1
|
Singh SK, Chaubey S, Bansal A, Kaur G, Malik DS. Cosmeceutical Aptitudes of Azelaic Acid. Curr Drug Res Rev 2021; 13:222-229. [PMID: 34042044 DOI: 10.2174/2589977513666210526122909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/08/2021] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Azelaic acid (AZA) is a white crystalline dicarboxylic acid naturally found in grains, rye and barley. AZA has substantial biological and therapeutic abilities (viz a viz) its anti-inflammatory, anti-oxidant, anti-keratinizing, anti-microbial properties, etc. which contribute to its applicability in the management of mild to harsh dermatological complications (acne, rosacea, dermatitis, hyper-pigmentation, carcinomas, etc.). AZA has shown its effectiveness against varied non-inflammatory and inflammatory lesions by normalizing the hyper-keratinization statie and attenuating the increased levels of microbial content. Topically AZA, either alone or in conjunction with other active moieties, has proved to be effective in preventing acne and several other hyper-pigmentary conditions. OBJECTIVES Chronic applicability of AZA has been evidenced with the effects like itching, burning, stinging, redness, etc. To deal with the former issues, research is being conducted to substitute the conventional formulations with novel preparations (liposome's, niosomes, micro sponges, lipid nanocarriers, etc.), which could enhance the overall pharmaceutical and pharmacological profile of the drug. CONCLUSION This article is an attempt to highlight the basic physiochemical properties of AZA, its physiological role (especially in dermatology), various commercial preparations and recent novel approaches that are in research with an aim to augment the therapeutic and safety profile of AZA.
Collapse
Affiliation(s)
| | - Saumya Chaubey
- Chitkara College of Pharmacy, Chitkara, University, Punjab, India
| | - Anil Bansal
- Chitkara College of Pharmacy, Chitkara, University, Punjab, India
| | - Gurpreet Kaur
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
| | | |
Collapse
|
2
|
Abstract
Azelaic Acid (AA) is a naturally occurring 9-carbon straight-chain saturated dicarboxylic
acid widely found in wheat, rye, and barley. It has been shown to possess numerous biochemical
activities, such as anti-inflammatory, anti-microbial, antioxidant, anticomedolytic and anticancer.
This therapeutic agent has been approved by US food Drug Administration for the treatment of mild
to moderate acne and rosacea. Further, azelaic acid has been reported for the management of skin
hyperpigmentation, melasma and alopecia. In this review article, several studies on azelaic acid that
pointed out its bioactivities and pharmacology along with its drug delivery systems are reviewed.
Additionally, an outlook on its mechanism of action is also given. Azelaic acid is an important moiety
for the management of acne owing to its benefits in addressing follicular excess sebum, inflammatory
action, hyperproliferation and activity against Propionibacterium acne. The commercially
available topical formulations normally contain 15 to 20% AA. In the future, a broadspectrum antibacterial
agent, azelaic acid can act as a pillar in acne therapy minimizing the potential risk of
emergence of resistance. This review will definitely provide a new perspective for research involving
this bioactive molecule.
Collapse
Affiliation(s)
- Anil Kumar
- Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science & Technology, Hisar, 125001, India
| | - Rekha Rao
- Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science & Technology, Hisar, 125001, India
| | - Poonam Yadav
- Department of Pharmaceutical Sciences, Maharishi Dayanand University, Rohtak, 124001, India
| |
Collapse
|
3
|
Papanikolaou M, Lawrence CM. Long-term outcomes of imiquimod-treated lentigo maligna. Clin Exp Dermatol 2019; 44:631-636. [PMID: 30663131 DOI: 10.1111/ced.13896] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lentigo maligna (LM) may be disfiguring and can progress to LM melanoma. Surgical excision remains the mainstay of treatment, but may result in disfigurement when used for large facial lesions. Topical imiquimod is a nonsurgical alternative although data on its long-term efficacy remain limited. AIM To assess long-term outcomes of LM treated with imiquimod cream. METHODS We collected data retrospectively for 33 patients treated with imiquimod cream for biopsy-proven LM from 2001 to 2016. Patients initially applied imiquimod once daily, 5 days/week for 6 weeks, aiming to produce a brisk local inflammatory response. If there was no response, the dose was increased to twice daily 7 days/week for 6 weeks and if again there was no response, to twice daily for 10 weeks. RESULTS An inflammatory response developed in 29 (88%) of the 33 patients, and of these, 4 patients stopped treatment earlier than planned because they could not tolerate the inflammatory reaction, while 3 patients reported systemic side effects. There was lesion clearance in 21 (72%) of the 29 patients, and they remained clear after a mean follow-up of 4.1 years. Eight failed to clear; in five the lesion was excised, while the remaining three were managed expectantly. CONCLUSIONS Our results support the use of imiquimod as an alternative to surgery for the treatment of LM in selected cases. With adequate patient preparation, imiquimod is generally tolerated and can achieve excellent cosmetic results. A clinical response is more likely if there is a brisk inflammatory response, and LM will not resolve if there is no inflammatory response.
Collapse
Affiliation(s)
- M Papanikolaou
- Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - C M Lawrence
- Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| |
Collapse
|
4
|
Higgins HW, Lee KC, Galan A, Leffell DJ. Melanoma in situ: Part II. Histopathology, treatment, and clinical management. J Am Acad Dermatol 2015; 73:193-203; quiz 203-4. [PMID: 26183968 DOI: 10.1016/j.jaad.2015.03.057] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 03/18/2015] [Accepted: 03/31/2015] [Indexed: 11/20/2022]
Abstract
Melanoma in situ (MIS) poses special challenges with regard to histopathology, treatment, and clinical management. The negligible mortality and normal life expectancy associated with patients with MIS should guide treatment for this tumor. Similarly, the approach to treatment should take into account the potential for MIS to transform into invasive melanoma, which has a significant impact on morbidity and mortality. Part II of this continuing medical education article reviews the histologic features, treatment, and management of MIS.
Collapse
Affiliation(s)
- H William Higgins
- Department of Dermatology, Brown University School of Medicine, Providence, Rhode Island.
| | - Kachiu C Lee
- Department of Dermatology, Brown University School of Medicine, Providence, Rhode Island
| | - Anjela Galan
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - David J Leffell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
5
|
Sieber MA, Hegel JKE. Azelaic acid: Properties and mode of action. Skin Pharmacol Physiol 2013; 27 Suppl 1:9-17. [PMID: 24280644 DOI: 10.1159/000354888] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Acne is a common skin disorder that can be problematic for adults as well as for adolescents. It has several key pathophysiological features such as follicular hyperkeratosis, elevated Propionibacterium acnes proliferation, and reactive inflammation, all of which should be targeted for an optimal outcome. Azelaic acid (AzA) has profound anti-inflammatory, antioxidative effects, and is bactericidal against a range of Gram-negative and Gram-positive microorganisms as well, including antibiotic-resistant bacterial strains. In addition, AzA's antikeratinizing effects are inhibitory toward comedones. AzA is effective overall in targeting multiple causes of acne and has been proven to be well tolerated in numerous clinical trials.
Collapse
Affiliation(s)
- M A Sieber
- Global Medical Affairs Dermatology, Bayer Pharma AG, Berlin, Germany
| | | |
Collapse
|
6
|
Abstract
Surgical excision is the treatment of choice for primary melanomas and radiation therapy is the accepted alternative for the subset of lesions not amenable to surgery. With the recent rise in melanoma incidence, especially in the elderly, there are a growing number of cases that are neither amenable to surgery nor radiation therapy. In this article, we review pharmacotherapeutic approaches to microinvasive melanoma (invasive radial growth phase melanoma) that might be considered in such circumstances. There are no approved drugs for the treatment of primary melanoma and randomized controlled trials with 5 or more years of follow-up have not been performed. The limited studies and numerous case series in the literature on pharmacologic treatment of primary melanoma have focused on topical therapies. Accordingly, we provide a review of the potential pharmacotherapeutic agents in the treatment of microinvasive melanoma by extrapolating from the available limited literature on the use of fluorouracil, azelaic acid, retinoic acid derivatives, interferon (IFN)-α, imiquimod, and other agents for melanoma in situ, invasive melanoma, and epidermotropic melanoma metastases. Our review indicates that topical fluorouracil and tretinoin are not effective as single agents. The efficacy of azelaic acid, tazarotene, cidofovir, and intralesional IFN-α, interleukin-2, and IFN-β is undefined. Imiquimod is the most studied and promising agent; however, optimal dosage, therapeutic regimen, and survival rates are unknown. In the face of a growing demand for non-surgical treatments, formal clinical trials are needed to ascertain the role of pharmacotherapeutic agents in the treatment of microinvasive melanoma.
Collapse
Affiliation(s)
- Elizabeth A Quigley
- Dermatology Service, Memorial Sloan Kettering Cancer Center, 136 Mountain View Blvd, Basking Ridge, NJ, USA.
| | | |
Collapse
|
7
|
Morpurgo G, Fioretti B, Catacuzzeno L. The main product of specialized tissues regulates cell life and may cause neoplastic transformation. Med Hypotheses 2009; 74:847-54. [PMID: 20036074 DOI: 10.1016/j.mehy.2009.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 11/24/2009] [Indexed: 11/15/2022]
Abstract
Many tissues and cells in vertebrates are highly specialized and devoted to a single function through the action of a single molecule, that we call the "main product" (MP) of the cell. The hypothesis here proposed is that these MPs control all aspects of the cell life, namely activity, division, differentiation and apoptosis. Evidences supporting this hypothesis are reported for the immune system, pancreatic beta-cells, melanocytes, connective tissues, thyroid cells, skin and erythroid cells. In all cases cell division and differentiation is promoted by a normal activity of the MP, while hyperactivity leads to cell apoptosis. Evidences are also provided that alterations of the activity of the MP may elicit pathological disorders; in particular mutations altering the structure of the MP may elicit tumoural transformation.
Collapse
Affiliation(s)
- Giorgio Morpurgo
- Dipartimento di Biologia Cellulare e Ambientale, Universita' di Perugia, Perugia, Italy
| | | | | |
Collapse
|
8
|
Mayer-da-Silva A. Azelaic acid: Pharmacology, toxicology and mechanism of action in acne. J DERMATOL TREAT 2009. [DOI: 10.3109/09546638909094475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
9
|
Breathnach A. Azelaic acid: A new agent in the treatment of acne: History, metabolism and biochemistry. J DERMATOL TREAT 2009. [DOI: 10.3109/09546638909094474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
10
|
Abstract
Lentigo maligna (LM), a melanoma in situ, is a fairly common melanocytic lesion that usually develops on the chronically sun-exposed skin of the head and neck of Caucasians. It occurs mostly in people older than 40 years, with an incidence rate that increases with age and peaks in the seventh and eighth decades of life. Its diagnosis and treatment remain challenging. In this article, we review the history, epidemiology, clinical presentation, histology, and treatment of LM.
Collapse
|
11
|
Ando H, Kondoh H, Ichihashi M, Hearing VJ. Approaches to Identify Inhibitors of Melanin Biosynthesis via the Quality Control of Tyrosinase. J Invest Dermatol 2007; 127:751-61. [PMID: 17218941 DOI: 10.1038/sj.jid.5700683] [Citation(s) in RCA: 245] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Tyrosinase, a copper-containing glycoprotein, is the rate-limiting enzyme critical for melanin biosynthesis in specialized organelles termed melanosomes that are produced only by melanocytic cells. Inhibitors of tyrosinase activity have long been sought as therapeutic means to treat cutaneous hyperpigmentary disorders. Multiple potential approaches exist that could control pigmentation via the regulation of tyrosinase activity, for example: the transcription of its messenger RNA, its maturation via glycosylation, its trafficking to melanosomes, as well as modulation of its catalytic activity and/or stability. However, relatively little attention has been paid to regulating pigmentation via the stability of tyrosinase, which depends on its processing and maturation in the endoplasmic reticulum and Golgi, its delivery to melanosomes and its degradation via the ubiquitin-proteasome pathway and/or the endosomal/lysosomal system. Recently, it has been shown that carbohydrate modification, molecular chaperone engagement, and ubiquitylation all play pivotal roles in regulating the degradation/stability of tyrosinase. While such processes affect virtually all proteins, such effects on tyrosinase have immediate and dramatic consequences on pigmentation. In this review, we classify melanogenic inhibitory factors in terms of their modulation of tyrosinase function and we summarize current understanding of how the quality control of tyrosinase processing impacts its stability and melanogenic activity.
Collapse
Affiliation(s)
- Hideya Ando
- Laboratory of Cell Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | | | | | | |
Collapse
|
12
|
Solano F, Briganti S, Picardo M, Ghanem G. Hypopigmenting agents: an updated review on biological, chemical and clinical aspects. ACTA ACUST UNITED AC 2007; 19:550-71. [PMID: 17083484 DOI: 10.1111/j.1600-0749.2006.00334.x] [Citation(s) in RCA: 454] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
An overview of agents causing hypopigmentation in human skin is presented. The review is organized to put forward groups of biological and chemical agents. Their mechanisms of action cover (i) tyrosinase inhibition, maturation and enhancement of its degradation; (ii) Mitf inhibition; (iii) downregulation of MC1R activity; (iv) interference with melanosome maturation and transfer; (v) melanocyte loss, desquamation and chemical peeling. Tyrosinase inhibition is the most common approach to achieve skin hypopigmentation as this enzyme catalyses the rate-limiting step of pigmentation. Despite the large number of tyrosinase inhibitors in vitro, only a few are able to induce effects in clinical trials. The gap between in-vitro and in-vivo studies suggests that innovative strategies are needed for validating their efficacy and safety. Successful treatments need the combination of two or more agents acting on different mechanisms to achieve a synergistic effect. In addition to tyrosinase inhibition, other parameters related to cytotoxicity, solubility, cutaneous absorption, penetration and stability of the agents should be considered. The screening test system is also very important as keratinocytes play an active role in modulating melanogenesis within melanocytes. Mammalian skin or at least keratinocytes/melanocytes co-cultures should be preferred rather than pure melanocyte cultures or soluble tyrosinase.
Collapse
Affiliation(s)
- Francisco Solano
- Department of Biochemistry and Molecular Biology B, University of Murcia, Murcia, Spain.
| | | | | | | |
Collapse
|
13
|
Abstract
Lentigo maligna is a premalignant melanocytic neoplasm occurring on the sun-exposed skin of the middle-aged and elderly. It is believed to represent the in situ phase of lentigo maligna melanoma and, as such, cure is usually the aim of treatment. However, factors such as site and size of lesion and patient co-morbidities may influence the treatment modality undertaken. Surgical excision is the treatment of choice to obtain clinical and histologic clearance, but many other modalities have been used with variable success. Mohs micrographic surgery is associated with the lowest recurrence rate at 4-5%, but conventional surgery, cryotherapy and radiotherapy also yield good results, with recurrence rates in the order of 7-10%. Other treatments have been tried but currently there are not enough data to support their routine use. In order to make the best decision regarding appropriate management of lentigo maligna, the dermatologist or surgeon must be aware of all the options available and the evidence supporting their use.
Collapse
|
14
|
Affiliation(s)
- A D Katsambas
- Department of Dermatology, University of Athens, School of Medicine, Andreas Sygros Hospital for Skin and Venereal Diseases, Athens, Greece.
| | | |
Collapse
|
15
|
Addo-Boadu K, Wojta J, Christ G, Hufnagl P, Pehamberger H, Binder BR. Azelaic acid decreases the fibrinolytic potential of cultured human melanoma cells in vitro. Cancer Lett 1996; 103:125-9. [PMID: 8635147 DOI: 10.1016/0304-3835(96)04185-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Azelaic acid (AZA) has been used successfully in the treatment of lentigo maligna melanoma. Since it is generally accepted that the fibrinolytic potential of tumour cells is related to their malignant phenotype, it was the aim of this study to investigate the effect of AZA on the fibrinolytic potential of three different human melanoma cell lines (Bowes, GUBSB and MJZJ). Melanoma cells were incubated with AZA in doses ranging from 10(-2) M to 4 x 10(-2) M for 5, 8 and 24 h. The expression of tissue-type plasminogen activator (t-PA), urokinase-type PA (u-PA) and PA inhibitor-1 (PAI-1) in such treated cells was investigated by specific ELISAs on the protein level and by Northern blotting on the mRNA level. AZA caused a time and dose dependent decrease in the fibrinolytic potential of all three cell lines investigated by decreasing t-PA antigen in Bowes, by decreasing u-PA antigen in GUBSB and by increasing PAI-1 antigen in MJZJ cells, respectively. There was no significant difference between the viability of cells in control cultures and those treated with AZA. The effect of AZA on specific mRNA for t-PA in Bowes cells, u-PA in GUBSB and PAI-1 in MJZJ was consistent with its effect on the secretion of these fibrinolytic proteins by the respective cells. The results show that AZA decreases the fibrinolytic potential of the three human melanoma cell lines in vitro. This decrease may be operative in the mechanism by which AZA has been shown to affect malignant melanoma in vivo.
Collapse
Affiliation(s)
- K Addo-Boadu
- Department of Medicine and Physiology, University of Vienna, Austria
| | | | | | | | | | | |
Collapse
|
16
|
Breathnach A, Levi-Montalcini R. The story of azelaic acid. A tribute to Marcella Nazzaro-Porro. RENDICONTI LINCEI 1995. [DOI: 10.1007/bf03001692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
17
|
Abstract
Lentigo maligna (LM) is a pigmented lesion that occurs on the sun-exposed skin, particularly the head and neck areas, of an older patient. The lesion increases in size and at some point, often many years after its onset, may become lentigo maligna melanoma (LMM). For this reason, most authors consider LM a form of melanoma in situ. Treatment includes surgical or destructive modalities; the preferred form of therapy is surgical removal. Histopathologic features include a proliferation of atypical melanocytes along the basal layer of the epidermis and adnexal structures. This article discusses the clinical, histopathologic, and epidemiologic features of LM. The prognosis and treatment of LM are reviewed. Although the lifetime risk of the development of LMM is unclear, LMM is discussed briefly.
Collapse
Affiliation(s)
- L M Cohen
- Pathology Services, Inc., Cambridge, MA 02139, USA
| |
Collapse
|
18
|
Abstract
Using a clonogenic assay in vitro, it has been shown that exposure to azelaic acid (1-100 mM) for 24 hours has a dose-dependent effect on the survival of the colony-forming ability of murine (B16) and human (HMB2, and SK23) melanoma cells as compared with a non-melanotic non-tumoral Chinese hamster cell line (CHO). Both human cell lines were more sensitive to the diacid than the murine cells, and the HMB2 cells were more sensitive than the SK23 cells. These differences may be partly correlated with differences in pigmentation and doubling times between the three melanoma cell lines. The two human lines were more pigmented than the B16, and the SK23 more than the HMB2; the human lines had a longer doubling time than the others.
Collapse
Affiliation(s)
- L Lemic-Stojcevic
- Richard Dimbleby Department of Cancer Research, UMDS, St. Thomas' Hospital Campus, London, U.K
| | | | | |
Collapse
|
19
|
Nguyen QH, Bui TP. Azelaic acid: pharmacokinetic and pharmacodynamic properties and its therapeutic role in hyperpigmentary disorders and acne. Int J Dermatol 1995; 34:75-84. [PMID: 7737781 DOI: 10.1111/j.1365-4362.1995.tb03583.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Q H Nguyen
- Department of Medicine, University of California at San Francisco, USA
| | | |
Collapse
|
20
|
|
21
|
Breathnach AS, Balus L, Amantea A. Penile lentiginosis. An ultrastructural study. PIGMENT CELL RESEARCH 1992; 5:404-13. [PMID: 1492076 DOI: 10.1111/j.1600-0749.1992.tb00571.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study on five patients has revealed more extensive alterations to melanocytes than previously reported, and emphasizes the fact that depigmentation is an essential element of the condition. In hyperpigmented areas, melanocytes were increased in number along the basal layer of the epithelium, were hyperactive, and in some cases contained bizarre melanosomes. In two cases there was suggestion of a defect in melanosome transfer to keratinocytes. Lymphocytes were closely apposed to melanocytes, and, in hypopigmented areas, were clearly involved in their disintegration. In depigmented areas, there was complete absence of melanocytes and of melanosomes in keratinocytes, and lymphocytes were present in the basal layer. In general, the appearances did not resemble melanoma in situ with spontaneous regression, although a second biopsy of one patient after one year did reveal features of melanocytes suggestive of an early stage of this condition. The study has provided no clear information as to the initial cause of the condition, but the manner of destruction of melanocytes suggests an immune reaction. Neither has it been of assistance in suggesting a more precise name for it.
Collapse
|
22
|
Grammatico P, Modesti A, Steindl K, Scarpa S, Heouaine A, Picardo M, Del Porto G. Lentigo maligna. Cytogenetic, ultrastructural, and phenotypic characterization of a primary cell culture. CANCER GENETICS AND CYTOGENETICS 1992; 60:141-6. [PMID: 1606557 DOI: 10.1016/0165-4608(92)90006-t] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Lentigo maligna is an early cutaneous neoplastic lesion. This article presents the cytogenetic, ultrastructural, and phenotypic characterization of a primary cell culture obtained from a patient affected with lentigo maligna. Two cellular clones were identified, both characterized by chromosomal markers involving chromosome 10 with a breakpoint at 10q26.
Collapse
Affiliation(s)
- P Grammatico
- Dipartimento di Medicina Sperimentale, Università degli Studi di Roma La Sapienza, Italy
| | | | | | | | | | | | | |
Collapse
|
23
|
Modifications of the Phase Transitions of Model Membranes by Exogen Molecules. NATO ASI SERIES 1992. [DOI: 10.1007/978-1-4684-9151-7_30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
24
|
Akamatsu H, Komura J, Asada Y, Miyachi Y, Niwa Y. Inhibitory effect of azelaic acid on neutrophil functions: a possible cause for its efficacy in treating pathogenetically unrelated diseases. Arch Dermatol Res 1991; 283:162-6. [PMID: 1867478 DOI: 10.1007/bf00372056] [Citation(s) in RCA: 83] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
It has been shown that acne, hyperpigmentation and lentigo malignant are more or less related pathogenetically to reactive oxygen species (ROS). It has recently been reported that azelaic acid is effective in treating these conditions and that it possesses anti-enzymatic and antimitochondrial activity, including cytochrome-P450 reductase and 5 alpha-reductase in microsomal preparations with nicotinamide adenine dinucleotide phosphate (NADPH). We therefore investigated the effects of azelaic acid on human neutrophil functions, such as chemotaxis, phagocytosis and ROS generation. ROS generation in a cell-free system was also assessed. The results revealed that neutrophil chemotaxis and phagocytosis as well as ROS generated in a xanthine-xanthine-oxidase system were not significantly changed in the presence of azelaic acid. However, azelaic acid markedly decreased O2- and OH. generated by neutrophils. It may be concluded that the reported clinical effectiveness of azelaic acid is partly due to its inhibitory action on neutrophil-generated ROS, leading to a reduction both in oxidative tissue injury at sites of inflammation and in melanin formation.
Collapse
Affiliation(s)
- H Akamatsu
- Department of Dermatology, Kansai Medical University
| | | | | | | | | |
Collapse
|
25
|
Balus S, Breathnach AS, O'Grady AJ. Ultrastructural observations on 'foam cells' and the source of their lipid in verruciform xanthoma. J Am Acad Dermatol 1991; 24:760-4. [PMID: 1869650 DOI: 10.1016/0190-9622(91)70117-k] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Verruciform xanthomas occur on mucocutaneous surfaces and are characterized by hyperkeratosis, acanthosis, and the occurrence of "foam cells" stuffed with lipid surrounding capillaries in the dermis between rete pegs. Ultrastructural examination of a lesion on the penis revealed the presence of melanocytes with many lipid droplets in the basal layer of the epidermis. We suggest that they are a major source of the lipid of the "foam cells." However, this study provides no information as to the nature or lineage of the "foam cells."
Collapse
Affiliation(s)
- S Balus
- Istituto Dermatologico S. Gallicano, Rome, Italy
| | | | | |
Collapse
|
26
|
Fitton A, Goa KL. Azelaic acid. A review of its pharmacological properties and therapeutic efficacy in acne and hyperpigmentary skin disorders. Drugs 1991; 41:780-98. [PMID: 1712709 DOI: 10.2165/00003495-199141050-00007] [Citation(s) in RCA: 151] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Azelaic acid is a naturally occurring saturated dicarboxylic acid which, on topical application (usually as a 20% cream), has been shown to be effective in the treatment of comedonal acne and inflammatory (papulopustular, nodular and nodulocystic) acne, as well as various cutaneous hyperpigmentary disorders characterised by hyperactive/abnormal melanocyte function, including melasma and, possibly, lentigo maligna. In addition, azelaic acid has an antiproliferative and cytotoxic effect on the human malignant melanocyte, and preliminary findings indicate that it may arrest the progression of cutaneous malignant melanoma. The mechanism of this selective cytotoxic action of azelaic acid is unclear, but may possibly be related to its inhibition of mitochondrial oxidoreductase activity and DNA synthesis. In controlled studies, topical azelaic acid demonstrated comparable anti-acne efficacy to topical tretinoin, benzoyl peroxide, erythromycin and oral tetracycline, while in patients with melasma azelaic acid proved at least as effective as topical hydroquinone. On topical application azelaic acid is well tolerated, with adverse effects apparently limited to a generally mild and transient local cutaneous irritation. Thus, topical azelaic acid, employed either as monotherapy or in combination with other treatments, is likely to prove of value in the management of acne and several hyperpigmentary disorders, most notably melasma.
Collapse
Affiliation(s)
- A Fitton
- Adis Drug Information Services, Auckland, New Zealand
| | | |
Collapse
|
27
|
Breathnach AS, Nazzaro-Porro M, Passi S, Picardo M. Ultrastructure of melanocytes in chronically sun-exposed skin of elderly subjects. PIGMENT CELL RESEARCH 1991; 4:71-9. [PMID: 1946212 DOI: 10.1111/j.1600-0749.1991.tb00318.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chronically sun-exposed facial skin of three females aged 68, 71, and 78 years, and of a male aged 78, was examined by electron microscopy in order to study the condition of the epidermal melanocytes. Considerable heterogeneity of morphological and functional characteristics of the cells was observed. The majority of melanocytes were large, active, with occasionally lobulated or double nuclei, an appearance indicative of hyperstimulation. Some cells exhibited an appearance of having reached the end of an active life cycle and were labelled "aged." Others, in the upper end of the outer root sheath of hair follicles and adjacent interfollicular epidermis, presented a typically inactive appearance, indistinguishable from that of fetal melanocytes, or of those in unexposed skin of younger subjects. A cell with indented nucleus, fully melanised melanosomes, and hypertrophic Golgi apparatus was sporadically seen. Minute foci of dissociation of keratocytes were present, and melanocytes included in these were frequently disrupted. Swelling of mitochondria and cytoplasmic lipid droplets occurred sporadically within all the above variants of melanocytes. It proved difficult to establish criteria of specific sun damage of melanocytes. It is suggested that either the melanocytes exhibiting stimulation or the relatively inactive ones could be the precursors of the proliferating cells of lentigo maligna.
Collapse
Affiliation(s)
- A S Breathnach
- Division of Physiology, UMDS, St. Thomas's Hospital Medical School, London, UK
| | | | | | | |
Collapse
|
28
|
Gasco M, Gallarate M, Pattarino F. In vitro permeation of azelaic acid from viscosized microemulsions. Int J Pharm 1991. [DOI: 10.1016/0378-5173(91)90361-q] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
29
|
Bossi G, Dubini B, Mariani P, Ponzi Bossi MG, Rustichelli F, Phadke RS. Azelaic acid in model membranes: A thermodynamical and structural study. ACTA ACUST UNITED AC 1990. [DOI: 10.1007/bf02450395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
Schallreuter KU, Wood JW. A possible mechanism of action for azelaic acid in the human epidermis. Arch Dermatol Res 1990; 282:168-71. [PMID: 2114832 DOI: 10.1007/bf00372617] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Azelaic acid, and other saturated dicarboxylic acids (C9-C12), are shown to be competitive inhibitors of tyrosinase (KI azelaic acid = 2.73 X 10(-3) M) and of membrane-associated thioredoxin reductase (KI azelaic acid = 1.25 X 10(-5) M). The monomethyl ester of azelaic acid does not inhibit thioredoxin reductase, but it does inhibit tyrosinase, although double the concentration is necessary compared with azelaic acid (KI azelaic acid monomethyl ester = 5.24 X 10(-3) M). Neither azelaic acid nor its monomethyl ester inhibit tyrosinase when catechol is used as a substrate instead of L-tyrosine. Therefore, the weak inhibitory action of azelaic acid on tyrosinase appears to be due to the competition of a single carboxylate group on this inhibitor for the alpha-carboxylate binding site of the L-tyrosine substrate on the enzyme active site. Based on the inhibitor constant on tyrosinase, at least cytotoxic levels of azelaic acid would be required for the direct inhibition of melanin biosynthesis in melanosomes if this mechanism is responsible for depigmentation in the hyperpigmentation disorders lentigo maligna and melasma. Alternatively only 10(-5) M azelaic acid is required to inhibit thioredoxin reductase. This enzyme is shown to regulate tyrosinase through a feedback mechanism involving electron transfer to intracellular thioredoxin, followed by a specific interaction between reduced thioredoxin and tyrosinase. Furthermore, the thioredoxin reductase/thioredoxin system is shown to be a principal electron donor for the ribonucleotide reductases which regulates DNA synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
31
|
Detmar M, Mayer-da-Silva A, Stadler R, Orfanos CE. Effects of azelaic acid on proliferation and ultrastructure of mouse keratinocytes in vitro. J Invest Dermatol 1989; 93:70-4. [PMID: 2473140 DOI: 10.1111/1523-1747.ep12277353] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The effects of azelaic acid (C9-dicarboxylic acid, AZA) on the proliferation and ultrastructure of neonatal NMRI mouse keratinocyte cultures were studied to clarify the mechanisms of AZA action on normal and diseased epidermis. The dose- and time-dependency of the drug effects on DNA synthesis was examined by 3H-thymidine incorporation into DNA and by autoradiography. Electron microscopy was used to detect the target cell organelles of the drug. Azelaic acid decreased DNA synthesis in a dose- and time-dependent manner with a 50% inhibitory concentration of 20 mM. The inhibition of DNA synthesis was already observed after 1 h of treatment, reached its maximum after 4 h, and was stable for 24 h. A complete reversibility of the inhibitory effects was observed within 2 h after discontinuation of the treatment, and, interestingly, a rebound effect occurred with a temporary increase of DNA synthesis. Furthermore, treatment with AZA reduced the RNA and protein synthesis of the cells. Electron microscopic evaluation of treated cultures showed early marked damage of the mitochondria, followed by dilation of the rough endoplasmic reticulum (RER). These alterations were completely reversible after discontinuation of the treatment. Our findings show that AZA exerts a dose- and time-dependent, reversible antiproliferative effect on keratinocytes, acting primarily on mitochondria and RER. The antiproliferative action of AZA could explain its beneficial effect in some skin disorders characterized by alteration of keratinocytic differentiation.
Collapse
Affiliation(s)
- M Detmar
- Department of Dermatology, University Medical Center Steglitz, Free University of Berlin, Federal Republic of Germany
| | | | | | | |
Collapse
|
32
|
Mingrone G, Tacchino RM, Greco AV, Arcieri-Mastromattei E, Marino F, Finotti E, Castagneto E. Preliminary studies of a dicarboxylic acid as an energy substrate in man. JPEN J Parenter Enteral Nutr 1989; 13:299-305. [PMID: 2503641 DOI: 10.1177/0148607189013003299] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Azelaic acid (Az), a straight saturated chain nine carbon dicarboxylic acid, was administered in saline form to six healthy male volunteers by iv route. Serum levels of Az and urinary amounts of both azelaic and pimelic (C7) acids were measured by an improved gas liquid chromatographic method. Stoichiometric analysis of Az metabolism was compared with that of glucose and palmitic acid. The respiratory quotient (RQ) as well as the ATP/CO2 ratio of Az were quite similar to that of palmitic acid. Therefore, Az oxidation is associated with a low cost of ATP synthesis in terms of carbon dioxide production. At the infusion rate used (7.5 g/hr) more than 50% of the administered dose was excreted in the urine. However, the remaining portion was cleared from the plasma in 200 min suggesting an uptake by body tissues which was also confirmed by indirect calorimetric analysis.
Collapse
Affiliation(s)
- G Mingrone
- Instituto di Clinica Medica, Università, Cattolica S. Cuore, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
33
|
Breathnach AC, Nazzaro-Porro M, Passi S, Zina G. Azelaic acid therapy in disorders of pigmentation. Clin Dermatol 1989; 7:106-19. [PMID: 2667735 DOI: 10.1016/0738-081x(89)90061-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- A C Breathnach
- Division of Anatomy, UMDS, St. Thomas's Hospital Campus, London, United Kingdom
| | | | | | | |
Collapse
|
34
|
Abstract
The human epidermis presents the first line of defense against invading free radicals. Therefore, the surface of the skin must be equipped to deal with both the penetration of ultra-violet light as well as the neutralization of reactive photochemical products such as superoxide anion radical, hydrogen peroxide and especially hydroxyl radicals. Consequently, the human epidermis contains a variety of anti-oxidants to reduce oxygen radicals and hydrogen peroxide. The photochemical production of hydroxyl radicals, from both extracellular and intracellular hydrogen peroxide, is of special significance to the integrity of cells in the human epidermis. Recently, both biochemical and clinical studies on the healthy human population, and on patients with pigmentation disorders, suggested a connection between free radical defense by plasma membrane associated thioredoxin reductase and melanin biosynthesis. This research provided the first evidence for a direct relationship between free radical concentration and pigmentation. Furthermore, this system has been shown to be regulated by both extracellular and intracellular calcium concentrations. Clinical studies show depigmentation disorders vitiligo and tyrosinase positive albinism (Hermansky-Pudlak syndrome) appear to have defective calcium uptake systems influencing both free radical defense and melanin biosynthesis.
Collapse
|
35
|
|
36
|
Abstract
This review is an update on the literature accumulated over the past 10 years following the original observation that azelaic acid, a naturally occurring and nontoxic C9 dicarboxylic acid, possesses significant biologic properties and a potential as a therapeutic agent. These studies have shown that azelaic acid is a reversible inhibitor of tyrosinase and other oxidoreductases in vitro and that it inhibits mitochondrial respiration. It can also inhibit anaerobic glycolysis. Both in vitro and in vivo it has an antimicrobial effect on both aerobic and anaerobic (Propionibacterium acnes) microorganisms. In tissue culture it exerts a dose- and time-dependent cytotoxic effect on malignant melanocytes, associated with mitochondrial damage and inhibition of deoxyribonucleic acid (DNA) synthesis. Tumoral cell lines not containing tyrosinase are equally affected. Normal cells in culture exposed to the same concentrations of the diacid that are toxic for tumoral cells are in general not damaged. Radioactive azelaic acid has been shown to penetrate tumoral cells at a higher level than normal cells of the corresponding line. Topically applied (a 20% cream), it has been shown to be of therapeutic value in skin disorders of different etiologies. Its beneficial effect on various forms of acne (comedogenic, papulopustular, nodulocystic) has been clearly demonstrated. Particularly important is its action on abnormal melanocytes, which has led to the possibility of obtaining good results on melasma and highly durable therapeutic responses on lentigo maligna. It is also capable of causing regression of cutaneous malignant melanoma, but its role in melanoma therapy remains to be investigated.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
37
|
Schallreuter KU, Wood JM. Azelaic acid as a competitive inhibitor of thioredoxin reductase in human melanoma cells. Cancer Lett 1987; 36:297-305. [PMID: 3652030 DOI: 10.1016/0304-3835(87)90023-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Azelaic acid has been shown to inhibit thioredoxin reductase (TR) at the surface of guinea pig and human skin, on cultures of human keratinocytes, melanocytes, melanoma cells, murine melanoma cells (Cloudman S91), and on purified enzymes from Escherichia coli, rat liver, and human melanoma. Human melanoma cells are more resistant to inhibition by azelaic acid than murine melanoma or human melanocytes. Kinetic studies with pure TRs indicate that azelaic acid is a reversible competitive inhibitor. Fluorescence spectroscopy has been used to show that azelaic acid does not interfere with electron transfer from NADPH to FAD on TR. However, azelaic acid does inhibit electron transfer from the dithiolate active site of this enzyme. Inhibition by azelaic acid is pH-dependent, requiring the dissociation of both carboxylate groups, and also the dissociation of the active site dithiol groups. Binding studies with [14C]azelaic acid at different pHs, indicate that inhibition is first due to the formation of a thioester on the active thiolate groups followed by transacylation of a basic amino acid residue in the active site. A comparative study of TR inhibition by C6, C9, C10 and C12 saturated dicarboxylic acids was also determined on guinea pig skin in vivo. These homologous dicarboxylic acids gave greater inhibition with increasing size (i.e. mol wt.).
Collapse
|
38
|
|
39
|
McLean DI, Peter KK. Apparent progression of lentigo maligna to invasive melanoma during treatment with topical azelaic acid. Br J Dermatol 1986; 114:685-9. [PMID: 3718862 DOI: 10.1111/j.1365-2133.1986.tb04876.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Nine patients with lentigo maligna were treated with topical azelaic acid. Clinical improvement was observed in four, with complete clearing in one. Two patients developed invasive lentigo maligna melanoma while on treatment. Caution should be exercised in the use of topical azelaic acid in the treatment of lentigo maligna.
Collapse
|
40
|
Ward BJ, Breathnach AS, Robins EJ, Bhasin YP, Ethridge L, Nazzaro-Porro M, Passi S. Effect of L-carnitine on cultured murine melanoma cells exposed to azelaic acid. J Invest Dermatol 1986; 86:438-41. [PMID: 3745962 DOI: 10.1111/1523-1747.ep12285783] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The cytotoxic effect of azelaic acid on murine melanoma cells in culture is due, at least in part, to an antimitochondrial action. We investigated the possibility that the addition of carnitine to the medium may increase the transport of azelaic acid into the mitochondria and thereby increase its cytotoxic effect. Using mitochondrial cross-sectional area measured from electron micrographs as a criterion for mitochondrial damage, we found that the addition of L-carnitine to the culture medium had no effect either alone or with a low (10(-3) M) concentration of azelaic acid. At a high concentration (5 X 10(-2) M) azelaic acid caused swelling and disruption of the mitochondria to such an extent that this was not increased by carnitine. At 10(-2) M azelaic acid, however, some swelling of the mitochondria occurred which was significantly increased by the addition of carnitine. This indicates that carnitine-mediated transport of the diacid into the mitochondria had occurred. We conclude that carnitine may reduce the time or concentration needed for azelaic acid to have a toxic effect on the malignant melanocyte.
Collapse
|
41
|
Abstract
We have shown that dicarboxylic acids (C9 and C12), known competitive inhibitors of tyrosinase, are selectively cytotoxic to malignant melanogenic melanocytes but not to normal pigmented cells or to amelanotic or non-melanogenic melanoma cells. The main target of this toxicity appears to be the mitochondria, which become markedly swollen and vacuolated. The mechanism of their action has been thought to be due to interference with oxidoreductases in the mitochondria. However, our results suggest that this cytotoxicity most probably does not result simply from inhibition of mitochondrial enzymes, but is closely related to the melanin biosynthesis pathway.
Collapse
|
42
|
Robins EJ, Breathnach AS, Bennett D, Ward BJ, Bhasin Y, Ethridge L, Nazzaro-Porro M, Passi S, Picardo M. Ultrastructural observations on the effect of azelaic acid on normal human melanocytes and a human melanoma cell line in tissue culture. Br J Dermatol 1985; 113:687-97. [PMID: 4096883 DOI: 10.1111/j.1365-2133.1985.tb02404.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Azelaic acid has been shown clinically to have a cytotoxic effect on the abnormally active and malignant human melanocyte, but it has no apparent effect upon normal melanocytes. This difference in reactivity between normal and abnormal cells in vivo is further examined here in vitro. The disodium salt of azelaic acid (C(9)2Na) was added to pure and mixed cultures of normal human melanocytes and to cultured human melanoma cells, at 10(-3) M, 10(-2) M, 5 X 10(-2) M, and 10(-1) M for 1 and 6 h. Control cultures and cultures exposed to the same concentrations of the disodium salt of adipic acid (C(6)2Na) were also examined. No damage to cells of any line was observed with diacids at 10(-3) M or 10(-2) M up to 6 h. At 5 X 10(-2) M some mitochondria of melanoma cells appeared swollen. With C(6)2Na at 10(-1) M for I and 6 h, minimal swelling of mitochondria was observed in some cells of all lines. Pure normal melanocytes and melanocytes of mixed cultures exhibited greater swelling of mitochondria with 10(-1) M C(9)2Na at 1 and 6 h, but the mitochondria of the malignant melanocytes were massively swollen with destruction of cristae. Plasma and nuclear membranes and membranes of rough endoplasmic reticulum were intact, but Golgi membranes exhibited vesiculation. These results provide further evidence that azelaic acid damages the human malignant melanocyte and that one of its targets is the mitochondrion. Damage to normal melanocytes, found here, may be due to the fact that, in culture, they are more active than in intact epidermis.
Collapse
|
43
|
Leibl H, Stingl G, Pehamberger H, Korschan H, Konrad K, Wolff K. Inhibition of DNA synthesis of melanoma cells by azelaic acid. J Invest Dermatol 1985; 85:417-22. [PMID: 4056455 DOI: 10.1111/1523-1747.ep12277084] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Azelaic acid was successfully used in the clinical treatment of 7 cases of lentigo maligna in that remission of the lesions was observed in all our patients. In order to elucidate mechanism(s) of the beneficial clinical effects, we studied the effect of azelaic acid on cultured melanoma cells. Cell numbers recovered from melanoma cell cultures grown for several days in the presence of 10 mM azelaic acid were 50-70% less than those recovered from control cultures or from cultures containing 10 mM adipic acid. This reduction of cell numbers was not due to a simple cytotoxic or cytolytic effect of azelaic acid but rather due to a dose-dependent inhibition of DNA synthesis. Interestingly, nontoxic concentrations of azelaic acid, which significantly reduced DNA synthesis of cultured melanoma cells, had no overt effect on the protein synthesis of these cells. It is conceivable that inhibition of DNA synthesis is one of the mechanisms by which azelaic acid prevents growth and proliferation of abnormal melanocytes.
Collapse
|
44
|
Robins EJ, Breathnach AS, Ward BJ, Bhasin YP, Ethridge L, Nazzaro-Porro M, Passi S, Picardo M. Effect of dicarboxylic acids on Harding-Passey and Cloudman S91 melanoma cells in tissue culture. J Invest Dermatol 1985; 85:216-21. [PMID: 4031537 DOI: 10.1111/1523-1747.ep12276681] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Clinically, dicarboxylic acids have a cytotoxic effect on the abnormally hyperactive and malignant epidermal melanocyte, and diacids from C8 to C13 have been shown to inhibit mitochondrial oxidoreductases. Here, their effect on the growth kinetics and ultrastructure of murine melanoma cells in culture is examined. Cultures of Harding-Passey and Cloudman S91 melanoma cells were exposed to single doses of the disodium salts of C12, C9, and C6 (which does not significantly inhibit mitochondrial enzymes) dicarboxylic acids at concentrations of 10(-3) M to 10(-1) M. With C12 and C9, viability and cell proliferation over 3 days were significantly affected by concentrations greater than 10(-2) M. With exposure to C6 at 10(-1) M and to medium to which NaCl was added to produce equal osmolarity, the effect was much less. Electron microscopy of cells exposed to C9 at 10(-1) M for 1 h and 6 h revealed massive swelling of mitochondria with destruction of cristae, but plasma and nuclear membranes and membranes of endoplasmic reticulum were intact. Similar damage was not seen with C6 at 10(-1) M nor with equiosomolar NaCl. The results confirm (1) the cytotoxicity of dicarboxylic acids for malignant melanocytes, and (2) that the mitochondrion is a prime target for their action.
Collapse
|
45
|
Pathak MA, Ciganek ER, Wick M, Sober AJ, Farinelli WA, Fitzpatrick TB. An evaluation of the effectiveness of azelaic acid as a depigmenting and chemotherapeutic agent. J Invest Dermatol 1985; 85:222-8. [PMID: 4031538 DOI: 10.1111/1523-1747.ep12276684] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In the past five years, it has been reported that certain dicarboxylic acids (C8-C13) and azelaic acid (C9) (AZA), in particular, have a remarkable effect in the management of lentigo maligna, human malignant melanoma, and certain disorders of hyperpigmentation. Preclinical trials, therefore, were undertaken in order to evaluate the effectiveness of AZA as a depigmenting agent and as a chemotherapeutic agent. Twenty-seven uniformly black pigmented guinea pigs were given topical applications of various concentrations (3, 5, 10, 15, and 20%) of AZA preparations for 8 weeks, and their effects on the melanocytes of epilated skin of the backs and the nonepilated ears of guinea pigs were compared to the effects of well-known depigmenting agents. Whereas 4-isopropylcatechol, monobenzylether of hydroquinone, monoethylether of hydroquinone, hydroquinone, and 4-hydroxyanisole were found to be selectively cytotoxic to melanocytes in black-skinned guinea pigs, AZA has little or no visually recognizable effect on melanocytes in these animals. The therapeutic effect of local s.c. injections of various concentrations of AZA preparations on the development of s.c. implanted B-16 melanoma tumor was evaluated in 96 C57BL/6J mice. In addition, 31 BDF1 mice, implanted i.p. with B-16 melanoma tumor, were used to assess the effect of 100-500 mg/kg concentrations of AZA administered i.p. In both studies, AZA revealed no significant tumoristatic or tumoricidal effect on the size, color, and growth of melanoma. The effect of AZA was also evaluated on S-91A (melanotic or pigmented) and S-91B (amelanotic) human melanoma cells in culture. Low concentrations (10(-5) and 10(-3) M) of AZA had no inhibitory effect on the growth of these cells. Only at higher concentrations (greater than 10(-3) M) was a cytotoxic effect on cell viability observed. These observations indicate AZA is not selectively cytotoxic to normal and proliferative melanocytes and has no apparent inhibitory effect on the formative process of melanin pigmentation.
Collapse
|
46
|
Picardo M, Passi S, Sirianni MC, Fiorilli M, Russo GD, Cortesi E, Barile G, Breathnach AS, Nazzaro-Porro M. Activity of azelaic acid on cultures of lymphoma- and leukemia-derived cell lines, normal resting and stimulated lymphocytes and 3T3 fibroblasts. Biochem Pharmacol 1985; 34:1653-8. [PMID: 4004885 DOI: 10.1016/0006-2952(85)90630-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Azelaic acid (C9- -dicarboxylic acid) is a competitive inhibitor of tyrosinase and some oxidoreductase in vitro, and in vivo has a beneficial effect on lentigo maligna and malignant melanoma. A definite cytotoxic effect in cultures of malignant melanocytes was also reported. In order to establish if the cytotoxic effect of the diacid is exerted equally in the absence of tyrosinase, lymphoma- and leukemia-derived cell lines were cultured for 72 hr with 10(-3) M, 10(-2) M and 5 X 10(-2) M C9 disodium salt. Normal resting lymphocytes, lymphocytes activated by phytohemoagglutinin, and mouse Balb/c 3T3 fibroblasts were also tested to study a possible effect of azelaic acid on DNA synthesis and cell duplication. At 10(-3) M C9 had no effect on the viability of all the cells tested; at 10(-2) M and 5 X 10(-2) M, C9 2Na had a 50-80% cytotoxic effect on lymphoma- and leukemia-derived cell lines, while at the same concentrations it was not toxic to normal lymphocytes, either resting or stimulated, or to 3T3 fibroblasts. The experiments on cellular incorporation of (1-9 14C) azelaic acid showed that the radiocarbon uptake was two to three times higher for lymphoma- and leukemia-derived cell lines than for lymphocytes, either resting or stimulated, or 3T3 fibroblasts. Biochemical analysis revealed that the diacid underwent beta-oxidation in all the cell cultures. Fractionated centrifugations of 3T3 fibroblasts cultured in the presence of radiolabelled azelaic acid (2 X 10(-4) M) plus cold C9 2Na (10(-2) M), showed that the radioactivity was mainly concentrated in the cytoplasm. The results, being similar to those obtained by adding azelaic acid to cultures of melanoma cells, suggest that the cytotoxic effect of azelaic acid may be due to interference with mitochondrial oxido-reductase enzymes, rather than with tyrosinase. The difference in reaction between lymphoma- and leukemia-derived cell lines and normal or stimulated lymphocytes, and 3T3 fibroblasts, could be explained on the basis of a different degree of permeability of the cell membrane, and/or to a possible different sensitivity of reaction of mitochondrial functions. A similar argument could be used to explain the absence of an effect of dicarboxylic acids upon normal as compared with hyperactive or malignant melanocytes in vivo.
Collapse
|
47
|
|
48
|
Ward BJ, Breathnach AS, Robins EJ, Bhasin Y, Ethridge L, Passi S, Nazzaro-Porro M. Analytical, ultrastructural, autoradiographic and biochemical studies on [3H]dicarboxylic acid added to cultures of melanoma cells. Br J Dermatol 1984; 111:29-36. [PMID: 6743538 DOI: 10.1111/j.1365-2133.1984.tb04013.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Lentigo maligna and malignant melanoma can be treated by dicarboxylic acids (C9 and C12), which are competitive inhibitors of tyrosinase. We therefore studied the intracellular location and possible sites of action of dodecanedioic acid (C12) in murine melanoma cells, using EM autoradiography and biochemical analysis of lipid extracts by HPLC. Significant levels of radioactivity were found in the mitochondria and in the nuclei but not in association with membranes of rough endoplasmic reticulum, Golgi-associated endoplasmic reticulum, or Golgi apparatus, and not in coated vesicles or melanosomes. Biochemical analysis revealed that the diacid underwent beta-oxidation, which occurs only in mitochondria. The results suggest that the toxicity of dicarboxylic acids in melanoma cells is not related to anti-tyrosinase activity but may be due to interference with oxidoreductase enzymes in the mitochondria and possibly to inhibition of DNA synthesis in the nucleus.
Collapse
|
49
|
Passi S, Nazzaro-Porro M, Picardo M, Mingrone G, Fasella P. Metabolism of straight saturated medium chain length (C9 to C12) dicarboxylic acids. J Lipid Res 1983. [DOI: 10.1016/s0022-2275(20)37897-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
50
|
Nazzaro-Porro M, Passi S, Picardo M, Breathnach A, Clayton R, Zina G. Beneficial effect of 15% azelaic acid cream on acne vulgaris. Br J Dermatol 1983; 109:45-8. [PMID: 6222755 DOI: 10.1111/j.1365-2133.1983.tb03990.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Patients treated with azelaic acid (15%) cream for chloasma reported simultaneous improvement of acne lesions within the treated areas. This prompted an open study of its effect in cases of acne without chloasma. One hundred patients with acne vulgaris were treated for 3-9 months by twice-daily application of the cream with significant improvement in every case.
Collapse
|