5-Aminolevulinic acid 78mg/g gel

Actinic keratosis is a common precancerous epidermal skin lesion characterized by rough, scaly patches on sun-exposed areas due to chronic UV exposure, and it carries a risk of progressing to squamous cell carcinoma. Both photodynamic therapy and imiquimod cream have been proven to be effective therapeutic option for actinic keratosis. However, there is no comprehensive systematic review that compare the efficacy of the two treatments. We conducted a comprehensive search of literature to evaluate the efficacy of photodynamic therapy and imiquimod cream in treating actinic keratosis. Meta-analysis was performed using Review Manager 5.4 software. After the screening of 1144 studies and 11 reports, six randomized controlled trials with two evaluation indicators were included. Our meta-analysis indicated that photodynamic therapy, particularly 5-aminolevulinic acid photodynamic therapy, produced superior results than imiquimod cream when analysing the lesion clearance rate, and imiquimod treatment is more likely to cause adverse reactions such as ulceration/crusting compared to photodynamic therapy.

Abstract licence: CC BY-NC-ND

5-Aminolevulinic acid (5-ALA) is an essential compound in the biosynthesis of heme, playing a critical role in various physiological processes within the human body. This review provides the thorough analysis of the latest research on the molecular mechanisms and potential therapeutic benefits of 5-ALA in managing metabolic disorders. The ability of 5-ALA to influence immune response and inflammation, oxidative/nitrosative stress, antioxidant system, mitochondrial functions, as well as carbohydrate and lipid metabolism, is mediated by molecular mechanisms associated with the suppression of the transcription factor NF-κB signaling pathway, activation of the transcription factor Nrf2/heme oxygenase-1 (HO-1) system leading to the formation of heme-derived reaction products (carbon monoxide, ferrous iron, biliverdin, and bilirubin), which may contribute to HO-1-dependent cytoprotection through antioxidant and immunomodulatory effects. Additionally, it regulates the expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, cytochrome c oxidase subunit IV, uncoupling proteins UCP1 and UCP2, glucose transporters GLUT1 and GLUT2, and sterol regulatory element-binding protein 1c in relevant tissues. Randomized controlled trials have confirmed the effects of 5-ALA on glucose control in both prediabetic and diabetic patients, noting its safety and tolerability, as well as the safety of its combined use with oral hypoglycemic agents. Only minor side effects have been reported. However, the impact of 5-ALA on markers of systemic inflammation, oxidative and nitrosative stress, and dyslipidemia was not evaluated in these studies. At the same time, preparations of 5-ALA may potentially be effective not only in the treatment of prediabetes and type 2 diabetes mellitus (T2DM), but also in other conditions associated with systemic inflammation, oxidative or nitrosative stress, mitochondrial dysfunction, as well as disorders of carbohydrate and lipid metabolism. It has been concluded that the promising advancement of formulations containing 5-ALA may pave the way for new strategies in preventing and treating these diseases, with subsequent preclinical and clinical trials likely to follow.

Abstract licence: CC BY

Objective: To evaluate the efficacy and safety of 5-aminolevulinic acid hydrochloride/sodium ferrous citrate (5-ALA-HCl/SFC) in patients with adult-onset Still’s disease (AOSD) refractory to corticosteroids. Methods/design: This multicenter, investigator-initiated, randomized, double-blind, placebo-controlled, parallel-group phase II trial was designed to enroll 30 participants but was prematurely terminated after enrolling four participants because of slow recruitment. Participants were randomized to receive 5-ALA-HCl/SFC (100 or 300 mg/day) or placebo for 8 weeks. The primary endpoint was the achievement of adapted ACR 30 at week 4. Results: All four enrolled participants achieved adapted ACR 30 at week 4. Adapted ACR 50/ 70/ 90 responses and improvements in systemic feature score, serum ferritin, and quality of life varied among individuals. No serious adverse events were observed. Conclusion: Efficacy signals were observed, especially in the high-dose group; however, the small sample size precludes definitive conclusions. Further research is required to confirm this.

Abstract licence: CC BY