Efficacy Of Tocotrienol a Natural Vitamin E In Biopsy Wound (TOP/OTOP)

Efficacy Of Tocotrienol a Natural Vitamin E In Biopsy Wound.

The following two objectives are proposed in healthy subjects to characterize (1) wound closure, (2) scar formation/appearance, and (3) inflammatory response:

Objective 1, (topical only - referred to as "TOP") - Topical application of Tocotrienol (TCT) vs placebo in bilateral punch biopsy

Objective 2, (oral and topical - referred to as "OTOP") - Combined oral supplementation and topical application of tocotrienol (TCT) vs placebo in bilateral punch biopsy

Objective 3, (topical only - referred to as "TAM") - Topical application of tamoxifen vs placebo in bilateral punch biopsy.

Objective 4, (topical only to normal skin) - Topical application of TCT vs placebo on bilateral lets on normal skin.

Study Overview

• Status: Unknown
• Conditions: Scar
• Intervention / Treatment: Device: Topical Tocotrienol (TCT); Dietary supplement: Oral Tocotrienol Capsules (TCT); Device: Placebo cream; Dietary supplement: placebo capsule; Device: Tamoxifen Cream

Detailed Description

• In nature, the vitamin E family is split into two classes: tocopherols (TCP) and tocotrienols (TCT). Members of the TCP and TCT family are biologically unique.

  • TCP are mainly found in green leafy vegetables while TCT are the primary vitamin E of seeds, including cereal grains such as wheat, rice, and barley.

• Vitamin E is thought to improve wound healing by inhibiting collagen synthesis and attenuating fibroblast proliferation and inflammation. However, outcomes based scientific literature on the therapeutic efficacy of vitamin E in skin wound closure is scant and has primarily focused on TCP.

  • Oral supplementation of TCP showed modest improvement in rodent wound closure, but the relevance of oral TCP supplementation in rats already receiving high dose vitamin E in a standard laboratory is questionable.
  • Topical TCP on surgical wounds of children have been shown to improve wound healing; yet no mechanistic basis for the observed effect was described.

• Preliminary observations from the PI's active IRB protocol to test TCT in scar appearance of surgical wounds led us to evaluate the potential of TCT vitamin E to improve wound closure in healthy subjects. To date, the therapeutic efficacy of TCT in either topical (TOP) or oral with topical (OTOP) applications for skin wound healing remains to be reported.

  • Preliminary observations also made show down-regulation of microRNA-200b supports cutaneous angiogenesis, the most important step in cutaneous wound healing. Tamoxifen silences mircroRNA-200b and later work has recognized that under non-neoplastic conditions, tamoxifen may induce angiogenesis.

• Study Type: Observational
• Enrollment (Anticipated): 101

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Columbus, Ohio, United States, 43210
      • The Ohio State University Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

We plan to recruit 27 healthy adult subjects for the TOP group, 34 healthy adult subjects for the OTOP group,10 healthy adult subjects for the TAM group and 30 healthy subjects for Normal Skin.

Description

Inclusion Criteria:

• Ages- 18-50 (Both Male & Female)
• Non-smoker - having quit at least 3 months prior to enrollment
• Non-diabetic
• Non-pregnant or non-breastfeeding - verbal assent.
• If a female subject of childbearing age misses her menstrual period after the start of the study, she will inform the investigators and be given a pregnancy test to ensure, for safety reasons, that she is not pregnant. If she is pregnant, she will discontinue participation in the study.
• No current use of OTC medications or other form of supplements containing vitamin-E

Exclusion Criteria:

• Diabetes or HIV diagnosis
• Alcohol or drug abuse
• unable to provide informed consent
• Therapeutically anti-coagulated
• Prisoner
• Currently prescribed immunosuppressant medication

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

6

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
1-TOP group 1; TOP group 1 will have biopsy #2 collected 3 days after 1st biopsy collected.
TOP group 2; TOP group 2 will have biopsy #2 collected 30 days after 1st biopsy collected.
OTOP group-1; OTOP will use topical cream (either topical tocotrienol (TCT) or placebo cream) as well as oral supplementation (either oral Tocotrienol capsules (TCT) or placebo capsules). OTOP group 1 will have biopsy #2 collected 3 days after 1st biopsy collected.	Device: Topical Tocotrienol (TCT); Natural Form Vitamin E topical cream(TCT); Other Names: TCT; Dietary supplement: Oral Tocotrienol Capsules (TCT); Natural Form Vitamin E Oral capsules (TCT); Other Names: TCT; Device: Placebo cream; Placebo cream; Other Names: Placebo; Dietary supplement: placebo capsule; placebo capsule; Other Names: placebo
OTOP group-2; OTOP will use topical cream (either topical tocotrienol (TCT) or placebo cream) as well as oral supplementation (either oral Tocotrienol capsules (TCT) or placebo capsules). OTOP group 2 will have biopsy #2 collected 30 days after 1st biopsy collected.	Device: Topical Tocotrienol (TCT); Natural Form Vitamin E topical cream(TCT); Other Names: TCT; Dietary supplement: Oral Tocotrienol Capsules (TCT); Natural Form Vitamin E Oral capsules (TCT); Other Names: TCT; Device: Placebo cream; Placebo cream; Other Names: Placebo; Dietary supplement: placebo capsule; placebo capsule; Other Names: placebo
TAM Group 1; TAM group 1 will have #2 biopsy collected 21 days after 1st biopsy collected. Tamoxifen cream and placebo cream will be applied where biopsies are collected from 1 week prior to having the biopsy procedure until the second biopsy is collected (21 days later).	Device: Tamoxifen Cream; Tamoxifen cream
Normal Skin; Placebo group will apply placebo and TCT cream that will be applied daily to a specified area on the subjects legs (normal skin) for 5 weeks. One leg will be applied with placebo and the other will be applied with TCT cream. Subjects will return weekly for 5 weeks, where non-invasive measurements using Laser Speckle imaging, will be completed at each study visit	Device: Placebo cream; Placebo cream; Other Names: Placebo; Device: Tamoxifen Cream; Tamoxifen cream

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
WOUND CLOSURE	Wound closure will be assessed by results of conventional camera and thermal imaging in Group 1 and Group 2 subjects.	1-2 month(s)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
SCARRING	Scarring will be assessed in group 1 and group 2 subjects by the Vancouver Scar Scale (VSS). Scoring will be performed by three blinded observers. The VSS evaluates vascularity (redness), height (hypertrophy), pliability (contracture and elastic texture) and pigmentation.	1-2 month (s)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Wound closure and Increased Angiogenesis	Test whether miR-200b is silenced with tamoxifen resulting in increased angiogenesis and faster wound closure	1-2 months

Collaborators and Investigators

• Sponsor: Chandan K Sen
• Collaborators: Carotech Inc.
• Investigators: Principal Investigator: Chandan K Sen, PhD, Ohio State University

Study record dates

Study Major Dates

• Study Start: January 1, 2012
• Primary Completion (Anticipated): December 1, 2018
• Study Completion (Anticipated): December 1, 2018

Study Registration Dates

• First Submitted: April 13, 2012
• First Submitted That Met QC Criteria: April 16, 2012
• First Posted (Estimate): April 17, 2012

Study Record Updates

• Last Update Posted (Actual): January 29, 2018
• Last Update Submitted That Met QC Criteria: January 25, 2018
• Last Verified: January 1, 2017

More Information

Terms related to this study

• Keywords: Healthy participants
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Hormones, Hormone Substitutes, and Hormone Antagonists; Antineoplastic Agents, Hormonal; Protective Agents; Micronutrients; Hormone Antagonists; Vitamins; Bone Density Conservation Agents; Estrogen Antagonists; Antioxidants; Selective Estrogen Receptor Modulators; Estrogen Receptor Modulators; Vitamin E; Tocopherols; Tamoxifen; Tocotrienols
• Other Study ID Numbers: 2011H0286