Tretinoin

3,7-dimethyl- 9-( 2,6,6- trimethyl- 1 -cyclohexenyl ) nona -2 ,4,6,8 - tetraenoic acid

• D10AD01
• L01XX14

Non-aromatic retinoid

182 ° C

Attention

2000 mg · kg -1 ( LD50, rat, oral)

Template: Infobox chemical / molecular formula search available

Tretinoin, vitamin A acid (abbreviated VAS ) or all-trans -retinoic acid (English: all-trans retinoic acid - in short, ATRA ) is a substance whose chemical structure of vitamin A1 ( retinol) derived. It is one of the non-aromatic retinoids of the first generation.

Representation

Tretinoin is formed by oxidation of all-trans - retinal, which can be obtained by oxidation of all-trans- retinol:

Areas of application

Tretinoin is used as drug use: Systemic it is used in the treatment of acute promyelocytic leukemia (APL ), a subtype of acute myeloid leukemia ( AML). Topically it comes as an effective ingredient of cream and gel formulations or alcoholic solutions in the treatment of acne and other hyperkeratotic skin diseases and cosmetics used. Tretinoin is approved in Europe and North America, such medicines are available on prescription in general.

Mechanisms of action

• Through a translocation at the genetic level is created in the promyelocytes a hybrid receptor for retinoic acid. There is an activation of cell division and thus for the expansion of leukemic cells. Systemic employed tretinoin intervenes in this process by guiding the leukemia cells to differentiation ( maturation ). There arise mature granulocytes with loss of mitotic activity. Tretinoin is used in combination with chemotherapy and so provides cure rates of up to 80 percent.
• Tretinoin stimulates Mitosetätigkeit of keratinizing epithelia and also inhibits the keratin. So it comes corneum to parakeratosis and thinning of the stratum. For the treatment of acne, this means that the pathologically altered cell differentiation of keratinocytes in Follikelinfundibulum favorably influenced, dissolved the coherence of the horn slats and the Keratinpfropf is lifted out of the Follikelinfundibulum. In addition to real Komedolyse also takes a prophylaxis against Komedonenneubildung.
• Tretinoin offers a wide range of immunomodulatory: Depending on the state of the treated skin may immunosuppressive, immunostimulatory, anti-inflammatory or pro-inflammatory effect.

Combinations with other active

For improving the therapeutic effect and reduce adverse effects of topical tretinoin use is combined with other active ingredients. When finished preparations, the combination with the antibiotic erythromycin and the treatment of severe keratinization disorders such as ichthyosis combination with urea ( Urea ) are available for acne treatment.

2013 was a prospective comparative study with 60 participants that the combination of tretinoin with a specific aloe vera gel after eight weeks of treatment, a better result in mild to moderate acne scored as the retinoid alone.

Pregnancy and lactation

In women of childbearing potential Tretinoin should not be applied systemically or only after exclusion of pregnancy due to its generally teratogenic effect. Otherwise, risk of serious birth defects in the fetus. The safety of topical use during pregnancy and lactation has not been adequately studied, so that is also advised thereof.