Efficacy Of Tocotrienol a Natural Vitamin E In Biopsy Wound
Efficacy Of Tocotrienol a Natural Vitamin E In Biopsy Wound
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.
-  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.
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