Pavez Loriè E, Cools M, Borgers M, Wouters L, Shroot B, Hagforsen E, Törmä H, Vahlquist A
Department of Medical Sciences/Dermatology, Uppsala University, SE-751 85 Uppsala, Sweden.
Br J Dermatol. 2009 Jan;160(1):26-36. doi: 10.1111/j.1365-2133.2008.08895.x. Epub 2008 Oct 21.
An alternative approach to retinoid therapy is to inhibit the cytochrome P450 (CYP)-mediated catabolism of endogenous all-trans retinoic acid in the skin by applying retinoic acid metabolism blocking agents such as talarozole (R115866).
To study the effects of topical talarozole on retinoid biomarkers in normal skin in a randomized phase I trial.
Gels containing talarozole (0.35% or 0.07%) and vehicle were applied once daily for 9 days on either buttock of 16 healthy volunteers. Epidermal shave biopsies (for mRNA analysis) and punch biopsies (for histology and immunofluorescence analysis) were collected from the treatment areas. Genes encoding the following were studied by quantitative real-time polymerase chain reaction: cellular retinoic acid binding protein 2 (CRABP2), cytokeratins (KRT2 and KRT4), CYP26A1, CYP26B1, CYP26C1 and CYP2S1, two enzymes in the retinol metabolism (retinal dehydrogenase-2 and retinol acyltransferase) and two proinflammatory cytokines [interleukin (IL)-1alpha and tumour necrosis factor-alpha].
Talarozole treatment increased the mRNA expression of CRABP2, KRT4, CYP26A1 and CYP26B1 dose dependently, and decreased the expression of KRT2 and IL-1alpha compared with vehicle-treated skin. No mRNA change in retinol-metabolizing enzymes was obtained. There was no induction of epidermal thickness or overt skin inflammation in talarozole-treated skin. Immunofluorescence analysis confirmed an upregulation of KRT4 protein, but no upregulation of CYP26A1 and CYP26B1 expression was detected.
Talarozole influences the biomarker pattern consistently with increased retinoic acid stimulation. The low irritancy of talarozole at the two examined dosages is a possible advantage over topical retinoids.
维甲酸治疗的另一种方法是通过应用诸如他拉罗唑(R115866)等维甲酸代谢阻断剂来抑制细胞色素P450(CYP)介导的皮肤内源性全反式维甲酸的分解代谢。
在一项随机I期试验中研究局部应用他拉罗唑对正常皮肤中维甲酸生物标志物的影响。
将含有他拉罗唑(0.35%或0.07%)和赋形剂的凝胶每天一次涂抹于16名健康志愿者的任一臀部,持续9天。从治疗区域采集表皮削片活检组织(用于mRNA分析)和打孔活检组织(用于组织学和免疫荧光分析)。通过定量实时聚合酶链反应研究编码以下物质的基因:细胞视黄酸结合蛋白2(CRABP2)、细胞角蛋白(KRT2和KRT4)、CYP26A1、CYP26B1、CYP26C1和CYP2S1、视黄醇代谢中的两种酶(视网膜脱氢酶-2和视黄醇酰基转移酶)以及两种促炎细胞因子[白细胞介素(IL)-1α和肿瘤坏死因子-α]。
与赋形剂处理的皮肤相比,他拉罗唑治疗剂量依赖性地增加了CRABP2、KRT4、CYP26A1和CYP26B1的mRNA表达,并降低了KRT2和IL-1α的表达。未观察到视黄醇代谢酶的mRNA变化。他拉罗唑治疗的皮肤未出现表皮厚度增加或明显的皮肤炎症。免疫荧光分析证实KRT4蛋白上调,但未检测到CYP26A1和CYP26B1表达上调。
他拉罗唑影响生物标志物模式,与维甲酸刺激增加一致。他拉罗唑在两种检测剂量下的低刺激性是相对于局部维甲酸的一个可能优势。