Systemic immunomodulatory effects of Polypodium leucotomos as an adjuvant to PUVA therapy in generalized vitiligo: A pilot study

Reyes, Eduardo; Jaén, Pedro; Heras, Elena de las; Eusebio, Ester de; Carrión, Flavio; Cuevas, J; González, Salvador; Villarrubia, V. G.; Álvarez‐Mon, Melchor

doi:10.1016/j.jdermsci.2005.12.006

Cited by 50 publications

(38 citation statements)

References 8 publications

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“…This randomized, doubleblind clinical trial investigated 19 patients who were given either placebo (n = 9) or PLE 720 mg/day (n = 10) and compared PUVA alone to PUVA plus oral PLE for the treatment of generalized vitiligo over 12 weeks. Their results were also consistent, with a significantly higher rate of moderate to excellent repigmentation ([50 %) in the PUVA plus PLE group (5/10) compared with in the PUVA alone group (0/9) [18].…”

Section: P Leucotomos Use In Vitiligosupporting

confidence: 64%

“…A smaller study conducted by Reyes et al [18] examined the role of P. leucotomos as an adjuvant to PUVA therapy in generalized vitiligo. This randomized, doubleblind clinical trial investigated 19 patients who were given either placebo (n = 9) or PLE 720 mg/day (n = 10) and compared PUVA alone to PUVA plus oral PLE for the treatment of generalized vitiligo over 12 weeks.…”

Section: P Leucotomos Use In Vitiligomentioning

confidence: 99%

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Polypodium leucotomos: A Potential New Photoprotective Agent

Bhatia

2015

Am J Clin Dermatol

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As the understanding of the immune system pathways, cytokine balances, and cellular interactions continues to expand, so must the potential applications of therapies that can impact the process of diseases instead of just controlling their symptoms. In the case of Polypodium leucotomos extract, which is derived from a tropical fern of the Polypodiaceae family, the future potential of applications in dermatology and beyond will be better understood as its incorporation into daily routines gives rise to the development of new regimens. Clinicians may position this agent as an option for daily maintenance, accept its use in combinations, or use it as a template for further development of oral supplementation that may evolve into a true immunomodulator. The antioxidant activity of P. leucotomos extract is primarily driven by caffeic acid and ferulic acid, resulting in the control of cutaneous responses to ultraviolet-induced erythema, in the interception of inflammatory mechanisms, and the promotion of other cytotoxic responses. Histologically, the impact of P. leucotomos extract induces an effect on the overall reduction of angiogenesis, photocarcinogenesis, and solar elastosis, while on the cellular level there are improvements in cell membrane integrity and elastin expression. Future applications for P. leucotomos extract could include the potential for photoprotective effects, and subsequent research efforts should focus on determining the optimal dosage regimen, duration of action, and utility of combinations with sunscreens, among other outcomes. Recently published data have also demonstrated how the antioxidant effects of oral P. leucotomos extract can delay tumor development in mice models, suggesting there might be a protective role that could be described with further clinical research. In addition, it is important to recognize the distinction between photoprotection and chemoprevention, in that there has yet to be any in vivo or controlled clinical trial data in human subjects that show a role for P. leucotomos extract in the prevention of carcinogenesis.

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Section: P Leucotomos Use In Vitiligosupporting

confidence: 64%

Section: P Leucotomos Use In Vitiligomentioning

confidence: 99%

Polypodium leucotomos: A Potential New Photoprotective Agent

Bhatia

2015

Am J Clin Dermatol

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“…A double blind, placebo-controlled study has showed that the conjoined use of PL with narrow-band UVB (NB-UVB) increases the repigmentation of the head and neck area of vitiligo patients [57]. Together with its beneficial effect on PUVA-therapy [28,58], these studies suggest that PL may be a beneficial, general use adjuvant in phototherapy protocols.…”

Section: Fernblock: a Multi-pronged Approach To Photoprotectionmentioning

confidence: 99%

Fernblock, a Nutriceutical with Photoprotective Properties and Potential Preventive Agent for Skin Photoaging and Photoinduced Skin Cancers

González

Gilaberte

Philips

et al. 2011

IJMS

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Many phytochemicals are endowed with photoprotective properties, i.e., the capability to prevent the harmful effects of excessive exposure to ultraviolet (UV) light. These effects include photoaging and skin cancer, and immunosuppression. Photoprotection is endowed through two major modes of action: UV absorption or reflection/scattering; and tissue repair post-exposure. We and others have uncovered the photoprotective properties of an extract of the fern Polypodium leucotomos (commercial name Fernblock). Fernblock is an all-natural antioxidant extract, administered both topically (on the skin) or orally. It inhibits generation of reactive oxygen species (ROS) production induced by UV including superoxide anion. It also prevents damage to the DNA, inhibits UV-induced AP1 and NF-κB, and protects endogenous skin natural antioxidant systems, i.e., CAT, GSH, and GSSR. Its photoprotective effects at a cellular level include a marked decrease of UV-mediated cellular apoptosis and necrosis and a profound inhibition of extracellular matrix remodeling. These molecular and cellular effects translate into long-term inhibition of photoaging and carcinogenesis that, together with its lack of toxicity, postulate its use as a novel-generation photoprotective nutriceutical of phytochemical origin.

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“…However, other mechanisms such as immuno-modulatory effect (s) (Reyes et al, 2006) and variations in drug metabolising genes (Yang and Yan, 2007) cannot be ruled out which could be contributing to the observed PUVA drug response variation. There is a lack of literature on the potential source of DNA repair as a confounding factor with respect to drug response variation in vitiligo.…”

Section: Discussionmentioning

confidence: 99%