The Experts below are selected from a list of 183 Experts worldwide ranked by ideXlab platform

Thomas Meyer - One of the best experts on this subject based on the ideXlab platform.

  • Sinecatechins polyphenon e ointment for treatment of external genital warts and possible future indications
    Expert Opinion on Biological Therapy, 2014
    Co-Authors: Eggert Stockfleth, Thomas Meyer
    Abstract:

    Introduction: Sinecatechins was the first botanical drug licensed for treatment in humans in the US. It is approved for the topical treatment of external genital and perianal warts. Some properties of the polyphenolic components included in Sinecatechins suggest additional therapeutic potential for other skin diseases. Areas covered: Studies and articles describing therapeutic application of Sinecatechins or green tea polyphenols in viral and proliferative skin diseases or investigating molecular activities relevant for the mode of action were identified by a PubMed search using ‘Sinecatechins’, ‘green tea polyphenols’, ‘polyphenon E’ and ‘EGCG’, each combined with ‘skin cancer’ and ‘genital warts’ as search criteria. Although a number of molecular mechanisms of green tea polyphenols were described, the exact mode of action operative in regression of genital warts is not yet clear. It may involve both antiproliferative, pro-apoptotic and antiviral activities that probably also account for efficacy against...

  • the use of Sinecatechins polyphenon e ointment for treatment of external genital warts
    Expert Opinion on Biological Therapy, 2012
    Co-Authors: Eggert Stockfleth, Thomas Meyer
    Abstract:

    Introduction: Sinecatechins is a standardized extract of green tea leaves, containing a mixture of catechin compounds. The 15% ointment has been approved for the topical treatment of condylomata acuminata (CA), caused by particular human papillomaviruses (HPV), mainly HPV types 6 and 11. Objective: To update the use of Sinecatechins for treatment of CA and to describe possible mechanisms involved in the mode of action. Areas covered: The clearance rate of wart lesions after treatment with Sinecatechins is similar to other topically applied drugs, like imiquimod and podophyllotoxin, but recurrences are seen less frequently after treatment with Sinecatechins. The molecular mode of action underlying the clinical efficacy has yet not been characterized, but the following properties are likely to be involved in the regression of genital warts: activation of cellular immune reactions, induction of cell cycle arrest and apoptosis, inhibition of HPV gene expression. Expert opinion: Sinecatechins is a safe and eff...

Stephen K Tyring - One of the best experts on this subject based on the ideXlab platform.

  • expression patterns of immune associated genes in external genital and perianal warts treated with Sinecatechins
    Viral Immunology, 2015
    Co-Authors: Hung Q Doan, Harrison P Nguyen, Peter L Rady, Stephen K Tyring
    Abstract:

    Abstract The role of human papillomavirus (HPV) in human disease includes external genital and perianal warts (EGW), with some HPV genotypes having oncogenic potential (i.e., HPV-16 and -18). While green-tea extracts have antitumor and antiproliferative effects in vitro, the mechanism of action of Sinecatechins in the treatment of EGW is not well understood. To investigate the role of immune-regulated genes further, an open-label, single institution, prospective study was conducted enrolling patients with clinically diagnosed EGW. Thirty subjects were enrolled, and 18 completed the trial. All patients applied Sinecatechins 15% ointment to target lesions in the study. RNA expression microarrays were obtained from treated EGW lesions and analyzed for differential gene expression of immune-regulated genes. HPV types were analyzed and, based on copy number, were stratified into virological responders (VR) or nonresponders (VNR). Gene expression analysis of RNA samples was performed using TaqMan arrays for hum...

  • cellular signaling in Sinecatechins treated external genital and perianal warts unraveling the mechanism of action of a botanical therapy
    Virologica Sinica, 2015
    Co-Authors: Hung Q Doan, Harrison P Nguyen, Peter L Rady, Stephen K Tyring
    Abstract:

    Dear Editor,Derived from green tea leaves,Sinecatechins(Veregen)ointment,15%is a topical therapy that is FDA-approved to treat human papillomavirus(HPV)-induced external genital and perianal warts(EGW)in immunocompetent patients aged 18 years and older.In two phase 3 trials enrolling over 1,000 participants with EGW,a 16-week treatment regimen with Sinecatechins ointment resulted in higher rates of complete clearance of all warts—both

  • apoptotic gene expression in Sinecatechins treated external genital and perianal warts
    Viral Immunology, 2014
    Co-Authors: Hung Q Doan, Harrison P Nguyen, Peter L Rady, David Brunell, Stephen K Tyring
    Abstract:

    External genital and perianal warts (EGW)—the most common viral sexually transmitted disease in the United States—are caused by the human papillomavirus (HPV), a family of DNA viruses with more than 150 genotypes characterized to date (7). In 2006, Sinecatechins ointment 15% (trade name Veregen ) was approved by the Food and Drug Administration for the treatment of EGW. Sinecatechins ointment is comprised of a proprietary blend of eight different catechins, the chief family of flavonoids believed to account for the wide array of health benefits attributed to green tea (12). In decreasing order of concentration, the four major catechins found in green tea are epigallocatechin gallate, epigallocatechin, epicatechin gallate, and epicatechin. Prior to their application for treating viral disease, catechins had been associated with a wide array of health benefits (10). Although it is believed that the majority of these health benefits are due to the catechins’ antioxidative activity, green tea catechins have also displayed poorly understood antiproliferative and antiviral properties (10). In vitro, epigallocatechin gallate can induce apoptotic growth inhibition of four HPV-infected tumor cell lines, and in vivo, green tea catechins were found to be effective in treating cervical HPV lesions, as determined by positive morphological changes of cervical lesions and a decrease of HPV DNA levels following treatment (8,11). However, despite these observations and FDA approval nearly a decade ago, the mechanism of action of Sinecatechins-induced growth inhibition of EGW is unknown. To begin to answer this question, we performed an openlabel, single-site study enrolling subjects with a clinical diagnosis of EGW, and used specialized microarrays to determine the expression-level changes specific to apoptosis of EGW before and after Sinecatechins treatment. A total of 30 subjects were recruited for the study, 24 male and 6 female, with a mean age of 39.2 – 10.6 years. Of these, 18 subjects remained enrolled and were available for follow-up for the duration of the study. Veregen ointment, 15%, was dispensed to the patient with instructions to apply to the target warts three times daily for 16 weeks. Three biopsies were taken from each patient—excised at baseline (B1), at the first visit with 50% or more clearance of target warts (B2), and at the first visit with complete clearance of target lesions (B3). Tissue samples were stored in RNAlater (Ambion) solution until processing, and nucleic acids were extracted from the samples using Trizol reagent (Sigma). HPV types from extracted DNA samples were detected by a nested polymerase chain reaction (PCR) approach as previously described (1), and copy number was determined with a custom-made real time PCR kit (Quantification of HPV6_15979, L1 protein, L1 gene, PrimerDesign Ltd.). Extracted and applied RNA, measured at A260/A280 nm, produced a ratio between 1.8 and 2.0. Subjects were stratified based on their response to treatment, which was quantitatively determined by measuring change in viral copy number between B1 and B3. Subjects were classified as virological responders (VR) if viral copy number decreased by at least 60% from B1, and were classified as virological nonresponders (VNR) if viral copy number remained the same or increased from B1. Of these, seven were found to be VR, and 11 were defined as VNR. In addition to the detection of HPV-6 in all lesions, one VR and three VNR were positive for co-infection with other HPV types (VR: HPV-18 and -35; VNR: HPV-7, -8, and -35). Next, the Applied Biosystems High Capacity RNAto-cDNA master mix was utilized for cDNA synthesis, and analysis of apoptotic gene expressions was then performed using TaqMan array 96-well plates. Initially, gene expression level was surveyed individually as an independent variable, and subsequently, group-based response values were generated using DataAssist v3.01 Software. Quantification of group-based responses for each gene were determined by calculating a fold change from biopsy 1 to biopsy 2 (B1_2), from biopsy 1 to biopsy 3 (B1_3), and from biopsy 2 to biopsy 3 (B2_3). Gene expression changes were categorized as biologically significant if there was at least a twofold change. To determine statistical significance of these fold changes, the statistical significance of these fold changes was evaluated using a nonparametric two-sided Wilcoxon signed-rank test with a significance level of p< 0.05.

  • effect of Sinecatechins on hpv activated cell growth and induction of apoptosis
    The Journal of clinical and aesthetic dermatology, 2012
    Co-Authors: Stephen K Tyring
    Abstract:

    The medicinal properties of tea leaves have been known for thousands of years.1,2 Tea leaves, produced from the plant Camellia sinensis, contain two unique bioactive compounds—flavonoids and methylxanthines.3 Methylxanthines, including caffeine, theobromine, and theophylline, are a group of alkaloids that are present in small quantities. Flavonols, which are a subtype of flavonoids, and also known as catechins, are the polyphenolic compounds that constitute 25 to 35 percent of green tea and are responsible for most of its beneficial effects.2–4 Epigallocatechin-3-gallate (EGCg) is an important constituent of catechins and considered the predominant therapeutic agent derived from green tea.3–5 Catechins, namely EGCg, have a wide variety of beneficial effects, including assisting in the prevention of chronic diseases ranging from cancer to cardiovascular diseases.3 Spectrum of biological and pharmacological activity of catechins. The spectrum of biological and pharmacological properties of green tea catechins includes antiangiogenic4,6–13 activity, anti-inflammatory and immunostimulatory2,3,5,8,10,11 activity, and antimicrobial potential.14–22 The antineoplastic activity of EGCg includes influencing tumor cell growth by inhibiting proliferation and inducing apoptosis.3,4 EGCg has been shown to inhibit growth and induce apoptosis in head and neck squamous cell carcinoma,6 and liver,8 ovarian,7 prostate,9,10 breast,11 and cervical cell lines.12 Antiproliferative and anticarcinogenic effects of EGCg have also been demonstrated in vitro in lung cancer cells,13 colon tumors, as well as lymphoma and leukemia cells.4 Tumor reduction induced by EGCg has been demonstrated in breast cancer cell lines.11 EGCg was shown to play an important role in inhibiting growth in a human papillomavirus (HPV) type 16-associated human cervical carcinoma cell line, CaSki. EGCg significantly inhibited growth by inducing apoptosis, possibly by negatively influencing cell proliferation at the G1 phase and gene expression pattern in CaSki cells.4 Similar results were seen in human prostate cancer cells, where EGCg was shown to affect mitogenesis and induce apoptosis by causing G0/G1-phase cell cycle arrest.9 Induction of apoptosis and cell cycle arrest at the G1 phase was also seen in ovarian and liver cancer cell lines.7,8 In the androgen-sensitive human prostate carcinoma cells, LNCaP, EGCg was shown to induce apoptosis through stabilization of p53 by phosphorylation on critical serine residues, and by negative regulation of nuclear factor-κB (NF-κB) activity, a family of transcriptional regulators.10 Upregulation of p53 expression was also seen in liver cancer cells,8 and reduction in NF-κB levels and activity by inhibition of the Her-2/neu signaling pathway was seen in breast cancer cells.11 Additionally, EGCg has also been associated with telomerase inhibition, a potentially selective target for treatment of cancer.12 However, despite the various mechanisms investigated, including modulation of signal transduction pathways, regulation of gene expression, induction of apoptosis, inhibition of cell proliferation and transformation, the exact mechanism of action of EGCg in inhibiting neoplastic growth is still unclear. EGCg also influences immunostimulation and anti-inflammatory responses by inducing the release of immune stimulatory agents while suppressing the release of immune inhibitory agents. The anti-inflammatory activity of EGCg may be related to an antioxidant function mediated by nonantioxidant mechanisms.2,3 This includes the ability of EGCg to modulate signal transduction pathways8,10 and inhibit the activity of transcription factors, such as NF-κB10,11 and activator protein 1 (AP-1).2 The antioxidant function of EGCg is characterized by its ability to scavenge reactive oxygen species (ROS),3,5 which also plays a key role in enhancing its anti-inflammatory properties.5 For example, the downstream effect of inhibiting NF-κB activation results in downregulation of interleukin-8 (IL-8), a major neutrophil chemoattractant and inflammatory mediator.2,5 In addition to IL-8, EGCg modulates inflammatory signaling pathways and negatively influences the infiltration of T cells into sites of inflammation.5 Additionally, catechins activate T lymphocytes and induce the release of tumor necrosis factor alpha (TNF-α) and interferon-gamma (IFN-γ). Immunostimulatory activity of catechins includes stimulating macrophages to release cytokines, promoting recruitment of monocytes, dendritic cells, lymphocytes, natural killer cells, and T-helper cells.2 EGCg has demonstrated a broad spectrum of antimicrobial activity against bacteria and fungi, including growth inhibition of Escherichia coli, Staphylococcus aureus, and Trichophyton sp.14,23 Most notable is the ability of catechins, such as EGCg, to protect against viral infections, including rotavirus,14 enterovirus,14,24 adenovirus,16,24 human immunodeficiency virus (HIV),17–19 Epstein-Barr virus (EBV),14 and influenza A and B.20–22 Catechins have exhibited antivirulent activity against HIV through several steps in the HIV life cycle. EGCg not only prevents HIV attachment and cell entry, but also destroys viral particles and virus production by competitively inhibiting HIV-1 deoxyribonucleic acid (DNA) polymerase and reverse transcriptase. Viral transcription is also impacted with a distinct decrease in the expression of messenger ribonucleic acid (mRNA) in the presence of EGCg.17,18 Furthermore, EGCg has been shown to inhibit HIV infection and replication without any observed apoptosis or necrosis.19 EGCg inhibits expression of EBV viral protein by inhibiting transcription of immediate-early genes, thus preventing initiation of EBV lytic cycle.14 In Madin-Darby canine kidney (MDCK) cells, EGCg affected the infectivity of influenza A and B viruses by agglutinating the virus, thus blocking the attachment of the viral particles to the target cell receptors and preventing the virus from absorbing to MDCK cells.20,21 In addition to preventing infection, EGCg was also shown to inhibit replication of the viruses by preventing acidification of endosomes and lysosomes, an essential step in uncoating of the virus and viral replication.21,22 Sinecatechins. Sinecatechins ointment, 15%, is manu-factured from the extract of green tea leaves from Camellia sinensis, consisting of 85- to 95-percent catechins, with EGCg representing the primary catechin at more than 55 percent (Figure 1).25 It is the first botanical agent approved by the United States Food and Drug Administration (FDA) for prescription use and is indicated for use as a topical patient-applied treatment for external genital and perianal warts (EGW).26 Two Phase 3 clinical trials involving more than 1,000 male and female patients with EGW treated for up to 16 weeks with Sinecatechins ointment, 15%, resulted in statistically superior complete clearance rates of all warts (baseline and newly emerging warts) compared with vehicle-treated patients (54.9% vs. 35.4%, respectively, p<0.001).27 In addition, recurrence of warts was assessed in all patients with complete clearance of all warts; low rates of recurrence (6.8%) were demonstrated with Sinecatechins ointment, 15%, when measured at 12 weeks post-treatment.27 As opposed to previous clinical trials of EGW therapies, which only measured the clearance of baseline warts, clearance of all (baseline and new) warts represents a much more relevant therapeutic endpoint.27 Figure 1 Structure of green tea catechins. Although the molecular mechanisms of the antiviral and anticarcinogenic potential of green tea catechins have been elucidated recently in numerous studies, the mechanism of action (MOA) of Sinecatechins in the eradication of EGW is unknown. As an anticarcinogenic agent, it has been shown that green tea catechins interfere with different biochemical pathways involved in tumor proliferation, mitogenic signal transduction, cell cycle progression, neoplastic cell transformation, and inflammation.3,4,6–13 As an antiviral agent, catechins have exhibited the ability to inhibit reverse transcriptase and viral transcription, interfere with viral replication, and prevent adherence of viral particles to target cell receptors.14,15,17–22 To study the growth inhibitory potential of Sinecatechins in HPV-positive tumor cell lines, four cervical carcinoma cell lines were treated with Sinecatechins. The objectives of this study were to investigate growth inhibitory potential of the catechins in human cervical carcinoma cell lines infected with HPV. This includes investigating the impact of catechins on the viability of HPV-16 positive cells (CaSki and SiHa) and HPV-18 positive cells (HeLa and C4-I), assessing the kinetics of the antiproliferative effect of Sinecatechins on cervical carcinoma cell lines, and determine whether the effect observed in the viability assays (WST-1) was due to a retardation in cell proliferation or due to reduction of total cell numbers leading to cell death. Furthermore, green tea extracts from different suppliers were evaluated to determine any differences in their growth inhibitory potential and further elucidate the potential MOA of Sinecatechins in the eradication of EGW.

  • Effect of Sinecatechins on HPV-Activated Cell Growth and Induction of Apoptosis.
    The Journal of clinical and aesthetic dermatology, 2012
    Co-Authors: Stephen K Tyring
    Abstract:

    The medicinal properties of tea leaves have been known for thousands of years.1,2 Tea leaves, produced from the plant Camellia sinensis, contain two unique bioactive compounds—flavonoids and methylxanthines.3 Methylxanthines, including caffeine, theobromine, and theophylline, are a group of alkaloids that are present in small quantities. Flavonols, which are a subtype of flavonoids, and also known as catechins, are the polyphenolic compounds that constitute 25 to 35 percent of green tea and are responsible for most of its beneficial effects.2–4 Epigallocatechin-3-gallate (EGCg) is an important constituent of catechins and considered the predominant therapeutic agent derived from green tea.3–5 Catechins, namely EGCg, have a wide variety of beneficial effects, including assisting in the prevention of chronic diseases ranging from cancer to cardiovascular diseases.3 Spectrum of biological and pharmacological activity of catechins. The spectrum of biological and pharmacological properties of green tea catechins includes antiangiogenic4,6–13 activity, anti-inflammatory and immunostimulatory2,3,5,8,10,11 activity, and antimicrobial potential.14–22 The antineoplastic activity of EGCg includes influencing tumor cell growth by inhibiting proliferation and inducing apoptosis.3,4 EGCg has been shown to inhibit growth and induce apoptosis in head and neck squamous cell carcinoma,6 and liver,8 ovarian,7 prostate,9,10 breast,11 and cervical cell lines.12 Antiproliferative and anticarcinogenic effects of EGCg have also been demonstrated in vitro in lung cancer cells,13 colon tumors, as well as lymphoma and leukemia cells.4 Tumor reduction induced by EGCg has been demonstrated in breast cancer cell lines.11 EGCg was shown to play an important role in inhibiting growth in a human papillomavirus (HPV) type 16-associated human cervical carcinoma cell line, CaSki. EGCg significantly inhibited growth by inducing apoptosis, possibly by negatively influencing cell proliferation at the G1 phase and gene expression pattern in CaSki cells.4 Similar results were seen in human prostate cancer cells, where EGCg was shown to affect mitogenesis and induce apoptosis by causing G0/G1-phase cell cycle arrest.9 Induction of apoptosis and cell cycle arrest at the G1 phase was also seen in ovarian and liver cancer cell lines.7,8 In the androgen-sensitive human prostate carcinoma cells, LNCaP, EGCg was shown to induce apoptosis through stabilization of p53 by phosphorylation on critical serine residues, and by negative regulation of nuclear factor-κB (NF-κB) activity, a family of transcriptional regulators.10 Upregulation of p53 expression was also seen in liver cancer cells,8 and reduction in NF-κB levels and activity by inhibition of the Her-2/neu signaling pathway was seen in breast cancer cells.11 Additionally, EGCg has also been associated with telomerase inhibition, a potentially selective target for treatment of cancer.12 However, despite the various mechanisms investigated, including modulation of signal transduction pathways, regulation of gene expression, induction of apoptosis, inhibition of cell proliferation and transformation, the exact mechanism of action of EGCg in inhibiting neoplastic growth is still unclear. EGCg also influences immunostimulation and anti-inflammatory responses by inducing the release of immune stimulatory agents while suppressing the release of immune inhibitory agents. The anti-inflammatory activity of EGCg may be related to an antioxidant function mediated by nonantioxidant mechanisms.2,3 This includes the ability of EGCg to modulate signal transduction pathways8,10 and inhibit the activity of transcription factors, such as NF-κB10,11 and activator protein 1 (AP-1).2 The antioxidant function of EGCg is characterized by its ability to scavenge reactive oxygen species (ROS),3,5 which also plays a key role in enhancing its anti-inflammatory properties.5 For example, the downstream effect of inhibiting NF-κB activation results in downregulation of interleukin-8 (IL-8), a major neutrophil chemoattractant and inflammatory mediator.2,5 In addition to IL-8, EGCg modulates inflammatory signaling pathways and negatively influences the infiltration of T cells into sites of inflammation.5 Additionally, catechins activate T lymphocytes and induce the release of tumor necrosis factor alpha (TNF-α) and interferon-gamma (IFN-γ). Immunostimulatory activity of catechins includes stimulating macrophages to release cytokines, promoting recruitment of monocytes, dendritic cells, lymphocytes, natural killer cells, and T-helper cells.2 EGCg has demonstrated a broad spectrum of antimicrobial activity against bacteria and fungi, including growth inhibition of Escherichia coli, Staphylococcus aureus, and Trichophyton sp.14,23 Most notable is the ability of catechins, such as EGCg, to protect against viral infections, including rotavirus,14 enterovirus,14,24 adenovirus,16,24 human immunodeficiency virus (HIV),17–19 Epstein-Barr virus (EBV),14 and influenza A and B.20–22 Catechins have exhibited antivirulent activity against HIV through several steps in the HIV life cycle. EGCg not only prevents HIV attachment and cell entry, but also destroys viral particles and virus production by competitively inhibiting HIV-1 deoxyribonucleic acid (DNA) polymerase and reverse transcriptase. Viral transcription is also impacted with a distinct decrease in the expression of messenger ribonucleic acid (mRNA) in the presence of EGCg.17,18 Furthermore, EGCg has been shown to inhibit HIV infection and replication without any observed apoptosis or necrosis.19 EGCg inhibits expression of EBV viral protein by inhibiting transcription of immediate-early genes, thus preventing initiation of EBV lytic cycle.14 In Madin-Darby canine kidney (MDCK) cells, EGCg affected the infectivity of influenza A and B viruses by agglutinating the virus, thus blocking the attachment of the viral particles to the target cell receptors and preventing the virus from absorbing to MDCK cells.20,21 In addition to preventing infection, EGCg was also shown to inhibit replication of the viruses by preventing acidification of endosomes and lysosomes, an essential step in uncoating of the virus and viral replication.21,22 Sinecatechins. Sinecatechins ointment, 15%, is manu-factured from the extract of green tea leaves from Camellia sinensis, consisting of 85- to 95-percent catechins, with EGCg representing the primary catechin at more than 55 percent (Figure 1).25 It is the first botanical agent approved by the United States Food and Drug Administration (FDA) for prescription use and is indicated for use as a topical patient-applied treatment for external genital and perianal warts (EGW).26 Two Phase 3 clinical trials involving more than 1,000 male and female patients with EGW treated for up to 16 weeks with Sinecatechins ointment, 15%, resulted in statistically superior complete clearance rates of all warts (baseline and newly emerging warts) compared with vehicle-treated patients (54.9% vs. 35.4%, respectively, p

Eggert Stockfleth - One of the best experts on this subject based on the ideXlab platform.

  • Sinecatechins polyphenon e ointment for treatment of external genital warts and possible future indications
    Expert Opinion on Biological Therapy, 2014
    Co-Authors: Eggert Stockfleth, Thomas Meyer
    Abstract:

    Introduction: Sinecatechins was the first botanical drug licensed for treatment in humans in the US. It is approved for the topical treatment of external genital and perianal warts. Some properties of the polyphenolic components included in Sinecatechins suggest additional therapeutic potential for other skin diseases. Areas covered: Studies and articles describing therapeutic application of Sinecatechins or green tea polyphenols in viral and proliferative skin diseases or investigating molecular activities relevant for the mode of action were identified by a PubMed search using ‘Sinecatechins’, ‘green tea polyphenols’, ‘polyphenon E’ and ‘EGCG’, each combined with ‘skin cancer’ and ‘genital warts’ as search criteria. Although a number of molecular mechanisms of green tea polyphenols were described, the exact mode of action operative in regression of genital warts is not yet clear. It may involve both antiproliferative, pro-apoptotic and antiviral activities that probably also account for efficacy against...

  • the use of Sinecatechins polyphenon e ointment for treatment of external genital warts
    Expert Opinion on Biological Therapy, 2012
    Co-Authors: Eggert Stockfleth, Thomas Meyer
    Abstract:

    Introduction: Sinecatechins is a standardized extract of green tea leaves, containing a mixture of catechin compounds. The 15% ointment has been approved for the topical treatment of condylomata acuminata (CA), caused by particular human papillomaviruses (HPV), mainly HPV types 6 and 11. Objective: To update the use of Sinecatechins for treatment of CA and to describe possible mechanisms involved in the mode of action. Areas covered: The clearance rate of wart lesions after treatment with Sinecatechins is similar to other topically applied drugs, like imiquimod and podophyllotoxin, but recurrences are seen less frequently after treatment with Sinecatechins. The molecular mode of action underlying the clinical efficacy has yet not been characterized, but the following properties are likely to be involved in the regression of genital warts: activation of cellular immune reactions, induction of cell cycle arrest and apoptosis, inhibition of HPV gene expression. Expert opinion: Sinecatechins is a safe and eff...

Kimberly A. Workowski - One of the best experts on this subject based on the ideXlab platform.

  • Updates on human papillomavirus and genital warts and counseling messages from the 2010 Sexually Transmitted Diseases Treatment Guidelines.
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020
    Co-Authors: Eileen F. Dunne, S. Deblina Datta, Lauri E. Markowitz, Allison Friedman, Kimberly A. Workowski
    Abstract:

    In April 2009, experts on sexually transmitted diseases (STDs) were convened to review updates on STD prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. At this meeting, there was a discussion of important updates on human papillomavirus (HPV), genital warts, and cervical cancer screening. Key questions were identified with assistance from an expert panel, and systematic reviews of the literature were conducted searching the English-language literature of the PubMed computerized database (US National Library of Medicine). The available evidence was reviewed, and new information was incorporated in the 2010 CDC STD Treatment Guidelines. Two HPV vaccines are now available, the quadrivalent HPV vaccine and the bivalent HPV vaccine; either vaccine is recommended routinely for girls aged 11 or 12 years. The quadrivalent HPV vaccine may be given to boys and men aged 9-26 years. A new patient-applied treatment option for genital warts, Sinecatechins 15% ointment, is available and recommended for treatment of external genital warts. This product is a mixture of active ingredients (catechins) from green tea. Finally, updated counseling guidelines and messages about HPV, genital warts, and cervical cancer are included. This manuscript highlights updates to the 2010 CDC STD Treatment Guidelines for HPV and genital warts. Important additions to the 2010 STD Treatment Guidelines include information on prophylactic HPV vaccine recommendations, new patient-applied treatment options for genital warts, and counseling messages for patients on HPV, genital warts, cervical cancer screening, and HPV tests.

  • Updates on Human Papillomavirus and Genital Warts and Counseling Messages From the 2010 Sexually Transmitted Diseases Treatment Guidelines
    Clinical Infectious Diseases, 2011
    Co-Authors: Eileen F. Dunne, Allison L. Friedman, S. Deblina Datta, Lauri E. Markowitz, Kimberly A. Workowski
    Abstract:

    Background In April 2009, experts on sexually transmitted diseases (STDs) were convened to review updates on STD prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. At this meeting, there was a discussion of important updates on human papillomavirus (HPV), genital warts, and cervical cancer screening. Methods Key questions were identified with assistance from an expert panel, and systematic reviews of the literature were conducted searching the English-language literature of the PubMed computerized database (US National Library of Medicine). The available evidence was reviewed, and new information was incorporated in the 2010 CDC STD Treatment Guidelines. Results Two HPV vaccines are now available, the quadrivalent HPV vaccine and the bivalent HPV vaccine; either vaccine is recommended routinely for girls aged 11 or 12 years. The quadrivalent HPV vaccine may be given to boys and men aged 9-26 years. A new patient-applied treatment option for genital warts, Sinecatechins 15% ointment, is available and recommended for treatment of external genital warts. This product is a mixture of active ingredients (catechins) from green tea. Finally, updated counseling guidelines and messages about HPV, genital warts, and cervical cancer are included. Conclusions This manuscript highlights updates to the 2010 CDC STD Treatment Guidelines for HPV and genital warts. Important additions to the 2010 STD Treatment Guidelines include information on prophylactic HPV vaccine recommendations, new patient-applied treatment options for genital warts, and counseling messages for patients on HPV, genital warts, cervical cancer screening, and HPV tests.

Silvio Tatti - One of the best experts on this subject based on the ideXlab platform.

  • Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults
    International Journal of Std & Aids, 2017
    Co-Authors: Helmut Schofer, Silvio Tatti, Jana Hercogova, Charles Lynde, Mihael Skerlev, Maria Rotaru, Juan Ballesteros, Piergiacomo Calzavarapinton
    Abstract:

    This review about the proactive sequential therapy (PST) of external genital and perianal warts (EGW) is based on the most current available clinical literature and on the broad clinical experience of a group of international experts, physicians who are well versed in the treatment of human papillomavirus-associated diseases. It provides a practical guide for the treatment of EGW, including epidemiology, etiology, clinical appearance, and diagnostic procedures for these viral infections. Furthermore, the treatment goals and current treatment options, elucidating provider- and patient-applied therapies, and the parameters driving treatment decisions are summarized. Specifically, the mode of action of the topical treatments Sinecatechins and imiquimod, as well as the PST for EGW to achieve rapid and sustained clearance is discussed. The group of experts has developed a treatment algorithm giving healthcare providers a practical tool for the treatment of EGW which is very valuable in the presence of many dif...

  • Polyphenon E: a new treatment for external anogenital warts.
    British Journal of Dermatology, 2009
    Co-Authors: Silvio Tatti, E. Stockfleth, K.r. Beutner, H. Tawfik, U. Elsasser, P. Weyrauch, A. Mescheder
    Abstract:

    Summary Background  External genital warts (EGWs, condylomata acuminata) are a common, highly contagious disease caused by human papillomavirus (HPV), predominantly HPV 6 and HPV 11. Green tea catechins have been identified for their immunostimulatory, antiproliferative and antitumour properties. Two phase III trials evaluated treatment of EGWs with ointment containing a mixture of green tea catechins (Polyphenon E®, U.S. adopted name: Sinecatechins). Objectives  To obtain additional data on the efficacy and safety of Polyphenon E® ointment in the treatment of EGWs from two randomized, double-blind, vehicle-controlled trials. Methods  Men and women aged ≥ 18 years (n = 1005), with two to 30 EGWs (12–600 mm2 total area) applied vehicle (GVeh; n = 207), Polyphenon E® ointment 10% (G10%; n = 401) or Polyphenon E® ointment 15% (G15%; n = 397) three times daily until complete clearance of all EGWs (baseline + new EGWs) or for a maximum of 16 weeks. Results  A total of 1004 patients were evaluable for safety and 986 for efficacy; 838 completed treatment after 16 weeks. Complete clearance of all EGWs was obtained in 53·6% (G10%) and 54·9% (G15%) of patients with Polyphenon E® vs. vehicle (35·4%) (P 

  • Sinecatechins a defined green tea extract in the treatment of external anogenital warts a randomized controlled trial
    Obstetrics & Gynecology, 2008
    Co-Authors: Silvio Tatti, James M Swinehart, Claus Thielert, Hoda Tawfik, Axel Mescheder, Karl R Beutner
    Abstract:

    OBJECTIVE: To estimate the clinical efficacy of topical Sinecatechins, a defined green tea extract, in the treatment of external genital and perianal warts. METHODS: This was a randomized, double-blind, vehicle-controlled trial involving 502 male and female patients aged 18 years and older, with 2-30 anogenital warts ranging from 12 to 600 mm(2) total wart area. Patients applied Sinecatechins ointment 15% or 10% or vehicle (placebo) three times daily for a maximum of 16 weeks or until complete clearance of all warts, followed by a 12-week treatment-free follow-up to assess recurrence. RESULTS: Complete clearance of all baseline and newly occurring warts was obtained in 57.2% and 56.3% of patients treated with Sinecatechins ointment 15% and 10%, respectively, compared with 33.7% for vehicle (both P<.001). Significance was observed at weeks 4 and 6 and all subsequent visits. Numbers needed to treat were 4.3 and 4.4. Partial clearance rates of at least 50% were reported for 78.4% and 74.0% of patients in the Sinecatechins ointment 15% and 10% groups compared with 51.5% of vehicle patients. During follow-up, recurrence of any wart was observed in 6.5%, 8.3%, and 8.8% in the Sinecatechins ointment 15% group, Sinecatechins ointment 10% group, and vehicle patients, respectively. A total of 3.7%, 8.3%, and 0.0% developed new warts, respectively. A total of 87.7% and 87.3% of patients in the Sinecatechins ointment 15% and 10% groups, and 72.1% of vehicle patients experienced application site reactions; 49.2%, 46.2%, and 65.4% of those, respectively, were mild or moderate. CONCLUSION: Topical Sinecatechins ointments 15% and 10% are effective and well-tolerated in the treatment of anogenital warts. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00449982. LEVEL OF EVIDENCE: I.

  • Sinecatechins, a defined green tea extract, in the treatment of external anogenital warts: a randomized controlled trial.
    Obstetrics & Gynecology, 2008
    Co-Authors: Silvio Tatti, James M Swinehart, Claus Thielert, Hoda Tawfik, Axel Mescheder, Karl R Beutner
    Abstract:

    OBJECTIVE: To estimate the clinical efficacy of topical Sinecatechins, a defined green tea extract, in the treatment of external genital and perianal warts. METHODS: This was a randomized, double-blind, vehicle-controlled trial involving 502 male and female patients aged 18 years and older, with 2-30 anogenital warts ranging from 12 to 600 mm(2) total wart area. Patients applied Sinecatechins ointment 15% or 10% or vehicle (placebo) three times daily for a maximum of 16 weeks or until complete clearance of all warts, followed by a 12-week treatment-free follow-up to assess recurrence. RESULTS: Complete clearance of all baseline and newly occurring warts was obtained in 57.2% and 56.3% of patients treated with Sinecatechins ointment 15% and 10%, respectively, compared with 33.7% for vehicle (both P