Supramolecular salicylic acid combined with niacinamide in chloasma: A randomized controlled trial.

BACKGROUND: No trial of supramolecular salicylic acid (SSA) for chloasma is available yet. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of Bole DA 30% supramolecular salicylic acid (SSA) combined with 10% niacinamide in treating chloasma. METHODS: This multicenter (n=15), randomized, double-blind, parallel placebo-controlled trial randomized the subjects (1:1) to Bole DA 30% SSA or placebo. The primary endpoint was the effective rate after 16 weeks using the modified melasma area severity index (mMASI) [(pretreatment-posttreatment)/pretreatment×100%]. RESULTS: This study randomized 300 subjects (150/group in the full analysis set, 144 and 147 in the per-protocol set). The total mMASI score, overall Griffiths 10 score, left Griffiths 10 score, and right Griffiths 10 score were significantly lower in the Bole DA 30% SSA group than in the placebo group (all P<0.001). One study drug-related AE and one study drug-unrelated adverse events (AE) were reported in the Bole DA 30% SSA group. No AE was reported in the placebo group. CONCLUSION: Bole DA 30% SSA combined with 10% niacinamide is effective and safe for treating chloasma. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2200065346.

Clinical practice Guidelines for 5-Aminolevulinic acid photodynamic therapy for acne vulgaris in China.

A variety of evidence suggest that 5-Aminolevulinic acid-based photodynamic therapy (ALA-PDT) is clinically effective in management of acne vulgaris. Several clinical guidelines for acne recommend PDT as an alternative treatment modality for severe acne. However, there is a lack of detailed clinical guideline for PDT in acne treatment. To propose up-to-date, evidence-based and practical recommendations on application of ALA-PDT for acne vulgaris, dermatologists and PDT experts from the Photodynamic Therapy Research Center of the CMA and Photodynamic Therapy Rehabilitation Training Center of CARD achieved consensus and guidelines based on careful evaluation of published literature, expert opinions and experience. ALA-PDT plays a therapeutic role in all four major pathogenesis of acne, and is suitable for moderate to severe acne and scar-prone acne, especially for patients who cannot tolerate or refused systemic antibiotics and isotretinoin. The efficacy and adverse reactions of ALA-PDT are closely related to therapeutic parameters including ALA concentration, incubation time, light source and dosage. Proper pretreatment helps to improve transdermal absorption of ALA and enhances its efficacy. We reviewed and proposed recommended protocols for four PDT procedures including conventional PDT (C-PDT), modified painless PDT (M-PDT), intense pulsed light PDT (IPL-PDT) and daylight PDT (DL-PDT). M-PDT with lower ALA concentration (3-5%), shorter incubation time (30 mins), and lower dose but prolonged illumination (630nm, 40-60 mW/cm2, 150 J/cm2) can improve lesions of moderate to severe acne vulgaris effectively with minimal pain and easier manipulation, and thus was recommended by Chinese dermatologists. Lastly, management of adverse reactions were addressed.

Modulation of skin microbiome in acne patients by aminolevulinic acid-photodynamic therapy.

BACKGROUND: Aminolevulinic acid-photodynamic therapy (ALA-PDT) has been an effective treatment for moderate to severe acne. However, the effect of ALA-PDT on skin microbiome in acne patients should also be examined.. AIM: To examine the composition, diversity, and resilience of skin microbiome in acne patients before and after ALA-PDT. METHOD: A prospective study was conducted on five patients with moderate to severe acne. All patients underwent a 5% ALA-PDT at a two-week interval for four sessions. Epidermal and follicular samples of acne patients were acquired for 16S rRNA gene amplicon metasequencing at baseline and before the final session. RESULT: ALA-PDT inhibited Cutibacterium acnes of follicular microbiome in acne. Follicular residential bacteria, mainly Bacillus and Lactococcus, rose in abundance after PDT. ALA-PDT increased the diversity of skin microbiome in acne and clustered follicular microbiome toward epidermal microbiome, both taxonomically and functionally. CONCLUSION: ALA-PDT exerts its therapeutic effect on acne partially through inhibiting C. acnes and modulating the composition and potential function of skin microbiome in acne.

The effects of ALA-PDT on microbiota in pilosebaceous units of patients with severe acne: A metagenomic study.

BACKGROUND: 5-aminolevulinic acid mediated photodynamic therapy (ALA-PDT) is increasingly used to control severe acne. However, its impact on skin microbiota remains uncertain. OBJECTIVES: We aimed to compare the makeup, diversity, and function of the microbiota in pilosebaceous units of patients with severe acne before and after ALA-PDT. METHODS: A longitudinal cohort study was performed on 11 participants with severe facial acne. All patients were given 5%ALA-PDT every two weeks for three sessions in total. The contents of lesions were sampled for metagenomic sequencing at baseline and two weeks after the first ALA-PDT session. RESULTS: Cutibacterium acnes was the most dominant species followed by Staphylococcus epidermidis and Pseudomonas fluorescens. Treatment with ALA-PDT led to clinical improvements in acne severity concurrent with a significant reduction in the relative abundance of C. acnes, while P. fluorescens increased significantly after ALA-PDT. No significant change was identified in other species. ALA-PDT administration was associated with an increased microbiota diversity and reductions in the relative abundance of the functional genes involved in energy metabolism and DNA replication. CONCLUSIONS: ALA-PDT plays a therapeutic role by killing C. acnes, increasing P. fluorescens and the microbiome diversity, while inhibiting the function of microbiota in pilosebaceous units of severe acne.

Neural progenitor cell-derived nanovesicles promote hair follicle growth via miR-100.

BACKGROUND: Accumulating evidence shows that mesenchymal stem cell-derived extracellular vesicles (EVs) hold great promise to promote hair growth. However, large-scale production of EVs is still a challenge. Recently, exosome-mimetic nanovesicles (NV) prepared by extruding cells have emerged as an alternative strategy for clinical-scale production. Here, ReNcell VM (ReN) cells, a neural progenitor cell line was serially extruded to produce NV. RESULTS: ReN-NV were found to promote dermal papilla cell (DPC) proliferation. In addition, in a mouse model of depilation-induced hair regeneration, ReN-NV were injected subcutaneously, resulting in an acceleration of hair follicle (HF) cycling transition at the site. The underlying mechanism was indicated to be the activation of Wnt/ß-catenin signaling pathway. Furthermore, miR-100 was revealed to be abundant in ReN-NV and significantly up-regulated in DPCs receiving ReN-NV treatment. miR-100 inhibition verified its important role in ReN-NV-induced ß-catenin signaling activation. CONCLUSION: These results provide an alternative agent to EVs and suggest a strategy for hair growth therapy.

CircMYC Regulates Glycolysis and Cell Proliferation in Melanoma.

Circular RNAs (cicRNAs) have been identified to play pivotal roles in several cancer types. However, functions of circRNA in malignant melanoma are poor defined. Our current study demonstrated that human circMYC was obviously upregulated in human melanoma tissue. Furthermore, circMYC promoted the proliferation of human melanoma cells and Mel-CV cells. The expression of circMYC can repress Mel-CV cell glycolysis and LDHA activities in the in vitro glycolysis and lactate production evaluations. circMYC directly bound to miR-1236 as a molecular sponge that targeting miR-1236 in Mel-CV cells via bioinformatics analysis, pull-down assay, and luciferase reporter assays. Our present study revealed that 3' UTR of LDHA acted as a target of miR-1236 using Mel-CV cells. Based on our findings, c-MYC-SRSF1 axis may regulate the production of circMYC. Overall, these results elucidate potential effects of circMYC in melanoma development and provide a promising biomarker for melanoma diagnosis.

Efficacy and Safety of Targeted High-Intensity Medium-Band (304-312 nm) Ultraviolet B Light in Pediatric Vitiligo.

BACKGROUND/OBJECTIVES: Phototherapy is a commonly used treatment for vitiligo that has demonstrated safety and efficacy. High-intensity targeted ultraviolet B (UVB) light (304-312 nm) delivered using a phototherapy device is a useful therapeutic option because it can induce repigmentation in a short time without global exposure to radiation, but information regarding this device in children is limited. METHODS: We performed a retrospective analysis of 95 patches of vitiligo in 27 children treated using a targeted phototherapy device. Phototherapy was administered twice a week. RESULTS: After the first 10 treatment sessions, 82 (86.3%) patches demonstrated some repigmentation and 36.8% achieved 50% or more repigmentation. After a mean of 20.4 treatment sessions, 86 patches (90%) demonstrated some repigmentation and 53.7% achieved 50% or more repigmentation. Responses varied depending on the anatomic location of the lesions. Better responses were usually observed on the face and trunk, whereas the extremities typically showed little response. Repigmentation was better in patients with active vitiligo than in those with stable vitiligo, with responses better with a disease duration of 1 year or less than in those with a duration of more than 1 year. There was no statistically significant difference in repigmentation between those with segmental and generalized vitiligo. The only short-term local side effect was mild erythema that required a decrease in dosage in six patients. CONCLUSION: Targeted high-intensity medium-band UVB phototherapy alone can produce clinical improvement in pediatric vitiligo and is well tolerated.

Long-term effect of early-life supplementation with probiotics on preventing atopic dermatitis: A meta-analysis.

The prevalence of allergic diseases has increased over the past few decades. Atopic dermatitis (AD) is a common allergic disease, for which there is currently no known cure. Administration of probiotics in early life may be an effective method to prevent AD, but very little is known about its long-time preventive effect. In this research, a meta-analysis has been conducted to evaluate the long-term effect of early-life supplementation with probiotics on preventing AD. Meta-analysis was performed by the Review Manager version 5.2 software. Risk ratio and 95% confidence intervals were calculated by a fixed effect model. Six trials and a total of 1955 patients were included in this meta-analysis. The combined risk ratio of the meta-analysis comparing probiotics with placebo for investigating the long-term preventive effect of AD was 0.86 (95% CI 0.77-0.96), which demonstrates that probiotics is likely to produce long-term prevention of AD.

Expression of Cyclooxygenase-2 in Squamous Cell Carcinoma and Keratoacanthoma and its Clinical Significance.

Cyclooxygenase (COX), also known as prostaglandin endoperoxide synthase, catalyzes the conversion of arachidonic acid to prostanoids. There are two different isoforms of COX, referred to as COX-1 and COX-2. Overexpression of COX-2 has been demonstrated in various neoplasms. In this study, we plan to utilize COX-2 in understanding the difference of squamous cell carcinoma and keratoacanthoma which have many similarities in both morphological and histological features. The objective of this study is to study the expression of COX-2 in squamous cell carcinoma and keratoacanthoma and to discuss its clinical significance. The expression of COX-2 in 55 cases of skin tumors (including 30 specimens of squamous cell carcinoma, 25 specimens of keratoacanthoma) and 20 normal skin tissues was detected by immunohistochemical technique. The positive expression of COX-2 was found in 73.3 % (22/30) of squamous cell carcinoma and 12 % (3/25) of keratoacanthoma cases. The positive expression rate of COX-2 in 55 skin tumors (45.5 %) was significantly higher than that in normal skin tissues (5 %) (χ (2) = 10.598 %, P < 0.05). The expression of COX-2 in squamous cell carcinoma (73.3 %) was significantly higher than that in keratoacanthoma (12 %) (χ (2) = 20.69, P < 0.05). COX-2 overexpression may play a potential role in the pathogenesis of skin tumors. The positive expression rate of COX-2 is associated with the malignant degree of the tumor, and also it may help differentiating squamous cell carcinoma from keratoacanthoma.

Low-Dose Topical 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Different Severity of Acne Vulgaris.

The objective of this article is to investigate the effectiveness and safety of photodynamic therapy (PDT) with 3.6 % topical aminolevulinic acid (ALA) and a short incubation time with red light in moderate to severe acne. One hundred and thirty-six patients with moderate to severe acne were treated with 3.6 % topical ALA-PDT for three sessions with an interval of 2 weeks. Patients were evaluated for efficacy and safety on week 2, 4, 6, 8, and 12 after the initial treatment. Most patients showed apparent clearance of acne lesions at the treated site after three sessions. The effective treatment rates were increased after the multiple therapies. The clinical outcomes are the best at 4 weeks after the final treatment. The total effectiveness rate and cure rate of the low-dose ALA-PDT procedure is 92.65 and 47.06 %, respectively. Thirty-one patients and nineteen patients showed apparent exacerbation of acne lesions before the 2nd and 3rd treatment, respectively, but all of them showed good or excellent improvement after a three-course treatment. A few patients showed mild relapse including papules and comedos at 8 weeks after the final treatment. No significant differences are found in the effects of different acne severity and different genders. Adverse reactions are mild and transient. A 3.6 % topical ALA-PDT with a short time incubation with red light is a simple and an effective treatment option for moderate to severe acne with mild side effects in Chinese people.