tretinoin and azelaic-acid

Acne and rosacea are common inflammatory skin conditions present in numerous racial and ethnic groups. There are distinct differences in clinical presentation, exacerbating factors, potential triggers and consequences of both conditions in individuals with skin of colour (SOC), classified as Fitzpatrick skin types III-VI. For example, acne can be complicated by the development of postinflammatory hyperpigmentation and keloid scarring in SOC, and this can influence treatment choice. Although rosacea is reported less frequently in SOC, this may be the result of delayed diagnosis or late presentation due to the difficulty in discerning the classic features of erythema in darker skin tones. In such cases, additional clues in the medical history and clinical examination may assist in making the diagnosis. This review aims to summarize nuances in both the diagnosis and management of these two common skin conditions in patients with SOC to support clinicians in providing an individualized treatment approach.

Topics: Acne Vulgaris; Adapalene; Diagnosis, Differential; Dicarboxylic Acids; Humans; Racial Groups; Rosacea; Skin Pigmentation; Tretinoin

Acne is an inflammatory disorder with a high global burden. It is common in adolescents and primarily affects sebaceous gland-rich areas. The clinical benefit of the topical acne treatments azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, and alpha-hydroxy acid is unclear.. To assess the effects of topical treatments (azelaic acid, salicylic acid, nicotinamide, zinc, alpha-hydroxy acid, and sulphur) for acne.. We searched the following databases up to May 2019: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers.. Clinical randomised controlled trials of the six topical treatments compared with other topical treatments, placebo, or no treatment in people with acne.. We used standard methodological procedures expected by Cochrane. Key outcomes included participants' global self-assessment of acne improvement (PGA), withdrawal for any reason, minor adverse events (assessed as total number of participants who experienced at least one minor adverse event), and quality of life.. We included 49 trials (3880 reported participants) set in clinics, hospitals, research centres, and university settings in Europe, Asia, and the USA. The vast majority of participants had mild to moderate acne, were aged between 12 to 30 years (range: 10 to 45 years), and were female. Treatment lasted over eight weeks in 59% of the studies. Study duration ranged from three months to three years. We assessed 26 studies as being at high risk of bias in at least one domain, but most domains were at low or unclear risk of bias. We grouped outcome assessment into short-term (less than or equal to 4 weeks), medium-term (from 5 to 8 weeks), and long-term treatment (more than 8 weeks). The following results were measured at the end of treatment, which was mainly long-term for the PGA outcome and mixed length (medium-term mainly) for minor adverse events. Azelaic acid In terms of treatment response (PGA), azelaic acid is probably less effective than benzoyl peroxide (risk ratio (RR) 0.82, 95% confidence interval (CI) 0.72 to 0.95; 1 study, 351 participants), but there is probably little or no difference when comparing azelaic acid to tretinoin (RR 0.94, 95% CI 0.78 to 1.14; 1 study, 289 participants) (both moderate-quality evidence). There may be little or no difference in PGA when comparing azelaic acid to clindamycin (RR 1.13, 95% CI 0.92 to 1.38; 1 study, 229 participants; low-quality evidence), but we are uncertain whether there is a difference between azelaic acid and adapalene (1 study, 55 participants; very low-quality evidence). Low-quality evidence indicates there may be no differences in rates of withdrawal for any reason when comparing azelaic acid with benzoyl peroxide (RR 0.88, 95% CI 0.60 to 1.29; 1 study, 351 participants), clindamycin (RR 1.30, 95% CI 0.48 to 3.56; 2 studies, 329 participants), or tretinoin (RR 0.66, 95% CI 0.29 to 1.47; 2 studies, 309 participants), but we are uncertain whether there is a difference between azelaic acid and adapalene (1 study, 55 participants; very low-quality evidence). In terms of total minor adverse events, we are uncertain if there is a difference between azelaic acid compared to adapalene (1 study; 55 participants) or benzoyl peroxide (1 study, 30 participants) (both very low-quality evidence). There may be no difference when comparing azelaic acid to clindamycin (RR 1.50, 95% CI 0.67 to 3.35; 1 study, 100 participants; low-quality evidence). Total minor adverse events were not reported in the comparison of a. Compared to benzoyl peroxide, azelaic acid probably leads to a worse treatment response, measured using PGA. When compared to tretinoin, azelaic acid probably makes little or no difference to treatment response. For other comparisons and outcomes the quality of evidence was low or very low. Risk of bias and imprecision limit our confidence in the evidence. We encourage the comparison of more methodologically robust head-to-head trials against commonly used active drugs.

Topics: Acne Vulgaris; Adapalene; Adolescent; Adult; Anti-Bacterial Agents; Benzoyl Peroxide; Bias; Child; Clindamycin; Dermatologic Agents; Dicarboxylic Acids; Erythromycin; Female; Glycolates; Humans; Keratolytic Agents; Male; Mandelic Acids; Niacinamide; Patient Dropouts; Pyruvic Acid; Quality of Life; Salicylic Acid; Sulfur; Tretinoin; Young Adult; Zinc

Postinflammatory hyperpigmentation (PIH) has posed a substantial challenge for patients with higher Fitzpatrick skin types, specifically types III to VI. Treatment modalities pose a number of limitations due to the number of treatments required, potential side effects, and overall efficacy. Fortunately, multiple therapies have been delineated that can be moderately to highly efficacious in treating PIH in patients with skin of color. This article will review some of these modalities and procedures for this common patient concern.

Topics: Chemexfoliation; Dermatitis; Dermatologic Agents; Dicarboxylic Acids; Drug Combinations; Ethanol; Glycolates; Humans; Hydroquinones; Hyperpigmentation; Inflammation; Keratolytic Agents; Lactic Acid; Pyrones; Resorcinols; Salicylates; Salicylic Acid; Skin Pigmentation; Tretinoin

Several methods of treatment are available to patients with melasma. First-line therapy usually consists of topical compounds that affect the pigment production pathway, broad-spectrum photoprotection, and camouflage. Second-line therapy often consists of the addition of chemical peels, although these must be used cautiously in patients with darker skin. Laser and light therapies represent potentially promising options for patients who are refractory to other modalities, but also carry a significant risk of worsening the disease. A thorough understanding of the risks and benefits of various therapeutic options is crucial in selecting the best treatment.

Topics: Administration, Topical; Asian People; Chemexfoliation; Dicarboxylic Acids; Drug Therapy, Combination; Glycolates; Glycyrrhiza; Humans; Hydroquinones; Low-Level Light Therapy; Melanins; Melanosis; Monophenol Monooxygenase; Phototherapy; Phytotherapy; Plant Extracts; Pyrones; Sunscreening Agents; Treatment Outcome; Tretinoin; Ultraviolet Rays

Increased fibroblast growth factor receptor-2 (FGFR2) signaling has been proposed to be involved in acne pathogenesis and explains acne lesions in Apert syndrome and unilateral acneiform nevus associated with gain-of-function point mutations of FGFR2. If, indeed, increased FGFR2 signaling plays a major pathogenic role in follicular hyperkeratinization and sebaceous gland hypertrophy in acne, effective anti-acne drugs may attenuate increased FGFR2 signaling. The purpose of this article is to elucidate the hypothesis that known anti-acne agents may operate by downregulation of increased FGFR2 signaling. Anti-androgens suppress FGF-ligand expression, benzoyl peroxide induces FGFR2 downregulation by lysosomal receptor degradation, azelaic acid inhibits mitochondrial ATP formation required for receptor tyrosine kinase phosphorylation, tetracyclines inhibit the expression, and activity of FGFR2b downstream matrix metalloproteinases, and retinoids attenuate the FGFR2 pathway at several regulatory levels of the signal transduction cascade critical for cell cycle control, cell proliferation, differentiation, and lipogenesis. Erythromycin, a P-450 inhibitor, may interfere with FGFR2 signaling by its inhibitory effect on retinoid catabolism. The gain-of-function mutations of FGFR2 in Apert syndrome and unilateral acneiform nevus, and the proposed synergistic inhibitory interactions of anti-acne agents at various levels of the FGFR2-signaling cascade underline the role of FGFR2 signaling in the pathogenesis of acne.

Topics: Acne Vulgaris; alpha-MSH; Androgen Antagonists; Benzoyl Peroxide; Dicarboxylic Acids; Erythromycin; Humans; Interleukin-1alpha; Isotretinoin; Reactive Oxygen Species; Receptor, ErbB-2; Signal Transduction; Tetracyclines; Tretinoin

Topics: Acne Vulgaris; Adapalene; Anti-Bacterial Agents; Benzoyl Peroxide; Clindamycin; Dermatologic Agents; Dicarboxylic Acids; Doxycycline; Erythromycin; Humans; Isotretinoin; Minocycline; Naphthalenes; Tetracycline; Tretinoin; Zinc

Melasma is an irregular brown or grayish-brown facial hypermelanosis, often affecting women, especially those living in areas of intense UV radiation. The precise cause of melasma remains unknown; however, there are many possible contributing factors. Because of its dermal component and tendency to relapse, melasma is often difficult to treat. The use of broad-spectrum (UVA + UVB) sunscreen is important, as is topical hydroquinone, the most common treatment for melasma. Other lightening agents include retinoic acid (tretinoin) and azelaic acid. Combination therapies such as hydroquinone, tretinoin, and corticosteroids have been used in the treatment of melasma, and are thought to increase efficacy as compared with monotherapy. Kojic acid, isopropylcatechol, N-acetyl-4-cysteaminylphenol, and flavonoid extracts are other compounds that have been investigated for their ability to produce hypopigmentation, but their efficacy, safety, or trial design indicates that the interventions would need further study before they could be recommended. Chemical peels, laser treatments, and intense pulsed light therapy are additional therapeutic modalities that have been used to treat melasma.

Topics: Adrenal Cortex Hormones; Adult; Chemexfoliation; Clinical Trials as Topic; Combined Modality Therapy; Dermabrasion; Dicarboxylic Acids; Double-Blind Method; Drug Therapy, Combination; Female; Flavonoids; Gonadal Steroid Hormones; Humans; Hydroquinones; Laser Coagulation; Melanosis; Phototherapy; Plant Extracts; Pregnancy; Pregnancy Complications; Pyrones; Randomized Controlled Trials as Topic; Skin; Sunlight; Treatment Outcome; Tretinoin; Ultraviolet Rays

Topics: Acne Vulgaris; Adapalene; Anti-Bacterial Agents; Benzoyl Peroxide; Clindamycin; Dermatologic Agents; Dicarboxylic Acids; Drug Therapy, Combination; Erythromycin; Humans; Isotretinoin; Naphthalenes; Tetracycline; Tretinoin; Zinc

Pigmentary disorders are one of the most common skin disorders among people of color. Dyspigmentation in the form of either hyperpigmentation or hypopigmentation is often psychologically devastating to patients with darker skin. There is marked contrast between normally pigmented hyperpigmented, hypopigmented or depigmented skin in people of color. Despite being common, pigmentary disorders remain difficult to treat.

Topics: Administration, Cutaneous; Arbutin; Black People; Dicarboxylic Acids; Humans; Hydroquinones; Keratolytic Agents; Pigmentation Disorders; Pyrones; Tretinoin

Hyperpigmentation disorders of the skin are common. Three of the more common forms include melasma, lentigines, and post-inflammatory hyperpigmentation. Significant negative psychological consequences can result. Many therapeutic options exist, though treatment is often difficult, requiring lengthy therapy.

Topics: Chemexfoliation; Cryotherapy; Dermatologic Agents; Dicarboxylic Acids; Humans; Hydroquinones; Hyperpigmentation; Inflammation; Keratolytic Agents; Laser Therapy; Lentigo; Melanosis; Patient Education as Topic; Primary Prevention; Risk Factors; Self Care; Sunlight; Tretinoin

Precise classification methods are used to define acne according to type (comedonal, papulopustular, or nodular) and severity. The relative effectiveness of several topical and systemic agents has been established in clinical trials, making possible an algorithm of specific treatment decisions based on acne classification.

Topics: Acne Vulgaris; Adapalene; Administration, Oral; Administration, Topical; Algorithms; Anti-Bacterial Agents; Benzoyl Peroxide; Contraceptives, Oral; Controlled Clinical Trials as Topic; Cost-Benefit Analysis; Decision Trees; Dermatologic Agents; Dicarboxylic Acids; Humans; Isotretinoin; Macrolides; Naphthalenes; Nicotinic Acids; Salicylates; Tretinoin; United States

Amelanotic lentigo maligna melanoma (ALMM) is an infrequent presentation of lentigo maligna melanoma, less than thirty cases having been reported to date. Hypopigmented or erythematous macules on the face of older women, resembling Bowen's disease or eczema, are the most common clinical presentation. We report a case of ALMM in a 73-year-old woman. Therapeutic trials with cryotherapy, 5-fluorouracil, and azelaic acid were unsuccessful, and the lesions were eventually cured by surgical excision. ALMM requires early clinical suspicion and histopathologic confirmation of diagnosis in every patient presenting with a slowly enlarging erythematous or hypopigmented macule, especially when located on the face of an older woman with a light complexion.

Topics: Aged; Antineoplastic Agents; Combined Modality Therapy; Cryotherapy; Dicarboxylic Acids; Female; Fluorouracil; Humans; Hutchinson's Melanotic Freckle; Melanoma, Amelanotic; Skin Neoplasms; Tretinoin

Acne is one of the most common diseases in dermatology. It is of considerable esthetic significance, which explains the mental stress in affected patients. Although acne almost always heals spontaneously in early adulthood, treatment measures can shorten the course, reduce the severity of the disease, and avoid complications such as scarring. Treatment has changed substantially in recent years. In accordance with pathogenic principles, effective treatment is possible. In most patients, a combination of drugs aimed at correcting abnormal keratinization and reducing the proliferation of Propionibacterium acnes is sufficient to control the disease. For more severely affected patients with no response to this approach, therapy to suppress sebum production is indicated. Of all therapeutic modalities available, only oral isotretinoin alters the natural course of the disease. In acne inversa, surgical management should be undertaken as early as possible.

Topics: Acne Vulgaris; Administration, Topical; Androgen Antagonists; Anti-Infective Agents, Local; Benzoyl Peroxide; Dermatologic Agents; Dicarboxylic Acids; Diuretics; Humans; Keratolytic Agents; Phototherapy; Tretinoin; Zinc

Clinical studies of patients with melasma have shown that topical 20 percent azelaic acid is superior to 2 percent hydroquinone and as effective as 4 percent hydroquinone, without the latter's undesirable side effects. Tretinoin appears to enhance this effect of azelaic acid. Azelaic acid with tretinoin caused more skin lightening after three months than azelaic acid alone, and a higher proportion of excellent responders at the end of treatment. The effect of azelaic acid can be attributed to its ability to inhibit the energy production and/or DNA synthesis of hyperactive melanocytes, and partially to its antityrosinase activity. This may also account for the beneficial effect on postinflammatory hyperpigmentation. Destruction of malignant melanocytes by a combination of the same activities, enhanced by the greater permeability of tumoral cells to azelaic acid, may account for the clinical effects of azelaic acid observed in lentigo maligna and individual lesions of primary melanoma.

Topics: Administration, Topical; Dermatologic Agents; Dicarboxylic Acids; Drug Therapy, Combination; Humans; Melanosis; Tretinoin

Melasma is a common acquired symmetric hypermelanosis characterized by irregular light- to gray-brown macules and patches involving sun-exposed areas of skin. Etiologic factors in the pathogenesis of melasma include genetic influences, exposure to UV radiation, pregnancy, hormonal therapies, cosmetics, phototoxic drugs, and antiseizure medications.. Melasma is often a therapeutically challenging disease, and current treatments include hypopigmenting agents, chemical peels, and lasers. Hypopigmenting agents include phenolic and nonphenolic derivatives. Phenolic agents include hydroquinone and hydroquinone combination preparations. Despite controversies regarding the issue of hydroquinone-induced ochronosis, hydroquinone remains the most effective topically applied bleaching agent approved by the Food and Drug Administration for the treatment of melasma. Nonphenolic bleaching agents include tretinoin and azelaic acid. Superficial, medium, and deep chemical peels are more often used in lighter-complexioned patients. Such peels should be used with caution in blacks. Although lasers have demonstrated significant efficacy in the treatment of a variety of hyperpigmentary disorders, their precise efficacy and place in the therapy of melasma have yet to be established.. In the hierarchy of therapies for melasma, the treating physician must consider the devastating psychosocial impact of pigmentary imperfections within the realm of the benefits and risks associated with each treatment.

Topics: Administration, Cutaneous; Chemexfoliation; Dermatologic Agents; Dicarboxylic Acids; Female; Humans; Hydroquinones; Keratolytic Agents; Laser Therapy; Male; Melanosis; Pregnancy; Tretinoin; United States; United States Food and Drug Administration

Topics: Acne Vulgaris; Administration, Topical; Benzoyl Peroxide; Clindamycin; Dicarboxylic Acids; Erythromycin; Humans; Miconazole; Oxytetracycline; Salicylates; Salicylic Acid; Tretinoin

20% azelaic acid cream was compared clinically with it vehicle in a 3-month double-blind study of 92 patients with moderate inflammatory acne. In a single-blind study of 289 patients with comedonal acne, the topical azelaic acid preparation was compared with 0.05% tretinoin cream over a period of 6 months. In both controlled studies, 20% azelaic acid cream significantly reduced the number of acne lesions and yielded clinically relevant improvement rates. Azelaic acid cream was significantly and substantially more effective than its vehicle, indicating that the dicarboxylic acid itself is an active drug in acne treatment. In the study of comedonal acne, 20% azelaic acid cream was equally effective as 0.05% tretinoin cream in reducing the number of comedones and with respect to overall response. However, azelaic acid cream was better tolerated, causing fewer local side effects than the topical retinoid.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Child; Clinical Trials as Topic; Dicarboxylic Acids; Double-Blind Method; Drug Eruptions; Erythema; Female; Humans; Male; Middle Aged; Tretinoin

20% azelaic acid cream was compared clinically with its vehicle in a 3-month double-blind study of 92 patients with moderate inflammatory acne. It was found that the azelaic acid treatment significantly reduced inflamed and non-inflamed lesions and yielded clinically relevant improvement rates. Its action was significantly more effective than its vehicle. In the study of comedo acne, 20% azelaic acid cream was equally effective as 0.05% tretinoin cream in reducing the number of comedones and with respect to overall response. However azelaic acid cream was better tolerated, causing fewer local side effects than the tretinoin.

Topics: Acne Vulgaris; Clinical Trials as Topic; Dermatologic Agents; Dicarboxylic Acids; Double-Blind Method; Humans; Ointments; Time Factors; Tretinoin

A range of treatment options are available in rosacea, which include several topical (mainly metronidazole, azelaic acid, other antibiotics, sulfur, retinoids) and oral drugs (mainly tetracyclines, metronidazole, macrolides). In some cases, the first choice is a systemic therapy because patients may have sensitive skin and topical medications can be irritant. Isotretinoin can be used in resistant cases of rosacea. Unfortunately, the majority of studies on rosacea treatments are at high or unclear risk of bias. A recent Cochrane review found that only topical metronidazole, azelaic acid, and oral doxycycline (40 mg) had some evidence to support their effectiveness in moderate to severe rosacea and concluded that further well-designed, adequately-powered randomised controlled trials are required. In our practice, we evaluate our patients for the presence of two possible triggers, Helicobacter pylori infection and small intestinal bacterial overgrowth. When they are present we use adapted antibiotic protocols. If not, we use oral metronidazole or oral tetracycline to treat papulopustolar rosacea. We also look for Demodex folliculorum infestation. When Demodex concentration is higher than 5/cm(2) we use topical crotamiton 10% or metronidazole.

Topics: Adapalene; Anti-Infective Agents; Cyclosporine; Dermatologic Agents; Dicarboxylic Acids; Humans; Immunosuppressive Agents; Isotretinoin; Keratolytic Agents; Metronidazole; Mite Infestations; Naphthalenes; Rosacea; Sulfacetamide; Tacrolimus; Tetracycline; Toluidines; Tretinoin

Hyperpigmentation has frustrated men and women as a cosmetic concern and as a reminder of past skin injury. While photoprotection is an important part of preventing dark marks on skin, therapeutic interventions are important as well. The authors review new treatment data for fractional thermolysis,Tri-Luma, azelaic acid and chemical peels. Many therapies have been available for years, although evidence is not always extensive. The emergence of new treatments and long-term safety data offers dermatologists a greater degree of confidence as to the treatment approaches they can offer patients with hyperpigmentation.

Topics: Chemexfoliation; Dermatologic Agents; Dicarboxylic Acids; Fluocinolone Acetonide; Humans; Hydroquinones; Hyperpigmentation; Laser Therapy; Tretinoin

Melasma (cloasma) is a typical hypermelanosis and a common dermatologic skin disease that involves sun-exposed areas of the skin. It mostly affects women of reproductive age. Solar and ultraviolet exposure are the most crucial etiologic factors. Pregnancy, certain endocrine disorders and hormonal treatments, cosmetics, phototoxic drugs, and antiseizure medications are well-known inducing and exacerbating factors. A classification of melasma is based on Wood's light examination, classifying it in four major clinical types and patterns: epidermal, dermal, mixed, and indeterminate. Different treatment options are currently available for melasma. The choice of proper treatment should take into account the type of melasma to be treated, the skin complexion of the patient, possible previous treatments, the expectations and compliance of the patient, and the season in which the treatment is started.

Topics: Chemexfoliation; Cosmetics; Dermatologic Agents; Dicarboxylic Acids; Drug Combinations; Humans; Hydroquinones; Hydroxybenzoates; Laser Therapy; Melanosis; Pyrones; Tretinoin

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Benzoyl Peroxide; Dermatologic Agents; Dicarboxylic Acids; Drug Therapy, Combination; Female; Humans; Keratolytic Agents; Male; Nonprescription Drugs; Tretinoin

The precise pathologic processes of comedo formation in acne are not well understood. Retention hyperkeratosis may play an important role. To evaluate the effects of three topical comedolytics, 20% azelaic acid, 0.1% tretinoin and 5% benzoyl peroxide, on the retention hyperkeratosis of experimentally induced comedones (EIC), an ultrastructural study was done. After formation of EIC with 50% oleic acid in paraffin oil on the external ears of rabbits, each comedolytic was applied for 4 weeks. Biopsies were taken every week and, using a Hitachi H-600 transmission electron microscope, morphologic observations were done in the upper portion of the follicular epithelium. In EIC, after application of each comedolytic, the markedly thinned horny layer was loosely adhered by extremely few desmosomes and desmosomal bodies. The number and size of tonofilaments and keratohyaline granules decreased, but the number of variable sized Odland bodies increased in the upper epidermis. These findings appeared 1 week after application of either azelaic acid or benzoyl peroxide, and 3 weeks after application of tretinoin. For the first 2 weeks of tretinoin application, EIC showed rather compact hyperkeratosis with more desmosomes and desmosomal bodies than before. Azelaic acid tretinoin and benzoyl peroxide increased the number of Odland bodies, and the horny cells became less adhesive. This lysis of retention hyperkeratosis resulted in comedolysis. During 4 weeks of treatment with these three comedolytics, only tretinoin normalized the keratinization process.

Topics: Acne Vulgaris; Animals; Benzoyl Peroxide; Dermatologic Agents; Dicarboxylic Acids; Disease Models, Animal; Epithelial Cells; Epithelium; Evaluation Studies as Topic; Keratolytic Agents; Keratosis; Rabbits; Tretinoin

Adult T cell leukemia derived factor (ADF), which was first reported as a cytokine-like factor produced by human T lymphotropic virus I (HTLV-I)-transformed T cells, is a human homologue of thioredoxin (TRX). ADF/TRX has multiple functions including growth promoting, antiapoptotic and radical scavenging activities, and is also involved in a wide variety of intracellular processes as a dithiol reducing agent in cooperation with the NADPH-TRX reductase system. In HTLV-1(+) T cell lines, HuT 102 and MT-2, which are ADF/TRX high producing cells, we found that the expression of ADF/TRX was dependent on the cell cycle and peaked at S phase. The reducing activity of ADF/TRX in these cells was also dependent on the cell cycle and elevated in S phase as determined by NADPH-dependent insulin degradation assay. Furthermore, inhibitors of TRX reductase, 13-cis-retinoic acid (13-cis-RA) and azelaic acid, inhibited the DNA synthesis of these cells. In contrast, the residual expression and reducing activity of ADF/TRX in HTLV-I(-) T cell lines did not show any significant correlation with the cell cycle. There was no distinct inhibitory effect of 13-cis-RA or azelaic acid on the growth of these ADF/TRX low producing cells. These results indicate that a high level of reducing activity of the ADF/TRX system may be required for the cell division of these virally transformed cells. This suggests that the TRX reductase inhibitors including retinoid derivatives have a potential therapeutic utility for treatment of HTLV-1(+) T cell leukemia without any effect on HTLV-I(-) cells.

Topics: Cell Cycle; Cell Division; Cell Line, Transformed; Cell Transformation, Viral; Cytokines; Dicarboxylic Acids; Enzyme Inhibitors; Growth Substances; Human T-lymphotropic virus 1; Humans; Insulin; Neoplasm Proteins; T-Lymphocytes; Thioredoxin-Disulfide Reductase; Thioredoxins; Tretinoin; Tumor Cells, Cultured; Vitamin K