Mechanism of Oleogel-S10: A triterpene preparation for the treatment of epidermolysis bullosa

Abstract

Epidermolysis bullosa (EB) is a group of rare heterogeneous, genetic disorders. Currently, there is no effective pharmacological or genetic therapy for all EB subtypes. Dry extract from birch bark and betulin upregulate some pro-inflammatory mediators and downregulate others. The increase in pro-inflammatory cytokines is temporary and attenuated over long-term treatment. This inflammatory stimulus is thought to be prerequisite for a secondary anti-inflammatory response. Dry extract from birch bark and its active marker substances have also been shown to increase the migration of primary human keratinocytes, accelerate wound closure, and promote differentiation of keratinocytes in vitro and in vivo—processes that are essential for reepithelialization and maintenance of the skin barrier. Comprehensive clinical data are available to support the use of Oleogel-S10 in the treatment of partial thickness wounds of different etiologies, and a proof-of-concept Phase 2 study in patients with dystrophic EB has suggested the potential for faster reepithelialization of wounds treated with Oleogel-S10.