A) Studien zu Phenylalanin und UV-Licht-Bestrahlung in deutscher Sprache (1 bis 5)
(Reihenfolge der Auflistung der Studien: Deutsch: gemischt; Englisch in der Reihenfolg der Veröffentlichung)
L-Phenylalanin mit UV-Licht:
L-Phenylalanin ist eine Vorstufe von Tyrosin und eine Vorstufe von Melanin.
1. Experimentelle Untersuchung: 21 Ptn. wurden mit 100 mg/kg L-Phenylalanin oral und UVA-Bestrahlung behandelt. 10 dieser Ptn. wurden zusätzlich an den vitiliginösen Stellen mit einer 10%igen Phenylalanin-Creme behandelt, und diese Gp. hatte die besten Resultate. Bei keiner der Gpn. gab es Nebenwirkungen [Antoniou C et al. Vitiligo therapy with oral and topical phenylalanine with UVA exposure. Int J Dermatol 28(8):545-47, 1989].
2.Experimentelle Untersuchung: 13 Kinder wurden mit L-Phenylalanin supplementiert und mit ultraviolettem Licht (UVA) bestrahlt. Bei 3 kam es zu einer Repigmentierung aller vitiliginösen Stellen, bei 6 Kindern zu einer 50 — 90%igen Besserung, und 4 besserten sich nicht. Keines der Kinder zeigte Nebenwirkungen [Schulpis CH et at. Phenylalanine plus ultraviolet light: preliminary report of a promising treatment for childhood vitiligo. Pediatr Dermatol 6(4):332-35, 1989
3. Experimentelle Untersuchung: 20 Ptn. wurden mit 50 mg L-Phenylalanin pro kg Körpergewicht und UVA-Bestrahlung behandelt. 85 % zeigten eine follikuläre und partiell konfluierende Repigmentierung, die 50 % der vitiliginösen Fläche nicht überschritt [Thiele B, Steigleder GK. [Repigmentation treatment of vitiligo with L-phenylalanine and UVA radiation.] Z Hautkr 62(7):519-23, 1987 (auf Deutsch)].
4. Experimentelle Untersuchung: Die Ptn. wurden 3 mal wöchentlich mit 50 mg Phenylalanin pro kg Körpergewicht behandelt und als Quelle für UVA dem Sonnenlicht ausgesetzt. 81 % besserten sich; 43 % sprachen innerhalb von 3 Monaten an. Ein Ptn. blieb zu lange in der Sonne. Die Repigmentierung war vorwiegend follikulär [Kuiters GR et al. Oral phenylalanine loading and sunlight as source of UVA irradiation in vitiligo on the Carribean island of Curacao NA. J Trop Med Hyg 89(3):149-55, 1986].
5. Experimentelle Untersuchung: Die Patienten erhielten 50 mg/kg Phenylalanin zusammen mit einer UV-Licht-Bestrahlung 30 — 45 Minuten nach der Einnahme (der Zeit der maximalen Konzentration im Blut). Nach 4 Mo. (32 Behandlungen) trat eine „vernünftige” Repigmentierung auf. Abgesehen von der Repigmentierung von unterpigmentierten Flecken konnten die Patienten mehr Sonne vertragen als gewöhnlich, besonders an der vitiliginösen Läsion [Cormane RH et al. Phenylalanine and UVA light for the treatment of vitiligo. Arch Dermatol Res 277(2):126-30, 1985].
(B) Studien zu Phenylalanin und UV-Licht-Bestrahlung in englischer Sprache (1 bis 10)
(Reihenfolge: zuerst ältere, dann neuere Studien)
1. L-Phenylalanine and UVA/sunlight for vitiligo. Arch Dermatol Res 1985;277(6):509 (ISSN: 0340-3696) Cormane RH; Siddiqui AH
2. Phenylalanine and UVA light for the treatment of vitiligo. Arch Dermatol Res 1985;277(2):126-30 (ISSN: 0340-3696) Cormane RH; Siddiqui AH; Westerhof W; Schutgens RB The administration of phenylalanine (Phe) combined with UVA exposure was found to be effective in vitiligo. Phe is an amino acid which constitutes part of the daily dietary protein, and when orally administered in a dose of 50 mg/kg body weight, it results in an elevated plasma level. Since peak concentrations of Phe in the blood are reached between 30 and 45 min after ingestion, UVA exposure was administered at this time. After 4 months (32 treatments) reasonable repigmentation preferentially occurred in the skin area of subcutaneous fat (adipose tissue). Apart from the repigmentation of hypo-pigmented macules, vitiligo patients can tolerate more sun than usual, especially at the vitiliginous lesion, and they experience no sunburn as a result of Phe-UVA therapy. Normal skin also tans very well.
3. Oral phenylalanine loading and sunlight as source of UVA irradiation in vitiligo on the Caribbean island of Curacao NA. J Trop Med Hyg 1986 Jun;89(3):149-55 (ISSN: 0022-5304) Kuiters GR; Hup JM; Siddiqui AH; Cormane RH Recently, favourable results have been reported from oral L-phenylalanine (Phe) combined with UVA/sunlight irradiation (Phe-UVA) in the treatment of vitiligo. In the present pilot study vitiligo patients were treated on a thrice weekly scheme of 50 mg Phe.kg-1 body weight and exposed to sunlight as a source of UVA. An observed 81% response on the skin disorder correlates with earlier figures; 43% responded within 3 months. The self-controlled treatment includes the risk of over-irradiation, as possibly happened with one patient. The repigmentation was predominantly of follicular pattern. The assumption that Phe plays a central biochemical regulatory role in melanin, catecholamine and antibody synthesis forms an attractive challenge for the explanation of repigmentation.
4. Repigmentation treatment of vitiligo with L-phenylalanine and UVA irradiation] [Repigmentierungsbehandlung der Vitiligo mit L-Phenylalanin und UVA-Bestrahlung (PAUVA).] Z Hautkr 1987 Apr 1;62(7):519-23 (ISSN: 0301-0481) Thiele B; Steigleder GK 20 patients suffering from vitiligo (17 with generalized, 3 with localized type) were treated with L-phenylalanine and UV-Airradiation (PAUVA). The dose of L-phenylalanine was 50 mg/kg per os. In 85% of the patients, this therapy resulted in a follicular and partially confluent repigmentation, which did not exceed 50% of the vitiliginous area.
5. Vitiligo therapy with oral and topical phenylalanine with UVA exposure. Int J Dermatol 1989 Oct;28(8):545-7 (ISSN: 0011-9059) Antoniou C; Schulpis H; Michas T; Katsambas A; Frajis N; Tsagaraki S; Stratigos J Dermatologic Clinic of Athens University, Andreas-Sygros Hospital, Greece. The administration of phenylalanine (Phe) combined with UVA exposure was found to be effective in treatingvitiligo. Twenty-one patients with vitiligo were divided in two groups: eleven patients were treated with oral L-Phe in a dose of 100 mg/kg body weight and with UVA exposure and ten patients were treated with oral L-Phe in a dose of 100 mg/kg body weight and with UVA exposure. In addition, in the second group, a cream containing 10% L-Phe was applied to the vitiliginous areas. The best results occurred in the second group. No side effects were found in either group.
6. Phenylalanine plus ultraviolet light: preliminary report of a promising treatment for childhood vitiligo. Pediatr Dermatol 1989 Dec;6(4):332-5 (ISSN: 0736-8046) Schulpis CH; Antoniou C; Michas T; Strarigos J Institute of Child Health, Aghia Sophia Children's Hospital, Athens, Greece. L-Phenylalanine is a promising agent for the treatment of vitiligo when taken orally and followed with ultraviolet light (UVA) irradiation. Of 13 children so treated, 3 experienced repigmentation of all vitiliginous areas, 6 showed 50% to 90% improvement, and 4 failed to respond. None of the children experienced side effects during the treatment
7. [Treatment of vitiligo using phenylalanine and UVA irradiation] [Behandlung der Vitiligo mit Phenylalanin und UVA-Bestrahlung.] Hautarzt 1990 Nov;41(11):636 (ISSN: 0017-8470) Biella U; Haustein UF , Klinik fur Hautkrankheiten, Karl-Marx-Universitat, Leipzig Dr. Th. Matschurat, Steinkirchnerstraße 8, D 82166 Gräfelfing,Tel. 089-8982650, Fax. -89826598
8. L-phenylalanine and UVA irradiation in the treatment of vitiligo. Dermatology 1994;188(3):215-8 (ISSN: 1018-8665) Siddiqui AH; Stolk LM; Bhaggoe R; Hu R; Schutgens RB; Westerhof W Department of Dermatology, Academisch Medisch Centrum, University of Amsterdam, The Netherlands. In order to evaluate the efficacy of L-phenylalanine (L-Phe) in combination with UVA therapy for vitiligo an open trial (149 patients, 18 months) and a small double-blind trial (32 patients, 6 months) were conducted. Oral L-Phe loading resulted in peak plasma levels of L-Phe after 30-60 min and a slight increase in the plasma tyrosine level. Response to L-Phe plus UVAirradiation was positive, and various grades of repigmentation not exceeding 77% in the open and 60% in the blind trial were observed. An increased L-Phe dose resulted in increased L-Phe plasma levels but not in improved clinical results. The optimal L-Phe dose appears to be lower than 50 mg/kg/day. Although it is difficult to draw firm conclusions from the present investigation, we think that L-Phe may have a place in the treatment of vitiligo.
9. [Vitiligo therapy with phenylalanine/UV A. Catamnestic studies after five years] [Vitiligo-Therapie mit Phenylalanin/UV A. Katamnestische Untersuchungen nach funf Jahren.] Hautarzt 1994 Jul;45(7):460-3 (ISSN: 0017-8470) Greiner D; Ochsendorf FR; Milbradt R Zentrum der Dermatologie und Venerologie Abteilung II, J.W. Goethe-Universitat, Frankfurt am Main. Since 1983 the administration of phenylalanine combined with UVA exposure (PAUVA) has been a well-known therapy for vitiligo. We have found no retrospective studies on this therapy. To document the long-term results and side effects, we performed a retrospective study on 41 patients who had received PAUVA therapy about 5 years ago. Examination was possible in 25 of the 41 patients, and 11 of them (44%) had permanent repigmentation. Depigmentation either during or after PAUVA therapy was recognized in 16 of the 25 patients (64%). In 52% of cases the patients were satisfied with the therapy and would repeat it; 68% would recommend it. Positive features in prognosis, i.e. indicative of good repigmentation, were vitiligo extending over less than 25% of the body surface, onset of vitiligo before the age of 21, generalized and symmetrical distribution and a long duration of UV therapy. None of our patients developed long-term side effects. PAUVA therapy is demonstrably a therapeutic alternative for certain patients.
10. Oral and topical L-phenylalanine, clobetasol propionate, and UVA/sunlight--a new study for the treatment of vitiligo. J Drugs Dermatol 2002 Sep;1(2):127-31 (ISSN: 1545-9616) Camacho F; Mazuecos J Departamento de Dermatologia Medico-Quirurgica y Venereologia Hospital Universitario Virgen Macarena Avda. Doctor Fedriani s/n 41009, Sevilla, Spain. firstname.lastname@example.org. BACKGROUND: Vitiligo is a hypopigmented skin condition that usually requires a combination of treatment options. AIM: To demonstrate the effectiveness of topical and oral L-phenylalanine in combination with light plus 0.025% clobetasol propionate at night. PATIENTS AND METHODS: We have performed an open trial on a group of 70 patients with evolutive vitiligo. Participants were treated with oral (100 mg/Kg/day) and topical (gel at 10%) L-phenylalanine, exposed to sunlight (spring-summer) or UVA lamps (autumn-winter), and given 0.025% clobetasol propionate at night. All patients were revisited every 6 months while in the study, with a maximum of 4 revisits. Biochemical studies were performed at the beginning of the treatment and at each revisit. RESULTS: Overall, 90.9% of participants showed improvement, with 68.5% of patients achieving an improvement of 75% or more. This 75% improvement rate was reached 87.9% of the time on the face, 60.4% on the trunk, and 54.6% on the limbs. However, there was a moderate response to the treatment in patients with focal and segmental vitiligo. There was a slight additional improvement in patients receiving UVA lamp light. No biochemical abnormalities were found in any patients. CONCLUSION: L-phenylalanine in combination with 0.025% clobetasol propionate and sunlight during sunny months or UVA lamps in winter, appears to improve evolutive vitiligo without side effects, and therefore is especially recommended on the face or for children.