摄入贯叶连翘生粉(金丝桃素)会增强患者在大剂量UVA1治疗过程中的红斑反应吗?

作     者：Beattie P.E. Dawe R.S. Traynor N.J. 焦婷 

作者机构：Dermatology Department University ofDundee Ninewells Hospital and Medical School Dundee DD1 9SY United Kingdom 

出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)

年 卷 期：2006年第2卷第3期

页      面：42-43页

学科分类：1008[医学-中药学(可授医学、理学学位)] 1006[医学-中西医结合] 1002[医学-临床医学] 100602[医学-中西医结合临床] 10[医学] 100206[医学-皮肤病与性病学] 

主　　题：治疗过程 金丝桃素 UVA1 贯叶连翘 大剂量 红斑反应 摄入 光毒性反应 患者 培养的细胞 

摘      要：Background: St John s wort (SJW) is widely used as a treatment for depression. A phototoxic reaction, due to its content of hypericin, can occur in animals and in cell culture, and has been reported in humans. Hypericin displays absorption within the ultraviolet (UV) A1 spectrum and there may therefore be a potential for phototoxicity if taken during high-dose UVA1 therapy. Objectives: To assess the phototoxicity risk of SJW ingestion. Methods: Eleven adult volunteers of skin types I and II were exposed to a geometric dose series of UVA1 irradiation from a high-output source (Dermalight Ultra 1; Dr H nle, Martinsreid, Germany; irradiance 70- 77 mW cm- 2) on the photoprotected lower back skin at eight 1.5-cm2 test areas. Irradiation was carried out at baseline and after 10 days of SJW extract 1020 mg (equivalent to 3000 μ g of hypericin) daily. Four, 8, 24 and 48 h after each exposure, the minimal erythema dose (MED) and the presence or absence of pigmentation were recorded visually and erythema was assessed objectively with an erythema meter. Results: The median MED and D0.025, an objective measure of MED, were lower at all time-points after SJW ingestion. The visual erythemal peak (lowest median MED), which was seen at 8 h postirradiation, was lower after SJW (median 14 J cm- 2, range 10- 56) than at baseline (median 20 J cm- 2, range 14- 56) (P = 0.047). Similarly, the median D0.025 at 8 h postirradiation was lower after SJW(median 22.0 J cm- 2, range 15.2- 53.9) than at baseline (median 33.7 J cm - 2, range 22.9- 136.0) (P = 0.014). The MED and D0.025 were also significantly different at the 48-h and 4-h time-points, respectively. Significance was not reached at the 24-h time-point. Median intensity of postirradiation erythema increased at all time-points after ingestion of SJW. Despite these differences, the maximum slope of the dose-response curve was not increased after SJW ingestion. Conclusions: These data suggest that SJW extract has the potential to lower