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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2020/05/10 04:25:39」(JST)

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Tretinoin, also known as all-trans retinoic acid (ATRA), is medication used for the treatment of acne and acute promyelocytic leukemia.^[3]^[4]^[5] For acne, it is applied to the skin as a cream or ointment.^[5] For leukemia, it is taken by mouth for up to three months.^[3]

Common side effects when used by mouth include shortness of breath, headache, numbness, depression, skin dryness, itchiness, hair loss, vomiting, muscle pains, and vision changes.^[3] Other severe side effects include high white blood cell counts and blood clots.^[3] When used as a cream, side effects include skin redness, peeling, and sun sensitivity.^[5] Use during pregnancy is contraindicated due to the risk of birth defects.^[3]^[1] It is in the retinoid family of medications.^[4]

Tretinoin was patented in 1957, and approved for medical use in 1962.^[6] It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.^[7] Tretinoin is available as a generic medication.^[8] In the United Kingdom the cream together with erythromycin costs the NHS about £7.05 per 25 mL while the pills are £1.61 per 10 mg.^[5] In 2017, it was the 293rd most commonly prescribed medication in the United States, with more than one million prescriptions.^[9]^[10]

Medical uses

Skin use

Tretinoin is most commonly used to treat acne.^[11] In topical form, this drug is pregnancy category C and should not be used by pregnant women.^[11]^[2]

People using the topical form should not also use any cream or lotion that has a strong drying effect, contains alcohol, astringents, spices, lime, sulfur, resorcinol, or aspirin, as these may interact with tretinoin or exacerbate its side effects.^[11]

Leukemia

Tretinoin is used to induce remission in people with acute promyelocytic leukemia who have a mutation (the t(15;17) translocation 160 and/or the presence of the PML/RARα gene) and who don't respond to anthracyclines or can't take that class of drug. It is not used for maintenance therapy.^[12]^[13]^[14]

By mouth, this drug is pregnancy category D and should not be used by pregnant women as it may harm the fetus.^[12]^[1]

Side effects

Skin use

Topical tretinoin is only for use on skin and it should not be applied to eyes or mucosal tissues. Common side effects include skin irritation, redness, swelling, and blistering.^[11]

Leukemia use

The oral form of the drug has boxed warnings concerning the risks of retinoic acid syndrome and leukocytosis.^[12]

Other significant side effects include a risk of thrombosis, benign intracranial hypertension in children, high lipids (hypercholesterolemia and/or hypertriglyceridemia), and liver damage.^[12]

There are many significant side effects from this drug that include malaise (66%), shivering (63%), hemorrhage (60%), infections (58%), peripheral edema (52%), pain (37%), chest discomfort (32%), edema (29%), disseminated intravascular coagulation (26%), weight increase (23%), injection site reactions (17%), anorexia (17%), weight decrease (17%), and myalgia (14%).^[12]

Respiratory side effects usually signify retinoic acid syndrome, and include upper respiratory tract disorders (63%), dyspnea (60%), respiratory insufficiency (26%), pleural effusion (20%), pneumonia (14%), rales (14%), and expiratory wheezing (14%), and many others at less than 10%.^[12]

Around 23% of people taking the drug have reported earache or a feeling of fullness in their ears.^[12]

Gastrointestinal disorders include bleeding (34%), abdominal pain (31%), diarrhea (23%), constipation (17%), dyspepsia (14%), and swollen belly (11%) and many others at less than 10%.^[12]

In the cardiovascular system, side effects include arrhythmias (23%), flushing (23%), hypotension (14%), hypertension (11%), phlebitis (11%), and cardiac failure (6%) and for 3% of patients: cardiac arrest, myocardial infarction, enlarged heart, heart murmur, ischemia, stroke, myocarditis, pericarditis, pulmonary hypertension, secondary cardiomyopathy.^[12]

In the nervous system, side effects include dizziness (20%), paresthesias (17%), anxiety (17%), insomnia (14%), depression (14%), confusion (11%), and many others at less than 10% frequency.^[12]

In the urinary system, side effects include chronic kidney disease (11%) and several others at less than 10% frequency.^[12]

Mechanism of action

For its use in cancer, its mechanism of action is unknown, but on a cellular level, laboratory tests show that tretinoin forces APL cells to differentiate and stops them from proliferating; in people there is evidence that it forces the primary cancerous promyelocytes to differentiate into their final form, allowing normal cells to take over the bone marrow.^[12] Recent study shows that ATRA inhibits and degrades active PIN1.^[15]

For its use in acne, the mechanism is unknown, but again on a cellular level there is evidence that it decreases the ability of epithelial cells in hair follicles to stick together, leading to fewer blackheads; it also seems to make the epithelial cells divide faster, causing the blackheads to be pushed out.^{[citation needed]}

Biosynthesis

Biosynthetic pathway of tretinon

Tretinoin is synthesized from Beta-carotene. The Beta-carotene is firstly cleaved into Beta-carotene 15-15'-monooxygenase through site 1 double bond oxidized to epoxide. The epoxide is attacked by water to form diol in site 1. NADH, as a reduction agent, reduce the alcohol group to aldehydes.^[16]

History

Tretinoin was co-developed for its use in acne by James Fulton and Albert Kligman when they were at University of Pennsylvania in the late 1960s.^[17]^[18] The University of Pennsylvania held the patent for Retin-A, which it licensed to pharmaceutical companies.^[18]

Etymology

The origin of the name tretinoin is uncertain,^[19]^[20] although several sources agree (one with probability,^[19] one with asserted certainty^[21]) that it probably comes from trans- + retinoic [acid] + -in, which is plausible given that tretinoin is the all-trans isomer of retinoic acid. The name isotretinoin is the same root tretinoin plus the prefix iso-. Regarding pronunciation, the following variants apply equally to both tretinoin and isotretinoin. Given that retinoic is pronounced /ˌrɛtɪˈnoʊɪk/,^[20]^[21]^[22]^[23] it is natural that /ˌtrɛtɪˈnoʊɪn/ is a commonly heard pronunciation. Dictionary transcriptions also include /ˌtrɪˈtɪnoʊɪn/ (tri-TIN-oh-in)^[20]^[22] and /ˈtrɛtɪnɔɪn/.^[21]^[23]

Research

Tretinoin has been explored as a treatment for hair loss, potentially as a way to increase the ability of minoxidil to penetrate the scalp, but the evidence is weak and contradictory.^[24]^[25]

It has been used off-label to treat and reduce the appearance of stretch marks.^[26] It has also been studied in skin aging.^[27]

References

^ ^a ^b ^c ^d "Tretinoin (Vesanoid) Use During Pregnancy". Drugs.com. 25 July 2019. Retrieved 16 January 2020.
^ ^a ^b ^c "Tretinoin topical Use During Pregnancy". Drugs.com. 1 July 2019. Retrieved 16 January 2020.
^ ^a ^b ^c ^d ^e "Tretinoin". The American Society of Health-System Pharmacists. Archived from the original on 30 November 2016. Retrieved 8 December 2016.
^ ^a ^b Tivnan A (2016). Resistance to Targeted Therapies Against Adult Brain Cancers. Springer. p. 123. ISBN 9783319465050. Archived from the original on 2017-11-05.
^ ^a ^b ^c ^d British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 627, 821–822. ISBN 9780857111562.
^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 476. ISBN 9783527607495. Archived from the original on 2017-11-05.
^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^ "Tretinoin topical". The American Society of Health-System Pharmacists. Archived from the original on 16 May 2016. Retrieved 8 December 2016.
^ "The Top 300 of 2020". ClinCalc. Retrieved 11 April 2020.
^ "Tretinoin - Drug Usage Statistics". ClinCalc. Retrieved 11 April 2020.
^ ^a ^b ^c ^d ^e "Tretinoin Cream- tretinoin cream". DailyMed. 1 December 2018. Retrieved 16 January 2020.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l "Tretinoin capsule". DailyMed. 12 December 2018. Retrieved 16 January 2020.
^ Huang ME, Ye YC, Chen SR, Chai JR, Lu JX, Zhoa L, et al. (August 1988). "Use of all-trans retinoic acid in the treatment of acute promyelocytic leukemia" (PDF). Blood. 72 (2): 567–72. doi:10.1182/blood.V72.2.567.567. PMID 3165295.
^ Castaigne S, Chomienne C, Daniel MT, Ballerini P, Berger R, Fenaux P, Degos L (November 1990). "All-trans retinoic acid as a differentiation therapy for acute promyelocytic leukemia. I. Clinical results" (PDF). Blood. 76 (9): 1704–9. doi:10.1182/blood.V76.9.1704.1704. PMID 2224119.
^ Wei S, Kozono S, Kats L, Nechama M, Li W, Guarnerio J, et al. (May 2015). "Active Pin1 is a key target of all-trans retinoic acid in acute promyelocytic leukemia and breast cancer". Nature Medicine. 21 (5): 457–66. doi:10.1038/nm.3839. PMC 4425616. PMID 25849135.
^ Woggon W (2009). "Oxidative cleavage of carotenoids catalyzed by enzyme models and beta-carotene 15,15´-monooxygenase". Pure and Applied Chemistry. 74 (8): 1397–1408. doi:10.1351/pac200274081397. ISSN 1365-3075.
^ Vivant Pharmaceuticals, LLC Press Release. July 10, 2013, Vivant Skin Care Co-founder James E. Fulton, MD, Loses Colon Cancer Battle
^ ^a ^b Gellene D (22 February 2010). "Dr. Albert M. Kligman, Dermatologist, Dies at 93". The New York Times.}
^ ^a ^b Merriam-Webster, Merriam-Webster's Unabridged Dictionary, Merriam-Webster.
^ ^a ^b ^c Oxford Dictionaries, Oxford Dictionaries Online, Oxford University Press, archived from the original on 2014-10-22.
^ ^a ^b ^c Houghton Mifflin Harcourt, The American Heritage Dictionary of the English Language, Houghton Mifflin Harcourt, archived from the original on 2015-09-25.
^ ^a ^b Merriam-Webster, Merriam-Webster's Medical Dictionary, Merriam-Webster.
^ ^a ^b Elsevier, Dorland's Illustrated Medical Dictionary, Elsevier.
^ Ralph M. Trüeb. The Difficult Hair Loss Patient: Guide to Successful Management of Alopecia and Related Conditions. Springer, 2015. ISBN 9783319197012 Pg. 95 Archived 2017-11-05 at the Wayback Machine
^ Rogers NE, Avram MR (October 2008). "Medical treatments for male and female pattern hair loss". Journal of the American Academy of Dermatology. 59 (4): 547–66, quiz 567–8. doi:10.1016/j.jaad.2008.07.001. PMID 18793935.
^ Arthur W. Perry (2007). Straight talk about cosmetic surgery. Yale University Press. pp. 63. ISBN 978-0-300-12104-9.
^ Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G (December 2006). "Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety". Clinical Interventions in Aging. 1 (4): 327–48. doi:10.2147/ciia.2006.1.4.327. PMC 2699641. PMID 18046911.

External links

"Tretinoin". Drug Information Portal. U.S. National Library of Medicine.
"Tretinoin Topical". MedlinePlus.

UpToDate Contents

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1. 成人における急性前骨髄球性白血病の初期治療initial treatment of acute promyelocytic leukemia in adults [show details]
…nearly 1000 patients who enrolled on prospective clinical trials that included early use of all-trans retinoic acid (ATRA; tretinoin) for APL, the incidence of early hemorrhagic death was 3.7 percent . Population-based …
2. 光による老化photoaging [show details]
…melanocyte atypia . Topical retinoids used for the treatment of photoaging include tretinoin (all-trans retinoic acid), tazarotene (a synthetic retinoid), and adapalene (a third-generation synthetic retinoid)…
3. Autosomal recessive congenital ichthyosisautosomal recessive congenital ichthyosis [show details]
4. 尋常性ざ瘡の治療treatment of acne vulgaris [show details]
…management of most patients. The first topical retinoid for the treatment of acne, topical all-trans retinoic acid (topical tretinoin), is still extensively used. Adapalene, tazarotene, and trifarotene are…
5. 急性白血病の治療に伴う分化症候群differentiation syndrome associated with treatment of acute leukemia [show details]
…a potentially fatal complication of treatment of acute promyelocytic leukemia (APL) with all-trans retinoic acid and/or arsenic trioxide, treatment of acute myeloid leukemia (AML) with inhibitors of isocitrate …

English Journal

Retinoic acid receptor-beta prevents cisplatin-induced proximal tubular cell death.

Yago-Ibáñez J, García-Pastor C, Lucio-Cazaña FJ, Fernández-Martínez AB.
Biochimica et biophysica acta. Molecular basis of disease. 2020 Jul;1866(7)165795.
Cisplatin's toxicity in renal tubular epithelial cells limits the therapeutic efficacy of this antineoplastic drug. In cultured human proximal tubular HK-2 cells (PTC) a prostaglandin uptake transporter (PGT)-dependent increase in intracellular prostaglandin E (iPGE) mediates cisplatin's toxicity (i
PMID 32278009

Roscovitine enhances All-trans retinoic acid (ATRA)-induced leukemia cell differentiation: Novel effects on signaling molecules for a putative Cdk2 inhibitor.

Rashid A, Duan X, Gao F, Yang M, Yen A.
Cellular signalling. 2020 Jul;71()109555.
All-trans retinoic acid (ATRA)-based differentiation therapy has been unsuccessful in treating t(15;17) negative acute myeloid leukemia (AML) patients, motivating interest in combination therapies using ATRA plus other agents. Using the t (15, 17) negative HL-60 human myeloblastic leukemia model, we
PMID 32032659

All-Trans Retinoic Acid Grafted Poly Beta-Amino Ester Nanoparticles: A Novel Anti-angiogenic Drug Delivery System.

Karimi N, Mansouri K, Soleiman-Beigi M, Fattahi A.
Advanced pharmaceutical bulletin. 2020 Jun;10(2)221-232.
Array 50
PMID 32373490

Japanese Journal

急性前骨髄球性白血病に対する治療 (特集急性白血病 : 最新の診断と治療) -- (治療)

木口亨
日本臨床 = Japanese journal of clinical medicine 78(3), 465-470, 2020-03
NAID 40022165793

急性前骨髄球性白血病の治療戦略の動向 (特集急性骨髄性白血病(AML)診療update)

横山泰久
血液内科 = Hematology 80(1), 46-50, 2020-01
NAID 40022146122

A novel screening test to predict the developmental toxicity of drugs using human induced pluripotent stem cells

Aikawa Nobuo
Ｔｈｅ　Ｊｏｕｒｎａｌ　ｏｆ　Ｔｏｘｉｃｏｌｏｇｉｃａｌ　Ｓｃｉｅｎｃｅｓ 45(4), 187-199, 2020
… The traditionally developmentally toxic drugs of aminopterin, methotrexate, all-trans-retinoic acid, thalidomide, tetracycline, lithium, phenytoin, 5-fluorouracil, warfarin and valproate were designated as class 2 or 3 according to the EST criteria, and their developmental toxicity was type 3. …
NAID 130007825450

「急性白血病」

Tretinoin
Clinical data
Pronunciation	See pronunciation note
Trade names	Vesanoid, Avita, Renova, Retin-a, others
AHFS/Drugs.com	Monograph, Monograph
MedlinePlus	a608032
License data	US DailyMed: Tretinoin; US FDA: Tretinoin;
Pregnancy; category	AU: X (High risk) (Oral), D (Topical); US: D (Evidence of risk) (Oral), C (Topical); ;
Routes of; administration	Topical, by mouth
ATC code	D10AD01 (WHO) L01XX14 (WHO), D10AD51 (WHO);
Legal status
Legal status	AU: S4 (Prescription only) ; UK: POM (Prescription only) ; US: ℞-only ;
Pharmacokinetic data
Protein binding	> 95%
Elimination half-life	0.5-2 hours
Identifiers
	IUPAC name (2E,4E,6E,8E)-3,7-Dimethyl-9-(2,6,6-trimethylcyclohexen-1-yl)nona-2,4,6,8-tetraenoic acid;
CAS Number	302-79-4 ;
PubChem CID	444795;
IUPHAR/BPS	2644;
DrugBank	DB00755 ;
ChemSpider	392618 ;
UNII	5688UTC01R;
KEGG	D00094 ; C00777 ;
ChEBI	CHEBI:15367 ;
ChEMBL	ChEMBL38 ;
CompTox Dashboard (EPA)	DTXSID7021239 ;
ECHA InfoCard	100.005.573
Chemical and physical data
Formula	C20H28O2
Molar mass	300.4412 g/mol g·mol−1
3D model (JSmol)	Interactive image;
Melting point	180 °C (356 °F)
	SMILES CC1=C(C(CCC1)(C)C)C=CC(=CC=CC(=CC(=O)O)C)C;
	InChI InChI=1S/C20H28O2/c1-15(8-6-9-16(2)14-19(21)22)11-12-18-17(3)10-7-13-20(18,4)5/h6,8-9,11-12,14H,7,10,13H2,1-5H3,(H,21,22)/b9-6+,12-11+,15-8+,16-14+ ; Key:SHGAZHPCJJPHSC-YCNIQYBTSA-N ;
(verify)

　　[★]

英: acute leukemia, AL
関: 白血病、FAB分類

概念

未分化の白血球の腫瘍性増殖

分類

急性リンパ性白血病：MPO染色において(leukemic blastの)3%未満が陽性の場合
急性骨髄性白血病　：MPO染色において(leukemic blastの)3%以上が陽性の場合

FAB分類

M0			minimally differentiated acute myeloblastic leukemia	AML
M1			acute myeloblastic leukemia, without maturation
M2			acute myeloblastic leukemia, with granulocytic maturation
M3			promyelocytic, or acute promyelocytic leukemia	APL
M4		急性骨髄単球性白血病	acute myelomonocytic leukemia	AMMoL
M4	M4eo		myelomonocytic together with bone marrow eosinophilia	AMMoL
M5	M5a	急性単芽球性白血病	acute monoblastic leukemia	AMoL
M5	M5b	急性単球性白血病	acute monocytic leukemia	AMoL
M6	M6a	赤白血病	acute erythroid leukemias, including erythroleukemia
M6	M6b	赤白血病	and very rare pure erythroid leukemia
M7		急性巨核芽球性白血病	acute megakaryoblastic leukemia
M8		急性好塩基球性白血病	acute basophilic leukemia
L1		小細胞型
L2		大細胞型
L3		Burkitt型

病態

白血球系芽球の腫瘍性増殖
骨髄機能障害
腫瘍細胞の臓器浸潤
腫瘍細胞の破壊亢進

徴候

全身：息切れ、全身倦怠感、発熱(免疫力低下による感染症、腫瘍細胞の崩壊)
皮膚：点状出血、紫斑
口腔内：歯肉出血
骨・関節：骨痛、関節痛　　←　腫瘍細胞の関節への浸潤
肝臓・脾臓：肝脾腫
リンパ節：腫脹(頚部リンパ節、鼡径リンパ節)
唾液腺：顎下唾液腺腫大

検査

血算

白血球：増加
血小板：減少
赤血球：減少 (正球性正色素性貧血)

血液生化学

LDH↑
ビタミンB12↑
尿酸↑

治療

小児

化学療法：小児のALLでは著効する
骨髄移植：小児のALLでは再発例に行う

成人

急性骨髄性白血病

化学療法：アントラサイクリン系抗悪性腫瘍薬(イダルビシン、ダウノルビシン, DNA二本鎖の間にintercalateしでDNA,RNAの合成を阻害)　＋　シタラビン(Ara-C, シトシンアナログ, 代謝拮抗薬)

急性前骨髄球性白血病

レチノイン酸(ATRA, all-trans retinoic acid)の経口投与で高い確率で寛解する
白血球や前骨髄球が多い場合には化学療法を併用する：レチノイン酸　＋　アントラサイクリン系抗悪性腫瘍薬(イダルビシン、ダウノルビシン, DNA二本鎖の間にintercalateしでDNA,RNAの合成を阻害)　＋　シタラビン(Ara-C, シトシンアナログ, 代謝拮抗薬)

急性リンパ性白血病

ビンクリスチン　＋　アントラサイクリン系悪性腫瘍薬(ダウノルビシン DNR、ドキソルビシン = アドリアマイシン ADR)　＋　シクロホスファミド　＋　L-アスパラギナーゼ　＋　プレドニゾロン

VACAP

予後

小児急性白血病の予後不良因子

YN.G-44改変

年齢(≦1 y.o. / ≧10 y.o.)、男児、FAB分類 L2,L3、AML、白血球数高値(≧2万/ul)、フィラデルフィア染色体

小児急性白血病の予後不良因子

1. 年齢：1歳以下、10歳以上
2. 男児
3. FAB分類：L2, L3
4. 非リンパ球性
5. WBC：2万以上
6. Ph染色体 t(9;22)　(小児のALLの数%)

成人急性白血病の予後不良因子

YN.G-44改変

高齢、二次性白血病、MDSからの移行、FAB分類 M0,M6,M7、白血球数高値、フィラデルフィア染色体 ALL、中枢神経浸潤

AMLの予後不良因子

染色体核型、年齢、初発時白血球数、FAB分類、3系統の形態異常、二次性白血病

染色体核型：最大の予後因子

NCCNガイドラインに基づくAMLの予後分類

参考1

	染色体核型	遺伝子異常
予後良好群	inv(16), t(8;21), t(15;17)(付加的染色体異常の有無を問わない)	正常核型におけるNPM1のみの異常
中間群	正常核型, +8, t(9;11),その他の予後良好にも不良にも属さない染色体異常	t(8;21), inv(16)患者におけるc-kit異常
予後不良群	複雑核型(3以上の異常), -5, -7, 5q-, 7q-,11q23異常(t(9;11)を除く), inv(3), t(3;3),t(6;9), t(9;22)	正常核型におけるFLT3-ITDのみの異常

参考

1. 造血細胞移植ガイドライン - 急性骨髄性白血病

http://www.jshct.com/guideline/pdf/2009AML.pdf

「急性前骨髄球性白血病」

　　[★]

英: acute promyelocytic leukemia, APL
同: M3。急性前骨髄芽球性白血病？
関: 急性骨髄性白血病 AML、白血病。前骨髄球

概念

急性骨髄性白血病の一病型
白血病細胞が前骨髄球の段階で成熟停止を起こした型
FAB分類：M3
アウエル小体が多く認められる。アウエル小体が集積した細胞(鳥の巣細胞、ファゴット細胞)がみられる。
免疫組織化学：MPO陽性(*ミエロペルオキシダーゼ活性はほぼ100%陽性)
異型前骨髄球がみられる。
染色体異常

95%以上の症例：t(15;17)(q22;q21)
全症例：PML遺伝子(chr.15)とRAR-α遺伝子(chr.17)の融合遺伝子の存在

M3と他のAMLを区別するポイント

免疫表現型：CD13(+), CD33(+), HLA-DR(-)。(micro granular cariantの時は)CD34(+), CD2(+)

検査

急性白血病に特徴的：高尿酸血症、LDH上昇
染色体異常：全例にt(15;17)を認め、PML遺伝子とRAR-α遺伝子が誘導したPML-RARA遺伝子を認める。

[show details]

合併症

播種性血管内凝固症候群(DIC)

Auer顆粒を豊富に含み、この中にはトロンボプラスチン類似物質を含む。この物質の逸脱により凝固が亢進しDICにつながる
線溶亢進型DICを引きおこし、臓器障害より出血症状が前面にてくる。フィブリノゲン減少、Dダイマー・FDP増加が見られる。

治療

レチノイン酸(ATRA, all-trans retinoic acid)の経口投与で高い確率で寛解する
白血球や前骨髄球が多い場合には化学療法を併用する：レチノイン酸　＋　アントラサイクリン系抗悪性腫瘍薬(イダルビシン、ダウノルビシン, DNA二本鎖の間にintercalateしでDNA,RNAの合成を阻害)　＋　シタラビン(Ara-C, シトシンアナログ, 代謝拮抗薬)

国試

105D048

「オールトランスレチノイン酸」

　　[★]

英: all-trans-retinoic acid、ATRA, all-trans retinoic acid
同: 全トランス型レチノイン酸
関: トレチノイン tretinoin、レチノイン酸、トランスレチノイン酸、all-transレチノイン酸
関: 分化誘導療法。急性前骨髄球性白血病

[show details]

オールトランス型レチノイン酸 : 66 件
全トランス型レチノイン酸 : 約 55,700 件
オールトランスレチノイン酸 : 約 111,000 件
全トランスレチノイン酸 : 約 56,900 件

「all-trans-retinoic acid」

　　[★] オールトランスレチノイン酸 ATRA

「ALL」

　　[★]

「all」

　　[★]

comb form.

他の、異型の。(化)異性体の

ex.

allodynia 異痛症

「trans」

　　[★]

トランス

関: t-、trance

[Drugs.com_oral_pregnancy-1] "Tretinoin (Vesanoid) Use During Pregnancy". Drugs.com. 25 July 2019. Retrieved 16 January 2020.

[Drugs.com_topical_pregnancy-2] "Tretinoin topical Use During Pregnancy". Drugs.com. 1 July 2019. Retrieved 16 January 2020.

[AHFS2016-3] "Tretinoin". The American Society of Health-System Pharmacists. Archived from the original on 30 November 2016. Retrieved 8 December 2016.

[Tiv2016-4] Tivnan A (2016). Resistance to Targeted Therapies Against Adult Brain Cancers. Springer. p. 123. ISBN 9783319465050. Archived from the original on 2017-11-05.

[BNF69-5] British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 627, 821–822. ISBN 9780857111562.

[Fis2006-6] Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 476. ISBN 9783527607495. Archived from the original on 2017-11-05.

[WHO21st-7] World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.

[AHFS2016B-8] "Tretinoin topical". The American Society of Health-System Pharmacists. Archived from the original on 16 May 2016. Retrieved 8 December 2016.

[9] "The Top 300 of 2020". ClinCalc. Retrieved 11 April 2020.

[10] "Tretinoin - Drug Usage Statistics". ClinCalc. Retrieved 11 April 2020.

[TopicalLabel-11] "Tretinoin Cream- tretinoin cream". DailyMed. 1 December 2018. Retrieved 16 January 2020.

[OralLabel-12] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l "Tretinoin capsule". DailyMed. 12 December 2018. Retrieved 16 January 2020.

[13] Huang ME, Ye YC, Chen SR, Chai JR, Lu JX, Zhoa L, et al. (August 1988). "Use of all-trans retinoic acid in the treatment of acute promyelocytic leukemia" (PDF). Blood. 72 (2): 567–72. doi:10.1182/blood.V72.2.567.567. PMID 3165295.

[14] Castaigne S, Chomienne C, Daniel MT, Ballerini P, Berger R, Fenaux P, Degos L (November 1990). "All-trans retinoic acid as a differentiation therapy for acute promyelocytic leukemia. I. Clinical results" (PDF). Blood. 76 (9): 1704–9. doi:10.1182/blood.V76.9.1704.1704. PMID 2224119.

[15] Wei S, Kozono S, Kats L, Nechama M, Li W, Guarnerio J, et al. (May 2015). "Active Pin1 is a key target of all-trans retinoic acid in acute promyelocytic leukemia and breast cancer". Nature Medicine. 21 (5): 457–66. doi:10.1038/nm.3839. PMC 4425616. PMID 25849135.

[16] Woggon W (2009). "Oxidative cleavage of carotenoids catalyzed by enzyme models and beta-carotene 15,15´-monooxygenase". Pure and Applied Chemistry. 74 (8): 1397–1408. doi:10.1351/pac200274081397. ISSN 1365-3075.

[FultonObit-17] Vivant Pharmaceuticals, LLC Press Release. July 10, 2013, Vivant Skin Care Co-founder James E. Fulton, MD, Loses Colon Cancer Battle

[KligmanObit-18] Gellene D (22 February 2010). "Dr. Albert M. Kligman, Dermatologist, Dies at 93". The New York Times.}

[MWU-19] Merriam-Webster, Merriam-Webster's Unabridged Dictionary, Merriam-Webster.

[OxfordDictionaries-20] Oxford Dictionaries, Oxford Dictionaries Online, Oxford University Press, archived from the original on 2014-10-22.

[AHD-21] Houghton Mifflin Harcourt, The American Heritage Dictionary of the English Language, Houghton Mifflin Harcourt, archived from the original on 2015-09-25.

[MW_Medical-22] Merriam-Webster, Merriam-Webster's Medical Dictionary, Merriam-Webster.

[Dorlands-23] Elsevier, Dorland's Illustrated Medical Dictionary, Elsevier.

[24] Ralph M. Trüeb. The Difficult Hair Loss Patient: Guide to Successful Management of Alopecia and Related Conditions. Springer, 2015. ISBN 9783319197012 Pg. 95 Archived 2017-11-05 at the Wayback Machine

[25] Rogers NE, Avram MR (October 2008). "Medical treatments for male and female pattern hair loss". Journal of the American Academy of Dermatology. 59 (4): 547–66, quiz 567–8. doi:10.1016/j.jaad.2008.07.001. PMID 18793935.

[26] Arthur W. Perry (2007). Straight talk about cosmetic surgery. Yale University Press. pp. 63. ISBN 978-0-300-12104-9.

[27] Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G (December 2006). "Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety". Clinical Interventions in Aging. 1 (4): 327–48. doi:10.2147/ciia.2006.1.4.327. PMC 2699641. PMID 18046911.

v t e Acne-treating agents (D10)
Antibacterial	Azelaic acid Benzoyl peroxide^# 8-Hydroxyquinoline Blue light therapy Tea tree oil
Keratolytic	Glycolic acid Salicylic acid^# Sulfur Benzoyl peroxide^#
Anti-inflammatory	Nicotinamide Ibuprofen^# Aspirin^# Red light therapy
Antibiotics	Clindamycin Dapsone Erythromycin Sulfacetamide Tetracyclines (Lymecycline Minocycline Doxycycline)
Hormonal	Antiandrogens Bicalutamide Cyproterone acetate Drospirenone Flutamide Spironolactone) Estrogens Estradiol Ethinylestradiol
Retinoids	Adapalene Isotretinoin Motretinide Tazarotene Tretinoin Trifarotene
Other	Benzamycin Epristeride Mesulfen Pelretin Stridex Tioxolone
Combinations	Adapalene/benzoyl peroxide Benzoyl peroxide/clindamycin Clindamycin/tretinoin Erythromycin/isotretinoin Sulfacetamide/sulfur
^#WHO-EM ^‡Withdrawn from market Clinical trials: ^†Phase III ^§Never to phase III

v t e Carotenoids
Carotenes (C₄₀)	α-Carotene β-Carotene γ-Carotene δ-Carotene ε-Carotene ζ-Carotene Lycopene Neurosporene Phytoene Phytofluene Torulene Lycopersene
Xanthophylls (C₄₀)	Antheraxanthin Astaxanthin Canthaxanthin Citranaxanthin Cryptoxanthin Diadinoxanthin Diatoxanthin Dinoxanthin Echinenone Flavoxanthin Fucoxanthin Lutein Neoxanthin Rhodoxanthin Rubixanthin Violaxanthin Zeaxanthin Zeinoxanthin
Apocarotenoids (C_<40)	Abscisic acid Apocarotenal Bixin Crocetin Food orange 7 Ionones Peridinin
Vitamin A retinoids (C₂₀)	Retinal Retinoic acid Retinol
Retinoid drugs	Acitretin Alitretinoin Bexarotene Etretinate Fenretinide Isotretinoin Tazarotene Temarotene Tretinoin Zuretinol acetate

v t e Retinoid receptor modulators
RAR	Agonists: 9CDHRA 9-cis-Retinoic acid (alitretinoin) AC-261066 AC-55649 Acitretin Adapalene all-trans-Retinoic acid (tretinoin) AM-580 BMS-493 BMS-753 BMS-961 CD-1530 CD-2314 CD-437 Ch-55 EC 23 Etretinate Fenretinide Isotretinoin Palovarotene Retinoic acid Retinol (vitamin A) Tamibarotene Tazarotene Tazarotenic acid TTNPB Antagonists: BMS-195614 BMS-493 CD-2665 ER-50891 LE-135 MM-11253 Retinoic acid metabolism inhibitors: Liarozole
RXR	Agonists: 9CDHRA 9-cis-Retinoic acid (alitretinoin) all-trans-Retinoic acid (tretinoin) Bexarotene CD 3254 Docosahexaenoic acid Fluorobexarotene Isotretinoin LG-100268 LG-101506 LG-100754 Retinoic acid Retinol (vitamin A) SR-11237 Antagonists: HX-531 HX-630 LG-100754 PA-452 UVI-3003 HX-603 LE135 (RAR beta selective) LE-540 CD3254 PA-451 PA-452 Rhein HX-711 6-(N-ethyl-N-(5-isobutoxy-4-isopropyl-2-(E)-styrylphenyl)amino)nicotinic acid
See also Receptor/signaling modulators Nuclear receptor modulators

リンク元	「急性白血病」「急性前骨髄球性白血病」「オールトランスレチノイン酸」
拡張検索	「all-trans-retinoic acid」
関連記事	「ALL」「all」「trans」

匿名

検索

案内

all-trans retinoic acid

Wikipedia preview

wiki en

Medical uses

Skin use

Leukemia

Side effects

Skin use

Leukemia use

Mechanism of action

Biosynthesis

History

Etymology

Research

See also

References

External links

UpToDate Contents

English Journal

Japanese Journal

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★リンクテーブル★

「急性白血病」

概念

分類

FAB分類

病態

徴候

検査

治療

小児

成人

急性骨髄性白血病

急性前骨髄球性白血病

急性リンパ性白血病

予後

小児急性白血病の予後不良因子

小児急性白血病の予後不良因子

成人急性白血病の予後不良因子

AMLの予後不良因子

NCCNガイドラインに基づくAMLの予後分類

参考

「急性前骨髄球性白血病」

概念

M3と他のAMLを区別するポイント

検査

合併症

治療

国試

「オールトランスレチノイン酸」

「all-trans-retinoic acid」

「ALL」

「all」

「trans」