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Molecules (Basel, Switzerland) Jul 2020Sun overexposure is associated with the development of diseases that primarily affect the skin, which can lead to skin cancer. Among the main measures of photoprotection... (Meta-Analysis)
Meta-Analysis
Sun overexposure is associated with the development of diseases that primarily affect the skin, which can lead to skin cancer. Among the main measures of photoprotection is the use of sunscreens. However, there is currently concern about the reported harmful effects to both humans and the environment due to several of the sunscreen ingredients available on the market. For this reason, the search for and development of new agents with photoprotective properties is required. In searching for these metabolites, researchers have turned their attention to microbial sources, especially the microbiota in unusual hostile environments. Among the diverse microorganisms available in nature, Actinobacteria and specifically , have been shown to be a source of metabolites with various biological activities of interest, such as antimicrobial, antitumor and immunomodulator activities. Herein, we present the results of a systematic review of the literature in which isolates were studied as a source of compounds with photoprotective properties. A meta-analysis of the structure-property and structure-activity relationships of those metabolites identified in the qualitative analysis phase was also carried out. These findings indicate that are a source of metabolites with potential applications in the development of new, safe and more eco-friendly sunscreens.
Topics: Antioxidants; Biological Products; Humans; Secondary Metabolism; Streptomyces; Structure-Activity Relationship; Sunscreening Agents; Ultraviolet Rays
PubMed: 32679651
DOI: 10.3390/molecules25143221 -
Frontiers in Bioengineering and... 2020Titanium dioxide nanoparticles (TiO NPs) are regularly used in sunscreens because of their photoprotective capacity. The advantage of using TiO on the nanometer scale is...
Titanium dioxide nanoparticles (TiO NPs) are regularly used in sunscreens because of their photoprotective capacity. The advantage of using TiO on the nanometer scale is due to its transparency and better UV blocking efficiency. Due to the greater surface area/volume ratio, NPs become more (bio)-reactive giving rise to concerns about their potential toxicity. To evaluate the irritation and corrosion of cosmetics, 3D skin models have been used as an alternative method to animal experimentation. However, it is not known if this model is appropriate to study skin irritation, corrosion and phototoxicity of nanomaterials such as TiO NPs. This systematic review (SR) proposed the following question: Can the toxicity of TiO nanoparticles be evaluated in a 3D skin model? This SR was conducted according to the Preliminary Report on Systematic Review and Meta-Analysis (PRISMA). The protocol was registered in CAMARADES and the ToxRTool evaluation was performed in order to increase the quality and transparency of this search. In this SR, 7 articles were selected, and it was concluded that the 3D skin model has shown to be promising to evaluate the toxicity of TiO NPs. However, most studies have used biological assays that have already been described as interfering with these NPs, demonstrating that misinterpretations can be obtained. This review will focus in the possible efforts that should be done in order to avoid interference of NPs with biological assays applied in 3D culture.
PubMed: 32587852
DOI: 10.3389/fbioe.2020.00575 -
Current Medicinal Chemistry 2020Bioactive compounds derived from mushrooms have been shown to present promising potential as cosmeceutical or nutricosmetic ingredients. Scientific data reviewed herein...
Bioactive compounds derived from mushrooms have been shown to present promising potential as cosmeceutical or nutricosmetic ingredients. Scientific data reviewed herein showed that extracts prepared from medicinal and edible mushrooms and their individual metabolites presented antiinflammatory, antioxidant, photoprotective, antimicrobial, anti-tyrosinase, anti-elastase, and anticollagenase activities. These metabolites can be utilised as ingredients to suppress the severity of Inflammatory Skin Diseases, offer photoprotection to the skin, and correct Hyperpigmentation. However, studies regarding the molecular mechanism behind the mentioned bioactivities are still lacking. Challenges associated with the use of mushroom extracts and their associated metabolites as cosmeceutical and nutricosmetic ingredients include several steps from the fruiting bodies to the final product: extraction optimization, estimation of the efficacy and safety claims, the use of micro and nanocarriers to allow for controlled release and the pros and cons associated with the use of extracts vs individual compounds. This systematic review highlights that mushrooms contain diverse biomolecules that can be sustainably used in the development of nutricosmetic and cosmeceutical formulations. Reports regarding stability, compatibility, and safety assessment, but also toxicological studies are still needed to be considered. Furthermore, some of the constraints and limitations hindering the development of this type of ingredients still require long-term studies to achieve major breakthroughs.
Topics: Agaricales; Anti-Inflammatory Agents; Antioxidants; Biological Products; Cosmeceuticals; Dietary Supplements; Humans; Skin Diseases
PubMed: 32238131
DOI: 10.2174/0929867327666200402100157 -
Journal of Dietary Supplements 2021Astaxanthin (AST), a naturally-occurring keto-carotenoid found in several species of bacteria and microalgae, has demonstrated diverse biological activities and . There...
Astaxanthin (AST), a naturally-occurring keto-carotenoid found in several species of bacteria and microalgae, has demonstrated diverse biological activities and . There is growing commercial interest in the application of astaxanthin in nutraceuticals and cosmeceuticals, due to its purported photoprotective, DNA repair, antioxidant, and anti-inflammatory benefits. This systematic review therefore aimed to summarize current clinical evidence on the effects of astaxanthin supplementation on skin health. Using the following combinations of broad Major Exploded Subject Headings (MesH) terms or text words [astaxanthin OR AST OR ASX OR carotenoid OR xanthophyll] AND [skin OR derm*], a comprehensive search of PubMed, EMBASE, Medline, Clinicaltrials.gov, and Google Scholar databases found a total of eleven clinical studies. There were six randomized, placebo-controlled, double-blind trials, while the rest were prospective, open-label studies. In many of the randomized, controlled trials reviewed, AST supplementation improved skin texture, appearance (wrinkles), and moisture content at the end of the study period. AST also appeared to protect against UV-induced skin damage. No serious adverse events were reported in any of the studies. However, most available studies had a relatively small sample size and were conducted on healthy Japanese females. Many of the studies were also funded by commercial entities, with potential conflicts of interests. This was difficult to account for in our analyses. Overall, there is some clinical data to support the benefits of astaxanthin supplementation (in the range of 3 to 6 mg/d) on skin health, especially for photoaged skin.
Topics: Dietary Supplements; Female; Humans; Prospective Studies; Randomized Controlled Trials as Topic; Skin; Xanthophylls
PubMed: 32202443
DOI: 10.1080/19390211.2020.1739187 -
The Journal of Maternal-fetal &... Jan 2022Retinopathy of prematurity (ROP) is a multifactorial retinal disorder characterized by an abnormal vascular development of the retina of the preterm infants. Carotenoids... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Retinopathy of prematurity (ROP) is a multifactorial retinal disorder characterized by an abnormal vascular development of the retina of the preterm infants. Carotenoids are natural pigments that are synthesized by all plants and some microorganisms where they play a role in photoprotection and coloration. Lutein and zeaxanthin (L/Z) are two carotenoids identified as the major components of the macular pigment. Recently it has been suggested that lutein and its isomer zeaxanthin may act as antioxidant agents and that they may prevent ROP.
OBJECTIVE
The primary objective of this study is to assess the safety and effectiveness of oral lutein in the prevention of retinopathy of prematurity in preterm neonates.
STUDY DESIGN
We conducted a systematic search for randomized or quasi-randomized controlled trials without any language or publication year restriction. The studies have to recruit preterm neonates ≤32 completed weeks of gestation and to compare the administration of oral L/Z at any dosage or duration, versus placebo in order to prevent ROP.
RESULT
Data from three RCT with a total of 406 participants failed to show any reduction in ROP incidence nor the risk of BPD, sepsis, NEC and mortality. It may reduce the number of transfusions but this result has to be assessed in a separate ad hoc trial.
Topics: Dietary Supplements; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Lutein; Retinopathy of Prematurity
PubMed: 32041442
DOI: 10.1080/14767058.2020.1712700 -
JAMA Dermatology Sep 2019Microcystic adnexal carcinoma (MAC) occurs primarily in older adults of white race/ethnicity on sun-exposed skin of the head and neck. There are no formal guiding...
IMPORTANCE
Microcystic adnexal carcinoma (MAC) occurs primarily in older adults of white race/ethnicity on sun-exposed skin of the head and neck. There are no formal guiding principles based on expert review of the evidence to assist clinicians in providing the highest-quality care for patients.
OBJECTIVE
To develop recommendations for the care of adults with MAC.
EVIDENCE REVIEW
A systematic review of the literature (1990 to June 2018) was performed using MEDLINE, Embase, Web of Science, and the Cochrane Library. The keywords searched were microcystic adnexal carcinoma, sclerosing sweat gland carcinoma, sclerosing sweat duct carcinoma, syringomatous carcinoma, malignant syringoma, sweat gland carcinoma with syringomatous features, locally aggressive adnexal carcinoma, and combined adnexal tumor. A multidisciplinary expert committee critically evaluated the literature to create recommendations for clinical practice. Statistical analysis was used to estimate optimal surgical margins.
FINDINGS
In total, 55 studies met our inclusion criteria. The mean age of 1968 patients across the studies was 61.8 years; 54.1% were women. Recommendations were generated for diagnosis, treatment, and follow-up of MAC. There are 5 key findings of the expert committee based on the available evidence: (1) A suspect skin lesion requires a deep biopsy that includes subcutis. (2) MAC confined to the skin is best treated by surgery that examines the surrounding and deep edges of the tissue removed (Mohs micrographic surgery or complete circumferential peripheral and deep margin assessment). (3) Radiotherapy can be considered as an adjuvant for MAC at high risk for recurrence, surgically unresectable tumors, or patients who cannot have surgery for medical reasons. (4) Patients should be seen by a physician familiar with MAC every 6 to 12 months for the first 5 years after treatment. Patient education on photoprotection, periodic skin self-examination, postoperative healing, and the possible normal changes in local sensation (eg, initial hyperalgesia) should be considered. (5) There is limited evidence to guide the treatment of metastasis in MAC due to its rarity. Limitations of our findings are that the medical literature on MAC comprises only retrospective reviews and descriptions of individual patients and there are no controlled studies to guide management.
CONCLUSIONS AND RELEVANCE
The presented clinical practice guidelines provide an outline for the diagnosis and management of MAC. Future efforts using multi-institutional registries may improve our understanding of the natural history of the disease in patients with lymph node or nerve involvement, the role of radiotherapy, and the treatment of metastatic MAC with drug therapy.
PubMed: 31268498
DOI: 10.1001/jamadermatol.2019.1251 -
JAMA Ophthalmology Jun 2019Cataract surgery, with intraocular lens (IOL) implantation, is the most common ocular surgical procedure worldwide. It has been suggested that IOLs that selectively...
IMPORTANCE
Cataract surgery, with intraocular lens (IOL) implantation, is the most common ocular surgical procedure worldwide. It has been suggested that IOLs that selectively attenuate short wavelength visible light (blue light-filtering IOLs) may be beneficial for macular health. Whether blue light-filtering IOLs impart retinal photoprotection is of public health relevance, particularly in the context of aging demographics and the increasing global prevalence of age-related macular degeneration. This review analyzes and interprets the key findings, including consideration of the implications for practice and future research, of a 2018 Cochrane systematic review that evaluated the efficacy and safety of blue light-filtering IOLs for providing protection to macular health and function.
OBSERVATIONS
The Cochrane systematic review included 51 randomized controlled trials that were performed in 17 countries. The trials involved adults undergoing cataract surgery in which a blue light-filtering IOL was compared with an equivalent non-blue light-filtering IOL. Study follow-up periods ranged from 1 month to 5 years. Together, these studies considered clinical outcomes in more than 5000 eyes. There was limited ability to combine data across trials (to draw overall conclusions) because of the use of different measurement techniques for outcomes, incomplete reporting of data, and/or varied follow-up periods. We identified substantial shortcomings in the internal validity of many of the included studies, particularly regarding trial design, conduct, and reporting. We propose several avenues for improving the rigor of potential future research in the field, including developing a core set of outcome measures, the inclusion of sample size calculations, the masking of trial participants and outcome assessors, and prospective clinical trial registration.
CONCLUSIONS AND RELEVANCE
Using blue light-filtering IOLs to impart benefits to the macula is currently not supported by the best available clinical research evidence, and it is important that clinicians are mindful of this evidence limitation when adopting these devices in clinical practice.
Topics: Cataract Extraction; Filtration; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Light; Prospective Studies; Radiation Injuries; Radiation Protection; Retina
PubMed: 30789642
DOI: 10.1001/jamaophthalmol.2019.0019 -
International Journal of Molecular... Jun 2017A review of the pharmacological applications of lignins provides evidence of their protective role against the development of different diseases. In many cases, the... (Review)
Review
A review of the pharmacological applications of lignins provides evidence of their protective role against the development of different diseases. In many cases, the effects of lignins could be explained by their antioxidant capacity. Here, we present a systematic review of the literature from the period 2010-2016 which provides information concerning new applications of lignins derived from recent research. The most promising findings are reported, including the methodologies employed and results obtained with lignins or their derivatives which may improve human health. We highlight potential applications in the treatment of obesity, diabetes, thrombosis, viral infections and cancer. Moreover, we report both that lignins can be used in the preparation of nanoparticles to deliver different drugs and also their use in photoprotection.
Topics: Animals; Antioxidants; Antiviral Agents; Drug Delivery Systems; Health Promotion; Humans; Immunologic Factors; Lignin
PubMed: 28590454
DOI: 10.3390/ijms18061219 -
The Cochrane Database of Systematic... May 2017Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus, which can cause scarring. Many drugs have been used to treat this disease and some (such as... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus, which can cause scarring. Many drugs have been used to treat this disease and some (such as thalidomide, cyclophosphamide and azathioprine) are potentially toxic. This is an update of a Cochrane Review first published in 2000, and previously updated in 2009. We wanted to update the review to assess whether any new information was available to treat DLE, as we were still unsure of the effectiveness of available drugs and how to select the most appropriate treatment for an individual with DLE.
OBJECTIVES
To assess the effects of drugs for discoid lupus erythematosus.
SEARCH METHODS
We updated our searches of the following databases to 22 September 2016: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and LILACS. We also searched five trials databases, and checked the reference lists of included studies for further references to relevant trials. Index Medicus (1956 to 1966) was handsearched and we approached authors for information about unpublished trials.
SELECTION CRITERIA
We included all randomised controlled trials (RCTs) of drugs to treat people with DLE in any population group and of either gender. Comparisons included any drug used for DLE against either another drug or against placebo cream. We excluded laser treatment, surgery, phototherapy, other forms of physical therapy, and photoprotection as we did not consider them drug treatments.
DATA COLLECTION AND ANALYSIS
At least two reviewers independently extracted data onto a data extraction sheet, resolving disagreements by discussion. We used standard methods to assess risk of bias, as expected by Cochrane.
MAIN RESULTS
Five trials involving 197 participants were included. Three new trials were included in this update. None of the five trials were of high quality.'Risk of bias' assessments identified potential sources of bias in each study. One study used an inappropriate randomisation method, and incomplete outcome data were a concern in another as 15 people did not complete the trial. We found most of the trials to be at low risk in terms of blinding, but three of the five did not describe allocation concealment.The included trials inadequately addressed the primary outcome measures of this review (percentage with complete resolution of skin lesions, percentage with clearing of erythema in at least 50% of lesions, and improvement in patient satisfaction/quality of life measures).One study of fluocinonide cream 0.05% (potent steroid) compared with hydrocortisone cream 1% (low-potency steroid) in 78 people reported complete resolution of skin lesions in 27% (10/37) of participants in the fluocinonide cream group and in 10% (4/41) in the hydrocortisone group, giving a 17% absolute benefit in favour of fluocinonide (risk ratio (RR) 2.77, 95% CI 0.95 to 8.08, 1 study, n = 78, low-quality evidence). The other primary outcome measures were not reported. Adverse events did not require discontinuation of the drug. Skin irritation occurred in three people using hydrocortisone, and one person developed acne. Burning occurred in two people using fluocinonide (moderate-quality evidence).A comparative trial of two oral agents, acitretin (50 mg daily) and hydroxychloroquine (400 mg daily), reported two of the outcomes of interest: complete resolution was seen in 13 of 28 participants (46%) on acitretin and 15 of 30 participants (50%) on hydoxychloroquine (RR 0.93, 95% CI 0.54 to 1.59, 1 study, n = 58, low-quality evidence). Clearing of erythema in at least 50% of lesions was reported in 10 of 24 participants (42%) on acitretin and 17 of 25 (68%) on hydroxychloroquine (RR 0.61, 95% CI 0.36 to 1.06, 1 study, n = 49, low-quality evidence). This comparison did not assess improvement in patient satisfaction/quality of life measures. Participants taking acitretin showed a small increase in serum triglyceride, not sufficient to require withdrawal of the drug. The main adverse effects were dry lips (93% of the acitretin group and 20% of the hydroxychloroquine group) and gastrointestinal disturbance (11% of the acitretin group and 17% of the hydroxychloroquine group). Four participants on acitretin withdrew due to gastrointestinal events or dry lips (moderate-quality evidence).One trial randomised 10 people with DLE to apply a calcineurin inhibitor, pimecrolimus 1% cream, or a potent steroid, betamethasone 17-valerate 0.1% cream, for eight weeks. The study reported none of the primary outcome measures, nor did it present data on adverse events.A trial of calcineurin inhibitors compared tacrolimus cream 0.1% with placebo (vehicle) over 12 weeks in 14 people, but reported none of our primary outcome measures. In the tacrolimus group, five participants complained of slight burning and itching, and for one participant, a herpes simplex infection was reactivated (moderate-quality evidence).Topical R-salbutamol 0.5% cream was compared with placebo (vehicle) over eight weeks in one trial of 37 people with DLE. There was a significant improvement in pain and itch in the salbutamol group at two, four, six, and eight weeks compared to placebo, but the trial did not record a formal measure of quality of life. None of the primary outcome measures were reported. Changes in erythema did not show benefit of salbutamol over placebo, but we could not obtain from the trial report the number of participants with clearing of erythema in at least 50% of lesions. There were 15 events in the placebo group (experienced by 12 participants) and 24 in the salbutamol group (experienced by nine participants). None of the adverse events were considered serious (moderate-quality evidence).
AUTHORS' CONCLUSIONS
Fluocinonide cream may be more effective than hydrocortisone in clearing DLE skin lesions. Hydroxychloroquine and acitretin appear to be of equal efficacy in terms of complete resolution, although adverse effects might be more frequent with acitretin, and clearing of erythema in at least 50% of lesions occurred less often in participants applying acitretin. Moderate-quality evidence found adverse events were minor on the whole. There is not enough reliable evidence about other drugs used to treat DLE. Overall, the quality of the trials and levels of uncertainty were such that there is a need for further trials of sufficient duration comparing, in particular, topical steroids with other agents.
Topics: Acitretin; Albuterol; Calcineurin Inhibitors; Dermatologic Agents; Fluocinonide; Humans; Hydrocortisone; Hydroxychloroquine; Lupus Erythematosus, Discoid; Randomized Controlled Trials as Topic; Tacrolimus; Treatment Outcome
PubMed: 28476075
DOI: 10.1002/14651858.CD002954.pub3 -
Eye (London, England) Feb 2017In recent years, manufacturers and distributors have promoted commercially available intraocular lenses (IOLs) with transmittance properties that filter visible... (Review)
Review
In recent years, manufacturers and distributors have promoted commercially available intraocular lenses (IOLs) with transmittance properties that filter visible short-wavelength (blue) light on the basis of a putative photoprotective effect. Systematic literature review. Out of 21 studies reporting on outcomes following implantation of blue-light-filtering IOLs (involving 8914 patients and 12 919 study eyes undergoing cataract surgery), the primary outcome was vision, sleep pattern, and photoprotection in 9 (42.9%), 9 (42.9%), and 3 (14.2%) respectively, and, of these, only 7 (33.3%) can be classed as high as level 2b (individual cohort study/low-quality randomized controlled trials), all other studies being classed as level 3b or lower. Of the level 2b studies, only one (14.3%) found in favor of blue-light-filtering IOLs vs ultraviolet (UV)-only filtering IOLs on the basis of an association between better post-operative contrast sensitivity (CS) at select frequencies with the former; however, that study did not measure or report CS preoperatively in either group, and the finding may simply reflect better preoperative CS in the eyes scheduled to be implanted with the blue-light-filtering IOL; moreover, that study failed to measure macular pigment, a natural preceptoral filter of blue-light, augmentation of which is now known to improve CS. In terms of photoprotection, there is no level 2b (or higher) evidence in support of blue filtering IOLs vs UV-only filtering IOLs. On the basis of currently available evidence, one cannot advocate for the use of blue-light-filtering IOLs over UV-only filtering IOLs.
Topics: Contrast Sensitivity; Evidence-Based Medicine; Filtration; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Radiation Protection; Retinal Pigments; Scattering, Radiation
PubMed: 27935597
DOI: 10.1038/eye.2016.266