Polypodium leucotomos extract in atopic dermatitis: a randomized, double-blind, placebo-controlled, multicenter trial.

INTRODUCTION: Topical corticosteroids are used to treat inflammation and relieve itching in atopic dermatitis, but their use is limited by adverse reactions. OBJECTIVES: The main aim of this study was to investigate whether daily treatment with Polypodium leucotomos extract would reduce the use of topical corticosteroids in children and adolescents with atopic dermatitis. We also analyzed oral antihistamine use and changes in disease severity. PATIENTS AND METHODS: We performed a phase IV randomized, double-blind, placebo-controlled, multicenter trial involving 105 patients aged between 2 and 17 years who were receiving topical corticosteroids to treat moderate atopic dermatitis. The patients were randomized to receive, in addition to their standard treatment, Polypodium leucotomos extract or placebo (both in capsule form) for 6 months. The percentage of days on which topical corticosteroids and other atopic dermatitis treatments were used was calculated. RESULTS: Use of Polypodium leucotomos extract did not significantly reduce the mean (SD) percentage of days on which topical corticosteroids were used (11% [12%] vs 12% [11%] for placebo). A significant reduction was, however, observed for oral histamine use (median percentage of days, 4.5% in the Polypodium leucotomos group and 13.6% in the placebo group [P= .038]). The percentage of patients who used oral antihistamines was also lower in the Polypodium leucotomos group. CONCLUSION: Long-term treatment with Polypodium leucotomos extract has benefits for children and adolescents with atopic dermatitis who require pharmacologic treatment to reduce inflammation and relieve itching.

Increase with age of serum lipid peroxides: implications for the prevention of atherosclerosis.

There is considerable support for the concept that oxygen free radicals and related lipid peroxides play a key role in the pathogenesis of normal senescence and of age-related chronic degenerative diseases, including atherosclerosis. This has led to a great deal of interest regarding peroxidized LDL, which seems to be more atherogenic than LDL. In contrast, the relationship of total serum or plasma lipid peroxides (which also have a marked atherogenic action) with both aging and atherogenesis are not well understood. In view of the above, we have determined the level of serum lipid peroxide (expressed as thiobarbituric acid reactive substances) in a sample of 100 healthy men and women ranging in age from 20 to 70 years. Our data show that there is an age related increase in the concentration of lipid peroxide, with men showing higher or about equal values than women until about 60 years, after which age women show the higher values. Our data also suggest that in certain men and women, aging is linked to a decline in the competence of the oxyradical-detoxifying mechanisms, which results in increased serum lipid peroxidation. Further research is needed to find out if lowering the serum peroxide levels of aging subjects by diet supplementation with antioxidants will decrease that risk. An adequate intake of antioxidants seems especially indicated in post-menopausal women because of their apparent greater sensitivity to age related oxygen stress.

An hydroalcoholic extract of curcuma longa lowers the apo B/apo A ratio. Implications for atherogenesis prevention.

It is generally accepted that free-radical induced blood lipid peroxidation and especially peroxidized LDL play a central role in the pathogenesis of atherosclerosis and related cardiovascular disease. Moreover, recent research highlights the key contribution of apolipoprotein B (apo B) to atherogenesis as the main inductor of one of its earlier steps, i.e. macrophage proliferation. This has led us to investigate the apo B response to a very effective phenolic lipid-antioxidant, namely an hydroalcoholic extract of Curcuma longa, which according to our previous work does not show any toxic effects and decreases the levels of blood lipid peroxides, oxidized lipoproteins and fibrinogen. The present study shows that a daily oral administration of the extract decreases significantly the LDL and apo B and increases the HDL and apo A of healthy subjects. This and recent data on the increased anti-atherogenic action of the physiological antioxidant tocopherol in the presence of phenolic co-antioxidants (which eliminate the tocopheroxyl radical), justifies planned clinical research to test the usefulness of the curcuma extract as a co-antioxidant complement to standard treatments to prevent or retard atherosclerosis.

Phototoxic effects of Hypericum extract in cultures of human keratinocytes compared with those of psoralen.

Extracts of Hypericum perforatum (St. John's wort) are used in the treatment of depression. They contain the plant pigment hypericin and hypericin derivates. These compounds have light-dependent activities. In order to estimate the potential risk of phototoxic skin damage during antidepressive therapy, we investigated the phototoxic activity of hypericin extract using cultures of human keratinocytes and compared it with the effect of the well-known phototoxic agent psoralen. The absorbance spectrum of our Hypericum extract revealed maxima in the whole UV range and in parts of the visible range. We cultivated human keratinocytes in the presence of different Hypericum concentrations and irradiated the cells with 150 mJ/cm2 UVB, 1 J/cm2 UVA or 3 h with a white light of photon flux density 2.6 mumol m-2 s-1. The determination of the bromodeoxyuridine incorporation rate showed a concentration- and light-dependent decrease in DNA synthesis with high hypericin concentrations (> or = 50 micrograms/mL) combined with UVA or visible light radiation. In the case of UVB irradiation a clear phototoxic cell reaction was not detected. We found phototoxic effects even with 10 ng/mL psoralen using UVA with the same study design as in the case of the Hypericum extract. These results confirm the phototoxic activity of Hypericum extract on human keratinocytes. However, the blood levels that are to be expected during antidepressive therapy are presumably too low to induce phototoxic skin reactions.

Levels of dopachrome tautomerase in human melanocytes cultured in vitro.

Several reports have been published about the level of activity and possible functions of dopachrome tautomerase (DCT) in mouse melanoma cells. Data about the levels of this activity in human melanocytes in culture are still scarce, and, as far as we know, a comparison between mouse and human melanocytes, or between normal and malignant melanocytes, has never been published. We have measured the tyrosinase and DCT activities, as well as the melanin content, in mouse Cloudman melanoma cells, two lines of human melanoma, and three lines of normal human melanocytes obtained from fetal skin. Although more cell lines should be tested to draw a general conclusion, our results suggest that normal melanocytes contained much higher tyrosinase activity and melanin content but lower DCT activity than malignant melanocytes. The two lines of human melanoma cells tested had lower levels of DCT activity than Cloudman melanoma cells. Finally, the low level of DCT activity found in normal human melanocytes cultured in vitro cannot be explained by any of the necessary stimulatory factors added to the cell culture media.

Effect of the dose of ultraviolet radiation on the pigment formation by human melanocytes in vitro.

Human melanocytes were cultivated under different conditions with phorbol ester (TPA), or with bovine pituitary extract (BPE). The cells altered their morphology with the different culture conditions. With TPA they were predominantly bipolar, while with BPE most of the cells had a dendritic cell shape. In order to investigate the effect of UV irradiation, the cells were irradiated with 50, 100 and 200 mJ/cm2 UVA/B. After irradiation with 200 mJ/cm2 UVA/B the cells cultured with TPA also showed a dendritic shape. We determined the tyrosinase activity, the cellular melanin content and the cell number 3 days after irradiation. In all cases the number of cells decreased depending on the UVA/B doses. In melanocytes we found a marked increase in tyrosinase activity and melanin content after irradiation with 200 mJ/cm2. The UV-induced effect on tyrosinase activity was higher in melanocytes cultured with BPE than in those cultured with TPA. The results were compared with two human melanoma cell lines. Only little pigment formation could be measured in the tested melanoma cell lines without change after UV irradiation.

[Study of the circulating lymphocytes populations in systemic scleroderma, chronic discoid lupus erythematosus and dermatomyositis]. / Estudio de las poblaciones linfocitarias circulantes en esclerodermia sistémica, lupus eritematoso discoide crónico y dermatomiositis.

The authors studied the peripheral blood lymphocytes in any autoimmune diseases. In scleroderma the T-lymphocytes and ratio T4/T8 are decreased and B-lymphocytes are normal. In the LEDC the T-lymphocytes are decreased and B-lymphocytes are increased. In dermatomyositis the B-lymphocytes are increased and T-lymphocytes are decreased, the ratio T4/T8 is normal.

[Effect of bornaprine in localized hyperhidrosis]. / Efecto de la bornaprina en las hiperhidrosis localizadas.

Therapeutic action of bornaprine on localized forms of hyperhidrosis is studied in 12 patients. 50% improved after a week treatment. Other patients showed an acceptable change in the third or fourth week. Side effects only appeared in one patient.

[Differentiation of human epidermis cultured in vitro]. / La diferenciación de la epidermis humana cultivada in vitro.

The authors studied human epidermal differentiation in normal skin and skin cultured according to Green's method. No differences was observed except for the filaggrin and involucrin patterns; the lectins revealed identical patterns in normal and cultured human epidermis. The ultrastructural study verified a similar morphology in both types of epidermis.

[Study of membrane oligosaccharides in keratinocytes using the lectins in normal epidermis]. / Estudio de los oligosacáridos de membrana en los queratinocitos mediante aplicación de lectinas en epidermis normal.

The authors studied the oligosaccharides coated membrane of normal keratinocytes with the lectins HPA, PHA-L, RCA-120; and ConA. The results permit to have a pattern of normally epidermic differentiation.

[Immune staining of Paget's cells]. / Inmunomarcaje de las células de Paget.

The authors studied with the technic of PAP a case of the Paget extramammary. The presence of the precursors of the human milk in these cells in a date for to thing than Paget extramammary is the origin eccrine or apocrine.

[Peripheral blood lymphocyte populations in 2 cases of Behçet syndrome]. / Estudio de las poblaciones linfocitarias en sangre periférica en dos casos de síndrome de Behçet.

The lymphocytes subsets in peripheral blood were studied in two patients with Behçet's syndrome. The finding about the decrease of T lymphocytes with the ratio elevated and specially the increase of B lymphocytes favors the hypothesis of predominance of the antibody formation over the cellular cytotoxicity.

[Langerhans cell population in basal cell epitheliomas]. / Estudio de la población de células de Langerhans en los epiteliomas basocelulares.

The authors studied the distribution of Langerhans cells in 42 cases of basal-cell epithelioma using monoclonals antibodies OKT6 and anti-HLA-Dr. The tumors are grouped in anatomopathologic subtypes. An increase of density of Langerhans cells is observed in the upper-tumoral epidermis. In the tissue tumour, the Langerhans cells are scarce, and we find a higher number of Langerhans cells in the peritumoral dermis.

[Changes in surface oligosaccharides in precancerous skin lesions]. / Estudio de las alteraciones de los oligosacáridos de superficie en lesiones cutáneas precancerosas.

The authors studied 5 cases of the actinic keratoses, 3 cases of the leukoplakia and 2 cases of the cutaneous horn with the lectins specifics on the oligosaccharides of the keratinocyte's membrane. The patterns in each disease are described according to grade of differentiation.

[Lectin staining of a Merkel cell tumor]. / Marcaje mediante lectinas de un tumor de células de Merkel.

The authors studied a Merkel's cell tumor with lectins. There is pattern of normal epidermis, but we see the N-acetyl-glucosamine an oligosaccharide not present in epidermis.

[Lectin staining of disorders of keratinization. I. Ichthyosis, Darier's disease and acrokeratosis verruciformis]. / Marcaje mediante lectinas de transtornos de la queratinización. I. Ictiosis, enfermedad de Darier y acroqueratoris verruciforme.

Lectin application is used to study 12 cases of ichthyosis, 8 cases of Darier's disease and two of acrokeratosis verruciformis, establishing comparative patterns with normal skin.

[Marking disorders of keratinization by means of lectins. II. Keratosis pilaris, lichen spinulosus, porokeratosis, lichen striatus and pityriasis rubra pilaris]. / Marcaje mediante lectinas de trastornos en la queratinización. II. Queratosis pilaris, liquen espinuloso, poroqueratosis, liquen estriado y pitiriasis rubra pilaris.

Lectins are used to study four cases of keratosis pilaris, four of lichen spinulosus, 11 of porokeratosis, 8 of striated lichen and one case of pityriasis rubra pilaris, with the aim of providing data to improve knowledge of the histogenesis of these processes.

[Atypical Sweet's syndrome. Apropos of 4 cases]. / Sindrome de Sweet atípico. A propósito de cuatro casos.

The authors study four cases of Sweet's syndrome in which the clinical manifestations differ from the original description, although the laboratory reports, the response to the treatment and histologic data were typical of this entity. By the way, the authors propose a hypothesis about the pathogenesis of this syndrome.

[Ultrastructural study of Leishmania tropica in the amastigote phase]. / Estudio ultraestructural de la Leishmania trópica en fase amastigota.

A case is reported of cutaneous leishmaniasis with an ultrastructural study of the amastigote form, emphasizing and discussing the presence of two flagella inwards in the same parasite, a fact which is indicative of the great activity of the parasite in host lesions.

[Spinocellular epithelioma. Risk factors in the occurrence of metastasis. Study of 650 cases]. / Epitelioma espinocelular. Factores de riesgo en la aparición de metástasis. Estudio de 650 casos.

An evaluation is made of the clinical and histological parameters of 650 cases of spinocellular epitheliomas. The statistical study shows metastasis to be related to tumor location, tumor size, Broder's grading and acantholysis.