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Del Rosso JQ, Kircik L. The cutaneous effects of androgens and androgen-mediated sebum production and their pathophysiologic and therapeutic importance in acne vulgaris. J DERMATOL TREAT 2024; 35:2298878. [PMID: 38192024 DOI: 10.1080/09546634.2023.2298878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024]
Abstract
Background: The recognition of an association between the development of acne vulgaris (AV) and pubertal hormonal changes during adolescence dates back almost 100 years. Since these formative observations, a significant role of circulating hormones in the pathophysiology of AV and other cutaneous disorders has been established.Aims: This review article aims to provide an overview of clinical and preclinical evidence supporting the influences of androgens on the skin and their therapeutic importance in AV pathophysiology.Results: The cutaneous effects of hormones are attributable, to a large extent, to the influence of steroid hormones, particularly androgens, on sebocyte development and sebum production in both sexes. Androgen-mediated excess sebum production is implicated as a necessary early step in AV pathophysiology and is therefore considered an important therapeutic target in AV treatment. Although the local production and/or activity of androgens within the skin is believed to be important in AV pathophysiology, it has received limited therapeutic attention.Conclusions: We have summarized the current evidence in support of the therapeutic benefits of targeted hormonal treatment to decrease androgen-stimulated sebum production for the effective and safe treatment of AV in both male and female patients.
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Affiliation(s)
- James Q Del Rosso
- Touro University Nevada, Henderson, NV, USA
- JDR Dermatology Research, Las Vegas, NV, USA
- Advanced Dermatology and Cosmetic Surgery, Maitland, FL, USA
| | - Leon Kircik
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Indiana University, School of Medicine, Indianapolis, IN, USA
- Physicians Skin Care, PLLC, Louisville, KY, USA
- DermResearch, PLLC, Louisville, KY, USA
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Unluhizarci K, Hacioglu A, Taheri S, Karaca Z, Kelestimur F. Idiopathic hirsutism: Is it really idiopathic or is it misnomer? World J Clin Cases 2023; 11:292-298. [PMID: 36686351 PMCID: PMC9850967 DOI: 10.12998/wjcc.v11.i2.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
Hirsutism, which is characterized by excessive growth of terminal hair in a male pattern, may result from various causes including polycystic ovary syndrome (PCOS), non-classic congenital adrenal hyperplasia, adrenal or ovarian tumors or it may be idiopathic. Idiopathic hirsutism is currently defined as hirsutism associated with normal ovulatory function, normal serum androgen levels and normal ovarian morphology, however, the pathogenesis of idiopathic hirsutism is not clear. The androgens are the main hormones to stimulate growth of body hair, therefore, there should be any form of increased androgen effect irrespective of normal serum androgen levels in any patient with hirsutism. In accordance to this scientific truth, we have previously shown that, although within normal limits, patients with idiopathic hirsutism have relatively higher serum androgen levels (relative hyperandrogenemia) in comparison to healthy subjects which let as to think that is idiopathic hirsutism really idiopathic? In addition to relative hyperandrogenemia, we have previously shown that, in comparison to healthy subjects, women with idiopathic hirsutism demonstrated higher expression of steroid sulphatase and 17-beta hydroxysteroid dehydrogenase mRNA both in the subumbilical region and arm skin, which contributes to local androgen metabolism. Those results support the idea that, in some patients, although the adrenals or ovaries do not secrete increased amount of androgens leading to hyperandrogenemia, pilocebaceous unit locally produce increased amount of androgens leading to hirsutism without ovulatory dysfunction. Upon the demonstration of relative hyperandrogenemia and possible increase in local androgen synthesis in patients with idiopathic hirsutism, we think that idiopathic hirsutism is not idiopathic and it may be named as “normoandrogenic hirsutism”. Furthermore, it may not be a different entity but may be an early stage of hyperandrogenic disorders such as PCOS. Clinically, this can be find out by following-up patients with idiopathic hirsutism prospectively.
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Affiliation(s)
- Kursad Unluhizarci
- Department of Endocrinology, Erciyes University Medical School, Kayseri 38039, Turkey
| | - Aysa Hacioglu
- Department of Endocrinology, Erciyes University Medical School, Kayseri 38039, Turkey
| | - Serpil Taheri
- Department of Medical Biology, Erciyes University Medical School, Kayseri 38039, Turkey
| | - Zuleyha Karaca
- Department of Endocrinology, Erciyes University Medical School, Kayseri 38039, Turkey
| | - Fahrettin Kelestimur
- Department of Endocrinology, Yeditepe University Medical School, Istanbul 34755, Turkey
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3
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Slominski AT, Slominski RM, Raman C, Chen JY, Athar M, Elmets C. Neuroendocrine signaling in the skin with a special focus on the epidermal neuropeptides. Am J Physiol Cell Physiol 2022; 323:C1757-C1776. [PMID: 36317800 PMCID: PMC9744652 DOI: 10.1152/ajpcell.00147.2022] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
The skin, which is comprised of the epidermis, dermis, and subcutaneous tissue, is the largest organ in the human body and it plays a crucial role in the regulation of the body's homeostasis. These functions are regulated by local neuroendocrine and immune systems with a plethora of signaling molecules produced by resident and immune cells. In addition, neurotransmitters, endocrine factors, neuropeptides, and cytokines released from nerve endings play a central role in the skin's responses to stress. These molecules act on the corresponding receptors in an intra-, juxta-, para-, or autocrine fashion. The epidermis as the outer most component of skin forms a barrier directly protecting against environmental stressors. This protection is assured by an intrinsic keratinocyte differentiation program, pigmentary system, and local nervous, immune, endocrine, and microbiome elements. These constituents communicate cross-functionally among themselves and with corresponding systems in the dermis and hypodermis to secure the basic epidermal functions to maintain local (skin) and global (systemic) homeostasis. The neurohormonal mediators and cytokines used in these communications regulate physiological skin functions separately or in concert. Disturbances in the functions in these systems lead to cutaneous pathology that includes inflammatory (i.e., psoriasis, allergic, or atopic dermatitis, etc.) and keratinocytic hyperproliferative disorders (i.e., seborrheic and solar keratoses), dysfunction of adnexal structure (i.e., hair follicles, eccrine, and sebaceous glands), hypersensitivity reactions, pigmentary disorders (vitiligo, melasma, and hypo- or hyperpigmentary responses), premature aging, and malignancies (melanoma and nonmelanoma skin cancers). These cellular, molecular, and neural components preserve skin integrity and protect against skin pathologies and can act as "messengers of the skin" to the central organs, all to preserve organismal survival.
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Affiliation(s)
- Andrzej T Slominski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
- Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, Alabama
- VA Medical Center, Birmingham, Alabama
| | - Radomir M Slominski
- Graduate Biomedical Sciences Program, University of Alabama at Birmingham, Birmingham, Alabama
| | - Chander Raman
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jake Y Chen
- Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mohammad Athar
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
- VA Medical Center, Birmingham, Alabama
| | - Craig Elmets
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
- Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, Alabama
- VA Medical Center, Birmingham, Alabama
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4
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Zouboulis CC, Coenye T, He L, Kabashima K, Kobayashi T, Niemann C, Nomura T, Oláh A, Picardo M, Quist SR, Sasano H, Schneider MR, Törőcsik D, Wong SY. Sebaceous immunobiology - skin homeostasis, pathophysiology, coordination of innate immunity and inflammatory response and disease associations. Front Immunol 2022; 13:1029818. [PMID: 36439142 PMCID: PMC9686445 DOI: 10.3389/fimmu.2022.1029818] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/17/2022] [Indexed: 08/01/2023] Open
Abstract
This review presents several aspects of the innovative concept of sebaceous immunobiology, which summarizes the numerous activities of the sebaceous gland including its classical physiological and pathophysiological tasks, namely sebum production and the development of seborrhea and acne. Sebaceous lipids, which represent 90% of the skin surface lipids in adolescents and adults, are markedly involved in the skin barrier function and perifollicular and dermal innate immune processes, leading to inflammatory skin diseases. Innovative experimental techniques using stem cell and sebocyte models have clarified the roles of distinct stem cells in sebaceous gland physiology and sebocyte function control mechanisms. The sebaceous gland represents an integral part of the pilosebaceous unit and its status is connected to hair follicle morphogenesis. Interestingly, professional inflammatory cells contribute to sebocyte differentiation and homeostasis, whereas the regulation of sebaceous gland function by immune cells is antigen-independent. Inflammation is involved in the very earliest differentiation changes of the pilosebaceous unit in acne. Sebocytes behave as potent immune regulators, integrating into the innate immune responses of the skin. Expressing inflammatory mediators, sebocytes also contribute to the polarization of cutaneous T cells towards the Th17 phenotype. In addition, the immune response of the perifollicular infiltrate depends on factors produced by the sebaceous glands, mostly sebaceous lipids. Human sebocytes in vitro express functional pattern recognition receptors, which are likely to interact with bacteria in acne pathogenesis. Sex steroids, peroxisome proliferator-activated receptor ligands, neuropeptides, endocannabinoids and a selective apoptotic process contribute to a complex regulation of sebocyte-induced immunological reaction in numerous acquired and congenital skin diseases, including hair diseases and atopic dermatitis.
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Affiliation(s)
- Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Tom Coenye
- Laboratory of Pharmaceutical Microbiology, Ghent University, Ghent, Belgium
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tetsuro Kobayashi
- Laboratory for Innate Immune Systems, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Kanagawa, Japan
| | - Catherin Niemann
- Center for Molecular Medicine Cologne, CMMC Research Institute, University of Cologne, Cologne, Germany
- Center for Biochemistry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Takashi Nomura
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Mauro Picardo
- San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Sven R. Quist
- Department of Dermatology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Hironobu Sasano
- Department of Pathology, Tohoku University School of Medicine, Sendai, Japan
| | - Marlon R. Schneider
- Institute of Veterinary Physiology, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Daniel Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen and ELKH-DE Allergology Research Group, Debrecen, Hungary
| | - Sunny Y. Wong
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, United States
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Abstract
Acne vulgaris is a multifactorial chronic inflammatory disorder of the pilosebaceous unit, and it represents the most common skin disease affecting about 85% of adolescents in Western populations. The prevalence of acne vulgaris in developed countries is higher than that in developing countries.Emerging data has shown some systemic diseases closely associated with acne, including obesity, diabetes mellitus, cardiovascular diseases, metabolic syndrome (Mets), and so on.This review summarizes acne-associated diseases that have been reported in studies, and analyzes the possible co-pathogenesis of these diseases and acne.
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Affiliation(s)
- Yun Wang
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People’s Republic of China
| | - Mingfang Zhu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People’s Republic of China
- Correspondence: Mingfang Zhu, Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, 233 Cai E North Road, Kaifu District, Changsha, People’s Republic of China, Tel +86-13907317358, Fax +86-731-84917727, Email
| | - Shuhui Wu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People’s Republic of China
| | - Huie Zheng
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People’s Republic of China
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Zhang C, Chinnappan M, Prestwood CA, Edwards M, Artami M, Thompson BM, Eckert KM, Vale G, Zouboulis CC, McDonald JG, Harris-Tryon TA. Interleukins 4 and 13 drive lipid abnormalities in skin cells through regulation of sex steroid hormone synthesis. Proc Natl Acad Sci U S A 2021; 118:e2100749118. [PMID: 34521750 DOI: 10.1073/pnas.2100749118] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 01/04/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by skin dryness, inflammation, and itch. A major hallmark of AD is an elevation of the immune cytokines IL-4 and IL-13. These cytokines lead to skin barrier disruption and lipid abnormalities in AD, yet the underlying mechanisms are unclear. Sebaceous glands are specialized sebum-producing epithelial cells that promote skin barrier function by releasing lipids and antimicrobial proteins to the skin surface. Here, we show that in AD, IL-4 and IL-13 stimulate the expression of 3β-hydroxysteroid dehydrogenase 1 (HSD3B1), a key rate-limiting enzyme in sex steroid hormone synthesis, predominantly expressed by sebaceous glands in human skin. HSD3B1 enhances androgen production in sebocytes, and IL-4 and IL-13 drive lipid abnormalities in human sebocytes and keratinocytes through HSD3B1. Consistent with our findings in cells, HSD3B1 expression is elevated in the skin of AD patients and can be restored by treatment with the IL-4Rα monoclonal antibody, Dupilumab. Androgens are also elevated in a mouse model of AD, though the mechanism in mice remains unclear. Our findings illuminate a connection between type 2 immunity and sex steroid hormone synthesis in the skin and suggest that abnormalities in sex steroid hormone synthesis may underlie the disrupted skin barrier in AD. Furthermore, targeting sex steroid hormone synthesis pathways may be a therapeutic avenue to restoring normal skin barrier function in AD patients.
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Li MT, Pi XX, Cai XL, Liu S, Huang Z, Zouboulis CC, Fan YM, Shi G. Ferredoxin reductase regulates proliferation, differentiation, cell cycle and lipogenesis but not apoptosis in SZ95 sebocytes. Exp Cell Res 2021; 405:112680. [PMID: 34090862 DOI: 10.1016/j.yexcr.2021.112680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 05/07/2021] [Accepted: 05/28/2021] [Indexed: 01/14/2023]
Abstract
Ferredoxin reductase (FDXR), a mitochondrial membrane-associated flavoprotein, is essential for electron transfer and modulates p53-dependent apoptosis in cancer cells.FDXR may be implicated in epidermal and sebocytic differentiation, but its explicit function in sebocytes remains to be elucidated. In the present study, immunohistochemistry revealed that FDXR expression was increased in sebaceous cells of acne lesions. FDXR, PPARγ, LXRα/β, SREBP1 and Sox9 expression was incremental during sebocyte differentiation. FDXR overexpression induced by Ad-GFP-FDXR infection enhanced differentiation, reactive oxygen species (ROS), lipogenesis and PPARγ expression, and consequnently inhibited proliferation in SZ95 sebocytes. Flow cytometry showed that FDXR overexpression induced significant blockade of G2/M phase but had no effect on sub-G1 (apoptotic) sebocytes. Insulin-like growth factor-1 (IGF-1)-induced FDXR and PPARγ expression and lipogenesis were abolished by pretreatment with PI3K inhibitor LY294002. These results suggest that FDXR overexpression might promote differentiation and lipogenesis via ROS production and suppress proliferation via G2/S blockade in SZ95 sebocytes. IGF-1 could facilitate differentiation and lipogenesis through PI3K/Akt/FDXR pathway. FDXR could serve as a potential marker of advanced sebaceous differentiation, and its overexpression may be involved in the development of acne lesions.
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Sobolev V, Nesterova A, Soboleva A, Dvoriankova E, Piruzyan A, Mildzikhova D, Korsunskaya I, Svitich O. The Model of PPARγ-Downregulated Signaling in Psoriasis. PPAR Res 2020; 2020:6529057. [PMID: 33133175 DOI: 10.1155/2020/6529057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/02/2020] [Accepted: 09/18/2020] [Indexed: 12/12/2022] Open
Abstract
Interactions of genes in intersecting signaling pathways, as well as environmental influences, are required for the development of psoriasis. Peroxisome proliferator-activated receptor gamma (PPARγ) is a nuclear receptor and transcription factor which inhibits the expression of many proinflammatory genes. We tested the hypothesis that low levels of PPARγ expression promote the development of psoriatic lesions. We combined experimental results and network functional analysis to reconstruct the model of PPARγ-downregulated signaling in psoriasis. We hypothesize that the expression of IL17, STAT3, FOXP3, and RORC and FOSL1 genes in psoriatic skin is correlated with the level of PPARγ expression, and they belong to the same signaling pathway that regulates the development of psoriasis lesion.
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9
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Zouboulis CC. Endocrinology and immunology of acne: Two sides of the same coin. Exp Dermatol 2020; 29:840-859. [DOI: 10.1111/exd.14172] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg Dessau Germany
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Yu B, Diao NN, Zhang Y, Li XZ, Yu N, Ding YF, Shi YL. Network pharmacology-based identification for therapeutic mechanisms of Dangguikushen pill in acne vulgaris. Dermatol Ther 2020; 33:e14061. [PMID: 32705750 DOI: 10.1111/dth.14061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 11/28/2022]
Abstract
The Dangguikushen (DGKS) pill is a proprietary traditional Chinese medicine that has shown superior efficacy in the treatment of acne vulgaris for many years. A network pharmacology-based analysis was performed to explore the potential anti-acne compounds, core therapeutic targets, and the main pathways, involved in the DGKS pill bioactivity. The matching results between the predicted targets of the DGKS pill and the well-known targets of acne vulgaris were collected, followed by network establishment using protein-protein interaction (PPI) data. Cytoscape was utilized to analyze the network and screen the core targets. Furthermore, the Database for Annotation, Visualization and Integrated Discovery (DAVID), and ClueGO were used for the enrichment analysis of the Kyoto Encyclopedia of Genes and Genomics (KEGG) pathways and Gene Ontology biological processes (GO-BP). Finally, the "compound-target-pathway" network was constructed. This approach identified 19 active compounds, 46 therapeutic targets, and 12 core therapeutic targets of the DGKS pill. The biological processes were primarily related to reactive oxygen species (ROS) metabolic process, gland morphogenesis, and female gonad development. The DGKS pill was significantly associated with eight pathways including the PI3K-Akt, TNF, NF-kappa B, and p53 signaling pathways. DGKS pill might have a synergistic effect on the inhibition of excessive sebaceous lipogenesis and sebocyte differentiation, and likewise, anti-inflammatory effects via the different signaling pathways (PI3K-Akt, TNF, NF-kappa B, and p53).
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Affiliation(s)
- Bo Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
| | - Nan-Nan Diao
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
| | - Ying Zhang
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
| | - Xing-Zi Li
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
| | - Ning Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
| | - Yang-Feng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
| | - Yu-Ling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, Puerto Rico, China
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Tonellotto Dos Santos J, Escarião da Nóbrega J, Serrano Mujica LK, Dos Santos Amaral C, Machado FA, Manta MW, Rizzetti TM, Zanella R, Fighera R, Antoniazzi AQ, Gonçalves PBD, Comim FV. Prenatal Androgenization of Ewes as a Model of Hirsutism in Polycystic Ovary Syndrome. Endocrinology 2018; 159:4056-4064. [PMID: 30376052 DOI: 10.1210/en.2018-00781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/24/2018] [Indexed: 02/04/2023]
Abstract
The main clinical feature associated with hyperandrogenism in polycystic ovary syndrome (PCOS) in humans is hirsutism, where hair increases its length, pigmentation, and particularly its diameter. Currently, it is not known whether PCOS animal models also exhibit changes in the hair. Therefore, the aim of this study was to explore the wool characteristics in sheep prenatally androgenized (PA) with testosterone propionate. After 4 and 13 months of life, wool was collected from the top of the shoulder of both females and males (both androgenized and controls). The offspring sheep were followed for up to 19 months of life to evaluate testosterone and androstenedione serum levels by ultra-high-performance liquid chromatography-tandem mass spectrometry, determine insulin and glucose response to intravenous glucose tolerance test, and address estrus cyclicity during the second breeding season. PA male animals showed a reduction in wool fiber diameter at 4 months of age compared with controls (P = 0.02) but not at 13 months, whereas PA females showed increased hair diameter at 13 months (P = 0.002), with no difference at 4 months. No substantial changes in other hair parameters (length, color, and medullation) were identified. In addition, increased levels of serum testosterone were observed in PA female sheep compared with controls at 12 months (P = 0.03). Our results indicate for the first time, to our knowledge, that changes in wool fiber diameter observed in PA ewes replicate, at the translational level, the increase in hair diameter in hirsute women with PCOS.
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Affiliation(s)
- Joabel Tonellotto Dos Santos
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Jandui Escarião da Nóbrega
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Lady Katerine Serrano Mujica
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Carolina Dos Santos Amaral
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Fabrício Amadori Machado
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Manuela W Manta
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Tiele Medianeira Rizzetti
- Laboratory of Pesticide Analysis (LARP), Department of Chemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Renato Zanella
- Laboratory of Pesticide Analysis (LARP), Department of Chemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Rafael Fighera
- Department of Pathology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Alfredo Quites Antoniazzi
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Paulo Bayard Dias Gonçalves
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Fabio Vasconcellos Comim
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
- Department of Clinical Medicine, Health Science Center, Federal University of Santa Maria, Santa Maria, Brazil
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Reddy R, Cary JH, Elmahdy A, Maibach H. Sebo-pharmacokinetics: a proposed percutaneous sebum egression method. J DERMATOL TREAT 2018; 30:189-193. [PMID: 29768083 DOI: 10.1080/09546634.2018.1476648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND/AIMS The sebaceous gland is widely believed a critical factor in the pathogenesis of acne vulgaris. Although extensive studies document the ability of oral and topical treatments to improve acne, little is known about the quantification and mechanism of drug delivery via the sebaceous gland. A percutaneous egression method presents a way to study how drugs reaching the bloodstream can enter the skin. METHODS A literature search was performed across databases (PubMed, Embase, and Google Scholar) and the University of California, San Francisco (UCSF) textbook library with relevant search terms. RESULTS This search failed to reveal data on sebo-pharmacokinetics (PK); however, many articles center on pharmacodynamics (PD) - i.e. functional improvement instigated by oral or topical treatments. Experiments on humans and hamsters - representative sebaceous gland models - demonstrate indirect PD measures of sebaceous gland function. DISCUSSION Here, we summarize the current available data on drug delivery via the sebaceous gland and suggest a practical method to directly document sebo-PK in man and animal.
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Affiliation(s)
- Rasika Reddy
- a Dermatology Service , Veterans Affairs Medical Center , San Francisco , CA , USA
| | - John Havens Cary
- b Department of Dermatology , University of California , San Francisco , CA , USA
| | - Akram Elmahdy
- b Department of Dermatology , University of California , San Francisco , CA , USA
| | - Howard Maibach
- b Department of Dermatology , University of California , San Francisco , CA , USA
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Szöllősi AG, Oláh A, Bíró T, Tóth BI. Recent advances in the endocrinology of the sebaceous gland. Dermatoendocrinol 2018; 9:e1361576. [PMID: 29484098 PMCID: PMC5821152 DOI: 10.1080/19381980.2017.1361576] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/26/2017] [Indexed: 12/13/2022]
Abstract
The sebaceous gland, long considered an evolutionary relic with little-to-no physiological relevance in humans, has emerged in recent decades as a key orchestrator and contributor to many cutaneous functions. In addition to the classical physico-chemical barrier function of the skin against constant environmental challenges, a more novel, neuro-immune modulatory role has also emerged. As part of the complex intercellular communication network of the integumentary system, the sebaceous gland acts as a “relay station” in the skin for many endocrine factors. This review aims to offer a comprehensive overview of endocrine effects and subsequent interactions on this much maligned mini-organ.
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Affiliation(s)
- Attila G Szöllősi
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs István Tóth
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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15
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Abstract
This review based on translational research predicts that the transcription factor p53 is the key effector of all anti-acne therapies. All-trans retinoic acid (ATRA) and isotretinoin (13-cis retinoic acid) enhance p53 expression. Tetracyclines and macrolides via inhibiting p450 enzymes attenuate ATRA degradation, thereby increase p53. Benzoyl peroxide and hydrogen peroxide elicit oxidative stress, which upregulates p53. Azelaic acid leads to mitochondrial damage associated with increased release of reactive oxygen species inducing p53. p53 inhibits the expression of androgen receptor and IGF-1 receptor, and induces the expression of IGF binding protein 3. p53 induces FoxO1, FoxO3, p21 and sestrin 1, sestrin 2, and tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), the key inducer of isotretinoin-mediated sebocyte apoptosis explaining isotretinoin's sebum-suppressive effect. Anti-androgens attenuate the expression of miRNA-125b, a key negative regulator of p53. It can thus be concluded that all anti-acne therapies have a common mode of action, i.e., upregulation of the guardian of the genome p53. Immortalized p53-inactivated sebocyte cultures are unfortunate models for studying acne pathogenesis and treatment.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.
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Fabbrocini G, Capasso C, Donnarumma M, Cantelli M, Le Maître M, Monfrecola G, Emanuele E. A peel-off facial mask comprising myoinositol and trehalose-loaded liposomes improves adult female acne by reducing local hyperandrogenism and activating autophagy. J Cosmet Dermatol 2017; 16:480-484. [DOI: 10.1111/jocd.12340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 01/26/2023]
Affiliation(s)
- Gabriella Fabbrocini
- Section of Dermatology; Department of Clinical Medicine and Surgery; University of Naples Federico II; Naples Italy
| | - Claudia Capasso
- Section of Dermatology; Department of Clinical Medicine and Surgery; University of Naples Federico II; Naples Italy
| | - Marianna Donnarumma
- Section of Dermatology; Department of Clinical Medicine and Surgery; University of Naples Federico II; Naples Italy
| | - Mariateresa Cantelli
- Section of Dermatology; Department of Clinical Medicine and Surgery; University of Naples Federico II; Naples Italy
| | | | - Giuseppe Monfrecola
- Section of Dermatology; Department of Clinical Medicine and Surgery; University of Naples Federico II; Naples Italy
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Ramot Y, Mastrofrancesco A, Camera E, Desreumaux P, Paus R, Picardo M. The role of PPARγ-mediated signalling in skin biology and pathology: new targets and opportunities for clinical dermatology. Exp Dermatol 2016; 24:245-51. [PMID: 25644500 DOI: 10.1111/exd.12647] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2015] [Indexed: 12/19/2022]
Abstract
Peroxisome proliferator-activated receptors (PPARs) are ligand-activated transcription factors that modulate the expression of multiple different genes involved in the regulation of lipid, glucose and amino acid metabolism. PPARs and cognate ligands also regulate important cellular functions, including cell proliferation and differentiation, as well as inflammatory responses. This includes a role in mediating skin and pilosebaceous unit homoeostasis: PPARs appear to be essential for maintaining skin barrier permeability, inhibit keratinocyte cell growth, promote keratinocyte terminal differentiation and regulate skin inflammation. They also may have protective effects on human hair follicle (HFs) epithelial stem cells, while defects in PPARγ-mediated signalling may promote the death of these stem cells and thus facilitate the development of cicatricial alopecia (lichen planopilaris). Overall, however, selected PPARγ modulators appear to act as hair growth inhibitors that reduce the proliferation and promote apoptosis of hair matrix keratinocytes. The fact that commonly prescribed PPARγ-modulatory drugs of the thiazolidine-2,4-dione class can exhibit a battery of adverse cutaneous effects underscores the importance of distinguishing beneficial from clinically undesired cutaneous activities of PPARγ ligands and to better understand on the molecular level how PPARγ-regulated cutaneous lipid metabolism and PPARγ-mediated signalling impact on human skin physiology and pathology. Surely, the therapeutic potential that endogenous and exogenous PPARγ modulators may possess in selected skin diseases, ranging from chronic inflammatory hyperproliferative dermatoses like psoriasis and atopic dermatitis, via scarring alopecia and acne can only be harnessed if the complexities of PPARγ signalling in human skin and its appendages are systematically dissected.
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Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
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Taheri S, Zararsiz G, Karaburgu S, Borlu M, Ozgun MT, Karaca Z, Tanriverdi F, Dundar M, Kelestimur F, Unluhizarci K. Is idiopathic hirsutism (IH) really idiopathic? mRNA expressions of skin steroidogenic enzymes in women with IH. Eur J Endocrinol 2015; 173:447-54. [PMID: 26194504 DOI: 10.1530/eje-15-0460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/20/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Hirsutism results from hyperandrogenemia and/or exaggerated androgen responsiveness. Among various causes of hirsutism, some patients do not exhibit androgen excess which is called idiopathic hirsutism (IH). The pathogenesis of IH could not so far be clearly established. DESIGN To investigate the mRNA expression of aromatase enzyme and the other enzymes having functional roles in the steroidogenic pathway, in freshly obtained skin tissue from subumbilical skin and the arm of the patients with IH and healthy women. METHODS Twenty-one women with IH and 15 healthy women were included in the study. We aimed to determine mRNA expressions of genes associated with local androgen synthesis and metabolism (CYP11A1, STS, CYP19A1, SRD5A1, SRD5A2, HSD3B1, AR, COMT, ESR1, ESR2, HSD3B2, CYP17A1, SULT2A1, SULT1E1, HSD17B2, IL6, TGFB1, TNFA) from skin biopsy and blood samples of patients with IH and the data compared with healthy subjects. RESULTS Patients with IH exhibit significantly lower interleukin 6 (IL6) mRNA expression and higher steroid sulphatase (STS) and hydroxysteroid (17beta) dehydrogenase 2 (HSD17B2), gene mRNA expression, respectively, in the subumbilical region skin biopsies. Similarly, patients with IH exhibit significantly lower IL6 mRNA expression and higher STS and HSD17B2 gene mRNA expression, respectively, in the arm skin compared to healthy women's subumbilical region. CONCLUSIONS In both arm and subumbilical skin biopsy of patients with IH, we observed an up-regulation of HSD17B2 and STS, decreased IL6 mRNA expression, probably determining an increase in the local amount of active androgens, which could then be used as substrate for other androgen metabolic routes.
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Affiliation(s)
- Serpil Taheri
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Gokmen Zararsiz
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Sulbiye Karaburgu
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Murat Borlu
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Mahmut Tuncay Ozgun
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Zuleyha Karaca
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Fatih Tanriverdi
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Munis Dundar
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Fahrettin Kelestimur
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
| | - Kursad Unluhizarci
- Departments of Medical BiologyStatisticsEndocrinologyDermatologyObstetrics and GynecologyGeneticsErciyes University Medical School, Kayseri 38039, TurkeyBetul-Ziya Eren Genome and Stem Cell CenterErciyes University, Kayseri, Turkey
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Abstract
Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.
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