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[A new drug combination for the topical treatment of acne. Miconazole 2% + benzoyl peroxide 5% versus benzoyl peroxide 5%--a double-blind study].

A double-blind, controlled clinical trial with 60 patients was employed in order to study the relative merits of two treatment schedules in acne vulgaris. One therapy comprised the topical application of a cream containing a combination of miconazole 2% and benzoylperoxide 5% (Acnidazil, Janssen) twice a day. In the other therapy, we applied a cream containing only benzoylperoxide 5%. Both groups of patients showed large and statistically significant reduction in the number of comedones, papules, and pustules during 12 weeks of therapy. Acnidazil, however, was found to have definitely better therapeutical results than benzoylperoxide alone: The lesions improved significantly faster, tolerance was better, and the patients overall evaluation clearly favored Acnidazil. 86,2% of the patients treated with Acnidazil rated the results good to very good, in contrast to 63% of the patients treated with benzoylperoxide only (p = 0.037).

Acne Vulgaris↗

Hydrogen peroxide or heat shock induces resistance to hydrogen peroxide in Chinese hamster fibroblasts.

Survival after H2O2 exposure or heat shock of asynchronous Chinese hamster ovary cells (HA-1) was assayed following pretreatment with mildly toxic doses of either H2O2 or hyperthermia. H2O2 cytotoxicity at 37 degrees C, expressed as a function of mM H2O2 was found to be dependent on cell density at the time of treatment. The density dependence reflected the ability of cells to reduce the effectiveness of H2O2 as a cytotoxic agent. When the survival data were plotted as a function of mumoles H2O2/cell at the beginning of the treatment, survival was independent of cell density. Cells pretreated with 0.1 mM (3-5 mumoles/cell X 10(-7)) H2O2 for 1 hr at 37 degrees C (30-50% survival) became resistant to a subsequent H2O2 treatment 16-36 hr after pretreatment [dose modifying factor (DMF) at 1% isosurvival = 4-6]. Their resistance to 43 degrees C heating, however, was only slightly increased over controls 16-36 hr following pretreatment (DMF at 1% isosurvival = 1.2). During this same interval, the synthesis of protein migrating in the 70 kD region of a one-dimensional SDS-polyacrylamide gel was enhanced twofold in the H2O2-pretreated cells. When the cells were heated for 15 min at 45 degrees C (40-60% survival), the survivors became extremely resistant to 43 degrees C heating and somewhat resistant to H2O2 (DMF at 1% isosurvival = 2). The heat-induced resistance to heat developed much more rapidly (reached a maximum between 6 and 13 hr) following pretreatment than the heat-induced resistance to H2O2 (16-36 hr). The enhanced synthesis of 70 kD protein after heat shock was greater in magnitude and occurred more rapidly following preheating than following H2O2 pretreatment. The cells that became resistant to H2O2 by either pretreatment (H2O2 or heat shock) also increased their ability to reduce the H2O2 cytotoxicity from the treatment medium beyond that of the untreated HA-1 cells. This may be one of the mechanisms involved in the increased resistance and a common adaptive mechanism induced by both stresses. These data indicate that mammalian cells develop resistance to H2O2 following mild pretreatment with H2O2 or heat shock. The cross-resistance induced by H2O2 and heat shock reinforce the hypothesis that some overlap in mechanisms exist between the cellular responses to these two stresses. However, the failure of H2O2 pretreatment to induce much resistance to heat indicates that there are also differences in the actions of the two agents.

Animals↗

The interaction of oxymyoglobin with hydrogen peroxide: the formation of ferrylmyoglobin at moderate excesses of hydrogen peroxide.

The reaction of oxymyoglobin with H2O2 has been examined at pH 7.2 and 20(+/-2) degrees over a range of [H2O2] up to an initial excess of 25:1. The reaction is characterized by a direct conversion of oxymyoglobin to ferrylmyoglobin without the intermediacy of the ferri derivative. The initial rate of loss of oxymyoglobin is first-order with respect to [oxymyoglobin], and exhibits saturation kinetics with increasing [H2O2]. In addition, the stoichiometric relationship between the reactants varies as [H2O2] increases. A complex non-Michaelis-Menten mechanism is proposed in which an intermediate, produced upon the initial interaction of the reactants, regenerates oxymyoglobin by reaction with further H2O2, in competition with the formation of the ferryl derivative. In this way, oxymyoglobin catalytically decomposes excess H2O2. Deoxygenated ferromyoglobin is substantially more reactive with H2O2 in producing the transient intermediate than the oxy analog. Some fundamental similarity is noted between the catalytic mechanism and that of catalase activity. From a detailed examination of the probable nature of the intermediate, conventional Fenton reactivity is rejected for the reaction of H2O2 with oxymyoglobin.

Catalase↗

The interaction of oxymyoglobin with hydrogen peroxide: a kinetic anomaly at large excesses of hydrogen peroxide.

The reaction of oxymyoglobin (MbO2) with H2O2 has been examined at pH 7.2 and 20(+/- 2) degrees C for reactant ratios of [H2O2]:[MbO2] greater than approximately 15:1. Under the conditions of large excesses of H2O2, the reaction is characterized by an increase in the rate of loss of MbO2 as [H2O2] is increased, for which a value of k(MbO2 + H2O2) approximately 3 M-1 s-1 is obtained. This kinetic behavior contrasts the saturation kinetics observed previously at lower values of [H2O2]. The change in kinetics at increasing excesses of H2O2 is accompanied by a progressive tendency toward the direct formation of ferrimyoglobin at the expense of ferrylmyoglobin formation. A mechanism is proposed in which an initially formed intermediate produces the ferryl derivative in competition with the formation of ferrimyoglobin through the interaction of further H2O2. Overall, the H2O2 is catalytically decomposed by the MbO2. This mechanism is integrated with that determined previously at low excesses of H2O2 into a complex general scheme that applies over the entire studied range of [H2O2]:[MbO2]. No evidence is obtained for the conversion of ferrylmyoglobin to oxymyoglobin by the large excesses of H2O2, regardless of whether the ferryl derivative is the product of the reaction of H2O2 with the oxy or ferri derivative of myoglobin.

Chemical Phenomena↗