Urinary detection of corticosteroid in topical treatment of skin disease by 19F MRS

Beathe Sitter

doi:10.1007/s10334-018-00734-y

Abstract

ObjectiveTo investigate if it was feasible to quantify the renal excretion of topically applied corticosteroids by 19F MRS.Materials and methodsFive participants, one healthy and four with skin diseases, were treated with ointment containing betamethasone 17-valerate. Urine samples were collected for up to 87 h after the initial application. A sample of ointment mixed with urine served as a study control. Organic fractions were obtained after sample freeze drying, and resolved in deuterated chloroform prior to acquisition of 19F MR spectra at 470 MHz for typically 8 h.ResultsWe detected fluorine signals in 40 of the 62 fractions of organic extracts. The corticosteroid was detected in samples from all patients, ranging from 0.1 to 2.8% of the applied steroid. No fluorine signal was obtained in samples from the healthy volunteer.Discussion19F MRS can be utilized to detect topically applied corticosteroids in urine. However, more work is required to optimize and control for extraction procedures, complete spectral assignments and reliable quantification.

Highlights

Topical application of corticosteroids is the first and main treatment for many skin diseases, like psoriasis, and has been used since the mid-60s [1, 2]
The detected fluorine resonances were in the chemical shift region − 165.5 and − 172.5 ppm, with betamethasone 17-valerate (BMV) assigned to the resonance signal at − 169.9 ppm
BMV or its metabolites were found in urine samples from all patients, but not in the urine from the healthy volunteer

Summary

Introduction

Topical application of corticosteroids is the first and main treatment for many skin diseases, like psoriasis, and has been used since the mid-60s [1, 2]. Their main actions are anti-inflammatory, antiproliferative, immunosuppressive and vasoconstrictive, mediated through binding to intracellular receptors and regulation of gene transcriptions [3]. As long-term corticosteroid application leads to skin thinning and inhibition of the cortisol production. Both the effectiveness of different treatments in psoriasis and comparative effectiveness for clinical variants should be studied more [3].

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Conclusion