Vectical - Vit. D3 Ointment Trials for Cathelicidins? - Rosacea Knowledge Forum by Geoffrey Nase PhD

Dr. Geoffrey Nase · #1 (**permalink**) 14th April 2010, 04:01 AM

Galderma has released a potent topical Vitamin D3 prescription treatment for Psoriasis (Topical Vectical). It is potent and effective... working on multiple levels of Dr. Gallo's research into Cathelicidins.

Vitamin D3 is vastly more effective topically than orally as shown in clinical studies testing Psoriasis and other inflammatory skin disorders.

Cathelicidins are regulated and normalized by Vitamin D3:

Our skin is constantly challenged by microbes but is rarely infected. Cutaneous production of antimicrobial peptides (AMPs) is a primary system for protection, and expression of some AMPs further increases in response to microbial invasion. Cathelicidins are unique AMPs that protect the skin through 2 distinct pathways: (1) direct antimicrobial activity and (2) initiation of a host response resulting in cytokine release, inflammation, angiogenesis, and reepithelialization. Cathelicidin dysfunction emerges as a central factor in the pathogenesis of several cutaneous diseases, including atopic dermatitis, in which cathelicidin is suppressed; rosacea, in which cathelicidin peptides are abnormally processed to forms that induce inflammation; and psoriasis, in which cathelicidin peptide converts self-DNA to a potent stimulus in an autoinflammatory cascade. Recent work identified vitamin D3 as a major factor involved in the regulation of cathelicidin. Therapies targeting control of cathelicidin and other AMPs might provide new approaches in the management of infectious and inflammatory skin diseases.

The D3 download

Vitamin D—particularly Vitamin D3 (calcitriol)—is an important factor in skin health. Calcitriol works on a cellular level to help inhibit the over production of skin cells, which is a key factor in psoriasis. Calcitriol is also thought to help diminish the excessive immune response in the skin of patients with psoriatic lesions (and affected rosacea skin).

The use of Vitamin D3 to treat psoriasis dates back to the 1930s, and has since become an important option for therapy, especially with its low rate of adverse events such as irritation.

While originally used in an oral medication, topical use of Vitamin D3 has been shown to help control mild to moderate psoriasis. Because of the chronic nature of this disease, both short-term and long-term treatment options are essential.

Topical Vectical in a water based gel or cream is being considered for testing on rosacea skin. It's safe, its available, its been tested... it would be quite easy to perform follow up studies for rosacea skin.

DO NOT TRY IT ON YOUR OWN AS THEY NEED TO ADJUST THE CONCENTRATION AND DELIVERY SYSTEM.

Link: Vitamin D3 and Psoriasis ? Vectical.com

Dr. Geoffrey Nase · #2 (**permalink**) 14th April 2010, 04:17 AM

Vitamin D3 Analogues already available at top compounding pharmacies. In fact, some are using the D3 lotion to successfully treat acne which is exacerbated by Cathelicidins:

Use of MC 903 lotion (Vitamin D3 Analogue) in the treatment of acne vulgaris of the face

A total of 10 patients with acne vulgaris of the face have been assessed in an open, non-controlled study of MC 903 lotion. Patients were treated for up to 6 weeks with twice daily applications of the lotion: 50 μg/ml. The study provided evidence that MC 903 lotion was well tolerated. Furthermore, the data pertaining to the therapeutic efficacy of the lotion are encouraging.

Please do not procede without discussing this treatment with your physician as some Vitamin D3 analogue creams can be irritating if used in too high a concentration or in an alcohol base.

Examples of such vitamin D analogues for such use are given in the above-mentioned Ser. No. 07/859,529. Particularly preferred for the treatment of acne are (1) calcipotriol (which is also designated herein as MC 903), a compound disclosed in Example 5 of international patent application No. PCT/DK86/0081, international filing date of Jul. 14, 1986, International Publication No. WO 87/00834; see also Calverley, J., Tetrahedron, 43:4609-4619 (1987); Binderup, L. and Bramm, E., Biochemical Pharmacology, 37:889-895 (1988)) and (2) the compound designated for convenience as KH 1060 which is disclosed in international patent application No. PCT/DK 90/00036 (Example 5, compound No. 106) i.e. 1(S),3(R)-dihydroxy-20(R)-(4'-hydroxy-4'-ethyl-1'-hexyloxy)- 9,10-seco-preg na-5(Z),7(E),10(19)-triene. See also U.S. application Ser. No. 08/016,186, filed Feb. 11, 1993 as a continuation of Ser. No. 07/721,562, filed Aug. 2, 1991, the contents of said PCT and U.S. applications being incorporated herein by reference.

Dr. Geoffrey Nase · #3 (**permalink**) 14th April 2010, 07:13 AM

Arch Dermatol Res. 2010 Mar 10. [Epub ahead of print]

Control of cutaneous antimicrobial peptides by vitamin D3.
Dombrowski Y, Peric M, Koglin S, Ruzicka T, Schauber J.

Abstract

Constant exposure to a wide variety of microbial pathogens represents a major challenge for our skin. Antimicrobial peptides (AMPs) are mediators of cutaneous innate immunity and protect primarily against microbial infections. Cathelicidins were among the first AMPs identified in human skin and recent evidence suggests that they exert a dual role in innate immune defense: At first, due to their antimicrobial activity they kill pathogens directly. In addition, these peptides initiate a potent host response to infection resulting in cytokine release, inflammation and a cellular response. Disturbed cathelicidin expression and function was observed in several common inflammatory skin diseases, such as psoriasis where cathelicidin peptide converts inert self-DNA and self-RNA into an autoimmune stimulus. In atopic dermatitis decreased levels of cathelicidin facilitating microbial superinfections have been discussed. Furthermore, abnormally processed cathelicidin peptides induce inflammation and a vascular response in rosacea. Until recently, the molecular mechanisms underlying cathelicidin regulation were unknown. Recently, the vitamin D3 pathway was identified as the major regulator of cathelicidin expression. Consequently, vitamin D3 entered the spotlight as an immune modulator with impact on both innate and adaptive immunity. Therapies targeting vitamin D3 signaling may provide new approaches for infectious and inflammatory skin diseases by affecting both innate and adaptive immune functions.

mrsmoof · #4 (**permalink**) 30th April 2010, 11:34 AM

Do you suggest taking more Vit D3? If so how much per day? I keep reading conflicting thoughts on this subject,

Thanks!

Dr. Geoffrey Nase · #5 (**permalink**) 4th May 2010, 07:52 PM

Quote:

Originally Posted by mrsmoof

Do you suggest taking more Vit D3? If so how much per day? I keep reading conflicting thoughts on this subject,

Thanks!

Doug,

It's safe to test and the worst thing that can happen... is nothing.

I would try the Vitamin D3, but would not exceed 500% above the RDA.

The interesting point is that the most effective Vitamin D2 is from the sun. I would try to get 30 minutes of sun in between 4 PM and 6 PM without any sunblock. This would be much more effective against Cathelicidins... if they play a role at all.

mrsmoof · #6 (**permalink**) 16th June 2010, 01:37 PM

Do you think Vitamin D therapy -oral and/or topical- can play a big role in controlling Rosacea? I have read about a few people who raised their Vitamin D levels into the 90-100 range and stayed at that range for 12-18 months that their Rosacea diminished greatly. I guess it would make sense since Vitamin D controls cathcathelicidin production and regulates our immune system.

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