Phase 2 trial of daily, oral epigallocatechin gallate in patients with light-chain amyloidosis.
Previous studies have suggested that an increase in mitochondrial reactive oxygen species may cause organ damage in patients with light-chain (AL) amyloidosis; however, this damage can be decreased by antioxidant-agent treatment. Epigallocatechin gallate (EGCG), the major natural catechin in green tea, has potent antioxidant activity. Because EGCG has recently been reported to have a favorable toxicity profile for treating amyloidosis, we sought to examine the clinical efficacy and toxicity of EGCG in patients with AL amyloidosis. Fifty-seven patients were randomly assigned to the EGCG and observation groups and observed for six months. There were no increases in grade 3-5 adverse events and EGCG therapy was well tolerated. Although a decrease in the urinary albumin level was found in the EGCG group in patients with obvious albuminuria after treatment initiation, its antioxidant activity may not be sufficient to clarify the potential effect of EGCG in patients with AL amyloidosis. Because some of the biological markers responsible for organ damage were well correlated to the level of antioxidant potential in patients' plasma, the status of oxidative stress in the blood may indicate the extent of organ damage in clinical situations.
Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan. sohmeshi@ims.u-tokyo.ac.jp.|Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, 4-6-1, Shiroganedai, Minato, Tokyo, Japan. sohmeshi@ims.u-tokyo.ac.jp.
Sohsuke
S
Meshitsuka
Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
Sumito
S
Shingaki
Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan.
Masatoshi
M
Hotta
Laboratory for Clinical Nutrition, Department of Food and Nutrition, Faculty of Human Life, Jumonji University, Niiza, Japan.
Miku
M
Goto
Central Research Institute, ITO EN, Ltd, Makinohara, Japan.
Makoto
M
Kobayashi
Central Research Institute, ITO EN, Ltd, Makinohara, Japan.
Yuuichi
Y
Ukawa
Central Research Institute, ITO EN, Ltd, Makinohara, Japan.
Yuko M
YM
Sagesaka
Laboratory for Clinical Nutrition, Department of Food and Nutrition, Faculty of Human Life, Jumonji University, Niiza, Japan.
Yasuyo
Y
Wada
Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, 4-6-1, Shiroganedai, Minato, Tokyo, Japan.
Masanori
M
Nojima
Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
Kenshi
K
Suzuki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000188:drug therapy*; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use; D002392:Catechin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000075363:Immunoglobulin Light-chain Amyloidosis; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D017382:Reactive Oxygen Species; D013662:Tea; D016896:Treatment Outcome
D000975:Antioxidants; D017382:Reactive Oxygen Species; D013662:Tea; D002392:Catechin; C045651:epigallocatechin gallate
Amyloidosis; BAP; EGCG; Light chain disease; dROM