Methozsalen Tablets (Mesoral-10) -https://vitiligo.see.me/

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Merhoxsalen (also called xanthotxin , marketed under the trade names Oxsoralen , Deltasoralen , Meladinine ) is a drug to treat Psoriasis , eczema , vitiligo , and some cutaneous lymphomas in conjunction with exposing the skin to UVA light from lamps or sunlight . Methoxsalen modifies the way skin cells receive the UVA radiation , allegedly clearing up the disease. The dosage comes in 10 mg tablets ,which are taken in the amount of 30 mg 75 minutes before a PUVA (psoralen + UVA) light treatment . Chemically , methoxsalen belongs to a class of organic natural molecules known as furanacoumarins. They consist contents :-

1. Natural occurrences

2. Biosynthesis: 

a.Synthesis of umbelliferone

b.Synthesis of methoxsalen

3. Risks and side effects

4. Cultural aspects

5. References.

# Natural occurrences :-

Methoxsalen is extracted from Ammi majus , a Plant of the family Apiaceae. The substance is also present in other Apiaceae Biosythesis.

The biosynthetic pathway is a combination of the shikimate pathway , which produces umbelliferone , and the mevalonate pathway.

Synthesis of umbelliferone

Umbelliferone

Umbelliferone is a phenylpropanoid and as such is synthesized from L-pheylalanine , which in turn is produced via the shikimate pathway. Phenylalanine is lysated into cinnamic acid , followed by hydroxylation by cinnamate 4-hydroxylase to yield 4-coumaric acid. The 4-coumaric acid is again hydroxylated by cinnamate/coumarate 2-hydroxy to yield 2,4- dihydroxy-cinnamic acid (umellic acid) followed by a bond rotation of the unsaturated bond adjacent to the cardoxylic acid group. Finally an intermolecular attack from the hydroxyl group of c2 to the carboxylic acid group closes the ring and forms the lactone umbelliferone.

Synthesis of methoxsalen

Dimethyallyl pyrophosphate.

The biosynthetic route then continues with the activation of dimethylallyl pyrophosphate (DMAPP) , produced via the mevalonate pathway , to form a carbo-cation via the cleavage of the diphosphates . Once activated , the enzyme umbelliferone 6-prenyltranferase catalyzes a C-alkylation between DMAPP and umbelliferone at the activated position ortho to the phenol , yielding demethylsuberosin. This is then followed by a hydroxylation catalyzed by the enzyme marmesin synthase to yield marmesin. Another hydroxyation is catalyzed by psoralen synthase to yield psoralen .A third hydroxylation by the enzyme psoralen 8-monooxygenase yields xanthotoxol which is followed by a methylation via the enzyme xanthotoxol 0-methyltransferase and s-adenosyl methionine to yield methoxsalen.

# Risks and side effects :-

Patients with high blood pressure or a histroy of liver problems are at risk for inflammation and irreparable damage to both liver and skin . The eyes must be protected from UVA radiation . Side effects include nausea , headaches , dizziness , in rare cases insomnia. Methoxsalen has also been classified as an IARC Group 1 carcinogen but only cancerous when combined with Ultra Voilet-A radiation.