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Melanotan 1 and melanotan II are both analogs of the peptide hormone alpha-melanocyte stimulating hormone (α-MSH) that have been shown to induce skin tanning in preliminary studies and clinical trials. Melanotan II has the additional effect of increasing libido. Derivatives of both peptides are in development by pharmaceutical companies, but as of 2008 no melanotan I or II based compound has been approved for use by drug regulatory bodies. Unlicensed and untested melanotan products are sold through the Internet [1]specify however, regulatory bodies have warned consumers they may be unsafe and ineffective.
Historical developmentBoth peptides were identified at the University of Arizona. Researchers there knew that one of the best defenses against skin cancer was a natural tan which has been slowly developed over weeks. They hypothesized that an effective way to reduce skin cancer rates in people would be to induce the body's natural tanning system to produce a protective tan prior to UV exposure. The body's naturally occurring hormone alpha-melanocyte stimulating hormone (α-MSH) causes melanogenesis, a process by which the skin's tanning cells (melanocytes) produce the skin's tanning pigment (melanin). With that knowledge they tested to see if administering this hormone to the body directly could be an effective method to cause sunless tanning. What they found was that while it appeared to work, natural alpha-MSH had too short a half life in the body to be practical as a therapeutic drug. So they decided to find a more potent and stable alternative, one that would be more practical. After synthesizing and screening hundreds of molecules, the researchers headed by Dr. Victor Hruby, found a peptide that after trials and testing seemed to be approximately 1,000 times more potent than natural α-MSH. [2] They dubbed this new peptide Melanotan. Since their discovery, numerous studies dating back to the mid-1980s have shown no obvious toxic effects of the Melanotan peptides (then known by their scientific names [Nle4, D-Phe7-α-MSH and Ac-Nle-cyclo[Asp-His-D-Phe-Arg-Trp-Lys]-NH2). The scientists hoped to use Melanotan peptides to combat melanoma by stimulating the body's natural tanning mechanism to create a tan without first needing exposure to harmful levels of UV radiation. [3] This in turn, they hypothesized, could reduce the potential for skin damage that can eventually lead to skin cancer. The scientists licensed their patented peptides, via a technology transfer company, to a number of biotechnology companies who intend to develop them into drugs.[4] Peptide properties and clinical trial informationMelanotan 1Melanotan 1 has the amino acid sequence Ac-Ser-Tyr-Ser-Nle-Glu-His-D-Phe-Arg-Trp-Gly-Lys-Pro-Val-NH2 or [Nle4, D-Phe7-alpha-MSH. A 1991 clinical Investigational new drug trial conducted at the Department of Internal Medicine, University of Arizona Health Sciences Center was carried out with Melanotan (then known by its chemical constituents [Nle4, D-Phe7 (NDP)-alpha-melanocyte-stimulating hormone) with 28, "healthy white men" who used a, "high-potency sunscreen during the trial" and concluded, "Human skin darkens as a response to a synthetic melanotropin given by subcutaneous injection. Skin tanning appears possible without potentially harmful exposure to ultraviolet radiation." [5] The Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona performed a comparative pharmacokinetic trial in three male volunteers to begin to establish efficacy of peptide administration via intravenous, oral and subcutaneous routes. Their study published in 1997 found that, "subcutaneous administration is an efficacious method of delivering melanotan". [6] A Section of Dermatology, Department of Medicine, College of Medicine, University of Arizona clinical dose ranging study on tanning effects in, "eight male volunteers with 'tannable' skin types III-IV" for melanotan published in 1999 determined that an optimal dose for ten daily subcutaneous injections is 0.16 mg/kg per day. [7] A clinical trial by the Department of Pharmacology and Arizona Cancer Center to determine increases of eumelanin expression in seven, "normal volunteers" for Melanotan published in 2000 concluded that, "results show that the tanning induced by Melanotan in the face and forearm is associated with a significant increase in the eumelanin content of the human skin." [8] A Phase IIb clinical human trial study conducted in 2003 at the University of Sydney demonstrated in a group of eighty volunteers that Melanotan caused a highly significant increase in skin-melanin. It found fairer-skin people (Fitzpatrick Types I/II, those who never tan and only burn and those who can tan in a limited fashion) recorded increases in melanin of up to 100% in some areas and that sunburn injury was reduced by more than 50% in fair skinned volunteers. [9][10] Three phase I clinical trials by the Department of Medicine, Cancer Center Division, University of Arizona, Tucson published in 2004 sought to establish the safety of melanotan therapy combined with UV-B light or sunlight. The first study was conducted with 8 volunteers the second study with 12 and the final with 8. The researchers determined, "Melanotan-1 can be safely combined with UV-B light or sunlight and appears to act synergistically in the tanning response to light." [11] Melanotan is currently being tested, developed, and clinically trialed under the International Nonproprietary Name afamelanotide (formerly the proprietary CUV1647)[12] by the Australian company Clinuvel Pharmaceuticals, for a series of skin related diseases including polymorphous light eruption (PMLE) and actinic keratosis (AK). Melanotan IIMelanotan II has tanning and aphrodisiac properties. [13][14] It is a cyclic lactam analog of alpha-MSH with the amino acid sequence Ac-Nle-cyclo[Asp-His-D-Phe-Arg-Trp-Lys]-NH2. A pilot Phase I clinical trial conducted on three males by the College of Medicine, Pharmacology Department, University of Arizona in Tucson, Arizona published in 1996 demonstrated that, "Melanotan II has tanning activity in humans given only 5 low doses every other day by subcutaneous injection." The side effects reported were mild nausea and a "stretching and yawning complex" that correlated with spontaneous penile erections. [15] A clinical study published in 2000 of 20 men with psychogenic and organic erectile dysfunction conducted at the Section of Urology of The University of Arizona College of Medicine concluded, "that Melanotan II is a potent initiator of penile erection in men with erectile dysfunction." [16] BremelanotidePalatin Technologies developed another hormone originally targeted towards sexual dysfunction based upon melanotan II called bremelanotide (formerly PT-141). Bremelanotide is a metabolite of melanotan II that lacks the C-terminal amide function. In 2008, development for sexual dysfunction was discontinued after concerns were raised by the U.S. Food and Drug Administration (FDA) about the adverse side effect of increased blood pressure found in Phase II clinical trials. Concurrently the company announced plans to develop it as a treatment for hemorrhagic shock instead. [17] Drug agency warningsIn 2007, the FDA issued a warning to an American vendor illegally marketing melanotan II on the internet as a drug that prevents skin cancer and assists tanning. The FDA has not licensed melanotan II, and explained: "There is no evidence that the product is generally recognized as safe and effective [GRAS/E] for its labeled uses." [18] On August 8, 2008 the Danish Medicines Agency (DMA) issued a warning[19] against the usage of Melanotan purchased on the internet, noting that claims that imply that it has an, "effect" for protection against skin cancer, "has not been documented". The DMA further warned that Melanotan has not undergone tests for its effect and possible side effects, and that it is not licensed for usage in the EU or the USA. References
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