Efficacy Of Tocotrienol a Natural Vitamin E In Biopsy Wound

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Efficacy Of Tocotrienol a Natural Vitamin E In Biopsy Wound.

Conditions
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Scar

Intervention / Treatment
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* Device: Topical Tocotrienol (TCT)
* Dietary Supplement: Oral Tocotrienol Capsules (TCT)
* Device: Tamoxifen Cream
* Device: Placebo cream
* Dietary Supplement: placebo capsule


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1-TOP group 1<br>TOP group 1 will have biopsy #2 collected 3 days after 1st biopsy collected. | |
| TOP group 2<br>TOP group 2 will have biopsy #2 collected 30 days after 1st biopsy collected. | |
| OTOP group-1<br>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)<br>* Natural Form Vitamin E topical cream(TCT)<br>* Other names: TCT;Dietary Supplement: Oral Tocotrienol Capsules (TCT)<br>* Natural Form Vitamin E Oral capsules (TCT)<br>* Other names: TCT;Device: Placebo cream<br>* Placebo cream<br>* Other names: Placebo;Dietary Supplement: placebo capsule<br>* placebo capsule<br>* Other names: placebo;|
| OTOP group-2<br>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)<br>* Natural Form Vitamin E topical cream(TCT)<br>* Other names: TCT;Dietary Supplement: Oral Tocotrienol Capsules (TCT)<br>* Natural Form Vitamin E Oral capsules (TCT)<br>* Other names: TCT;Device: Placebo cream<br>* Placebo cream<br>* Other names: Placebo;Dietary Supplement: placebo capsule<br>* placebo capsule<br>* Other names: placebo;|
| TAM Group 1<br>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<br>* Tamoxifen cream<br>|
| Normal Skin<br>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: Tamoxifen Cream<br>* Tamoxifen cream<br>Device: Placebo cream<br>* Placebo cream<br>* Other names: Placebo;|

What is the study measuring?
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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) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Healthy participants