Protection against visible light by dihydroxyacetone in erythropoietic protoporphyria.

BACKGROUND: Patients with erythropoietic protoporphyria (EPP) are hypersensitive to long wave ultraviolet (UVA) radiation and visible light and they experience severe skin pain by light exposure. The patients have very limited treatment options. Sunless skin tanning with dihydroxyacetone (DHA) is now being investigated as a possible treatment modality of skin photosensitivity in EPP. METHODS: We simulated the theoretical light protection factor provided by DHA application. In addition, we present 19 cases with EPP who were treated at our department with DHA weekly during spring and summer from 2018 to 2021 inclusive. RESULTS: The protection factor against UVA and visible light was estimated to approximately two. Out of the 19 patients with EPP who were treated with DHA in 2018, 11 patients experienced a sustained good effect and continued to use the treatment on a weekly basis in the spring and summer of 2019, 2020, and 2021. CONCLUSION AND PERSPECTIVES: Both the theoretical estimates and the uncontrolled study suggest that sunless tanning with DHA reduces photosensitivity in patients with EPP. Our hypothesis is that skin treated with DHA can tolerate twice the daylight dose compared to untreated skin before onset of skin symptoms. To validate this conclusion, we plan a randomized clinical trial to determine the effect of DHA application to reduce photosensitivity in patients with EPP under controlled clinical conditions. The study protocol for this trial is presented in the paper.

Antidotal effect of dihydroxyacetone against phosphine poisoning in mice.

Phosphine (PH3 ) is widely used as an insecticide and rodenticide. On the contrary, many cases of PH3 poisoning have been reported worldwide. Unfortunately, there is no specific antidote against PH3 toxicity. Disruption of mitochondrial function and energy metabolism is a well-known mechanism of PH3 cytotoxicity. Dihydroxyacetone (DHA) is an adenosine triphosphate supplying agent which significantly improves mitochondrial function. The current study was designed to evaluate DHA's effect on inhalational PH3 poisoning in an animal model. DHA was injected into BALB/c mice before and/or after the start of the PH3 inhalation. The cytochrome c oxidase activity was assessed in the animals' brain, heart, and liver exposed to PH3 (for 15, 30, and 60 min, with and without the antidote). The LC50 of PH3 was calculated to be 18.02 (15.42-20.55) ppm over 2 h of exposure. Pretreatment of DHA (1 or 2 g/kg) increased the LC50 of PH3 by about 1.6- or 3-fold, respectively. Posttreatment with DHA (2 g/kg) increased the LC50 of PH3 by about 1.4-fold. PH3 inhibited the activity of cytochrome c oxidase in the assessed organs. It was found that DHA treatment restored mitochondrial cytochrome c oxidase activity. These findings suggested that DHA could be an effective antidote for PH3 poisoning.

Dihydroxyacetone Production in the Nectar of Australian Leptospermum Is Species Dependent.

This study is the first large-scale survey of the presence of dihydroxyacetone (DHA) in the nectar of the Australian Leptospermum tree species. The work undertaken supports the growing global demand for bioactive Leptospermum honey. Leptospermum honey derived from L. scoparium in New Zealand, also referred to as Ma̅nuka honey, has a reputation for wound-healing and antimicrobial properties, which is based on its methylglyoxal (MGO) content. High-DHA nectar correlates to high-MGO honey, but not all Leptospermum species produce DHA in their nectar. This study investigates 55 of the 84 Leptospermum species native to Australia for their DHA-producing capability, with the DHA to total sugar (DHA:Tsugar) ratio of nectar samples determined by HPLC-PDA. DHA:Tsugar ranged from nondetectable in L. laevigatum, L. coriaceum, and L. trinervium to >16 000 mg/kg in L. speciosum and L. whitei. High-DHA Leptospermum species were identified for beekeepers to target for honey production and plantation development.

Dihydroxyacetone as a definitive treatment for aluminium phosphide poisoning in rats.

Aluminium phosphide (AlP), a very toxic pesticide also known as the rice tablet, releases phosphine gas upon contact with water, moisture, or gastric acid. Its mortality rate in humans is 70-100 % due to cardiogenic shock and refractory hypotension. Dihydroxyacetone (DHA) is a simple ketonic carbohydrate, mainly used for sunless skin tanning. It also plays a beneficial role in the treatment of hypotension and cardiogenic shock by restoring blood volume and cellular respiration. The aim of this study was to investigate the its effect on the haemodynamics and electrocardiogram (ECG) in male rats poisoned with AlP. The animals were divided into the following groups: control (received 1 mL corn oil, orally), AlP (received 15 mg kg-1 AlP solved in corn oil, orally), AlP plus DHA (treated with 50 mg kg-1 of DHA 30 min after receiving AlP), and AlP plus N-acetyl cysteine (NAC) (treated with 200 mg kg-1 of NAC 30 min after receiving AlP). The animals were then anaesthetised and ECG, blood pressure, and heart rate were recorded for 120 min. Treatment with AlP alone and in combination with NAC was associated with progressive hypotension, tachycardia, and ECG disturbances in rats, resulting in 100 % mortality 3 h after poisoning. However, DHA achieved 100 % survival in the poisoned rats and prevented AlP-induced ECG and haemodynamic abnormalities. The main mechanism of DHA in the treatment of AlP poisoning is unclear, but the findings suggest the promising therapeutic potential of DHA against AlP poisoning.

Camouflaging vitiligo with dihydroxyacetone.

Dihydroxyacetone (DHA), the active ingredient in sunless tanning agents, can provide cosmetically acceptable camouflage for some vitiligo patients.

Xanthotrichia (yellow hair) due to selenium sulfide and dihydroxyacetone.

Hair shaft discoloration has been documented to be caused by disease states, medications, and exogenous chemicals. After researching the literature, xanthotrichia or yellow hair has been determined to be caused predominately by exogenous chemicals. Two cases of new chemicals causing yellow hair shaft discoloration are reported. The chemicals include selenium sulfide 2.5% shampoo and dihydroxyacetone.

The maillard reaction for sunlight protection.

During seven months of a clinical trial in spring, summer, and fall, 30 UVA/B/Soret band-photosensitive patients used sequential topical applications of dihydroxyacetone (DHA) followed by naphthoquinone only at bedtime and received excellent photoprotection without a single therapeutic failure or loss of any patient to follow-up. Eighteen of the 30 patients extended the limits of their photoprotection repeatedly over a seven-month period to tolerate without sunburns six to eight hours of midday sunlight under all kinds of occupational and recreational environmental conditions. Previously, the use of 3% DHA topically in earlier studies gave only a sun protection factor (SPF) of 3. In this reanalysis of the original notes of a previous clinical study of the melanoidins produced by DHA followed by naphthoquinone in the keratin layers of the epidermis of minimally pigmented Caucasian photosensitive patients, it is determined that these patients received a minimal UVB photoprotection of SPF 18 or more. This represents at least a sixfold amplification of the UVB photoprotective effect over the use of only dihydroxyacetone in the Maillard reaction.

Durability of the sun protection factor provided by dihydroxyacetone.

BACKGROUND/PURPOSE: The sunless tanning agent dihydroxyacetone (DHA) is known to protect against longwave ultraviolet radiation (UVA) and visible light. Recently, our laboratory has shown that DHA in addition offers a modest sun protection factor (SPF) in humans. We conducted this study in order to investigate the durability of the SPF provided by DHA. METHODS: Ten healthy volunteers were treated with 20% DHA cream twice in three areas on the volar forearm. One, 5 and 7 days after the second application the participants were phototested with simulated sunlight in each area. Blue reflectance was used to measure the skin coloration by DHA in the test sites. RESULTS: DHA generated a significant SPF of 3.0 at day 1, 2.0 at day 5 and 1.7 at day 7 (P<0.0001). The SPF was positively correlated to the change in blue reflectance (r=0.39, P=0.034). The loss of SPF unit/day was not significantly different between the subjects (P<0.122). However, the intercepts were significantly different (P<0.0001) indicating differences in the initial SPF obtained among the subjects. CONCLUSIONS: The SPF of DHA decreases with the same loss of SPF unit/day between humans and the durability of the SPF thus depends on the initial SPF provided.

Antagonism of cyanide poisoning by dihydroxyacetone.

Dihydroxyacetone (DHA) effectively antagonized the lethal effect of cyanide in mice and rabbits, particularly if administered in combination with thiosulfate. Oral DHA (2 and 4 g/kg) given to mice 10 min before injection (i.p.) of cyanide increased the LD50 values of cyanide from 5.7 mg/kg to 12 and 17.6 mg/kg, respectively. DHA prevented cyanide-induced lethality most effectively, if given orally 10-15 min before injection of cyanide. A combination of pretreatment with oral DHA (4 g/kg) and post-treatment with sodium thiosulfate (1 g/kg) increased the LD50 of cyanide by a factor of 9.9. Furthermore, DHA given intravenously to rabbits 5 min after subcutaneous injection of cyanide increased the LD50 of cyanide from 6 mg/kg to more than 11 mg/kg, while thiosulfate (1 g/kg) given intravenously 5 min after cyanide injection increased the LD50 of cyanide only to 8.5 mg/kg. DHA also prevented the convulsions that occurred after cyanide intoxication.

Dihydroxyacetone in a new formulation--a powerful therapeutic option in vitiligo.

BACKGROUND: Most treatment protocols for vitiligo require a long treatment duration and usually do not result in complete repigmentation. Therefore, cosmetically acceptable and easily to handle alternatives are warranted. OBJECTIVE: To evaluate the properties of dihydroxyacetone (DHA) in a new formulation for the treatment of vitiligo on exposed areas. METHODS: We treated 10 patients suffering from vitiligo affecting the face and/or hands with a newly introduced, commercially available self-bronzing cream containing DHA 5%. DHA was applied every second day. RESULTS: The characteristic pigmentation showed very satisfactory cosmetic results in 8 out of 10 patients after 2 weeks of treatment. CONCLUSION: The new DHA formulation is a practical and well-accepted treatment modality.

Turbo-PUVA: dihydroxyacetone-enhanced photochemotherapy for psoriasis: a pilot study.

BACKGROUND: Dihydroxyacetone (DHA), a colorless sugar in "sunless" tanning lotions, binds to stratum corneum to form a UV-A-protective brown pigment. Bound DHA polymer is shed faster from hyperproliferative skin sites such as psoriatic plaques. We tested the hypothesis that selective shedding of DHA pigment during psoralen-UV-A (PUVA) treatment of psoriasis may allow higher UV-A doses, thus accelerating clearing while protecting uninvolved skin. Concurrent use of lactic acid was investigated as an aid in removing scale and residual DHA from psoriatic plaques. OBSERVATIONS: Thirty psoriatic patients with more than 20% body surface area involvement were recruited. The 6 PUVA study groups were (1) standard American style, (2) American style plus lactic acid, (3) DHA-PUVA or "topical ultraviolet-resisting barrier to optiimize PUVA" (Turbo-PUVA), (4) Turbo-PUVA with lactic acid, (5) European style, and (6) European style plus DHA. Combinations of lactic acid and European-style treatment were not studied. Each subject received up to 30 oral PUVA treatments twice weekly 3 days apart. The DHA-PUVA groups used 15% DHA lotion twice weekly. Lactic acid groups used 7% lotion daily except on treatment days. Psoriasis area and severity index scores were recorded weekly. Turbo-PUVA allowed higher UV-A exposures with minimal burns, showed faster clearing, and required fewer treatments for 90% clearing (P<.001). CONCLUSIONS: Protection of uninvolved skin by DHA during PUVA treatment allows higher UV-A exposures to be tolerated, demonstrates faster clearing, and requires fewer treatments to clear psoriasis. By reducing the total body dose received, Turbo-PUVA may also reduce long-term risks.

Inhibition of regain in body weight and fat with addition of 3-carbon compounds to the diet with hyperenergetic refeeding after weight reduction.

OBJECTIVE: To investigate the efficacy of the 3-carbon compounds pyruvate and dihydroxyacetone (PD) in inhibiting reaccumulation of body weight and fat with refeeding after weight loss. DESIGN: Longitudinal, in Clinical Research Center. After weight loss induced by hypoenergetic diet (1.3 MJ/d) for 3 weeks, refeeding with hyperenergetic diet (1.5 x resting energy expenditure) for 3 weeks. Refeeding diet randomized to contain PD or placebo (PL, polyglucose) as approximately 20% of energy intake. SUBJECTS: 17 obese healthy women (n = 8 in PL group, n = 9 in PD group) (age: 22-60 y, weight: 72.5-139.7 kg). MEASUREMENTS: Resting energy expenditure (REE), body composition (by bioelectrical impedance), nitrogen balance, serum proteins, biochemical profile, thyroid hormones, and insulin, before and after refeeding and weight and fat gain. RESULTS: Refeeding with a hyperenergetic diet, weight gain was significantly less in patients receiving PD compared to placebo (1.8 + 0.2 kg vs 2.9 +/- 0.1 kg, P < 0.01). Body fat regain was also less with feeding of PD (0.8 +/- 0.2 kg vs 1.8 +/- 0.2 kg, P < 0.01). Body protein metabolism, as measured by nitrogen balance, serum protein concentrations and fat free mass, was similar in subjects consuming either PD or PL. CONCLUSIONS: We conclude that 3-carbon compounds decrease weight gain and reaccumulation of body fat, without decreasing body protein gain, in obese subjects with hyperenergetic refeeding subsequent to weight loss.

Body composition, energy utilization, and nitrogen metabolism with a severely restricted diet supplemented with dihydroxyacetone and pyruvate.

To determine the effect of dietary modification on energy utilization during severely restrictive hypocaloric feeding, we measured body composition, energy deficit, and nitrogen metabolism in 13 obese women housed in a metabolic ward consuming a 2.1-MJ diet for 21 d with the three-carbon compounds dihydroxyacetone and pyruvate (DHAP), partially, isocalorically substituted for glucose. Body composition and amino acid (leucine) oxidation and turnover were determined before and after weight loss. Energy deficit was calculated from metabolic rates and compared with weight and fat loss. Subjects fed dihydroxyacetone and pyruvate showed a greater weight loss (DHAP = 6.5 +/- 0.3 kg, P = 5.6 +/- 0.2 kg), fat loss (DHAP = 4.3 +/- 0.2 kg, P = 3.5 +/- 0.1 kg), and weight and fat loss/4.25-MJ deficit (P less than 0.05 for all determinations). Nitrogen balance (urine and stool) and leucine metabolism were similar in both groups. We conclude that partial substitution of DHAP for six-carbon compounds of a 2.1-MJ diet will increase weight and fat loss.

Broad-spectrum photoprotection: the roles of tinted auto windows, sunscreens and browning agents in the diagnosis and treatment of photosensitivity.

Since window glass absorbs sunlight below 320 nm, it provides a means of assessing sensitivity to longer wavelengths, i.e. UVA and visible radiation. Positive responses to the query of whether symptoms develop in the auto with the windows up must now be interpreted with regard to the possible presence of tinted plastic film on side and rear windows. These films block nearly all UVA radiation, as does the plastic interleaf of windshields. Thus, occupants of an auto equipped with plastic film receive photoprotection from UVB radiation and well into the UVA region. We define three classes of topical sunscreens: (1) conventional UVB screens, (2) broad-spectrum preparations containing a UVB screen and a UVA absorber and (3) browning agents such as dihydroxyacetone (DHA) that produce a skin coloration that absorbs in the low end of the visible region, with overlap into long-wavelength UVA. By considering responses of photosensitive persons in autos with tinted or untinted windows, coupled with efficacy of appropriate sunscreens, we produced an algorithm defining three photosensitivity subsets. Persons sensitive to long-wavelength UVA and/or visible radiation will benefit from tinted auto windows. In particular, patients with lupus erythematosus (LE) have actively promoted legislation allowing tinted windows. Support for their position is documented by recent reports of induction of lesions in LE patients by exposure to UVA and visible radiation. The brown color produced by DHA is a useful adjunct to the screening action of broad-spectrum sunscreens. Development of a durable color overnight allows application of the DHA preparation in the evening, thus eliminating possible interference with sunscreen use during the day.