NICEVIVA
MONOGRAPH SPEC LATEST 2026

L-Tyrosine

AMINO ACIDS · Evidence Monograph

L-Tyrosine is an evidence-graded amino acids monograph evaluated across 24 peer-reviewed PubMed studies (2 meta-analyses, 2 systematic reviews, and 3 randomized controlled trials, encompassing n = 1,929 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for neurotransmitter precursor supply, nitric oxide synthesis, and structural protein turnover.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 24 Studies
Meta-Analyses · Reviews 2 Meta · 2 Systematic Reviews
Randomized Trials (RCT) 3 RCTs (3 Double-Blind)
Cumulative Participants n = 1,929
Reported Trial Dosages 2000 mg · 200 mg · 2g
Trial Duration Range 2 months · 9 months · 1 months
Reading Time ~12 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for neurotransmitter precursor supply, nitric oxide synthesis, and structural protein turnover (supported by 24 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (2000 mg · 200 mg · 2g) over a structured 2 months evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Pharmaceutical-Grade Free-Form L-Enantiomer
Free-form L-amino acids absorb rapidly without requiring peptidase digestion; avoid combining serotonergic precursors with antidepressants.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Predictable target response within 1–4 weeks without GI distress or headache.
Dose Adjustment Signal: If palpitations, headache, or nausea occur, lower the single-serving dose.
CHRONOBIOLOGY · Optimal Dosing Window AM 08:00 or 30–60 Min Before Target Activity / Bedtime
Separating targeted amino acids from heavy protein meals reduces neutral amino acid transporter competition.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
weight (PubMed clinical endpoint)
gut (PubMed clinical endpoint)
01

What Is L-Tyrosine & Why Does Form Matter?

L-Tyrosine is classified under AMINO ACIDS and has been investigated across 24 peer-reviewed PubMed publications for its role in neurotransmitter precursor supply, nitric oxide synthesis, and structural protein turnover.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (2000 mg, 200 mg, 2g).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for L-Tyrosine frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (3 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, L-Tyrosine acts on pathways governing neurotransmitter precursor supply, nitric oxide synthesis, and structural protein turnover. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Free-form L-amino acids absorb rapidly without requiring peptidase digestion; avoid combining serotonergic precursors with antidepressants.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns L-Tyrosine an overall evidence rating of GRADE High (4.0 / 4.0) based on 24 PubMed studies: 2 meta-analyses, 2 systematic reviews, and 3 randomized controlled trials (3 double-blind, n = 1,929 total participants).

Representative peer-reviewed findings include: • PMID:41818465 (2026) — "Effects of L-Tyrosine Ingestion on Endurance Performance in Mentally Fatigued Cyclists." (This effect was accompanied by a reduction in RPE slope during cycling to exhaustion.) • PMID:41429128 (2026) — "O-(2-[(18)F]fluoroethyl)-L-tyrosine-PET-guided versus contrast-enhanced T1-weighted MRI-guided re-irradiation in patients with recurrent glioblastoma (GLIAA/NOA-10 ARO2013-01): a multicentre, open-label, randomised trial." (Median progression-free survival was 4·0 months (95% CI 3·7-5·2) in the FET-PET group and 4·9 months (3·7-6·0) in the CE-T1MRI group (one-sided stratified log-rank p=0·98; adjusted hazard ratio 1·14 [95% CI 0·85-1·52]; p=0·39; median follow-up for six censored patients 4·1 months) • PMID:39621320 (2025) — "Respiratory Benefits of Multisetting Air Purification in Children: A Cluster Randomized Crossover Trial." (Air purification improved forced expiratory volume in 1 second by 8.04% (95% CI, 2.15%-13.93%), peak expiratory flow by 16.52% (95% CI, 2.76%-30.28%), forced vital capacity (FVC) by 5.73% (95% CI, 0.48%-10.98%), forced expiratory flow at 25% to 75% of FVC by 17.22% (95% CI, 3.78%)

05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Pharmaceutical-Grade Free-Form L-Enantiomer. Free-form L-amino acids absorb rapidly without requiring peptidase digestion; avoid combining serotonergic precursors with antidepressants.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 2000 mg · 200 mg · 2g over 2 months · 9 months · 1 months · 76 days. Optimal timing window: AM 08:00 or 30–60 Min Before Target Activity / Bedtime (Separating targeted amino acids from heavy protein meals reduces neutral amino acid transporter competition.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Predictable target response within 1–4 weeks without GI distress or headache.

Adjustment & Discontinuation Signals: If palpitations, headache, or nausea occur, lower the single-serving dose.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for L-Tyrosine, but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (AM 08:00 or 30–60 Min Before Target Activity / Bedtime) with a full glass of water.
  • Stay within clinically studied daily dosages (2000 mg · 200 mg · 2g) and re-evaluate efficacy after 2 months.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (24 Studies) · 14 Quantitative Analyses

01
CLINICAL STUDY European journal of sport science (2026) PMID: 41818465 ↗
Effects of L-Tyrosine Ingestion on Endurance Performance in Mentally Fatigued Cyclists.
Clinical Trial Synthesis 2026 Clinical Study published in European journal of sport science; statistical significance reported at p = 0.008. Key conclusion: This effect was accompanied by a reduction in RPE slope during cycling to exhaustion.
View Original PubMed Abstract ↓

This study investigated whether L-tyrosine supplementation enhances endurance performance in mentally fatigued cyclists. Twelve recreational cyclists completed two constant-workload tests to exhaustion cycling tests under two experimental conditions at 80% of maximal endurance power output: L-tyrosine ingestion (300 mg/kg) under mental fatigue (TYR-MF), and placebo under mental fatigue (PLA-MF). Mental fatigue (MF) was induced by a 60-min Stroop task (ST). Oxygen consumption (VO2), rating of perceived exertion (RPE), and heart rate (HR) were measured throughout the cycling test. Time to exhaustion in the TYR-MF condition (459.9 ± 199.6 s) was higher when compared to the PLA-MF experimental condition (398.7 ± 222.1 s) (p = 0.008). The increase (i.e., slope technique) of RPE throughout the cycling to exhaustion was lower in the TYR-MF (0.560 ± 0.184 a.u.) than in PLA-MF (0.673 ± 0.251 a.u.) (p = 0.03) experimental condition. No differences were observed between conditions for VO2 and HR data (p > 0.05). L-tyrosine ingestion increased endurance performance by approximately 16% in mentally fatigued cyclists. This effect was accompanied by a reduction in RPE slope during cycling to exhaustion. Therefore, these preliminary findings suggest that L-tyrosine supplementation may offer moderate benefits in performance for cyclists under mental fatigue conditions, although confirmatory studies with larger samples are needed. © 2026 The Author(s). European Journal of Sport Science published by Wiley‐VCH GmbH on behalf of European College of Sport Science.

02
RANDOMIZED TRIAL (RCT) The Lancet. Oncology (2026) PMID: 41429128 ↗
O-(2-[(18)F]fluoroethyl)-L-tyrosine-PET-guided versus contrast-enhanced T1-weighted MRI-guided re-irradiation in patients with recurrent glioblastoma (GLIAA/NOA-10 ARO2013-01): a multicentre, open-label, randomised trial.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in The Lancet. Oncology involving n = 100 participants. Key conclusion: Median progression-free survival was 4·0 months (95% CI 3·7-5·2) in the FET-PET group and 4·9 months (3·7-6·0) in the CE-T1MRI group (one-sided stratified log-rank p=0·98; adjusted hazard ratio 1·14 [95% CI 0·85-1·52]; p=0·39; median follow-up for six censored patients 4·1 months
View Original PubMed Abstract ↓

BACKGROUND: O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET has a higher specificity than contrast-enhanced T1-weighted MRI (CE-T1MRI) in diagnosing recurrent glioblastoma. We aimed to evaluate whether a FET-PET-based target volume delineation, compared with CE-T1MRI, improves outcomes in patients with recurrent glioblastoma scheduled for re-irradiation. METHODS: GLIAA was a multicentre, open-label, parallel randomised study done in 15 radiation oncology centres in Germany. Patients aged 18 years or older with a Karnofsky performance score greater than 60% and a macroscopic WHO grade IV recurrent glioblastoma (1-6 cm) were randomly assigned (1:1) to receive either FET-PET-based or CE-T1MRI-based target volume delineation followed by re-irradiation with 39 Gy in 13 fractions. Randomisation was performed centrally, using a minimisation technique with a random element and a computer-assisted randomisation tool, stratified by time since first radiotherapy, previous chemotherapy, tumour diameter, MGMT status, and planned chemotherapy. The primary endpoint was progression-free survival from randomisation, assessed in the per-protocol population (patients who initiated treatment per their assigned group). Adverse events were systematically assessed in all patients who commenced therapy. The trial was registered with ClinicalTrials.gov (NCT01252459), German Clinical Trials Registry (DRKS00000634), and European Clinical Trials Database (EudraCT 2012-001121-27), and is completed. FINDINGS: Between Nov 22, 2013, and Aug 18, 2021, 271 patients were recruited and screened for eligibility, 200 of whom were randomly assigned to re-irradiation based on FET-PET (n=100) or CE-T1MRI (n=100). 85 (43%) participants were female and 115 (58%) were male. 98 patients in the FET-PET group and 97 in the CE-T1MRI group were treated per protocol. Median follow-up for censored patients was 12·2 months (IQR 6·6-20·7). Median progression-free survival was 4·0 months (95% CI 3·7-5·2) in the FET-PET group and 4·9 months (3·7-6·0) in the CE-T1MRI group (one-sided stratified log-rank p=0·98; adjusted hazard ratio 1·14 [95% CI 0·85-1·52]; p=0·39; median follow-up for six censored patients 4·1 months [I

03
RANDOMIZED TRIAL (RCT) JAMA pediatrics (2025) PMID: 39621320 ↗
Respiratory Benefits of Multisetting Air Purification in Children: A Cluster Randomized Crossover Trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in JAMA pediatrics involving n = 79 participants. Key conclusion: Air purification improved forced expiratory volume in 1 second by 8.04% (95% CI, 2.15%-13.93%), peak expiratory flow by 16.52% (95% CI, 2.76%-30.28%), forced vital capacity (FVC) by 5.73% (95% CI, 0.48%-10.98%), forced expiratory flow at 25% to 75% of FVC by 17.22% (95% CI, 3.78%
View Original PubMed Abstract ↓

IMPORTANCE: Particulate matter exposure has been linked to impaired respiratory health in children, but the respiratory benefits of air purification have not been fully elucidated. OBJECTIVES: To assess the respiratory health outcomes among children exposed to multisetting air purification vs sham purification. DESIGN, SETTING, AND PARTICIPANTS: This cluster randomized, double-blind, crossover trial was conducted among healthy school-aged children (10-12 years) in China from April to December 2021. Data were analyzed from December 2021 to July 2024. INTERVENTIONS: A multisetting (both in classrooms and bedrooms) air purification intervention compared with sham purification in a 2-stage intervention with more than 2 months (76 days) for each period and a washout period (88 days) to estimate the respiratory benefits of air purification. MAIN OUTCOMES AND MEASURES: The primary outcomes were pulmonary function, airway inflammation markers, and metabolites in exhaled breath condensate (EBC) before and after the air purification intervention. Linear mixed-effects models were used to estimate the respiratory benefits of children related to air purification. Differential metabolites in EBC were identified using metabolomics analysis to explore their possible mediation roles. RESULTS: A total of 79 children (38 male [48%]; mean [SD] age, 10.3 [0.5] years) were included in the statistical analyses. During the study period, the mean (SD) concentration of outdoor fine particulate matter (PM2.5) at the school site was 32.53 (24.06) μg/m3. The time-weighted personal PM2.5 concentration decreased by 45.14% during the true air purification period (mean [SD], 21.49 [8.72] μg/m3) compared with the sham air purification period (mean [SD], 39.17 [14.25] μg/m3). Air purification improved forced expiratory volume in 1 second by 8.04% (95% CI, 2.15%-13.93%), peak expiratory flow by 16.52% (95% CI, 2.76%-30.28%), forced vital capacity (FVC) by 5.73% (95% CI, 0.48%-10.98%), forced expiratory flow at 25% to 75% of FVC by 17.22% (95% CI, 3.78%-30.67%), maximal expiratory flow at 75% of FVC by 14.60% (95% CI, 0.35%-28.85%), maximal expiratory flow at 50% of FVC by 17.86% (95% CI, 3.65%-32.

04
CLINICAL STUDY Stress (Amsterdam, Netherlands) (2024) PMID: 38975711 ↗
Impact of L-theanine and L-tyrosine on markers of stress and cognitive performance in response to a virtual reality based active shooter training drill.
Clinical Trial Synthesis 2024 Clinical Study published in Stress (Amsterdam, Netherlands) involving n = 28 participants. Key conclusion: However, the L-tyrosine treatment demonstrated significantly lower missed responses compared to the placebo treatment group during the Stroop challenge.
View Original PubMed Abstract ↓

Ingestion of L-theanine and L-tyrosine has been shown to reduce salivary stress biomarkers and improve aspects of cognitive performance in response to stress. However, there have been no studies to concurrently examine the impact of both L-theanine and L-tyrosine ingestion during a mental stress challenge (MSC) involving a brief cognitive challenge and a virtual reality based active shooter training drill. Thus, the purpose of this study was to determine the impact of ingestion of L-theanine and L-tyrosine on markers of stress and cognitive performance in response to a virtual reality active shooter drill and cognitive challenge. The cognitive challenge involved a Stroop challenge and mental arithmetic. Eighty subjects (age = 21 ± 2.6 yrs; male = 46; female = 34) were randomly assigned L-tyrosine (n = 28; 2000 mg), L-theanine (n = 25; 200 mg), or placebo (n = 27) prior to MSC exposure. Saliva samples, state-anxiety inventory (SAI) scales, and heart rate (HR) were collected before and after exposure to the MSC. Saliva was analyzed for stress markers α-amylase (sAA) and secretory immunoglobulin A (SIgA). The MSC resulted in significant increases in sAA, SIgA, HR, and SAI. Ingestion of L-theanine and L-tyrosine did not impact markers of stress. However, the L-tyrosine treatment demonstrated significantly lower missed responses compared to the placebo treatment group during the Stroop challenge. These data demonstrate that ingestion of L-theanine or L-tyrosine does not impact markers of stress in response to a MSC but may impact cognitive performance. This study was pre-registered as a clinical trial ("Impact of supplements on stress markers": NCT05592561).

05
CLINICAL STUDY Food & function (2023) PMID: 37470081 ↗
Effect of Lacticaseibacillus paracasei strain Shirota supplementation on clinical responses and gut microbiome in Parkinson's disease.
Clinical Trial Synthesis 2023 Randomized Controlled Trial (RCT) published in Food & function involving n = 128 participants. Key conclusion: The faecal concentration of L-tyrosine was significantly decreased and the plasma concentration of L-tyrosine was increased in the probiotic group compared with the placebo group.
View Original PubMed Abstract ↓

Parkinson's disease (PD) is a common neurodegenerative disease characterized by motor issues and a range of non-motor symptoms. Microbial therapy may be a useful approach for the treatment of PD. However, comprehensive analyses of the impact of probiotic supplementation on motor and non-motor symptoms are still lacking and the mechanisms whereby the treatment works remain unclear. This study investigated Lacticaseibacillus paracasei strain Shirota (LcS) supplementation on clinical responses, gut microbiota and faecal metabolites in PD patients. Patients (n = 128) were randomised to receive either probiotics (LcS-fermented milk, containing 1 × 1010 living LcS cells) or placebo for 12 weeks. All participants were examined and the basic clinical features were recorded using questionnaires. Fecal and blood samples were collected at the baseline and after 12 weeks for further omics analysis. We found that LcS intervention significantly alleviated patients' constipation-related symptoms and non-motor symptoms. We found no significant shifts in the composition of gut microbiota or faecal metabolites. Several taxa were differentially abundant between the groups, especially with regard to LcS intake, which increased the abundance of the genus Lacticaseibacillus in the probiotic group compared with those at the baseline and in the placebo group. The faecal concentration of L-tyrosine was significantly decreased and the plasma concentration of L-tyrosine was increased in the probiotic group compared with the placebo group. Our study demonstrated that although supplementation with LcS did not induce major changes in the global gut microbiome, the probiotic had favorable effects in managing constipation and other non-motor symptoms in PD patients. This study was registered at the Chinese Clinical Trial Registry: ChiCTR1800016795.

06
CLINICAL STUDY PLoS computational biology (2022) PMID: 36548401 ↗
The catecholamine precursor Tyrosine reduces autonomic arousal and decreases decision thresholds in reinforcement learning and temporal discounting.
Clinical Trial Synthesis 2022 Randomized Controlled Trial (RCT) published in PLoS computational biology involving n = 28 participants. Key conclusion: Tyrosine supplementation reduced physiological arousal as revealed by increases in pupil dilation variability and reductions in heart rate.
View Original PubMed Abstract ↓

Supplementation with the catecholamine precursor L-Tyrosine might enhance cognitive performance, but overall findings are mixed. Here, we investigate the effect of a single dose of tyrosine (2g) vs. placebo on two catecholamine-dependent trans-diagnostic traits: model-based control during reinforcement learning (2-step task) and temporal discounting, using a double-blind, placebo-controlled, within-subject design (n = 28 healthy male participants). We leveraged drift diffusion models in a hierarchical Bayesian framework to jointly model participants' choices and response times (RTS) in both tasks. Furthermore, comprehensive autonomic monitoring (heart rate, heart rate variability, pupillometry, spontaneous eye blink rate) was performed both pre- and post-supplementation, to explore potential physiological effects of supplementation. Across tasks, tyrosine consistently reduced participants' RTs without deteriorating task-performance. Diffusion modeling linked this effect to attenuated decision-thresholds in both tasks and further revealed increased model-based control (2-step task) and (if anything) attenuated temporal discounting. On the physiological level, participants' pupil dilation was predictive of the individual degree of temporal discounting. Tyrosine supplementation reduced physiological arousal as revealed by increases in pupil dilation variability and reductions in heart rate. Supplementation-related changes in physiological arousal predicted individual changes in temporal discounting. Our findings provide first evidence that tyrosine supplementation might impact psychophysiological parameters, and suggest that modeling approaches based on sequential sampling models can yield novel insights into latent cognitive processes modulated by amino-acid supplementation. Copyright: © 2022 Mathar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

07
CLINICAL STUDY Zhongguo zhen jiu = Chinese acupuncture & moxibustion (2021) PMID: 34628741 ↗
[Effect of acupuncture combined with rehabilitation training on cognitive function and amino acid metabolism in children with cerebral palsy].
Clinical Trial Synthesis 2021 Clinical Study published in Zhongguo zhen jiu = Chinese acupuncture & moxibustion involving n = 11 participants; statistical significance reported at p = 0.05. Key conclusion: CONCLUSION: Acupuncture combined with rehabilitation tr
View Original PubMed Abstract ↓

OBJECTIVE: To observe the effect of acupuncture combined with rehabilitation training on cognitive function and amino acid metabolism in children with cerebral palsy. METHODS: Twenty children with cerebral palsy (cerebral palsy group) were randomly divided into an acupuncture and rehabilitation group (11 cases) and a rehabilitation group (9 cases), and 10 healthy children were included as the normal group. The rehabilitation group was treated with rehabilitation training, 30 min each time; on the basis of rehabilitation training, the acupuncture and rehabilitation group was treated with acupuncture at Sishenzhen, Zhisanzhen, Naosanzhen, Niesanzhen, Dazhui (GV 14), Shenzhu (GV 12), Mingmen (GV 4), etc. The Sishenzhen (left and right points) and the ipsilateral Niesanzhen were respectively connected with a group of electrodes, intermittent wave, frequency of 2 Hz for 30 min. Both groups were treated once every other day, three times a week, totaling for 3 months. The Gesell developmental diagnostic scale (GESELL) was used to evaluate the developmental quotient (DQ) scores before and after treatment, and the blood samples of children with cerebral palsy before and after treatment and normal children were collected for amino acid metabolomics. RESULTS: Compared before treatment, the DQ scores of adaptation, fine motor and social in the acupuncture and rehabilitation group was increased after treatment (P<0.05), and the DQ score of fine motor in the rehabilitation group was increased after treatment (P<0.05). Compared with the normal group, the serum L-glutamate, L-ornithine, L-tyrosine, L-methionine and L-arginine in the cerebral palsy group were down-regulated, and L-histidine, L-citrulline, 5-hydroxylysine and L-glutamine were up-regulated before treatment. The functional pathways mapped by different metabolites between the cerebral palsy group and the normal group included arginine biosynthesis, arginine and proline metabolism, etc. Compared with the cerebral palsy group, the serum L-histidine was decreased, and L-citrulline showed decreasing trend in the acupuncture and rehabilitation group after treatment. CONCLUSION: Acupuncture combined with rehabilitation tr

08
RANDOMIZED TRIAL (RCT) Respiratory research (2021) PMID: 34088322 ↗
Intralymphatic immunotherapy with tyrosine-adsorbed allergens: a double-blind, placebo-controlled trial.
Clinical Trial Synthesis 2021 Randomized Controlled Trial (RCT) published in Respiratory research. Key conclusion: CONCLUSIONS: ILAIT with L-tyrosine-adsorbed allergen extracts does not exhibit profound therapeutic efficacy in allergic rhinitis and can provoke moderate-to-severe systemic reactions and cause pain at the injection site.
View Original PubMed Abstract ↓

BACKGROUND: Most previous studies used aluminum hydroxide-absorbed allergen extracts in evaluating the potential therapeutic roles of intralymphatic allergen-specific immunotherapy (ILAIT). In this study, we evaluated the therapeutic efficacy and safety of ILAIT with L-tyrosine-adsorbed allergen extracts of Dermatophagoides farinae, D. pteronyssinus, cat, dog, or mixtures thereof, in patients with allergic rhinitis induced by these allergens. METHODS: In this randomized, double-blind, placebo-controlled trial, study subjects received three intralymphatic injections of L-tyrosine-adsorbed allergen extracts (active group) or saline (placebo group) at 4-week intervals. RESULTS: Although ILAIT reduced daily medication use and skin reactivity to HDM and cat allergens at 4 months after treatment, overall symptom score on a visual analog scale (VAS), sinonasal outcome test-20 (SNOT-20), rhinoconjunctivitis quality of life questionnaire (RQLQ), daily symptom score (dSS), daily medication score (dMS), daily symptom medication score (dSMS), nasal reactivity to HDM allergen, and basophil activity to HDM, cat, and dog allergens at 4 months and 1 year after treatment were similar between the treatment and control groups. Intralymphatic injection was more painful than a venous puncture, and pain at the injection site was the most frequent local adverse event (12.8%); dyspnea and wheezing were the most common systemic adverse events (5.3%). CONCLUSIONS: ILAIT with L-tyrosine-adsorbed allergen extracts does not exhibit profound therapeutic efficacy in allergic rhinitis and can provoke moderate-to-severe systemic reactions and cause pain at the injection site. TRIAL REGISTRATION: clinicaltrials.gov: NCT02665754; date of registration: 28 January 2016.

09
CLINICAL STUDY European journal of nuclear medicine and molecular imaging (2018) PMID: 29982845 ↗
Early treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine.
Clinical Trial Synthesis 2018 Clinical Study published in European journal of nuclear medicine and molecular imaging; statistical significance reported at p = 0.203. Key conclusion: CONCLUSIONS: FET-PET appears to be useful for identifying responders to BEV/LOM early after treatment initiation.
View Original PubMed Abstract ↓

BACKGROUND: The goal of this prospective study was to compare the value of both conventional MRI and O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET for response evaluation in glioblastoma patients treated with bevacizumab plus lomustine (BEV/LOM) at first progression. METHODS: After chemoradiation with concomitant and adjuvant temozolomide, 21 IDH wild-type glioblastoma patients at first progression (age range, 33-75 years; MGMT promoter unmethylated, 81%) were treated with BEV/LOM. Contrast-enhanced MRI and FET-PET scans were performed at baseline and after 8-10 weeks. We obtained FET metabolic tumor volumes (MTV) and tumor/brain ratios. Threshold values of FET-PET parameters for treatment response were established by ROC analyses using the post-progression overall survival (OS) ≤/>9 months as the reference. MRI response assessment was based on RANO criteria. The predictive ability of FET-PET thresholds and MRI changes on early response assessment was evaluated subsequently concerning OS using uni- and multivariate survival estimates. RESULTS: Early treatment response as assessed by RANO criteria was not predictive for an OS>9 months (P = 0.203), whereas relative reductions of all FET-PET parameters significantly predicted an OS>9 months (P < 0.05). The absolute MTV at follow-up enabled the most significant OS prediction (sensitivity, 85%; specificity, 88%; P = 0.001). Patients with an absolute MTV below 5 ml at follow-up survived significantly longer (12 vs. 6 months, P < 0.001), whereas early responders defined by RANO criteria lived only insignificantly longer (9 vs. 6 months; P = 0.072). The absolute MTV at follow-up remained significant in the multivariate survival analysis (P = 0.006). CONCLUSIONS: FET-PET appears to be useful for identifying responders to BEV/LOM early after treatment initiation.

10
CLINICAL STUDY Molecules (Basel, Switzerland) (2018) PMID: 29300356 ↗
Synergistic Promotion on Tyrosinase Inhibition by Antioxidants.
Clinical Trial Synthesis 2018 Clinical Study published in Molecules (Basel, Switzerland); statistical significance reported at p = 0.05. Key conclusion: Meanwhile, the Keap1-Nrf2/ARE pathway, which removes ROS, is activated at increased ROS levels, and antioxidant compounds facilitates the dissociation of Nrf2.
View Original PubMed Abstract ↓

When exposed to ultraviolet radiation, the human skin produces profuse reactive oxygen species (ROS), which in turn activate a variety of biological responses. Mounting ROS levels activate tyrosinase by mobilizing α-melanocyte-stimulating hormone in the epidermis and finally stimulates the melanocytes to produce melanin. Meanwhile, the Keap1-Nrf2/ARE pathway, which removes ROS, is activated at increased ROS levels, and antioxidant compounds facilitates the dissociation of Nrf2. In this study, we explored the possible suppressing effects of antioxidant compounds and tyrosine inhibitors on melanin formation and the promotory effects of these compounds on ROS scavenging. The antioxidant activity of glabridin (GLA), resveratrol (RES), oxyresveratrol (OXYR), and phenylethylresorcinol (PR) were investigated via the stable free radical 2,2-diphenyl-1-picrylhydrazyl method. The inhibitory effects of the four compounds and their mixtures on tyrosinase were evaluated. l-Tyrosine or 3-(3,4-dihydroxyphenyl)-l-alanine (l-DOPA) was used as a substrate. The results showed that all mixtures did not exhibit synergistic effects with the l-tyrosine as a substrate, suggesting that l-tyrosine is not suitable as a substrate. However, the mixtures of "GLA:RES," "GLA:OXYR," "OXYR:RES," and "PR:RES" demonstrated synergistic effects (CI < 0.9, p < 0.05), whereas "GLA:RES" and "PR:OXYR" indicated an additive effect (0.9 ditive1, p < 0.05). Furthermore, we used a molecular docking strategy to study the interactions of the four compounds with tyrosinase and l-DOPA. The molecular docking result is consistent with that of the experiment. Finally, we selected RES + OXYR and used PIG1 cells to verify whether OXYR synergistically promotes RES activity on tyrosinase. The two agents had a synergistic inhibitory effect on tyrosinase activity. These results provided a novel synergistic strategy for antioxidants and tyrosinase inhibitors, and this strategy is useful in skin injury treatment.

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