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Use of Dermatologics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Isotretinoin is the drug with greatest teratogenic potential of all the medications to which pregnant woman may be exposed in the first trimester, except for thalidomide. The “retinoic acid embryopathy” is a distinct pattern of anomalies that has been described in several reports encompassing over 80 offspring of women exposed to this agent during the first trimester of pregnancy (Coberly et al., 1996; Lammer, 1985, Lammer et al., 1987; Medical Letter, 1983; MMWR, 1984; Rizzo et al., 1991; Rosa, 1983; Rosa et al., 1986; Thompson and Cordero, 1989). Among 94 infants born to women who used isotretinoin in early pregnancy, 28 percent had major congenital anomalies, and 18 percent of the pregnancies resulted in spontaneous abortions (Chen et al., 1990; Dai et al., 1992). The constellation of anomalies observed in exposed infants is called retinoic acid embryopathy (Box 13.1). Postnatal intellectual development of retinoic acid exposed infants was subnormal at 5 years of age (IQ less than 85) in 47 percent of 31, although they were apparently unaffected (without major or minor congenital anomalies) at birth (Adams and Lammer, 1993; Adams et al., 1991, 1992).
Micronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Retinal, the aldehyde form of vitamin A, is a cofactor for opsin, an apoprotein in the eye. Opsins are responsible for dim-light vision in the rods (rhodopsin) and are involved in color and bright-light vision in the cone of the retina (iodopsin). Retinoic acid is the metabolite form of vitamin A that regulates genes. It binds to proteins called retinoic acid receptors (RARs) and retinoid X receptors (RXRs). These proteins are transcription factors belonging to the steroid/thyroid hormone receptor superfamily of proteins and are found throughout the body. The RAR/RXR proteins regulate the transcription of numerous target genes important for cell development (90).
Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
Patients can present with DIC. All trans-retinoic acid, ATRA, is an important component of therapy to control DIC in APL and has been safely used during pregnancy [78–80]. ATRA is given with daunorubicin. The response seen with ATRA alone versus with daunorubicin is not significant, however, it may impact relapse rate. Being similar to retinoid, ATRA is contraindicated during the first trimester. A serious side effect of ATRA is differentiation syndrome (unexplained fever, respiratory distress due to capillary leak) and is treated with steroids. Arsenic trioxide, also used with ATRA in non-pregnant women, is also teratogenic during first trimester. There are limited case reports of safe use of arsenic in the second and third trimesters [81–83].
The role of serum inflammatory in mycoplasma pneumonia infection with respiratory asthma
Published in Journal of Asthma, 2023
Xiaoju Zhou, Wei Jiang, Qianyi Zhou, Wenjie Yang
Vitamin A and vitamin D were also regulated by many factors, such as the parathyroid hormone system. Some of the effects of vitamin A are related to the regulatory role played in TSH-secreting pituitary function (52). In addition, some of the effects of vitamin A appear to be related to the regulatory role played by retinol in TSH-secreting pituitary function (53,54). Abnormal tissue levels of the vitamin A metabolite, retinoic acid, can result in detrimental effects which can include congenital defects, immune deficiencies, proliferative defects, and toxicity. For this reason, intricate feedback mechanisms have evolved to allow tissues to generate appropriate levels of active retinoid metabolites despite variations in the level and format, or in the absorption and conversion efficiency of dietary vitamin A precursors (55). Few foods naturally contain vitamin D (oily fish such as sardines, herring, tuna, mackerel, salmon and cod liver oil, egg yolks, shiitake mushrooms, liver, or offal), so skin synthesis after ultraviolet-B (UVB) radiation remains the primary way to obtain vitamin D, accounting for 90% of vitamin D supplementation (56–59). In addition, vitamin D levels are also influenced by vitamin D receptors, and since VDR is present not only in the small intestine but also in the colon, osteoblasts, activated T and B lymphocytes, monocytes, β islet cells, and major organs (e.g. brain, heart, skin, gonads, prostate, and breast), concomitant extraskeletal effects of vitamin D deficiency are to be expected (60–62).
Differentiation and Maturation Effect of All-Trans Retinoic Acid on Cultured Fetal RPE and Stem Cell-Derived RPE Cells for Cell-Based Therapy
Published in Current Eye Research, 2022
Tingyu Yan, Na Yang, Wei Hu, Xinxin Zhang, Xuedong Li, Youjin Wang, Jun Kong
Retinoic acid, a derivative of vitamin A and biologically active metabolite of the visual transduction pathway, regulates cell growth, differentiation, and matrix formation in various types of tissues and is necessary for both normal and diseased eyes.21 All-trans retinoic acid (ATRA) can up-regulate the expression of the tight junction-associated protein in the RPE-choroid complex and promotes the epithelial barrier function of the RPE monolayer during the development of myopia.22–24 Studies also showed that ATRA can inhibit immortalization of human epidermal keratinocytes during or after transfection with human papilloma virus (HPV) 16.25 Based on these results and the fact that ARTA plays important role in the differentiation and development of the normal retina, we hypothesized that adding ARTA into fRPE and stem cell-derived RPE culture medium may help further differentiation of the passaged RPE and promote their physical behaviors.
Current status and future directions of hepatocellular carcinoma-targeted nanoparticles and nanomedicine
Published in Expert Opinion on Drug Delivery, 2021
Vikas Kumar, Mahfoozur Rahman, Prashant Gahtori, Fahad Al-Abbasi, Firoz Anwar, Hyung Sik Kim
Retinoic acid analogs have been reported to suppress the expansion of HCC. Retinoic acid receptors strongly affect carcinogenesis and embryogenesis. The biological function of retinoids is exerted by linking with the specific nuclear receptors in the thyroid/steroid hormone family [75]. The structure of retinoic acid is composed of different regions (A to E), in the structure, the C domain belongs to cysteine with various DNA-binding and E domains represent the Retinoids binding site. Retinoid X Receptors (Retioic X) and Retinoic Acid Receptors (RARs) are the 2 major classes of retinoid receptors, each class consisting of three distinct receptor subtypes (α, β, and π) [76]. Retinoic acid receptor-α consider as the dominant receptor in the HCC and its mRNA expression observe low in the normal liver but reach higher during the HCC [77]. Retinoic acid is the derivative of vitamin A and has a significant role in the differentiation and regulation of cell and showed the inhibitory effect on cancer cell growth [78]. Varshosaz et al., used this receptor to target HCC during doxorubicin treatment [79]. They prepared retinoic acid with chitosan and further synthesize with co-polymers with different degrees of retinoic acid substitution on chitosan. After the retinoic acid-chitosan conjugate, it is grafted to NPs of albumin for the targeted doxorubicin delivery. MTT assay was used for estimating the cytotoxicity effect of doxorubicin-loaded NPs. The study showed one-third less IC50 as compared to free drugs and non-targeted NPs, respectively.