacy and tolerance questionnaires. RESULTS: Included were 57 patients with mean age of 38 years (range 19-70 years). The mean amount of emollient used after 10 weeks was 447.3 g (range 29-1099 g) and 613.2 g (range 97-2565 g) for the Emollient 'plus' versus the Control, respectively (p = 0.0277). After 10 weeks, subjects in the Emollient 'plus' had a significantly greater reduction in current pruritus (p = 0.0277) and a greater reduction in some DLQI items compared to the Control group. CONCLUSIONS: In patients with moderate to severe AD receiving systemic treatment, the Emollient 'plus' regimen significantly improved pruritus and quality of life items compared to the control, while using 23% less product over a 10-week period. These results stress the importance of daily use of emollients, especially emollients 'plus' to improve signs, symptoms and quality of life in patients with AD.


Assuntos
Dermatite Atópica , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/diagnóstico , Emolientes/uso terapêutico , Detergentes , Qualidade de Vida , Resultado do Tratamento , Prurido/tratamento farmacológico , Prurido/etiologia , Higiene da Pele , Índice de Gravidade de Doença
2.
J Am Acad Dermatol ; 80(5): 1395-1402, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30894279

RESUMO

BACKGROUND: Anecdotal evidence suggests that neurokinin 1 receptor antagonism reduces pruritus intensity in chronic pruritic conditions such as prurigo nodularis (PN). OBJECTIVE: This study assessed safety and efficacy of the neurokinin 1 receptor antagonist serlopitant for treatment of pruritus in PN. METHODS: In this randomized, double-blind, placebo-controlled study, 128 patients with chronic, treatment-refractory PN for more than 6 weeks received serlopitant, 5 mg, or placebo orally once daily for 8 weeks. The primary end point was change in average itch visual analog scale score at weeks 4 and 8. RESULTS: Average itch visual analog scale scores significantly improved with serlopitant versus with placebo at weeks 4 and 8: the least squares mean difference (serlopitant minus placebo) was -1.0 at week 4 (P = .02) and -1.7 at week 8 (P < .001). The least squares mean difference between serlopitant and placebo reached statistical significance at week 2 (-0.9 [P = .011]). The most frequently reported treatment-emergent adverse events in the serlopitant group were nasopharyngitis, diarrhea, and fatigue. LIMITATIONS: The 8-week duration may be insufficient to assess clinically relevant resolution of PN lesions. CONCLUSIONS: Serlopitant reduced pruritus in patients with treatment-refractory PN and was well tolerated.


Assuntos
Isoindóis/uso terapêutico , Antagonistas dos Receptores de Neurocinina-1/uso terapêutico , Prurido/tratamento farmacológico , Adulto , Idoso , Doença Crônica , Diarreia/induzido quimicamente , Método Duplo-Cego , Fadiga/induzido quimicamente , Feminino , Humanos , Isoindóis/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nasofaringite/induzido quimicamente , Antagonistas dos Receptores de Neurocinina-1/efeitos adversos , Prurigo/complicações , Prurido/etiologia , Escala Visual Analógica
3.
Acta Derm Venereol ; 99(4): 379-385, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30653242

RESUMO

The aim of this multicentre, randomized, double-blind, placebo-controlled, cross-over, phase-II study was to determine the antipruritic effect of aprepitant vs. placebo in 58 patients with anti-histamine-refractory chronic pruritus in chronic nodular prurigo. Patients were randomized to receive either first oral aprepitant 80 mg/day or placebo for 4 weeks. Following a 2-week wash-out phase, the patients were crossed-over to receive the other treatment for 4 weeks. Primary efficacy criterion was the intra-individual difference between mean itch intensity (visual analogue scale) at baseline compared with the end of treatment period. Prurigo lesions, pruritus course, quality of life, patient benefits, and safety were secondary parameters. No significant differences were found between aprepitant treatment and placebo for any of the parameters investigated. Under the experimental conditions of the study, aprepitant, 80 mg daily for 4 weeks, did not have an antipruritic effect in patients with chronic prurigo. (DRKS00005594; EudraCT Number: 2013-001601-85).


Assuntos
Antipruriginosos/uso terapêutico , Aprepitanto/uso terapêutico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Antagonistas dos Receptores de Neurocinina-1/uso terapêutico , Prurigo/tratamento farmacológico , Adolescente , Adulto , Idoso , Antipruriginosos/efeitos adversos , Aprepitanto/efeitos adversos , Estudos Cross-Over , Método Duplo-Cego , Resistência a Medicamentos , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas dos Receptores de Neurocinina-1/efeitos adversos , Prurigo/diagnóstico , Prurigo/imunologia , Qualidade de Vida , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
5.
Int J Mol Sci ; 19(12)2018 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-30487387

RESUMO

Melatonin (Mel) is the major biologically active molecule secreted by the pineal gland. Mel and its metabolites, 6-hydroxymelatonin (6(OH)Mel) and 5-methoxytryptamine (5-MT), possess a variety of functions, including the scavenging of free radicals and the induction of protective or reparative mechanisms in the cell. Their amphiphilic character allows them to cross cellular membranes and reach subcellular organelles, including the mitochondria. Herein, the action of Mel, 6(OH)Mel, and 5-MT in human MNT-1 melanoma cells against ultraviolet B (UVB) radiation was investigated. The dose of 50 mJ/cm² caused a significant reduction of cell viability up to 48%, while investigated compounds counteracted this deleterious effect. UVB exposure increased catalase activity and led to a simultaneous Ca++ influx (16%), while tested compounds prevented these disturbances. Additional analysis focused on mitochondrial respiration performed in isolated mitochondria from the liver of BALB/cJ mice where Mel, 6(OH)Mel, and 5-MT significantly enhanced the oxidative phosphorylation at the dose of 10-6 M with lower effects seen at 10-9 or 10-4 M. In conclusion, Mel, 6(OH)Mel and 5-MT protect MNT-1 cells, which express melatonin receptors (MT1 and MT2) against UVB-induced oxidative stress and mitochondrial dysfunction, including the uncoupling of oxidative phosphorylation.


Assuntos
Melanoma/metabolismo , Melatonina/metabolismo , Melatonina/farmacologia , 5-Metoxitriptamina/farmacologia , Animais , Cálcio/metabolismo , Catalase/metabolismo , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos da radiação , Humanos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/efeitos da radiação , Melatonina/análogos & derivados , Camundongos Endogâmicos BALB C , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/efeitos da radiação , Fosforilação Oxidativa/efeitos dos fármacos , Fosforilação Oxidativa/efeitos da radiação , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/efeitos da radiação , Raios Ultravioleta
6.
Exp Dermatol ; 26(8): 739-742, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27892633

RESUMO

Chronic pruritus is difficult to treat. Current treatment options are frequently ineffective and new therapeutic approaches are urgently needed. Avenanthramides are active substances in oats that exhibit anti-inflammatory effects. Their potential to interrupt pruritus mechanisms was investigated in this study. It was found that the synthetic analog dihydroavenanthramide D (DHAvD) can interact with the neurokinin-1 receptor (NK1R) and inhibit mast cell degranulation. DHAvD also affects inflammatory processes and reduces secretion of the cytokine interleukin-6. Our findings indicate that DHAvD may act as a NK1R inhibitor and could be a promising candidate for topical treatments of chronic pruritus.


Assuntos
Mastócitos/efeitos dos fármacos , Prurido/tratamento farmacológico , Receptores da Neurocinina-1/metabolismo , ortoaminobenzoatos/uso terapêutico , Animais , Sinalização do Cálcio/efeitos dos fármacos , Linhagem Celular , Doença Crônica , Avaliação Pré-Clínica de Medicamentos , Humanos , Ratos , Substância P , ortoaminobenzoatos/farmacologia
7.
Exp Dermatol ; 26(4): 328-334, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27376341

RESUMO

Psoriasis is a chronic inflammatory disease appearing as scaly erythematous cutaneous lesions, which are characterized by parakeratosis and acanthosis as well as the infiltration of immune cells, such as T helper-1 and T helper-17 cells. Here, we demonstrated that KdPT, a tripeptide structurally related to the C-terminal amino acids of alpha-melanocyte-stimulating hormone, which was previously shown to exhibit anti-inflammatory effects in intestinal inflammation, ameliorated ongoing disease in the mouse model of imiquimod-induced psoriasis-like skin inflammation and in the small xenotransplant mouse model of psoriasis. We could show that systemic KdPT treatment significantly reduced hyperkeratosis and acanthosis in murine as well as human skin. Moreover, KdPT upregulated Foxp3 in CD4+ T cells from mice and from peripheral blood of individuals with psoriasis and decreased the expression of type 1 inflammatory cytokines, indicating that the beneficial effect of KdPT was, at least in part, mediated by the induction of functional regulatory T cells that suppressed the activation of pathogenic CD4+ IFN-γ+ and CD4+ IL-17+ T cells. Thus, these data might suggest KdPT as a potential novel therapeutic alternative for the treatment of psoriasis.


Assuntos
Anti-Inflamatórios/uso terapêutico , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/metabolismo , Oligopeptídeos/uso terapêutico , Psoríase/tratamento farmacológico , Animais , Anti-Inflamatórios/farmacologia , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/patologia , Células Cultivadas , Modelos Animais de Doenças , Fatores de Transcrição Forkhead/metabolismo , Humanos , Interferon gama/metabolismo , Interleucina-17/metabolismo , Ceratose/tratamento farmacológico , Células de Langerhans/efeitos dos fármacos , Células de Langerhans/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Oligopeptídeos/farmacologia , Psoríase/imunologia , Psoríase/metabolismo , Psoríase/patologia , Células Th1/efeitos dos fármacos , Células Th1/patologia , Células Th17/efeitos dos fármacos , Células Th17/patologia , Transplante Heterólogo
8.
Exp Dermatol ; 26(1): 73-81, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27576129

RESUMO

Although there is increasing evidence that oxidative stress is involved in collagen synthesis and myofibroblast activation, the NADPH oxidase (Nox) system is incompletely investigated in the context of human dermal fibroblasts (HDFs) and skin fibrosis. Using the pan-Nox inhibitor diphenyleneiodonium (DPI) as an initial tool, we show that gene expression of collagen type I, α-smooth muscle actin (α-SMA) and fibronectin 1 is suppressed in HDFs. Detailed expression analysis of all Nox isoforms and adaptors revealed expression of RNA and protein expression of Nox4, p22phox and Poldip2 but neither Nox1 nor Nox2. Nox4 could be immunolocalized to the endoplasmic reticulum. Importantly, TGF-ß1 had a dose- and time-dependent upregulating effect on NADH activity and Nox4 gene expression in HDFs. Genetic silencing of Nox4 as demonstrated by siRNA in HDFs as well as in murine fibroblasts established from Nox4 knockout mice confirmed that TGF-ß1 -mediated collagen type I gene, α-SMA and fibronectin 1 gene expressions were Nox4-dependent. This TGF-ß1 effect was mediated by Smad3 as shown by in silico promoter analysis, pharmacological inhibition and gene silencing of Smad3. The relevance of these findings is highlighted in the bleomycin-induced scleroderma mouse model. DPI treatment attenuated skin fibrosis and myofibroblast activation. Moreover, Nox4 knockdown by siRNA reduced skin collagen synthesis, α-SMA and fibronectin 1 expression in vivo. Finally, analyses of HDFs from patients with systemic sclerosis confirmed the expression of Nox4 and its adaptors, whereas Nox1 and Nox2 were not detectable. Our findings indicate that Nox4 targeting is a promising future treatment for fibrotic skin diseases.


Assuntos
Fibroblastos/enzimologia , NADPH Oxidase 4/genética , Escleroderma Sistêmico/enzimologia , Pele/enzimologia , Pele/patologia , Actinas/genética , Adulto , Animais , Células Cultivadas , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Cadeia alfa 1 do Colágeno Tipo I , Simulação por Computador , Citocinas/genética , Modelos Animais de Doenças , Inibidores Enzimáticos/farmacologia , Feminino , Fibronectinas , Fibrose , Expressão Gênica/efeitos dos fármacos , Perfilação da Expressão Gênica , Inativação Gênica , Humanos , Recém-Nascido , Isoenzimas/genética , Masculino , Camundongos , Pessoa de Meia-Idade , Complexos Multienzimáticos/metabolismo , Miofibroblastos , NADH NADPH Oxirredutases/metabolismo , NADPH Oxidase 1/genética , NADPH Oxidase 2/genética , NADPH Oxidase 4/metabolismo , Oniocompostos/farmacologia , Cultura Primária de Células , RNA Mensageiro/metabolismo , Escleroderma Sistêmico/induzido quimicamente , Escleroderma Sistêmico/patologia , Fator de Crescimento Transformador beta/farmacologia , Adulto Jovem
9.
Acta Derm Venereol ; 96(6): 792-6, 2016 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-26527564

RESUMO

This study was a prospective, parallel-group, randomized, double-blind, vehicle-controlled, multi-centre clinical trial to compare the efficacy of topical sertaconazole 2% cream with vehicle in reducing chronic pruritus in subjects with atopic dermatitis, and to assess its safety and local tolerability. A total of 70 subjects applied either of the 2 treatments twice daily for a period of 4 weeks on affected, itchy skin areas. Treatment efficacy was evaluated primarily considering the item itch intensity on a 5-point verbal rating scale. Insomnia, state of atopic dermatitis (Scoring Atopic Dermatitis; SCORAD), quality of life and therapy benefit were also assessed. No significant difference between active treatment and vehicle was found at any of the time-points for any of the investigated parameters. Under the experimental conditions of the study, sertaconazole 2% cream did not exert anti-pruritic effects that were better than vehicle in subjects with atopic dermatitis who had chronic pruritus. Trial registration ClinicalTrials.gov #NCT01792713.


Assuntos
Antifúngicos/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Imidazóis/uso terapêutico , Prurido/tratamento farmacológico , Tiofenos/uso terapêutico , Adolescente , Adulto , Idoso , Método Duplo-Cego , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
10.
Ann Neurol ; 75(5): 739-58, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24771567

RESUMO

OBJECTIVE: Environmental conditions (eg, latitude) play a critical role in the susceptibility and severity of many autoimmune disorders, including multiple sclerosis (MS). Here, we investigated the mechanisms underlying the beneficial effects of immune regulatory processes induced in the skin by moderate ultraviolet B (UVB) radiation on central nervous system (CNS) autoimmunity. METHODS: Effects of UVB light were analyzed in a murine model of CNS autoimmunity (experimental autoimmune encephalomyelitis). Additionally, patients with relapsing-remitting MS were treated with narrowband UVB phototherapy. Immunomodulatory effects were examined in skin biopsies, serum samples, and immune cells of the peripheral blood. RESULTS: Regulatory T cells (Tregs), which are induced locally in the skin-draining lymph nodes in response to UVB exposure, connect the cutaneous immune response to CNS immunity by migration to the sites of inflammation (blood, spleen, CNS). Here, they attenuate the inflammatory response and ameliorate disease symptoms. Treg-inducing tolerogenic dendritic cells (DCs) were further necessary for induction of this systemic immune regulation by UVB radiation, because ablation of Langerhans cells abolished the UVB-induced phenotype. MS patients treated with UVB phototherapy showed an increase in induced Tregs and tolerogenic DCs accompanied by the downregulation of the T-cell effector cytokine interleukin 21. The treatment further induced elevated serum levels of vitamin D. INTERPRETATION: Local UVB radiation of the skin influences systemic immune reactions and attenuates systemic autoimmunity via the induction of skin-derived tolerogenic DCs and Tregs. Our data could have implications for the understanding or therapeutic modulation of environmental factors that influence immune tolerance.


Assuntos
Encefalomielite Autoimune Experimental/radioterapia , Imunidade Celular/efeitos da radiação , Esclerose Múltipla Recidivante-Remitente/radioterapia , Linfócitos T Reguladores/efeitos da radiação , Raios Ultravioleta , Terapia Ultravioleta , Adulto , Animais , Células Cultivadas , Células Dendríticas/imunologia , Células Dendríticas/efeitos da radiação , Encefalomielite Autoimune Experimental/imunologia , Encefalomielite Autoimune Experimental/patologia , Feminino , Humanos , Imunidade Celular/imunologia , Masculino , Camundongos , Camundongos Congênicos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Esclerose Múltipla Recidivante-Remitente/imunologia , Esclerose Múltipla Recidivante-Remitente/patologia , Linfócitos T Reguladores/imunologia , Terapia Ultravioleta/métodos , Adulto Jovem
11.
Clin Exp Rheumatol ; 33(5 Suppl 93): S14-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26472560

RESUMO

The coexistence of psoriasis arthritis (PsA) and psoriasis vulgaris in about 20% of patients with psoriasis leads to a need for rheumatologic-dermatologic team work. We summarise the role of dermatologists in assessment of the skin in psoriasis. Chronic plaque psoriasis must be differentiated from other subtypes such as generalised pustular psoriasis (GPP) or palmoplantar pustulosis (PPP). Therapeutic management is based on the evaluation of the disease severity. Quantitative scoring of skin severity includes calculation of the Psoriasis Area and Severity Index (PASI), body surface area (BSA) as well as the Dermatology Life Quality Index (DLQI). These scoring systems do not replace the traditional dermatologic medical history and physical examination of the patient. The skin should be examined for additional skin diseases; moreover, patients should be monitored for comorbidity, most importantly PsA and cardiovascular comorbidity.


Assuntos
Psoríase/patologia , Pele/patologia , Algoritmos , Comorbidade , Procedimentos Clínicos , Nível de Saúde , Humanos , Exame Físico , Valor Preditivo dos Testes , Prognóstico , Psoríase/classificação , Psoríase/epidemiologia , Psoríase/psicologia , Psoríase/terapia , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
12.
Acta Derm Venereol ; 95(3): 266-71, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25136974

RESUMO

The complex nature and difficult-to-establish aetiology of chronic pruritus (CP) makes it challenging to provide medical care for patients with CP. This challenge can only be met with a multidisciplinary approach. The first multidisciplinary Itch Centre in Germany was established at the University of Münster in 2002 to meet the needs of this patient population. More than 2,500 outpatients and 400 inpatients are diagnosed and receive treatment each year. To ensure evidence-based medical care, an electronic system for medical documentation and patient-reported outcomes was established. Automated data transfer to a research database enables comprehensive data analysis. Our translational research has characterized peripheral and central itch mechanisms, provided novel clustering of CP patients, and identified novel target-specific therapies (e.g. neurokinin 1 receptor-antagonist). The multidisciplinary approach, combined with basic, clinical and translational research, enables comprehensive medical care of patients as well as implementation of high-quality experimental and clinical studies.


Assuntos
Comportamento Cooperativo , Comunicação Interdisciplinar , Ambulatório Hospitalar/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Prurido , Antipruriginosos/uso terapêutico , Doença Crônica , Registros Eletrônicos de Saúde/organização & administração , Alemanha/epidemiologia , Humanos , Modelos Organizacionais , Valor Preditivo dos Testes , Prognóstico , Desenvolvimento de Programas , Prurido/diagnóstico , Prurido/tratamento farmacológico , Prurido/epidemiologia , Prurido/fisiopatologia , Fatores de Risco , Pesquisa Translacional Biomédica/organização & administração , Fluxo de Trabalho
13.
Handb Exp Pharmacol ; 226: 237-55, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25861784

RESUMO

Substance P (SP) is an important mediator of pro-inflammatory mechanisms in the skin. It targets multiple cells such as keratinocytes, mast cells, and fibroblasts which are involved in the cutaneous generation of pruritus. This suggests that SP is an interesting target for therapy. In fact, in recent case reports and case series, SP antagonists demonstrated a significant antipruritic effect in acute and chronic pruritus such as drug-induced pruritus, paraneoplastic pruritus, prurigo nodularis, cutaneous T-cell lymphoma, and brachioradial pruritus.


Assuntos
Morfolinas/uso terapêutico , Prurido/tratamento farmacológico , Receptores da Neurocinina-1/fisiologia , Substância P/antagonistas & inibidores , Animais , Aprepitanto , Humanos , Morfolinas/efeitos adversos , Prurido/etiologia , Substância P/fisiologia
14.
Arthritis Rheum ; 65(3): 792-804, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23440693

RESUMO

OBJECTIVE: There is increasing evidence that serotonin (5-hydroxytryptamine [5-HT]) and distinct 5-HT receptors are involved in the pathogenesis of systemic sclerosis. The aim of this study was to test the hypothesis that tropisetron, a routinely used antiemetic agent previously characterized as a 5-HT(3/4) receptor-modulating agent, can directly affect collagen synthesis in vitro and attenuate experimentally induced fibrosis in vivo. METHODS: Functional in vitro studies were performed using human dermal fibroblasts (HDFs). Signal transduction studies included immunofluorescence analysis, Western immunoblotting, promoter reporter assays, cAMP/Ca(2+) measurements, and use of pharmacologic activators and inhibitors. Gene silencing was performed using small interfering RNA. Putative receptors of tropisetron were detected by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunofluorescence. The murine model of bleomycin-induced scleroderma was used to assess the antifibrogenic and antifibrotic effects of tropisetron in vivo. Collagen expression in vitro, ex vivo, and in situ was determined by real-time RT-PCR analysis, Western immunoblotting, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunohistochemical analysis. RESULTS: Tropisetron suppressed collagen synthesis induced by transforming growth factor ß1 (TGFß1). This effect was independent of 5-HT(3/4) receptor but was mediated via α7 nicotinic acetylcholine receptor (α7nAChR). Suppression of TGFß1-induced collagen synthesis occurred via an unknown molecular mechanism not involving modulation of the Smad, cAMP, Akt, c-Jun, or MAPK pathway. In vivo, tropisetron not only prevented skin fibrosis but also reduced the collagen content in established dermal fibrosis induced by bleomycin. CONCLUSION: Tropisetron directly reduces collagen synthesis in HDFs via an α7nAChR-dependent mechanism. The antifibrogenic and antifibrotic effects of this agent observed in a mouse model of bleomycin- induced scleroderma indicate the future potential of tropisetron in the treatment of fibrotic diseases such as scleroderma.


Assuntos
Colágeno/biossíntese , Indóis/farmacologia , Receptores Nicotínicos/metabolismo , Escleroderma Sistêmico/tratamento farmacológico , Células 3T3 , Adulto , Idoso , Animais , Antibióticos Antineoplásicos/toxicidade , Bleomicina/toxicidade , Derme/efeitos dos fármacos , Derme/metabolismo , Derme/patologia , Modelos Animais de Doenças , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Fibroblastos/patologia , Fibrose/tratamento farmacológico , Fibrose/metabolismo , Fibrose/patologia , Humanos , Camundongos , Pessoa de Meia-Idade , Escleroderma Sistêmico/metabolismo , Escleroderma Sistêmico/patologia , Antagonistas da Serotonina/farmacologia , Transdução de Sinais/efeitos dos fármacos , Fator de Crescimento Transformador beta1/metabolismo , Tropizetrona , Receptor Nicotínico de Acetilcolina alfa7
15.
J Dtsch Dermatol Ges ; 12(12): 1112-9, 2014 Dec.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-25482694

RESUMO

BACKGROUND AND OBJECTIVES: Progressive pigmented purpuric dermatosis (PPPD, Schamberg disease) is a rare benign, but chronic dermatosis frequently misdiagnosed as vasculitis or bleeding disorder. Although affected patients experience significant impairment in quality of life no effective treatment has been established. The aim of our two center case series was to evaluate efficacy and tolerability of the antioxidants rutoside and ascorbic acid as combination treatment for PPPD. PATIENTS AND METHODS: A retrospective review was performed on 35 patients with PPPD treated with 2 × 50 mg rutoside and 1,000 mg ascorbic acid daily between 2004 until 2011. The mean treatment duration was 8.2 months. RESULTS: 71.4% of the participants experienced complete clearance and 20.0% an improvement of more than 50%, accompanied by increased quality of life. Nine participants (25.1%) relapsed after discontinuation. In seven, rutoside and ascorbic acid was re-initiated, and all responded again. Only three participants reported mild adverse effects. Participants with shorter disease duration showed better therapeutic success, shorter time to response and lower risk of recurrence. CONCLUSION: Oral rutoside and ascorbic acid may be an efficient and well tolerated treatment for PPPD. Early treatment is recommended to achieve best clinical outcome.


Assuntos
Ácido Ascórbico/administração & dosagem , Transtornos da Pigmentação/tratamento farmacológico , Transtornos da Pigmentação/patologia , Púrpura/tratamento farmacológico , Púrpura/patologia , Rutina/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Quimioterapia Combinada , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
16.
Exp Dermatol ; 22(12): 792-4, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24131319

RESUMO

The melanocortin-1 receptor (MC1 ) - being most abundantly expressed in the skin by melanocytes - has a physiological role for melanin pigmentation in many vertebrate species. MC1 has also been implicated in regulation of skin inflammation as this receptor is detectable in the majority of non-melanocytic cell types and its ligand α-melanocyte-stimulating hormone (α-MSH) exerts immunoregulatory and anti-inflammatory effects. However, in vivo studies on mice with targeted disruption of MC1 have been missing in the context of skin inflammation until recently. Wolnicka-Glubisz et al. now reported that the course of ultraviolet (UV)-induced inflammation, contact hypersensitivity, neonatal immune tolerance and UV-induced immunosuppression is similar in MC1 signal-deficient (C57BL/6-Mc1r(e/e)) and wild-type mice. These unexpected findings are supported by own observations in experimentally induced immune-complex-mediated vasculitis: Mc1r(e/e) mice exhibited a similar extent of the reverse passive cutaneous Arthus reaction compared with wild-type animals. Future studies are thus needed to clarify whether these findings are due to limitations in the chosen mouse model and/or point to additional MC subtypes that may regulate inflammatory and immune responses in the skin.


Assuntos
Inflamação/etiologia , Inflamação/fisiopatologia , Receptor Tipo 1 de Melanocortina/fisiologia , Pele/fisiopatologia , Pele/efeitos da radiação , Raios Ultravioleta/efeitos adversos , Animais
17.
Dermatology ; 227(4): 353-60, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24281309

RESUMO

BACKGROUND: In the treatment of atopic dermatitis, pimecrolimus has high antipruritic effects. OBJECTIVE: To investigate the efficacy of 1% pimecrolimus cream in comparison to 1% hydrocortisone cream in non-atopic prurigo nodularis (PN). METHODS: A randomized, controlled, double-blind study with intraindividual randomization was done in 30 patients (17 females, 13 males; mean age 58.5 years) with PN. RESULTS: Pruritus intensity decreased significantly (p < 0.001) on both treated sides as early as after 10 days of treatment; scratch lesions improved (p < 0.001). Quality of life as assessed by the Dermatology Life Quality Index improved significantly. However, a significant advantage of pimecrolimus over hydrocortisone was not found. CONCLUSION: The results suggest that the non-steroid pimecrolimus is an effective alternative for PN treatment.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Neuropeptídeos/metabolismo , Prurigo/tratamento farmacológico , Prurido/tratamento farmacológico , Tacrolimo/análogos & derivados , Administração Cutânea , Adulto , Idoso , Anti-Inflamatórios/uso terapêutico , Biomarcadores/metabolismo , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Método Duplo-Cego , Feminino , Humanos , Hidrocortisona/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prurigo/complicações , Prurigo/metabolismo , Prurido/etiologia , Prurido/metabolismo , Qualidade de Vida , Tacrolimo/administração & dosagem
18.
J Allergy Clin Immunol ; 129(4): 1085-93, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22178636

RESUMO

BACKGROUND: Little is known about the effect of neuropeptides on basophils, which are important effector cells in immune and allergic responses. OBJECTIVE: This study aimed at revealing the role of α-melanocyte-stimulating hormone (α-MSH) on basophil function. METHODS: Expression of melanocortin receptors and proopiomelanocortin (POMC) was analyzed by means of RT-PCR, Western immunoblotting, fluorescence-activated cell sorting, and double-immunofluorescence analysis. Signal transduction studies included cyclic AMP and Ca(2+) mobilization assays. Basophil activity was assessed based on CD63 surface expression and cytokine release. RESULTS: MC-1R expression was detectable in basophils isolated from human peripheral blood, as well as in basophils within nasal tissue. In isolated basophils from human blood, truncated POMC transcripts were present, but there was no POMC protein. Treatment of basophils with α-MSH increased intracellular Ca(2+) but not cyclic AMP levels. α-MSH at physiologic doses potently suppressed basophil activation induced by N-formyl-methionyl-leucyl-phenylalanine, phorbol 12-myristate 13-acetate, or grass pollen allergen in whole blood of healthy or allergic subjects, respectively. The effect of α-MSH on basophil activation was MC-1R mediated (as shown by blockade with a peptide analogue of agouti-signaling protein) and imitated by adrenocorticotropic hormone but not elicited by the tripeptides KPV and KdPT, both of which lack the central pharmacophore of α-MSH. Moreover, α-MSH at physiologic doses significantly suppressed secretion of 3 proallergic cytokines, IL-4, IL-6, and IL-13, in basophils stimulated with anti-IgE, N-formyl-methionyl-leucyl-phenylalanine, or phorbol 12-myristate 13-acetate. CONCLUSION: Our findings highlight a novel functional activity of α-MSH, which acts as a natural antiallergic basophil-response modifier. These findings might point to novel therapeutic strategies in treating allergic diseases.


Assuntos
Basófilos/efeitos dos fármacos , Basófilos/metabolismo , alfa-MSH/farmacologia , Alérgenos/imunologia , Basófilos/imunologia , Sinalização do Cálcio/efeitos dos fármacos , Linhagem Celular , AMP Cíclico/metabolismo , Citocinas/metabolismo , Humanos , N-Formilmetionina Leucil-Fenilalanina/farmacologia , Pró-Opiomelanocortina/genética , Receptores de Melanocortina/metabolismo , Transdução de Sinais/efeitos dos fármacos , Transcrição Gênica
19.
Endocr Rev ; 29(5): 581-602, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18612139

RESUMO

Alpha-MSH is a tridecapeptide derived from proopiomelanocortin. Many studies over the last few years have provided evidence that alpha-MSH has potent protective and antiinflammatory effects. These effects can be elicited via centrally expressed melanocortin receptors that orchestrate descending neurogenic antiinflammatory pathways. alpha-MSH can also exert antiinflammatory and protective effects on cells of the immune system and on peripheral nonimmune cell types expressing melanocortin receptors. At the molecular level, alpha-MSH affects various pathways implicated in regulation of inflammation and protection, i.e., nuclear factor-kappaB activation, expression of adhesion molecules and chemokine receptors, production of proinflammatory cytokines and mediators, IL-10 synthesis, T cell proliferation and activity, inflammatory cell migration, expression of antioxidative enzymes, and apoptosis. The antiinflammatory effects of alpha-MSH have been validated in animal models of experimentally induced fever; irritant and allergic contact dermatitis, vasculitis, and fibrosis; ocular, gastrointestinal, brain, and allergic airway inflammation; and arthritis, but also in models of organ injury. One obstacle limiting the use of alpha-MSH in inflammatory disorders is its pigmentary effect. Due to its preserved antiinflammatory effect but lack of pigmentary action, the C-terminal tripeptide of alpha-MSH, KPV, has been delineated as an alternative for antiinflammatory therapy. KdPT, a derivative of KPV corresponding to amino acids 193-195 of IL-1beta, is also emerging as a tripeptide with antiinflammatory effects. The physiochemical properties and expected low costs of production render both agents suitable for the future treatment of immune-mediated inflammatory skin and bowel disease, fibrosis, allergic and inflammatory lung disease, ocular inflammation, and arthritis.


Assuntos
Doenças do Sistema Imunitário/tratamento farmacológico , Inflamação/tratamento farmacológico , alfa-MSH/uso terapêutico , Sequência de Aminoácidos , Animais , Anti-Inflamatórios/uso terapêutico , Modelos Animais de Doenças , Humanos , Dados de Sequência Molecular , Peptídeos/uso terapêutico
20.
Am J Pathol ; 179(3): 1230-42, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21741932

RESUMO

Treatment options for inflammatory bowel disease (IBD) are incompletely helpful, and surgery is often needed. One promising class of future therapeutic agents for IBD is melanocortin-related peptides, which exhibit potent immunomodulatory effects. We investigated KdPT, a tripeptide derivative of the C-terminus of α-melanocyte-stimulating hormone, as an anti-inflammatory small molecule in vivo and in vitro. Intestinal inflammation was studied after oral administration of dextran sodium sulfate and in IL-10 gene-deficient mice. The effects of KdPT on key colonic epithelial cell functions were studied in vitro and in vivo by evaluating proliferation, wound healing, transepithelial resistance, and expression of tight junction proteins. Melanin assays were performed to determine the melanotropic effects of KdPT. KdPT-treated animals showed markedly reduced severity of inflammation in both colitis models. In colonic epithelial cells, KdPT increased proliferation, accelerated closure of wounds, and improved transepithelial electrical resistance after stimulation with interferon-γ/tumor necrosis factor-α. Moreover, treatment with KdPT also prevented the loss of tight junction protein expression and improved barrier function in vivo. KdPT acted independently of IL-1 receptor type I in vivo and did not affect melanogenesis in vitro. KdPT is capable of attenuating the course of experimental colitis in different models and maintains epithelial cell function. Furthermore, KdPT does not induce pigmentation, emphasizing the potential of this small molecule for the future treatment of IBD.


Assuntos
Colite/prevenção & controle , Oligopeptídeos/administração & dosagem , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Células Cultivadas , Colite/metabolismo , Relação Dose-Resposta a Droga , Vias de Administração de Medicamentos , Células Epiteliais , Imunofluorescência , Interleucina-10/deficiência , Interleucina-1beta/metabolismo , Mucosa Intestinal/metabolismo , Antígeno Ki-67/metabolismo , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Cicatrização/efeitos dos fármacos
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