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Tocotrienol-Rich Fraction Attenuates Blue Light-Induced Oxidative Stress and Melanogenesis in B16-F1 Melanocytes via Anti-Oxidative and Anti-Tyrosinase Properties

Neo JRE, Teo CWL, Ung YW, Yap WN

Int J Mol Sci, 2023 Oct 19;24(20).
PMID: 37895053 DOI: 10.3390/ijms242015373

Our skin is constantly exposed to blue light (BL), which is abundant in sunlight and emitted by digital devices. Prolonged exposure to BL can lead to oxidative stress-induced damages and skin hyperpigmentation. For this study, we used a cell line-based model to examine the protective effects of tocotrienol-rich fraction (TRF) on BL-induced oxidative stress and hyperpigmentation in B16-F1 melanocytes. Alpha-tocopherol (αTP) was used as a comparator. Molecular assays such as cell viability assay, flow cytometry, western blotting, fluorescence imaging, melanin and tyrosinase analysis were performed. Our results showed that TRF effectively suppressed the formation of reactive oxygen species and preserved the mitochondrial membrane potential. Additionally, TRF exhibited anti-apoptotic properties by reducing the activation of the p38 mitogen-activated protein kinase molecule and downregulating the expression of cleaved caspase-3. Moreover, TRF modulated tyrosinase activity, resulting in a lowered rate of melanogenesis and reduced melanin production. In contrast, αTP did not exhibit significant protective effects against skin damages and pigmentation in BL-induced B16-F1 cells. Therefore, this study indicates that TRF may offer superior protective effects over αTP against the effects of BL on melanocytes. These findings demonstrate the potential of TRF as a protective natural ingredient that acts against BL-induced skin damages and hyperpigmentation via its anti-oxidative and anti-melanogenic properties.
Fulltext Tocotrienol is a cardioprotective agent against ageing-associated cardiovascular disease and its associated morbidities

Ramanathan N, Tan E, Loh LJ, Soh BS, Yap WN

Nutr Metab (Lond), 2018;15:6.
PMID: 29387138 DOI: 10.1186/s12986-018-0244-4

Ageing is a nonmodifiable risk factor that is linked to increased likelihood of cardiovascular morbidities. Whilst many pharmacological interventions currently exist to treat many of these disorders such as statins for hypercholesterolemia or beta-blockers for hypertension, the elderly appear to present a greater likelihood of suffering non-related side effects such as increased risk of developing new onset type 2 diabetes (NODM). In some cases, lower efficacy in the elderly have also been reported. Alternative forms of treatment have been sought to address these issues, and there has been a growing interest in looking at herbal remedies or plant-based natural compounds. Oxidative stress and inflammation are implicated in the manifestation of ageing-related cardiovascular disease. Thus, it is natural that a compound that possesses both antioxidative and anti-inflammatory bioactivities would be considered. This review article examines the potential of tocotrienols, a class of Vitamin E compounds with proven superior antioxidative and anti-inflammatory activity compared to tocopherols (the other class of Vitamin E compounds), in ameliorating ageing-related cardiovascular diseases and its associated morbidities. In particular, the potential of tocotrienols in improving inflammaging, dyslipidemia and mitochondrial dysfunction in ageing-related cardiovascular diseases are discussed.
Fulltext Vitamin E in Atopic Dermatitis: From Preclinical to Clinical Studies

Teo CWL, Tay SHY, Tey HL, Ung YW, Yap WN

Dermatology, 2021;237(4):553-564.
PMID: 33070130 DOI: 10.1159/000510653

BACKGROUND: Oxidative stress and inflammation are some of the proposed mechanisms involved in the pathogenesis of atopic dermatitis (AD). Current pharmacotherapeutic approaches are effective yet they are not without adverse effects. Vitamin E has great potential as an adjunctive treatment for AD owing to its antioxidant and anti-inflammatory bioactivities.
SUMMARY: This review article summarizes the current available evidence from cellular, animal and clinical studies on the relationship between vitamin E and AD. The future prospects of vitamin E are also discussed. Vitamin E in practice does not show any toxicity to humans within a range of reasonable dosage. Albeit rarely, vitamin E as a contact allergen should be considered. Collectively, this review envisaged vitamin E as an adjunctive treatment for AD patients. Future research on the distinct effects of different vitamin E isoforms as well as their delivery system in skin disorders is needed.
Fulltext Efficacy of Topical Emollients on Skin Biophysical Properties and Inflammatory Markers in Stasis Eczema

Goon JA, Jamil A, Al-Jameel I, Saud Gany SL, Yap WN, Loong HY, et al.

Skin Pharmacol Physiol, 2026 Oct 10.
PMID: 42858311 DOI: 10.1159/spp/aetag006

INTRODUCTION: Stasis eczema is a chronic inflammatory skin condition commonly associated with chronic venous insufficiency and represents a significant clinical burden. Emollients are widely used to improve skin hydration and barrier function; however, their effects on inflammation and skin remodeling in stasis eczema remain unclear. This study aimed to evaluate the impact of a topical emollient on skin barrier integrity and systemic inflammatory markers in affected patients.
METHODS: Fifty patients with stasis eczema were randomized to receive either a topical emollient or placebo for 6 weeks. Skin parameters, including melanin content, hydration, and transepidermal water loss, were assessed using Tewameter. Plasma levels of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), anti-inflammatory cytokine IL-10, and matrix metalloproteinases (MMPs: MMP-1, MMP-2, MMP-3, and MMP-9) were measured using enzyme-linked immunosorbent assay at baseline and after treatment.
RESULTS: Baseline clinical assessment demonstrated a high prevalence of comorbidities, particularly hypertension, chronic venous insufficiency, diabetes mellitus, and dyslipidemia. No statistically significant changes were observed in skin barrier parameters or circulating cytokine levels following 6 weeks of treatment. MMP-1 and MMP-2 concentrations remained stable in both groups. However, posttreatment MMP-3 levels were significantly higher in the emollient group than in the placebo group, while MMP-9 demonstrated a significant within-group change in the placebo group only.
CONCLUSION: Short-term use of a topical emollient may help maintain skin barrier function and systemic inflammatory status but does not appear to produce clinically meaningful improvements in most skin barriers or inflammatory parameters, despite isolated significant changes observed in specific MMP biomarkers in patients with chronic stasis eczema. These findings highlight the complexity of disease management in this population and suggest that longer treatment durations, larger sample sizes, consideration and statistical adjustment for baseline comorbidities are warranted in future studies.
Fulltext From Flying Surgeon to Permanent Hub: A Historical Vignette of Decentralised Neurosurgical Service Development in Rural East Coast Sabah

Yap TC, Tan SE, Yap WN, Melchior RG, Bong JN, Wan Mohd Azaharuddin WNS, et al.

Malays J Med Sci, 2026 Aug;33(4):140-157.
PMID: 42936808 DOI: 10.21315/mjms-02-2026-113

BACKGROUND: Access to neurosurgical care in remote regions remains challenging because of the uneven distribution of specialists, transportation limitations, and infrastructure constraints. For many years, patients from East Coast Sabah relied on transfer to Queen Elizabeth Hospital, Kota Kinabalu, for emergency and elective neurosurgical care, often requiring long-distance evacuation. This study describes the phased development of a decentralised neurosurgical service in Tawau and evaluates associated regional service trends.
METHODS: This descriptive historical vignette and service evaluation reviewed aggregated neurosurgical data from Tawau Hospital, Duchess of Kent Hospital (Sandakan), and Lahad Datu Hospital from 2019 through April 2026. Service activity was analysed across three phases: the flying surgeon model, rotational specialist postings, and permanent specialist deployment. Referrals, admissions, outpatient attendance, operative activity, interhospital transfers, and mortality were evaluated descriptively.
RESULTS: The East Coast Sabah Neurosurgical Service evolved from a monthly visiting service to rotational specialist coverage and, ultimately, a permanent Tawau-based hub in 2025. Referrals, outpatient attendance, and operative workload increased progressively across the three phases. Mean annual referrals increased from 1,388 to 1,802 and reached an annualised 2,130 during early Phase 3. Annual outpatient attendance increased from 1,117 to 1,675, with an annualised total of 2,526 visits. Operative volume increased from 202 to 366, with an annualised total of 374 procedures, while the proportion of elective procedures rose from 1.9% to 16.5%. Crude inpatient mortality rates were 5.8%, 4.9%, and 3.2% across the three phases. Following establishment of the permanent hub, emergency transfers from Tawau decreased from approximately 35 per year during Phase 2 to an annualised 18 per year during early Phase 3, corresponding to a crude administrative estimate of annual government cost avoidance of approximately RM425,000 to RM680,000 through reduced emergency air evacuations.
CONCLUSION: The phased decentralisation of neurosurgical services in Tawau was associated with expanded local capacity, improved continuity of care, and reduced reliance on transfers to a tertiary referral centre for selected neurosurgical conditions.