Role of Oral Polypodium Leucotomos Extract in Dermatologic Diseases: A Review of the Literature

February 2014 | Volume 13 | Issue 2 | Original Article | 148 | Copyright © February 2014


Samreen Z. Choudhry MD,a Neal Bhatia MD,b Roger Ceilley MD,c Firas Hougeir MD,d
Robert Lieberman MD,e Iltefat Hamzavi MD,a and Henry W. Lim MDa

aDepartment of Dermatology, Henry Ford Hospital, Detroit, MI
bAssociate Clinical Professor, Harbor-UCLA Medical Center, Los Angeles, CA
cClinical Professor of Dermatology, University of Iowa, Private Practice, West Des Moines, IA
dAtlanta, GA
eThomas Dermatology, Inc. Las Vegas, NV

Given these multiple mechanisms of action and impacts on the effects of immune responses, PLE may provide a new adjunctive option for safe maintenance or additional approach to difficult chronic diseases such as photodermatoses, melasma, psoriasis, and vitiligo. Further studies with larger sample sizes are needed, however, to confirm these beneficial effects.

DISCLOSURES

Samreen Choudhry MD has no relevant conflicts to disclose; Neal Bhatia MD is affiliated with Bayer, Dusa, Ferndale, Galderma, Genentech, Leo, Medicis, Onset, PharmaDerm, Promius, Quinnova, and Valeant; Roger Ceilley MD is a consultant for Ferndale Labs; Firas Hougier MD has served as a consultant for Ferndale; Robert Lieberman MD is affiliated with Ferndale and Medicis; Iltefat Hamzavi MD serves as a consultant for Daavlin, and has received research grants from Clinuvel, Estée Lauder, and Johnson and Johnson; Henry W. Lim MD has served as consultant for Ferndale, La Roche-Posay, Uriage, and Pierre Fabre, and has received research grants from Clinuvel and Estée Lauder.

REFERENCES

  1. Horvath A, Alvarado F, Szocs J, et al. Metabolic Effects of calagualine, an antitumoral saponine of Polypodium leucotomos. Nature. 1967; 214:1256-1258.
  2. Padilla HC, Lainez H, Pacheco JA. A new agent (hydrophilic fraction of Polypodium leucotomos) for management of psoriasis. Int J Dermatol. 1974; 13:276-282.
  3. Ruiz H. Disertaciones sobre la raiz de la Rathania, de la Calaguala y de la China y acerca de la yerba llamada Canchalagua. Madrid: Fundacion Ciencias de la Salud, Sociedad Estatal Quinto Centenario y Real Jardin Botanico (CISC); 1992. Cited by: Gonzalez S, Alonso-Lebrero JL, Del Rio R, et al. Polypodium Leucotomos Extract: A Nutraceutical with Photoprotective Properties. Drugs Today. 2007; 43(7):475-485.
  4. Runger TM. Ultraviolet Light. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. Vol 2. 3rd ed. Philadelphia, PA: Elsevier; 2012:1455-1465.
  5. Garcia F, Pivel JP, Guerrero A, et al. Phenolic components and antioxidant activity of Fernblock, an aqueous extract of the aerial parts of the fern Polypodium leucotomos. Methods Find Exp Clin Pharmacol. 2006; 28: 157-160.
  6. Gombau L, Garcia F, Lahoz A, et al. Polypodium leucotomos extract: Antioxidant activity and disposition. Toxicol In Vitro. 2006; 20: 464-471.
  7. Gonzalez S, Alcaraz MV, Cuevas J, et al. An Extract of the Fern Polypodium Leucotomos (Difur) modulates Th1/Th2 Cytokines Balance in Vitro and Appears to Exhibit Anti-angiogenic Activities in Vivo:Pathogenic Relationships and Therapeutic Implications. Anticancer Res. 2000; 20:1567-1576.
  8. Alonso-Lebrero JL, Dominguez-Jimenez C, Tejedor R, et al. Photoprotective properties of a hydrophilic extract of the fern Polypodium leucotomos on human skin cells. J Photochem Photobiol, B. 2003; 70:31-37.
  9. Philips N, Smith J, Keller T, et al. Predominant effects of Polypodium leucotomos on membrane integrity, lipid peroxidation, and expression of elastin and matrixmetalloproteinase-1 in ultraviolet radiation exposed fibroblasts, and keratinocytes. J Dermatol Sci. 2003; 32:1-9.
  10. Capote R, Alonso-Lebrero JL, Garcia F, et al. Polypodium leucotomos extract inhibits trans-urocanic acid photoisomerization and photodecomposition. J Photochem Photobiol, B. 2006; 82:173-179.
  11. Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Oral Polypodium leucotomos extract decreases ultraviolet-induced damage of human skin. J Am Acad Dermatol. 2004; 51(6): 910-918.
  12. Villa A, Viera MH, Amini S, et al. Decrease of ultraviolet A light–induced “common deletion” in healthy volunteers after oral Polypodium leucotomos extract supplement in a randomized clinical trial. J Am Acad Dermatol. 2010; 62(3): 511-513.
  13. Berneburg M, Plettenburg H, Medve-König K, et al. Induction of the photoaging- associated mitochondrial common deletion in vivo in normal human skin. J Invest Dermatol. 2004; 122:1277-1283.
  14. Zattra E, Coleman C, Arad S, et al. Oral Polypodium leucotomos decreases UV-induced Cox-2 expression, inflammation, and enhances DNA repair in Xpc +/- mice. Am J Pathol. 2009; 175:1952-1961.
  15. Aguilera P, Carrera C, Puig-Butille JA, et al. Benefits of oral Polypodium Leucotomos extract in MM high-risk patients. J Eur Acad Dermatol Venereol. 2013; 27:1095-1100.
  16. Caccialanza M, Percivalle S, Piccinno R, Brambilla R. Photoprotective activity of oral polypodium leucotomos extract in 25 patients with idiopathic photodermatoses. Photodermatol Photoimmunol Photomed. 2007; 23:46-47.
  17. Caccialanza M, Recalcati S, Piccinno R. Oral polypodium leucotomos extract photoprotective activity in 57 patients with idiopathic photodermatoses. G Ital Dermatol Venereol. 2011; 146: 85-87.
  18. Tanew A, Radakovic S, Gonzalez S, et al. Oral administration of a hydrophilic extract of Polypodium leucotomos for the prevention of polymorphic light eruption. J Am Acad Dermatol. 2012; 66(1):58-62.
  19. Breithaupt AD, Jacob SE. Subacute Cutaneous Lupus Erythematosus: A Case Report of Polypodium leucotomos as an Adjuvant Therapy. Cutis. 2012;89:183-184.
  20. Martin LK, Caperton C, Woolery-Lloyd H, Avashia N. A randomized doubleblind placebo controlled study evaluating the effectiveness and tolerability of oral Polypodium leucotomos in patients with melasma. Poster #4630. Paper presented at: American Academy of Dermatology; March 2012; San Diego, CA.
  21. Ahmed A, Lopez I, Perese F, et al. A Randomized, Double-Blinded, Placebo- Controlled Trial of Oral Polypodium Leucotomos Extract as Adjunct to Sunscreen in the Treatment of Melasma. JAMA Dermatol. 2013;1-2. doi:10.1001/ jamadermatol.2013.4294.
  22. Pacifico A, Iacovelli P, Paro Vidolin A, Leone G. Combined treatment of NBUVB phototherapy and oral Polypodium Leucotomos extract versus NBUVB therapy alone in the treatment of patients with vitiligo. Poster #3111. Paper presented at: American Academy of Dermatology; March 2009; San Francisco, CA.
  23. Reyes E, Jaén P, Cuevas J, et al. Systemic immunomodulatory effects of Polypodium leucotomos as an adjuvant to PUVA therapy in generalized vitiligo: A pilot study. J Dermatol Sci. 2006; 41(3):213-216.
  24. Middlekamp MA, Bos JD, Ruis-Diaz F, et al. Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study. J Eur Acad Dermatol Venereol. 2007; 21(7):942-950.
  25. De las Heras ME, Ledo E, Gonzalez S, et al. Polypodium leucotomos extract as adjuvant to PUVA therapy in the treatment of Plaque Psoriasis. Med Cutan Iber Lat Am. 1997; 25:103-107.
  26. Middlekamp-Hup MA, Pathak MA, Parrado C, et al. Orally administered Polypodium leucotomos extract decreases psoralen-UVA-induced phototoxicity, pigmentation, and damage of human skin. J Am Acad Dermatol. 2004; 50:41-49.
  27. Ramirez-Bosca A, Zapater P, Betlloch I, et al. Polypodium leucotomos Extract in Atopic Dermatitis: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Actas Dermosifiliogr. 2012; 103:599-607.
  28. Solivellas BM, Martin TC. Polypodium leucotomos Extract use to prevent and reduce the risk of infectious diseases in high performance athletes. Infect Drug Resist. 2012; 5:149-153.
  29. Bernd A, Ramirez-Bosca A, Huber H, et al. In vitro studies on the immunomodulating effects of Polypodium leucotomos extract on human leucocyte fractions. Arzneimittelforschung. 1995; 45(2): 901-904.
  30. Sempere JM, Campos A, Rodrigo C, et al. Induction of T lymphocytes and NK cells by anapsos. Inmunologia. 1999; 18(Suppl 1)

AUTHOR CORRESPONDENCE

Henry W. Lim MDhlim1@hfhs.org
Close Menu