-
Indian Journal of Ophthalmology Nov 2017Psoralen compounds such as methoxsalen are photosensitizer agents used in conjunction with ultraviolet A (UVA) radiation exposure as photochemotherapy (Psoralens and...
Psoralen compounds such as methoxsalen are photosensitizer agents used in conjunction with ultraviolet A (UVA) radiation exposure as photochemotherapy (Psoralens and ultraviolet-A therapy [PUVA therapy]) for certain epidermal skin disorders such as psoriasis and vitiligo. Methoxsalen has been shown to be associated with premature cataract formation by forming adducts with lens proteins following oral administration and subsequent UVA exposure. Hence, the use of UV-filtering glasses is recommended during PUVA therapy sessions. Ocular tissues can be exposed to its photosensitizing effect with subsequent UV radiation exposure through sunlight if the patient was to be without protective eye glasses, potentially causing macular toxicity. Till date, there have been no reports in the literature of any posterior segment ocular toxicity arising from methoxsalen use. Here, we describe a case of a bilateral macular toxicity in a middle-aged male treated with methoxsalen for vitiligo.
Topics: Electrooculography; Electroretinography; Humans; Macula Lutea; Male; Methoxsalen; Middle Aged; Photosensitizing Agents; Retinal Diseases; Retinal Pigment Epithelium; Visual Acuity; Vitiligo
PubMed: 29133667
DOI: 10.4103/ijo.IJO_413_17 -
Giornale Italiano Di Dermatologia E... Dec 2017Mycosis fungoides (MF), the most common variant among cutaneous T cell lymphomas (CTCL), is characterized in its early stages by clonal proliferation of malignant... (Review)
Review
Mycosis fungoides (MF), the most common variant among cutaneous T cell lymphomas (CTCL), is characterized in its early stages by clonal proliferation of malignant T-cells in the skin manifesting as erythematous patches and plaques with a chronic course and progression to cutaneous tumors and extracutaneous organs in some patients. Skin directed therapies (SDT) are primarily used for effective palliation in early stage disease. Phototherapy with ultraviolet A radiation combined with 8-methoxypsoralen (PUVA) and with ultraviolet B radiation (UVB) has a longstanding history in the treatment of MF and are highly effective in inducing remissions. Patients with erythroderma and blood involvement benefit from treatment with extracorporeal photochemotherapy (ECP) where peripheral blood is exposed to PUVA. Phototherapy can be safely combined with systemic agents, most notably interferon-alpha and retinoids. Recently updated treatment guidelines have been published to provide evidence based algorithms for the stage-oriented treatment of MF. PUVA and narrow-band UVB (NB-UVB) are recommended as first line treatment for early stages with combination modalities reserved for refractory and more advanced cases and ECP is among the standard treatments for MF erythroderma. Areas of uncertainty relate to optimized treatment dose and schedules, the use of phototherapy for maintenance, and the role of newer phototherapeutic modalities (e.g. ultraviolet A1 radiation, excimer sources, photodynamic therapy) in the treatment of MF.
Topics: Combined Modality Therapy; Dermatologic Agents; Humans; Methoxsalen; Mycosis Fungoides; PUVA Therapy; Photosensitizing Agents; Phototherapy; Practice Guidelines as Topic; Skin Neoplasms
PubMed: 28845954
DOI: 10.23736/S0392-0488.17.05737-6 -
Biomedicine & Pharmacotherapy =... Feb 2022Acetylcholinesterase (AChE) inhibitor is the first choice for the treatment of Alzheimer's disease (AD), but it has some defects, such as dose limitation and... (Review)
Review
Acetylcholinesterase (AChE) inhibitor is the first choice for the treatment of Alzheimer's disease (AD), but it has some defects, such as dose limitation and unsatisfactory long-term treatment effect. Recent studies have shown that butyrylcholinesterase (BuChE) inhibitors or double acetyl and butyryl cholinesterase inhibitors have better curative effects on AD, and the side effects are lower than those of specific AChE inhibitors. Dual target cholinesterase inhibitors have become a new hotspot in the research of anti-AD drugs. Herein, the synthesis and bioactivities of BuChE inhibitors were reviewed.
Topics: Acridines; Alzheimer Disease; Butyrylcholinesterase; Cholinesterase Inhibitors; Humans; Methoxsalen; Structure-Activity Relationship
PubMed: 34953393
DOI: 10.1016/j.biopha.2021.112556 -
Photochemical & Photobiological... Dec 2018Cutaneous T-cell lymphomas (CTCL) are a heterogenous group of non-Hodgkin lymphomas arising in the skin. Mycosis fungoides (MF), the most common variant, is... (Review)
Review
Cutaneous T-cell lymphomas (CTCL) are a heterogenous group of non-Hodgkin lymphomas arising in the skin. Mycosis fungoides (MF), the most common variant, is characterised by clonal proliferation of skin residing malignant T-cells. Initially appearing with erythematous patches and plaques it follows a chronic course with progression to cutaneous tumours and extracutaneous involvement in some patients. Phototherapy with ultraviolet A radiation combined with 8-methoxypsoralen (PUVA) and with narrow-band ultraviolet B radiation (NB-UVB) are among the first line options for the treatment of MF and can induce remission in most patients. Sézary syndrome (SS) is a rare and more aggressive CTCL variant with generalized skin involvement. Patients with SS and with erythroderma from MF can benefit from treatment with extracorporeal photochemotherapy (ECP) where peripheral blood is exposed to PUVA. Phototherapy can be safely combined with systemic agents, most notably interferon-alpha and retinoids. Another photoresponsive CTCL variant is lymphomatoid papulosis (LP), a CD30+ lymphoproliferative disease characterised by chronically recurring papules. The disease responds favourably to PUVA but low dose methotrexate might be preferred for long term disease control. Recently updated treatment guidelines have been published to provide evidence-based algorithms for the stage-oriented treatment of MF, SS and LP. Areas of uncertainty are treatment schedules that are currently not optimised for CTCL, the use of phototherapy for maintenance, and the value of ultraviolet A1 radiation, excimer lasers, and photodynamic therapy.
Topics: Humans; Lymphoma, T-Cell, Cutaneous; Lymphomatoid Papulosis; Methoxsalen; Mycosis Fungoides; Photosensitizing Agents; Phototherapy; Skin Neoplasms; Ultraviolet Rays
PubMed: 30325389
DOI: 10.1039/c8pp00170g -
BioRxiv : the Preprint Server For... Jun 2023Cigarette smoking remains the leading preventable cause of disease and death. Nicotine is the primary reinforcing ingredient in cigarettes sustaining addiction. Cotinine...
Cigarette smoking remains the leading preventable cause of disease and death. Nicotine is the primary reinforcing ingredient in cigarettes sustaining addiction. Cotinine is the major metabolite of nicotine that produces a myriad of neurobehavioral effects. Cotinine supported self-administration and rats with a history of intravenous self-administration of cotinine exhibited relapse-like drug-seeking behavior, suggesting cotinine may also be reinforcing. To date, a potential contribution of cotinine to nicotine reinforcement remains unknown. Nicotine metabolism is mainly catalyzed by hepatic CYP2B1 enzyme in the rat and methoxsalen is a potent CYP2B1 inhibitor. The study tested the hypothesis that methoxsalen inbibits nicotine metabolism and self-administration, and that cotinine replacement attenuates the inhibitory effects of methoxsalen. Acute methoxsalen decreased plasma cotinine levels and increased nicotine levels following subcutaneous nicotine injection. Repeated methoxsalen reduced the acquisition of nicotine self-administration, leading to fewer nicotine infusions, disruption of lever differentiation, smaller total nicotine intake, and lower plasma cotinine levels. On the other hand, methoxsalen did not alter nicotine self-administration during the maintenance phase despite great reduction of plasma cotinine levels. Cotinine replacement by mixing cotinine with nicotine for self-administration dose-dependently increased plasma cotinine levels, counteracted effects of methoxsalen, and enhanced the acquisition of self-administration. Neither basal nor nicotine-induced locomotor activity was altered by methoxsalen. These results indicate that methoxsalen depressed cotinine formation from nicotine and the acquisition of nicotine self-administration, and that replacement of plasma cotinine attenuated the inhibitory effects of methoxsalen, suggesting that cotinine may contribute to the development of nicotine reinforcement.
PubMed: 37333320
DOI: 10.1101/2023.06.04.543614 -
Phytotherapy Research : PTR Nov 2021Bergapten is a natural furocoumarin, also known as 5-methoxypsoralen, and its medicinal value has been paid more and more attention. By sorting out the pharmacological... (Review)
Review
Bergapten is a natural furocoumarin, also known as 5-methoxypsoralen, and its medicinal value has been paid more and more attention. By sorting out the pharmacological literature of bergapten, we found that bergapten has a wide range of pharmacological effects, including neuroprotection, organ protection, anticancer, antiinflammatory, antimicrobial, and antidiabetes effects. However,bergapten has complex impacts on the hepatic metabolic enzyme. Moreover, pharmacokinetic studies showed that bergapten has higher absolute bioavailability and can cross the blood-brain barrier and has a great potential for treating brain disease, but the mechanism needs further clarification to make greater use of its ability to treat brain diseases. Furthermore, the phototoxicity of bergapten combined with ultraviolet light has always been mentioned. In view of its wide range of pharmacological activities, bergapten is expected to be a potential drug candidate for the treatment of diabetes and diabetes-induced osteoporosis, epilepsy, Alzheimer's disease, depression, and cancer. However, further studies are needed to elucidate its molecular mechanisms and targets. The phototoxicity of bergapten as a side effect should be further avoided. On the other hand, the photoactivation of bergapten in the anticancer aspect can be better utilized.
Topics: 5-Methoxypsoralen; Anti-Inflammatory Agents; Humans; Methoxsalen; Osteoporosis; Ultraviolet Rays
PubMed: 34347307
DOI: 10.1002/ptr.7221 -
European Journal of Ophthalmology May 2021A number of systemic medications are known to cause macular toxicity, and bull's eye maculopathy is caused by some of them like hydroxychloroquine and clofazimine. A...
A number of systemic medications are known to cause macular toxicity, and bull's eye maculopathy is caused by some of them like hydroxychloroquine and clofazimine. A 55-year-old female, known case of vitiligo with history of undergoing methoxsalen-ultraviolet A therapy, presented with painless defective vision in both eyes. Fundus examination and autofluorescence showed macular degeneration with bull's eye configuration. Optical coherence tomography showed perifoveal loss of photoreceptors and outer retinal thinning with foveal sparing appearing as 'flying saucer'. Multifocal electroretinogram showed pan-macular suppression of waveforms. Patient was diagnosed as case of methoxsalen-induced advanced macular toxicity. This is the first reported case of methoxsalen-induced advanced bull's eye maculopathy.
Topics: Electroretinography; Female; Fovea Centralis; Humans; Macular Degeneration; Methoxsalen; Middle Aged; Tomography, Optical Coherence
PubMed: 32064940
DOI: 10.1177/1120672120907317