Novel retinoid ester in combination with salicylic acid for the treatment of acne.

BACKGROUND: Retinoids (RC), alpha-hydroxy acids (AHA), and salicylic acid (BHA) treat acne through differing mechanisms of action. It is theorized that optimal improvement can be achieved by combining the RC-induced normalization of cellular differentiation, AHA-induced exfoliation in hydrophilic areas, and BHA-induced exfoliation in lipophilic areas. AHA and RC have been combined in a bioengineered molecule (AHA retinoid conjugate, or AHA-RC) delivering both lactic acid (AHA) and RC in a manner reducing retinoid-associated irritation. OBJECTIVES: To evaluate efficacy and tolerability of a twice-daily, three-product skincare regimen using AHA-RC in combination with BHA for patients with acne. METHODS: A total of 27 women (age range 20-58 years, mean 37.81 ± 10.04 years) with mild-to-moderate acne used a 3-product regimen consisting of a twice-daily cleanser and topical serum (0.1% AHA-RC, 2% salicylic acid, and 10.4% l-lactic acid), with broad-spectrum SPF 50+ sunscreen as needed, over an 8-week period. Counts were made at baseline, week 4, and week 8 of total inflammatory (papules, pustules) and noninflammatory (open comedones, closed comedones) lesions. Dryness, stinging, and other secondary endpoints were rated on a 0-5 scale. RESULTS: Statistically significant reduction in inflammatory and noninflammatory lesion counts (P = 0.006 and P = 0.015, respectively) was noted at 4 weeks. Improvement continued into week 8 with highly significant (P < 0.001) reductions in both lesion counts. CONCLUSIONS: The topical combination of lactic acid, SA, and AHA-RC produced acne improvement after 4 weeks with continuing cumulative improvement at 8 weeks. AHA-RC represents a new molecule combining several mechanisms of action to achieve acne improvement.

The Tolerability and Efficacy of a Three-product Anti-aging Treatment Regimen in Subjects with Moderate-to-severe Photodamage.

Retinoids and alpha hydroxy acids differ in mechanism of action for treatment of photodamage, but concurrent use may produce a synergistic effect by combining retinoid-induced normalization of cellular differentiation with alpha hydroxy acid-induced exfoliation (in hydrophilic areas) and enhanced dermal and epidermal hydration. A recent bioengineered molecule, ethyl lactyl retinoate (alpha hydroxy acid retinoid conjugate), is the first to deliver alpha hydroxy acids and retinoids together in a hydrolysis-based time-released fashion. This could improve efficacy while minimizing irritation commonly associated with retinoid use. An eight-week clinical study was conducted to examine the efficacy and tolerability of this formulation; 25 women aged 54.1 ±8.9 years (mean ± SD) with moderate-to-severe photodamage (as determined by physician investigators using the Glogau Wrinkle Scale) employed a twice-daily regimen of cleanser (7.8% 1-lactic acid, 2% salicylic acid) and anti-aging serum (0.1% alpha hydroxy acids-retinoids, 6.5% 1-lactic acid) with concurrent use of sun protection factor 50+ sunscreen as needed. Longitudinal analysis of study data revealed statistically significant improvement in photodamage, dryness/flaking, dyschromia, and global appearance at eight weeks. All study products were well-tolerated throughout. Investigators concluded that the alpha hydroxy acid retinoid conjugate is a safe and effective topical therapy for moderate-to-severe photodamage, warranting further study, (clinicaltrials.gov, NCT02422836, https://clinicaltrials.gov/ct2/show/NCT02422836?term=NCT02422836).

[The effectiveness of montelukast in recurrent post-bronchiolitis wheezing]. / Eficienta Montelukastului în wheezingul recurent post bronsiolitic.

Some studies showed increased levels of leukotrienes in the nasopharyngeal secretions in children with wheezing secondary to viral infections, leading to therapeutical attempts with leukotriene receptor inhibitors in infants and small children with recurrent wheezing. This is a double blind randomized study for evaluating the efficacy of montelukast in infants and small children. In the study group (20 children) treated with montelukast, 5 mg/day for 3 months, the frequency of bronchial obstruction episodes in the 6 months following the start of therapy was significantly lower (p = 0.001) than the 6 months before treatment (1.25 +/- 1.41 versus 3.79 +/- 2.41). In the control group (18 children) treated with placebo, the frequency of the bronchial obstruction episodes decreased (from 3.04 +/- 1 to 2.41 +/- 1.5) in the two analyzed periods, but the differences were not statistically significant (p = 0.067). The differences between the two groups are present also after excluding the children with atopy. The results suggest the beneficial role of leukotriene receptor antagonists in improving the symptoms of patients with recurrent post-bronchiolitis wheezing.