title: Randomized, split-body, single-blinded clinical trial of topical broccoli sprout extract: Assessing the feasibility of its use in keratin-based disorders.
abstract: BACKGROUND
  Epidermolysis bullosa simplex is a skin-blistering disorder caused by mutations in keratin (K)14 or K5. Treatment with nuclear factor (erythroid-derived 2)-like 2 inducer sulforaphane ameliorated skin blistering in Krt14-null mice, correlating with induction of K17. To be therapeutically useful for epidermolysis bullosa simplex, topical broccoli sprout extract (BSE), enriched for sulforaphane, would ideally induce the expression of homologous keratins (eg, K6, K17, K16) in the basal layer of human epidermis without impacting expression of defective keratins (K5/K14).
  
  
  OBJECTIVE
  The purpose of this 1-week, randomized, split-body, single-blinded, placebo-controlled trial was to assess the impact of BSE on keratin expression.
  
  
  METHODS
  Five subjects (34-71 years old) applied BSE (500 nmol of sulforaphane/mL) or vehicle alone to the inner aspect of the arm daily. Expression of keratin, nuclear factor (erythroid-derived 2)-like 2, and other markers was assessed using reverse transcription-polymerase chain reaction and indirect immunofluorescence.
  
  
  RESULTS
  One subject (age 71 years) was excluded a posteriori because of poor tissue quality. Topical BSE activated nuclear factor (erythroid-derived 2)-like 2 and up-regulated K17 in the epidermis of all subjects, had variable effects on K16 and K6 expression, and did not alter expression of K14 or K5.
  
  
  CONCLUSIONS
  Small sample size is a limitation.
  
  
  CONCLUSIONS
  BSE represents an attractive therapeutic candidate for K14-associated epidermolysis bullosa simplex.
authors.affiliation: Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Kerns
authors.affiliation: Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Lark
authors.initials: L
authors.lastname: Guss
authors.affiliation: Department of Clinical Pharmacology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jed
authors.initials: J
authors.lastname: Fahey
authors.affiliation: Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Bernard
authors.initials: B
authors.lastname: Cohen
authors.affiliation: Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jill M C
authors.initials: JM
authors.lastname: Hakim
authors.affiliation: Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sung
authors.affiliation: Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Rosemary G
authors.initials: RG
authors.lastname: Lu
authors.affiliation: Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; Department of Biological Chemistry, School of Medicine, Johns Hopkins University, Baltimore, Maryland; Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, Maryland. Electronic address: coulombe@jhu.edu.
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Coulombe
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D001937:Brassica; D016110:Epidermolysis Bullosa Simplex / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D053547:Keratin-14 / Q000235:genetics / Q000378:metabolism; D053536:Keratin-16 / Q000235:genetics / Q000378:metabolism; D053537:Keratin-17 / Q000235:genetics / Q000378:metabolism; D053555:Keratin-5 / Q000235:genetics / Q000378:metabolism; D053553:Keratin-6 / Q000235:genetics / Q000378:metabolism; D007633:Keratins / Q000378:metabolism*; D008875:Middle Aged; D051267:NF-E2-Related Factor 2 / Q000378:metabolism; D008517:Phytotherapy; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000378:metabolism; D036226:Seedlings; D016037:Single-Blind Method; D015854:Up-Regulation / Q000187:drug effects
chemical_list: D053547:Keratin-14; D053536:Keratin-16; D053537:Keratin-17; D053555:Keratin-5; D053553:Keratin-6; D051267:NF-E2-Related Factor 2; C495635:NFE2L2 protein, human; D010936:Plant Extracts; D012333:RNA, Messenger; D007633:Keratins
keywords: broccoli sprout extract; epidermolysis bullosa simplex; keratin; nuclear factor (erythroid-derived 2)-like 2; sulforaphane