Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • A61K38/18—Growth factors; Growth regulators
  • A61K38/185—Nerve growth factor [NGF]; Brain derived neurotrophic factor [BDNF]; Ciliary neurotrophic factor [CNTF]; Glial derived neurotrophic factor [GDNF]; Neurotrophins, e.g. NT-3
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K8/00—Cosmetics or similar toiletry preparations
  • A61K8/18—Cosmetics or similar toiletry preparations characterised by the composition
  • A61K8/30—Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
  • A61K8/64—Proteins; Peptides; Derivatives or degradation products thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P17/00—Drugs for dermatological disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61Q—SPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
  • A61Q19/00—Preparations for care of the skin
  • A61Q19/04—Preparations for care of the skin for chemically tanning the skin

Definitions

• the present invention concerns a topical preparation for inducing skin pigmentation and for the treatment of cutaneous dyschromias and vitiligo. More specifically, the invention concerns a method for increasing the skin pigmentation, both for merely cosmetic purposes and for therapeutic purposes, so as to obtain an intensification of the skin color or the re-pigmentation of skin areas which are de-pigmented due to vitiligo or other hypopigmentary cutaneous disorders. The method is based on the administration of a topical product containing NGF (nerve growth factor).
• NGF nerve growth factor
• the color of the skin is determined by the amount of melanin produced by melanocytes. It is well known that differences in the intensity of color of the skin are not due to anatomical but functional factors, since the number of melanocytes is in all cases identical, irrespectively of the color of the skin, and is genetically determined (Summa Gallicana Vol. 2, Chapter 27). Melanin is produced in the form of granules, which are released through an active mechanism and reach the epidermis, where they result in the skin color. An alteration in the mechanisms of melanin production and release involves a disturbance of melanic pigmentation of the skin.
• self-tanning products are in use These products are often used as an alternative to traditional sun exposure to avoid the risk of consequences associated with excessive sun exposure, such as sunburn, premature skin aging and increased risk of skin cancer.
• DHA dihydroxyacetone
• the self-tanning agents such as DHA have a number of disadvantages, including the ability to stain on clothes, the ability to give to the skin a non-uniform color and usually a typical unpleasant smell.
• Another field where a treatment capable of effectively darkening the skin is required is that of hypopigmentary cutaneous disorders, among which vitiligo is the best known one.
• Vitiligo is a fairly common non-contagious skin disease, characterized by a disorder of skin pigmentation, which is manifested by the appearance of irregular and sharply-edged patches, having very variable shape and size, in which the skin is de-pigmented.
• the de-pigmentation is caused by a loss of the natural pigment of the skin (melanin), with the formation of a light spot, called macula, which spreads over time affecting a larger area of the body.
• the de-pigmented patches may appear anywhere in the body, but the most commonly involved sites are hands, arms, the skin of the anogenital, perioral and periorbital regions.
• the patches edges are often hyperpigmented, which evidences the contrast with the color of normally pigmented surrounding skin.
• the onset of vitiligo is independent of sex and skin color of those affected, and its appearance is, therefore, as more evident as darker the complexion of the person affected is. Apart from the change in color, the skin of the affected areas is absolutely normal.
• the patches may gradually extend over time, sometimes instead they remain steady, but they rarely regress.
• the course of the disease may be aggravated by psychic trauma and anxiety.
• vitiligo The origin of vitiligo is unknown, although autoimmune factors and/or genetic predisposition are suspected.
• Various pathogenic theories have been formulated, the most reliable ones being the autoimmune theory, the self- cytotoxic theory and the neural or neurogenic theory. None of them has so far been able to satisfactorily explain the appearance of the typical de-pigmented skin patches. The only certain element is that, by examining under a microscope a fragment of skin taken from an achromic area, a reduction of melanocytes and lack of melanin may be observed, melanin being the pigment to which the skin color iss due (Kim YC et a!., Histopathologic features in vitiligo, Am. J. Dermatopathol., 2008).
• the melanocytes are unable to synthesize melanin and can be numerically reduced or replaced by other cells: in this case the cells that will migrate from the basal layer of the epidermis towards the upper layers will be devoid of melanin. These cells, once emerged on the surface, will give rise to the appearance of an achromic patch.
• the main therapy for vitiligo is based on topical immunomodulating agents (in particular, corticosteroids).
• topical immunomodulating agents in particular, corticosteroids
• the latter are applied on the de-pigmented areas, usually in combination with ultraviolet light (UV) irradiation.
• UV ultraviolet light
• Other known treatments include the application of activated vitamin D 3 or photosensitizing agents (psoralens), again in combination with ultraviolet light (UV) irradiation.
• a therapeutic approach currently accepted and widespread at present for the treatment of vitiligo is represented by psoralens therapy in combination with ultraviolet irradiation limited to the UV-A range, also known as PUVA therapy or PUVA-therapy. This has been shown to be able to effectively improve the condition of skin discoloration in approximately 50% of cases, while steroids are moderately effective only in cases of fast-spreading vitiligo, and the disorder often occurs again after the therapy was discontinued.
• capsaicin, curcumin and piperine have been particularly studied. These substances are contained, respectively, in chili, curry and black pepper, and may be effective in controlling the progression of vitiligo.
• the use of these natural antioxidants for the treatment of the disease has emerged, in particular, from a biochemistry survey conducted in vitro on primary cultures of keratinocytes.
• creams containing piperine or also capsaicin as vanilloid skin receptor TRPV1 agonists and modulators of melanogenesis have been proposed for the treatment of cutaneous achromias and hypochromias such as vitiligo.
• NGF nerve growth factor
• the nerve growth factor is the first component of a complex family of neurotrophins, and is well-known for its trophic, tropic and differentiating action on cholinergic neurons of the central nervous system and on the peripheral sympathetic system.
• NGF is produced in many mammalian tissues, including human, and is released into the bloodstream at higher levels during the growth and differentiation of the nervous system.
• Biological, biochemical and molecular studies carried out on in vitro cell systems showed a high sequence homology between murine and human NGF.
• the NGF is normally present both in the cerebrospinal fluid and in blood stream at concentrations in the range of 10 to 15 pg/ml, which increase in some inflammatory pathologies (autoimmune diseases, allergic diseases, etc..) and decrease in others (diabetes)
• the NGF contained in murine salivary glands is a 140 kdalton molecular complex, with a sedimentation coefficient equal to 7S, consisting of three sub-units, ⁇ , ⁇ and ⁇ , the second one of which represents the actual active form.
• the latter called pNGF, with a sedimentation coefficient of 2.5 S, is usually extracted and purified according to three not very different techniques (Bocchini V., Angeletti P.U., Biochemistry, 64:787-793, 1969; Varon S. et al., Methods in Neurochemistry, 203-229, 1972; Mobley W.C. et al., Molecular Brain Research, 387: 53-62, 1986).
• the pNGF thus obtained is a dimer consisting of two identical chains of 1 18 amino acids, having an overall molecular weight of about 26,000 Daltons. Each single chain is stabilized by three disulfide bridges, while non-covalent bonds ensure the dimeric structure formation.
• This molecule being very stable, is soluble in almost any solvent, either aqueous or oily, maintaining unchanged its biochemical characteristics and biological activity. Further details about the structure, physical and bio- chemical characteristics of the molecule are reported in Greene, L.A. e Shooter, E.M., Ann. Rev. Neurosci. 3:353, 1980.
• NGF neurotrophic factor
• NGF in the treatment of vitiligo other studies have suggested that a therapy aimed at reducing the skin levels of NGF could be beneficial to the hypopigmentary skin lesions of vitiligo (Rateb A. et al ., J. Egypt. Worn Dermatol. Soc, 2004). In this study it is suggested that in hypo-pigmented skin patches an increased expression of NGF occurs, and that the activation of the NGF receptors placed on melanocytes is critical for their degeneration/destruction in vitiligo and that therefore, theoretically, an NGF antagonist may represent a future therapy for vitiligo.
• FGF Fibroblast Growth Factor
• bFGF basic Fibroblast Growth Factor
• polypeptide sequences derived from it in particular, in the US Patent No. 6143723 and in the patent applications EP-A-1754489 and US 2007/0027080 (all in the name Abburi, Ramaiah) there is proposed the use of preparations containing partial sequences of bFGF for topical application on the skin for the treatment of vitiligo, either alone or in combination with other therapies already known for the treatment of vitiligo.
• FGF Fibroblastic Growth Factor
• aFGF acid
• bFGF basic
• EGF Epidermal Growth Factor
• VEGF Vascular Endothelial Growth Factor
• PDGF Platelet Derived Growth Factor
• An object of the present invention is to provide a topical dermatological preparation to be applied on healthy skin as a self-tanning agent, or on depigmented skin of patients suffering from vitiligo and/or other hypopigmentary cutaneous disorders, for the therapy and/or prophylaxis of such disorders.
• NGF and its receptors have been studied in the dermis and epidermis, both in the in vitro and in vivo experiments mentioned above and in tissues obtained from human biopsies. It was observed that both the NGF and its high affinity (TrkA) and low affinity (p75) receptors are located both on keratinocytes that on the melanocytes and fibroblasts, in agreement with previous literature cited above.
• NGF and its receptors in the healthy normal skin which has been verified by means of immunohistochemical and molecular techniques, represents a fundamental prerequisite because it can show its biological activity, and therefore also a therapeutic effect.
• NGF NGF receptors
• the present invention provides a product for topical application capable of increasing the skin pigmentation for the purpose of tanning or darkening the skin, as well as for the treatment of vitiligo and other hypopigmentary skin conditions.
• the product is to be applied locally in order to facilitate or accelerate the pigmentation or re-pigmentation, by increasing the cutaneous sensory innervation and by stimulating the melanocytes.
• NGF nerve growth factor
• a complex structure 26,800 Dalton
• active ingredients for topical application to the skin are already known (in particular, steroids such as cortisone), which are able to penetrate through the epidermis and reach the deeper layers at therapeutically effective concentrations, but their molecular sizes are considerably smaller than the size of NFG.
• NGF although having a complex structure and a large molecular weight, includes both hydrophilic and lipophilic groups, which allows the molecule to pass through the homologous anatomical barriers (hydrophilic and lipophilic).
• NGF neurotrophic factor
• the present invention specifically provides a topical cutaneous preparation containing nerve growth factor (NGF) for inducing, intensifying or accelerating the skin pigmentation in dermatologically healthy subjects and for the therapy and/or the prophylaxis of dyschromic skin disorders.
• NGF nerve growth factor
• the proposed preparation according to the invention contains as active ingredient an effective amount of the neurotrophin named nerve growth factor (NGF) in a pharmaceutically or cosmetically acceptable carrier, dermatologically tolerated and compatible with the active substance itself.
• NGF nerve growth factor
• the NGF used in the formulation proposed can be the protein of human origin or that of murine origin, or is a recombinant human NGF, or it may also be a substance that plays a role similar to NGF by binding to an NGF receptor of, namely an agonist or a NGF-mimetic substance.
• Nerve Growth Factor to the family of neurotrophins, and specifically neurotrophin-3 (NT-3), neurotrophin-4 (NT-4) and the brain derived neurothophic Factor (BDNF), may represent valid candidates for the same therapeutic or cosmetic use according to the invention.
• NT-3 neurotrophin-3
• NT-4 neurotrophin-4
• BDNF brain derived neurothophic Factor
• the proposed topical preparation containing NGF can be applied to the skin surface of dermatologically healthy subjects, i.e. not suffering from skin diseases, merely in order to darken their complexion and provide an effect of tanning equivalent to that obtainable through the exposure to solar irradiation. Therefore, the NGF-based product can be used as an active ingredient, alone or in combination with other active ingredients known in the industry and compatible therewith, both in self-tanning cosmetic formulations and as an additive in conventional sun-protection products, in order to intensify the natural tan or to prolong it.
• said topical preparation is suitable for the therapy and/or the prophylaxis of de-pigmentary and/or hypopigmentary skin disorders, or disorders of the melanic pigmentation of the skin, such as specific pathologies of trophic, neurotrophic, post-traumatic, post-infectious, post-surgical, autoimmune, genetic, metabolic, nutritional, endocrine, chemical, physical, dystrophic, degenerative or post-inflammatory origin.
• the skin diseases that can make use of the treatment with NGF according to the invention include those listed in the following group consisting of: vitiligo, bilateral vitiligo, acrofacial vitiligo, generalized vitiligo, focal vitiligo, segmental vitiligo, universal vitiligo, perinevic vitiligo or Sutton nevus, leucoderma, cutaneous dyschromia, piebaldism, pitiyiasis alba, pitiyiasis versicolor, idiopathic and post- inflammarory guttate hypomelanosis, achromic or depigmented nevi, progressive macular hypomelanosis, hypomelanoses caused by metabolic or nutritional or endocrine disorders, hypomelanoses caused by chemical, physical or pharmaceutic agents, infective and post-infective hypomelanoses, inflammatory hypomelanoses..
• disorders that appear with achromic or hypochromic skin and that may be treated, at least as regards the dermatological appearance, with a preparation of NGF according to the invention are: albinism, albinoid disorders, gray hair, incontinentia pigmenti, Ito hypomelanosis, pigmentary mosaicism, sclero-atrophic lichen, melano- leucodermia, Chediak-Higashi syndrome, Rozycki syndrome, Waardenburg hypomelanosis, Fisch syndrome, Bourneville tuberous sclerosis, hypo- melanosis of Ziprkowski-Margolis, Menkes syndrome, Westerhof syndrome, Vogt-Koyanagi-Harada syndrome, Alezzandrini syndrome, hereditary sclerosing poikiloderma, Dohi acropigmentation.
• the invention relates to the use of the neurotrophin called nerve growth factor (NGF) in the form of aqueous, alcoholic or oily solution or suspension, emulsion, spray, lotion, liniment, cream, ointment or gel, containing NGF as active ingredient in a pharmaceutically acceptable carrier.
• NGF nerve growth factor
• the NGF, or a preparation containing it can be added to a local bandage to be applied on areas of de-pigmented skin.
• a medicinal product according to the invention suitable for application to the skin surface may preferably contain, alone or in combination with one or more other active ingredients, from 10 to 1000 micrograms/ml of NGF, preferably from 10 to 500 micrograms/ml of NGF, and even more preferably from 50 to 500 micrograms/ml of NGF.
• the NGF can also be present in combination with one or more other active ingredients indicated for the treatment and/or the prophylaxis of the dermatological disease treated, or it may be conjugated with a carrier molecule.
• a specific formulation suitable for topical application may consist, for example, of lyophilized purified murine NGF, re-suspended in 0.9% sodium chloride saline, or in balanced saline solution (BSS) and finally mixed with a preparation of base cream or base ointment so as to obtain a final mixture with 200 ⁇ g/ml of NGF for topical application to the skin.
• BSS balanced saline solution
• formulations based on NGF include formulations in spray, ointment, gel, cream or liniment and include suitable carriers such as polyethylene glycol or polyethylene oxide, polyacrylate, carboxy-methylcellulose, fatty acids and fatty alcohols, lanolin, cetomacrogol, paraffin and the like.
• the solution, suspension or emulsion containing NGF according to the invention may contain various additional biologically active components, and/or NGF can be conjugated with carrier molecules or with molecules known to facilitate the permeation through the epidermis, or with cosmetically acceptable vehicles (i.e., vehicles suitable for cosmetic use), and can contain other optional components known in the art and selected from those conventionally used in the pharmaceutical and cosmetics industries, such as acidifying agents, alkalizing agents, preservatives and antimicrobials, antioxidants, buffers, chelating agents, dispersants, emollients, humectants, fragrances, sunscreen agents, dermatological agents and other ingredients.
• Non-limiting examples of such categories of excipients and coadjuvants of the formulation are listed below.
• Examples of acidifying agents that can be added to obtain the desired pH include citric acid, lactic acid, glycolic acid, acetic acid, malic acid and propionic acid, while examples of alkalizing agents include edetol, potassium carbonate, potassium or sodium hydroxides, sodium borate, sodium carbonate, sodium citrate, sodium lactate, sodium glycolate.
• Antimicrobial agents and preservatives may be used when the products to be applied on the skin are subject to microbial infection and/or in order to protect the product from degradation.
• suitable preservatives include phenoxyethanol, methylparaben, ethylparaben, propylparaben, butilaraben, benzalkonium chloride, benzethonium chloride, chlorobutanol, benzoic acid, sodium benzoate, benzyl alcohol, phenylmercuric acetate, potassium sorbate, sorbic acid and their mixtures, such as oil LiquaPar ® .
• antioxidant agents can be employed.
• suitable agents include water-soluble antioxidants such as ascorbic acid, sodium bisulfite or metabisulfite, sodium formaldehyde sulfoxylate, ascorbic acid, isoascorbic acid, cysteine hydrochloride, 1 ,4-diazabicyclo(2,2,2)-octane and mixtures thereof.
• liposoluble antioxidants examples include ascorbyl palmitate, butyl hydroxyanisole, butyl hydroxytoluene, potassium propyl gallate, octyl gallate and dodecyl gallate, phenyl-alpha-naphthylamine, and tocopherols such as alpha-tocopherol.
• excipients may be added, which are selected from those conventionally used in the pharmaceutical art, for example to buffer the solution, suspension or emulsion, to stabilize the active principle and/or to make the preparation more tolerable.
• Suitable buffers should maintain the pH between 4 and 8.
• buffers suitable for use on the skin include calcium acetate, potassium metaphosphate, monobasic potassium phosphate, and tartaric acid.
• chelating agents that can be used to maintain the ionic strength of the product and/or bind to destructive compounds and metals that are included or come in contact with the product include ethylene-diamino- tetraacetic acid (EDTA) and its salts, such as dipotassium edetate, disodium edetate and tetrasodium EDTA.
• EDTA ethylene-diamino- tetraacetic acid
• its salts such as dipotassium edetate, disodium edetate and tetrasodium EDTA.
• dispersing agents suitable for the topical cutaneous formulations based on NGF of the invention include carrageenan, magnesium and aluminum silicate, xanthan gum and silicon dioxide.
• Emollients are agents that soften and make smooth the epidermis, and may thus facilitate the passage of the product through the stratum corneum.
• the cutaneous bioavailability of NGF can be further increased by using compounds that promote the permeation of the active ingredient, such as dimethyl sulfoxide, taurocholates, membrane phospholipids and various surfactants suitable for dermatological use.
• emollients include oils and waxes such as microcrystalline wax, triglyceride esters such as castor oil, safflower oil, corn oil, olive oil, cod liver oil, almond oil, palm oil, soybean oil, cocoa butter, squalene, acetylated monoglycerides, ethoxylated glycerides, fatty acids, fatty acid alkyl esters, fatty acid alkenyl esters, fatty alcohols, fatty alcohol ethers, lanolin and its derivatives, polyhydroxy alcohol esters, esters of waxes such as wax beeswax, vegetable wax, isopropyl palmitate and glyceryl stearate.
• oils and waxes such as microcrystalline wax, triglyceride esters such as castor oil, safflower oil, corn oil, olive oil, cod liver oil, almond oil, palm oil, soybean oil, cocoa butter, squalene, acetylated monoglycerides,
• Humectants are agents that typically promote moisture retention, for example moisturizing agents.
• humectants include siloxanes, sorbitol, glycerin, glicereth-5-lactate, glicereth-7-triacetate, glicereth-7-di- isononanoate, hexanetriol, glycols such as methylpropanediol, 1 ,2- pentanediol, hexylene glycol and propylene glycol, alkoxylated glucose, D- panthenol and its derivatives, hyaluronic acid.
• fragrances that can be added to the topical skin product according to the invention are peppermint, rose oil, rose water, aloe vera, clove oil, menthol, camphor, eucalyptus oil and other plant extracts.
• peppermint peppermint
• rose oil rose water
• aloe vera clove oil
• menthol aloe vera
• camphor camphor
• eucalyptus oil and other plant extracts.
• ethylene brassylate may be used, for example ethylene brassylate.
• Sunscreen agents are typically employed to block or reduce the amount of ultraviolet radiation that affects the skin (eg., by absorption, by diffusion or by reflection of the ultraviolet radiation).
• sunscreens are known in the literature, and among these, for example, both organic compounds and their salts, such as butyl metoxydibenzoylmethane, diethylhexyl butamido triazone, diethylamino hydroxybenzoyl hexyl benzoate, ethylhexyl triazone, bis-ethylexyloxyphenol methoxyphenil triazine, methylene bis-benzotriazolyl tetramethylbuthylphenol, phenylbenzimidazole sulfonic acid, ethylhexyl salicylate, benzophenone-3, octocrylene, avobenzone, menthyl- anthranilate and 2-ethylhexyl-p-methoxycinnamate
• Dermatologically active agents which may be added to the product- based NGF according to the invention include agents already mentioned for the treatment of hypochromic or achromic skin, and of vitiligo in particular, as well as agents approved for the treatment of other dermatological conditions which may be associated or must be prevented during a tanning treatment, such as retinoic acid.
• the present invention relates to a method for inducing or intensifying the skin pigmentation by applying a preparation containing nerve growth factor (NGF) on the skin area to be treated, said preparation preferably containing from 10 to 1000 ⁇ g/ml of NGF.
• NGF nerve growth factor
• Particularly preferred concentrations of NGF may vary between 50 and 500 micrograms/ml of NGF. This method allows to stimulate and/or accelerate skin pigmentation, both for purely cosmetic purposes and for the treatment of cutaneous and hypopigmentary pathologies such as vitiligo.
• the topical product based on NFG can be formulated together with a self-tanning preparation or used concurrently with it, or it may be combined with a sun tan preparation, and the application of said preparation may be combined with exposure to UV radiation or sunlight.
• the application of the NGF-based preparation is preferably combined with one or more of the following:
• said skin diseases treated are selected from the group consisting of: vitiligo, bilateral vitiligo, acrofacial vitiligo, generalized vitiligo, focal vitiligo, segmental vitiligo, universal vitiligo, perinevic vitiligo or Sutton nevus, leucoderma, cutaneous dyschromia, piebaldism, pitiyiasis alba, pitiyiasis versicolor, idiopathic and post-inflammarory guttate hypomelanosis, achromic or depigmented nevi, progressive macular hypomelanosis, hypome- lanoses caused by metabolic or nutritional or endocrine disorders, hypome- lanoses caused by chemical, physical or pharmacologic agents, infective and post-infective hypomelanoses, inflammatory hypomelanoses.
• the nerve growth factor which is included in the formulation to be used for the method proposed according to the invention can be NGF of human origin or NGF of murine origin, or is a human recombinant NGF, or can also be an agonist of NGF .
• Pigmented guinea pigs of four weeks of age that had been previously acclimatized for one week were shaved twice a week in the dorsal part, with an electric razor, in an area of about 6cm x 6cm.
• the administration was carried out in two sites of the shaved area spaced apart from either side of the midline: on the left side a topical preparation containing 200 ⁇ g/ml of murine NGF in a vehicle of base cream was applied, while on the right side the base cream alone was applied.
• the application was carried out uniformly twice daily for 6 weeks, in the central part of the shaved area, approximately 2cmx2cm. Starting on the second day and subsequently, the application sites were cleansed by wiping the skin before applying the preparations under test. Attention was given to avoid any exposure of the dnimals to ultraviolet light. The color of the skin was measured by means of a colorimeter before the first application (time zero) and after the end of treatment.
• a topical treatment with a preparation containing 50 ⁇ g/ml of murine NGF in base cream was applied 4 times a day for 8 weeks in two volunteer patients (one man and one woman) suffering from vitiligo, on a patch of depigmented skin surface.
• the color of the patch of skin subjected to treatment was measured with a colorimeter before and after the treatment itself, and was compared with the color of healthy pigmented skin in a nearby skin area of the same patient, as well as with the color of the treated patch after the treatment.
• the contact sensitivity was measured using a Cochet-Bonnet contact aesthesiometer, and evaluating the difference between skin sensitivity in two points, in the de-pigmented patch and in an area of healthy skin in the vicinity, using a calibrated compass.
• NGF in base cream was applied 3 times a day for 4 weeks in two volunteer patients (one man and one woman) suffering from vitiligo, on a patch of depigmented skin surface.
• NGF in base cream was administered 2 times per day for 2 weeks to two patients with vitiligo (a man and a woman).

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