Pantethine, a derivative of vitamin B5, improved the effectiveness of standard topical psoriasis treatment in a clinical study. Experiments in cells and mice linked its effects to cholesterol metabolism in immune cells. The study, conducted by Chinese researchers, was published in the Journal of Experimental Medicine.
The researchers studied dendritic cells, which help coordinate the immune response and activate T cells. Excessive activity of these cells can contribute to inflammation in psoriasis and other diseases.
Activated dendritic cells from patients and mice were found to produce increased levels of enzymes from the Vanin family, which break down pantethine. Reduced pantethine availability was accompanied by cholesterol accumulation and increased immune cell activity.
Adding pantethine or inhibiting Vanin reduced excess cholesterol and weakened the inflammatory response in experimental models. In mice, these interventions alleviated psoriasis-like inflammation.
The researchers then tested the approach in 24 patients. All participants received a topical treatment containing calcipotriol and betamethasone, while half also took pantethine. After 12 weeks, symptoms had improved more significantly in the combination therapy group. The improvement was particularly pronounced in patients who had high cholesterol levels at the start of the study.
The small sample size does not yet allow researchers to determine who benefits from adding pantethine or how long its effects last. The clinical improvement also does not prove that the mechanism identified in cell experiments was responsible for the results in humans. Larger controlled trials are needed to evaluate this approach.
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