@article{9b3c8f90071943959676826a14e9e15a,
title = "Decreased urinary polyamines in patients with psoriasis treated with etretinate",
abstract = "Oral administration of the aromatic retinoid etretinate is effective therapy for psoriasis and other epidermal hyperproliferative disorders. Since polyamine metabolism is known to be important in cell growth and differentiation, we measured urinary levels of the polyamines putrescine, spermidine, and spermine as a reflection of cutaneous polyamine metabolism in 19 psoriatic patients treated with etretinate for 16 weeks. Using thin-layer chromatography, polyamine determinations were performed on urine collected pretherapy, during therapy, and 8 weeks after therapy was concluded. Good to excellent clearing of psoriasis occurred in 18 of 19 patients. All urinary polyamines showed a downward trend in the first week of therapy, prior to significant clinical improvement. At week 16 of therapy, the greatest reduction in mean urinary polyamine content occurred. Mean putrescine levels decreased from pretherapy to week 16 by 27% (p < 0.001), mean spermidine values fell by 34% (p < 0.001), and mean spermine levels declined by 37% (p = 0.005). These data are consistent with the hypothesis that etretinate inhibits polyamine biosynthesis.",
author = "Grekin, {R. C.} and Ellis, {C. N.} and Goldstein, {N. G.} and Swanson, {N. A.} and Anderson, {T. F.} and Duell, {E. A.} and Voorhees, {J. J.}",
note = "Funding Information: It is now well established that oral administration of the aromatic retinoid etretinate (Ro 10-9359) is an effective psoriasis therapy, either alone or in combination with other agents [1-3]. The mechanism of action of retinoids has not been established; however, attention has focused on polyamines and their possible role in the pathogenesis of psoriasis. Polyamine levels are increased in the involved and uninvolved skin and in the urine of psoriasis patients [ 4,5]; furthermore, Proctor et al [6] and others [ 4,5], have demonstrated a decrease in both urina1·y and skin polyamine levels with effective treatment. Whether declines in polyamine values represent treatmentinduced events or are secondary to lesional resolution produced by an effective therapy is unclear. Certain evidence suggests that polyamines may play an important role in the regulation of proliferation. The activity of ornithine decarboxylase (ODC), the rate-limiting enzyme in polyamine synthesis [7], rises prior to the increase in cellular proliferation caused by various stimuli both in vitro [8] and in vivo [9,10). Polyamines added to cell culture systems stimulate cell growth [11], while inhibition of polyamine synthesis by treatment with ODC inhibitors impedes cellular proliferation in vitro [13,14] and in the skin (15]. It has also been shown that retinoid therapy lowers cutaneous polyamine levels in psoriasis patients [16]. As a noninvasive procedure, we wondered whether measurement of urinary polyamine levels would refl ect Manuscript received December 7, 1981; accepted for publication July 22, 1982. Supported in part by a National Institutes of Health Grant No. T32AM017197. Reprint requests to: Dr. Roy C. Grekin, Department of Dermatology, Box 31, University of Michigan Medical School, Ann Arbor, Michigan 48109. Abbreviations: ODC: ornithine decarboxylase those changes known to occur in the skin. Therefore, in 19 patients with severe psoriasis treated with etretinate, we determined urinary polyamine values for putrescine, spermjdine, and spermine before and during therapy and after therapy had been stopped.",
year = "1983",
doi = "10.1111/1523-1747.ep12533435",
language = "English (US)",
volume = "80",
pages = "181--184",
journal = "Unknown Journal",
issn = "0973-3698",
publisher = "Elsevier (Singapore) Pte Ltd",
number = "3",
}