Table Info

Table 3.

Polypodium preparation

Polypodium preparation	Result of interest	Photoprotective activity (assays)	Radiation type	Route and dose	Refs.
Capsule	Significant reduction of cutaneous reaction and symptoms/photoprotection treatment in idiopathic photodermatosis	In vivo—human	UVA/UVB	Oral Used dose: 480 mg/day	[18]
Capsule	Decreased erythema/increased minimal erythema dose (MED)	In vivo—human	UVB	Oral Used dose: 120–1,080 mg/day	[16, 40, 77]
Hydrophilic extract	Prevention and delay of typical lesions (eruptions) caused by UVR	In vivo—human	UVA/UVB	Oral Used dose: 720, 960, 1,200 mg/day	[14]
Extract	Inhibition of elastase activity/stimulation of cell expression/strengthening cell matrix/prevention in photoaging	In vitro—enzymes and substrate	UVA/UVB	Enzyme (starting concentration of 1 μg/μL) with its substrate 0.5 mM	[78]
Extract	Negative photobiological effects/reduction of UVB rays	In vivo—human	UVB	Oral Used dose: 480 mg/day	[7]
Hydrophilic extract (Fernblock)	Cell damage prevention/increased expression of matrix metalloproteinase-1 and cathepsin K/slowing expression of fibrillin 1, 2 and elastin	In vitro—cell cultures (human dermal fibroblasts)	Infrared A and visible light	Incubation	[11]
Extract	Decrease in darkening, cyclooxygenase-2 (marker of cell damage)	In vivo—human	Visible light	Oral Used dose: 480 mg/day	[79]
Extract (Fernblock)	Protective activity against oxidative stress and aging	In vitro—non-tumorigenic human keratinocyte cells	UVB	Incubation	[68]

Declarations

Author contributions

RYMSC and SVA: Investigation, Methodology, Formal analysis, Visualization, Writing—original draft. MRAJ: Supervision. AR and MSAP: Conceptualization, Methodology, Formal analysis, Writing—review & editing, Project administration, Supervision.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

References

Horvath A, Alvarado F, Szöcs J, de Alvardo ZN, Padilla G. Metabolic effects of calagualine, an antitumoral saponine of Polypodium leucotomos. Nature. 1967;214:1256–8. [DOI] [PubMed]

Choudhry SZ, Bhatia N, Ceilley R, Hougeir F, Lieberman R, Hamzavi I, et al. Role of oral Polypodium leucotomos extract in dermatologic diseases: are view of the literature. J Drugs Dermatol. 2014;13:148–53. [PubMed]

Efectos del extracto de Polypodium leucotomos sobre la tumorogénesis inducida por la radiación ultravioleta [Internet]. Theses and Dissertations Online; [cited 2022 Sep 9]. Available from: http://hdl.handle.net/10803/8754

Nogal-Ruiz JJ, Gómez-Barrio A, Escario JA, Martínez-Fernández AR. Effect of Anapsos in a murine model of experimental trichomoniasis. Parasite. 2003;10:303–8. [DOI] [PubMed]

Garcia F, Pivel JP, Guerrero A, Brieva A, Martinez-Alcazar MP, Caamano-Somoza M, et al. Phenolic components and antioxidant activity of Fernblock, an aqueous extract of the aerial parts of the fern Polypodium leucotomos. Methods Find Exp Clin Pharmacol. 2006;28:157–60. [DOI] [PubMed]

Gombau L, García F, Lahoz A, Fabre M, Roda-Navarro P, Majano P, et al. Polypodium leucotomos extract: antioxidant activity and disposition. Toxicol Vitr. 2006;20:464–71. [DOI] [PubMed]

Kohli I, Shafi R, Isedeh P, Griffith JL, Al-Jamal MS, Silpa-Archa N, et al. The impact of oral Polypodium leucotomos extract on ultraviolet B response: a human clinical study. J Am Acad Dermatol. 2017;77:33–41.e1. [DOI] [PubMed] [PMC]

Saorin DCM, inventor. Transformação de Polypodium leucotomos extrato seco das raízes no fotoprotetor oral sob forma de cápsulas. Portuguese patent PI 0904487-6 A2. 2011 Jan 4.

Bhatia N. Polypodium leucotomos: a potential new photoprotective agent. Am J Clin Dermatol. 2015;16:73–9. [DOI] [PubMed]

10.

Parrado C, Mascaraque M, Gilaberte Y, Juarranz A, Gonzalez S. Fernblock (Polypodium leucotomos extract): molecular mechanisms and pleiotropic effects in light-related skin conditions, photoaging and skin cancers, a review. Int J Mol Sci. 2016;17:1026. [DOI] [PubMed] [PMC]

11.

Zamarrón A, Lorrio S, González S, Juarranz Á. Fernblock prevents dermal cell damage induced by visible and infrared A radiation. Int J Mol Sci. 2018;19:2250. [DOI] [PubMed] [PMC]

12.

Schalka S, Vitale-Villarejo MA, Agelune CM, Bombarda PCP. Benefícios do uso de um composto contendo extrato de Polypodium leucotomos na redução da pigmentação e do eritema decorrentes da radiação ultravioleta. Surg Cosmet Dermatol. 2014;6:344–8. Portuguese.

13.

Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, et al.; Brazilian Society of Dermatology. Brazilian consensus on photoprotection. An Bras Dermatol. 2014;89:1–74. [DOI] [PubMed] [PMC]

14.

Tanew A, Radakovic S, Gonzalez S, Venturini M, Calzavara-Pinton P. Oral administration of a hydrophilic extract of Polypodium leucotomos for the prevention of polymorphic light eruption. J Am Acad Dermatol. 2012;66:58–62. [DOI] [PubMed]

15.

Charoo NA. Hyperpigmentation: looking beyond hydroquinone. J Cosmet Dermatol. 2022;21:4133–45. [DOI] [PubMed]

16.

Aguilera P, Carrera C, Puig-Butille JA, Badenas C, Lecha M, González S, et al. Benefits of oral Polypodium leucotomos extract in MM high-risk patients. J Eur Acad Dermatol Venereol. 2013;27:1095–100. [DOI] [PubMed] [PMC]

17.

Caccialanza M, Percivalle S, Piccinno R, Brambilla R. Photoprotective activity of oral Polypodium leucotomos extract in 25 patients with idiopathic photodermatoses. Photodermatol Photoimmunol Photomed. 2007;23:46–7. [DOI] [PubMed]

18.

Caccialanza M, Recalcati S, Piccinno R. Oral Polypodium leucotomos extract photoprotective activity in 57 patients with idiopathic photodermatoses. G Ital Dermatol Venereol. 2011;146:85–7. [PubMed]

19.

Middelkamp-Hup MA, Bos JD, Rius-Diaz F, Gonzalez S, Westerhof W. Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study. J Eur Acad Dermatol Venereol. 2007;21:942–50. [DOI] [PubMed]

20.

Searle T, Al-Niaimi F, Ali FR. Polypodium leucotomos as an adjunct to the treatment of vitiligo. J Am Acad Dermatol. 2022;86:e65. [DOI] [PubMed]

21.

Szczurko O, Boon HS. A systematic review of natural health product treatment for vitiligo. BMC Dermatol. 2008;8:2. [DOI] [PubMed] [PMC]

22.

Berman B, Ellis C, Elmets C. Polypodium leucotomos--an overview of basic investigative findings. J Drugs Dermatol. 2016;15:224–8. [PubMed] [PMC]

23.

Gonzalez S, Gilaberte Y, Philips N. Mechanistic insights in the use of a Polypodium leucotomos extract as an oral and topical photoprotective agent. Photochem Photobiol Sci. 2010;9:559–63. [DOI] [PubMed]

24.

Torricelli P, Fini M, Fanti PA, Dika E, Milani M. Protective effects of Polypodium leucotomos extract against UVB-induced damage in a model of reconstructed human epidermis. Photodermatol Photoimmunol Photomed. 2017;33:156–63. [DOI] [PubMed]

25.

Parrado C, Gilaberte Y, Philips N, Juarranz A, Gonzalez S. Chapter 34 - FFern extract, oxidative stress, and skin cancer. In: Preedy VR, Patel VB, editors. Cancer (second edition): oxidative stress and dietary antioxidants. San Diego: Academic Press; 2021. pp. 387–98. [DOI]

26.

Sánchez-Rodríguez C, Peraza Cruces KR, Rodrigáñez Riesco L, García-Vela JA, Sanz-Fernández R. Immunomodulatory effect of Polypodium leucotomos (Anapsos) in child palatine tonsil model. Int J Pediatr Otorhinolaryngol. 2018;107:56–61. [DOI] [PubMed]

27.

Solivellas BM, Martín TC. Polypodium leucotomos extract use to prevent and reduce the risk of infectious diseases in high performance athletes. Infect Drug Resist. 2012;5:149–53. [DOI] [PubMed] [PMC]

28.

Gálvez J, Sánchez de Medina F, Romero J, Zarzuelo A. Effect of Polypodium leucotomos on acute, chronic and reactivated trinitrobenzene sulphonic acid colitis in rats. Inflammopharmacology. 2000;8:89–105. [DOI]

29.

Auriemma M, Di Nicola M, Gonzalez S, Piaserico S, Capo A, Amerio P. Polypodium leucotomos supplementation in the treatment of scalp actinic keratosis: could it improve the efficacy of photodynamic therapy? Dermatol Surg. 2015;41:898–902. [DOI] [PubMed]

30.

Piaserico S, Mazzetto R, Sartor E, Bortoletti C. Combination-based strategies for the treatment of actinic keratoses with photodynamic therapy: an evidence-based review. Pharmaceutics. 2022;14:1726. [DOI] [PubMed] [PMC]

31.

Stump M, Dhinsa H, Powers J, Stone M. Attenuation of actinic prurigo eruptions with Polypodium leucotomos supplementation. Pediatr Dermatol. 2022;39:145–6. [DOI] [PubMed]

32.

Sempere-Ortells JM, Campos A, Velasco I, Marco F, Ramirez-Bosca A, Diaz J, et al. Anapsos (Polypodium leucotomos) modulates lymphoid cells and the expression of adhesion molecules. Pharmacol Res. 2002;46:185–90. [DOI] [PubMed]

33.

Thompson KG, Kim N. Dietary supplements in dermatology: a review of the evidence for zinc, biotin, vitamin D, nicotinamide, and polypodium. J Am Acad Dermatol. 2021;84:1042–50. [DOI] [PubMed]

34.

Dedios M, Ninell J. Niveles de radiación ultravioleta, fenotipos e infraestructura de protección solar en instituciones educativas de Piura, Perú. Rev Colomb Enfermería. 2017;15:40–9. Spanish. [DOI]

35.

Garnacho Saucedo GM, Salido Vallejo R, Moreno Giménez JC. Efectos de la radiación solar y actualización en fotoprotección. An Pediatr (Engl Ed). 2020;92:377.e1–9. Spanish. [DOI] [PubMed]

36.

Subhadarshani S, Athar M, Elmets CA. Photocarcinogenesis. Curr Derm Rep. 2020;9:189–99. [DOI]

37.

García-Malinis AJ, Gracia-Cazaña T, Zazo M, Aguilera J, Rivas-Ruiz F, de Troya Martín M, et al. Hábitos y conocimientos sobre fotoprotección y factores de riesgo para quemadura solar en corredores de maratones de montaña. Actas Dermo-Sifiliogr. 2021;112:159–66. Spanish. [DOI] [PubMed]

38.

Gracia-Cazaña T, González S, Parrado C, Juarranz Á, Gilaberte Y. La influencia del exposoma en el cáncer de piel. Actas Dermo-Sifiliogr. 2020;111:460–70. Spanish. [DOI] [PubMed]

39.

Palomino OM. Current knowledge in Polypodium leucotomos effect on skin protection. Arch Dermatol Res. 2015;307:199–209. [DOI] [PubMed]

40.

Parrado C, Nicolas J, Juarranz A, Gonzalez S. The role of the aqueous extract Polypodium leucotomos in photoprotection. Photochem Photobiol Sci. 2020;19:831–43. [DOI] [PubMed]

41.

Nestor MS, Berman B, Swenson N. Safety and efficacy of oral Polypodium leucotomos extract in healthy adult subjects. J Clin Aesthet Dermatol. 2015;8:19–23. [PubMed] [PMC]

42.

Narayanan DL, Saladi RN, Fox JL. Ultraviolet radiation and skin cancer. Int J Dermatol. 2010;49:978–86. [DOI] [PubMed]

43.

Corrêa Mde P. Solar ultraviolet radiation: properties, characteristics and amounts observed in Brazil and South America. An Bras Dermatol. 2015;90:297–313. [DOI] [PubMed] [PMC]

44.

Bharath AK, Turner RJ. Impact of climate change on skin cancer. J R Soc Med. 2009;102:215–8. [DOI] [PubMed] [PMC]

45.

Bosch R, Philips N, Suárez-Pérez JA, Juarranz A, Devmurari A, Chalensouk-Khaosaat J, et al. Mechanisms of photoaging and cutaneous photocarcinogenesis, and photoprotective strategies with phytochemicals. Antioxidants (Basel). 2015;4:248–68. [DOI] [PubMed] [PMC]

46.

Scalbert A, Johnson IT, Saltmarsh M. Polyphenols: antioxidants and beyond. Am J Clin Nutr. 2005;81:215S–7S. [DOI] [PubMed]

47.

Khatoon M, Islam E, Islam R, Rahman AA, Alam AH, Khondkar P, et al. Estimation of total phenol and in vitro antioxidant activity of Albizia procera leaves. BMC Res Notes. 2013;6:121. [DOI] [PubMed] [PMC]

48.

San-Miguel A, Martin-Gil FJ. Importancia de las especies reactivas al oxigeno (radicales libres) y los antioxidantes en clinica. Gac Med Bilbao. 2009;106:106–13. Spanish. [DOI]

49.

Esteva E. Fotoprotección. Offarm. 2005;24:64–72. Spanish.

50.

Seto Y, Ohtake H, Sato H, Onoue S. Phototoxic risk assessment of dermally-applied chemicals with structural variety based on photoreactivity and skin deposition. Regul Toxicol Pharmacol. 2020;113:104619. [DOI] [PubMed]

51.

Taylor JH, Rosen CF. Correction to: systemic photoprotection. Curr Derm Rep. 2020;9:362. [DOI]

52.

Dunaway S, Odin R, Zhou L, Ji L, Zhang Y, Kadekaro AL. Natural antioxidants: multiple mechanisms to protect skin from solar radiation. Front Pharmacol. 2018;9:392. [DOI] [PubMed] [PMC]

53.

Smijs TG, Pavel S. Titanium dioxide and zinc oxide nanoparticles in sunscreens: focus on their safety and effectiveness. Nanotechnol Sci Appl. 2011;4:95–112. [DOI] [PubMed] [PMC]

54.

Serini S, Guarino R, Ottes Vasconcelos R, Celleno L, Calviello G. The combination of sulforaphane and Fernblock^® XP improves individual beneficial effects in normal and neoplastic human skin cell lines. Nutrients. 2020;12:1608. [DOI] [PubMed] [PMC]

55.

González S, Pathak MA. Inhibition of ultraviolet-induced formation of reactive oxygen species, lipid peroxidation, erythema and skin photosensitization by polypodium leucotomos. Photodermatol Photoimmunol Photomed. 1996;12:45–56. [DOI] [PubMed]

56.

Gonzalez S, Gilaberte Y, Philips N, Juarranz A. Fernblock, a nutriceutical with photoprotective properties and potential preventive agent for skin photoaging and photoinduced skin cancers. Int J Mol Sci. 2011;12:8466–75. [DOI] [PubMed] [PMC]

57.

Herrera MC, León SV, Tolentino RG, Francisca MV, Vázquez CCR. Antioxidantes: perspectiva actual para la salud humana. Marcela Rev chil nutr. 2015;42:2. Spanish. [DOI]

58.

Avello M, Suwalsky M. Radicales libres, antioxidantes naturales y mecanismos de protección. Atenea. 2006:161–72. Spanish. [DOI]

59.

Salido FP, Fernández JJR. Influencia de los radicales libres en el envejecimiento celular. Offarm. 2002;21:96–100. Spanish.

60.

Addor FAS. Antioxidants in dermatology. An Bras Dermatol. 2017;92:356–62. [DOI] [PubMed] [PMC]

61.

Silva SAME, Michniak-Kohn B, Leonardi GR. An overview about oxidation in clinical practice of skin aging. An Bras Dermatol. 2017;92:367–74. [DOI] [PubMed] [PMC]

62.

González S, Lucena SR, Delgado P, Juarranz A. Comparison of several hydrophilic extracts of Polypodium leucotomos reveals different antioxidant moieties and photoprotective effects in vitro. J Med Plants Res. 2018;12:336–45. [DOI]

63.

Capote R, Alonso-Lebrero JL, García F, Brieva A, Pivel JP, González S. Polypodium leucotomos extract inhibits trans-urocanic acid photoisomerization and photodecomposition. J Photochem Photobiol B. 2006;82:173–9. [DOI] [PubMed]

64.

Nichols JA, Katiyar SK. Skin photoprotection by natural polyphenols: anti-inflammatory, antioxidant and DNA repair mechanisms. Arch Dermatol Res. 2010;302:71–83. [DOI] [PubMed] [PMC]

65.

Afaq F, Katiyar SK. Polyphenols: skin photoprotection and inhibition of photocarcinogenesis. Mini Rev Med Chem. 2011;11:1200–15. [DOI] [PubMed] [PMC]

66.

García LAEZ. El envejecimiento y el estrés oxidative. Rev Cubana Invest Bioméd. 2002;21:3. Spanish.

67.

Vaquero-Raya EC, Molero-Richard X. Especies reactivas de oxígeno en las enfermedades inflamatorias del páncreas: ¿una posible diana terapéutica? Gastroenterol Hepatol. 2005;28:473–84. Spanish. [DOI] [PubMed]

68.

Delgado-Wicke P, Rodríguez-Luna A, Ikeyama Y, Honma Y, Kume T, Gutierrez M, et al. Fernblock^® upregulates NRF2 antioxidant pathway and protects keratinocytes from PM_2.5-induced xenotoxic stress. Oxid Med Cell Longev. 2020;2020:2908108. [DOI] [PubMed] [PMC]

69.

El-Haj N, Goldstein N. Sun protection in a pill: the photoprotective properties of Polypodium leucotomos extract. Int J Dermatol. 2015;54:362–6. [DOI] [PubMed]

70.

Bosqueta LG. Los peligros de la radiación solar. Fotoprotección. Offarm. 2001;20:75–84. Spanish.

71.

Marcos FV. La Contaminación ambiental como factor determinante de la salud. Rev Esp Salud Publica. 2005;79:117–27. Spanish. [DOI] [PubMed]

72.

Sanmartín Jimenez O. The rising incidence of melanoma and nonmelanoma skin cancer obliges us to persevere with primary and secondary prevention campaigns. Actas Dermo-Sifiliográficas. 2017;108:324. [DOI] [PubMed]

73.

Ramos MFS, Santos EP, Dellamora-Ortiz GM. Avaliação da atividade antisolar e estudos preliminares de fotodegradação da propolis. Rev Fitos. 2010;5:3. Portuguese.

74.

Nascimento LF, Santos EP, Aguiar AP. Fotoprotetores orgânicos: pesquisa, inovação e a importância da síntese organic. Rev Virtual Quim. 2014;6:190–223. Portuguese.

75.

Vieira CBS, Orlanda JFF. Atividade antioxidante e fotoprotetora do extrato etanólico de Ocimum gratissimum L. (alfavaca, Lamiaceae). Rev Cubana Plant Med. 2018;23:3. Portuguese.

76.

Korman AM, Reynolds KA, Nabhan F, Konda B, Shah MH, Kaffenberger BH. Vandetanib-induced phototoxic drug eruption treated with Polypodium leucotomos extract: a case report and review of the literature. J Clin Aesthet Dermatol. 2019;12:35–8. [PubMed] [PMC]

77.

Emanuele E, Bertona M, Biagi M. Comparative effects of a fixed Polypodium leucotomos/Pomegranate combination versus Polypodium leucotomos alone on skin biophysical parameters. Neuro Endocrinol Lett. 2017;38:38–42. [PubMed]

78.

Philips N, Gonzalez S. Beneficial regulation of elastase activity and expression of tissue inhibitors of matrixmetalloproteinases, fibrillin, transforming growth factor-β, and heat shock proteins by P. leucotomos in nonirradiated or ultraviolet-radiated epidermal keratinocytes. ISRN Oxidative Med. 2013;2013:257463.

79.

Mohammad TF, Kohli I, Nicholson CL, Treyger G, Chaowattanapanit S, Nahhas AF, et al. Oral Polypodium leucotomos extract and its impact on visible light-induced pigmentation in human subjects. J Drugs Dermatol. 2019;18:1198–203. [PubMed]