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Topical Cream Regulates Skin Cell Growth.

ARLINGTON, VA. -- A topical preparation of parathyroid hormone (1-34), an agonist of parathyroid hormone-related peptide, shuts down epidermal hyperproliferation in psoriasis and may do the same in other disorders, Dr. Michael F. Holick said at the Clinical Research 2001 meeting.

"We may have found the master switch for regulating skin cell growth," said Dr. Holick of Boston University.

Parathyroid hormone-related peptide (PTHrp), which is produced by keratinocytes and other squamous cells, has long been associated with cancers. When Dr. Holick and his associates incubated keratinocytes with the PTHrp agonist parathyroid hormone (1-34) [PTH(1-34)], it inhibited cell proliferation and induced terminal differentiation.

"We concluded that PTHrp is probably a major endogenous antiproliferative factor that regulates squamous cell growth, particularly in the skin," he said at the meeting sponsored by the American Federation for Medical Research.

The researchers formulated a topical, nonionic liposomal preparation of PTH(1 34); 18 patients with psoriasis applied the test cream or a placebo cream to a 25-cm area of a psoriatic lesion daily for 2 months.

The active cream produced clear benefits within days. At 2 months, it had markedly reduced plaque thickness, scaling, erythema, and induration, compared with placebo. Histologic analysis at 2 months showed normal skin at the treated sites, with complete restoration of normal proliferative activity. Markers of cell differentiation were normal. There were no adverse effects or signs of toxicity.

In an extension of the study, five patients applied the PTH(1-34) cream to lesions as extensive as 1,000 [cm.sup.2]. The disease cleared quickly in all five patients and has remained clear with daily use of the cream over 10 months of follow-up.

One patient with a 20-year history of extensive psoriasis with no previous response to treatment showed complete resolution of lesions, he noted.

"We think that by using PTHrp agonists like PTH(1-34) we can completely shut down skin cell growth in hyperproliferative skin disorders such as psoriasis," Dr. Holick said.

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Publication:Family Practice News
Article Type:Brief Article
Geographic Code:1USA
Date:Jun 1, 2001
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