1
|
Baroud S, Wu J, Zouboulis CC. Acne Syndromes and Mosaicism. Biomedicines 2021; 9:biomedicines9111735. [PMID: 34829964 PMCID: PMC8615598 DOI: 10.3390/biomedicines9111735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/14/2021] [Accepted: 11/19/2021] [Indexed: 01/14/2023] Open
Abstract
Abnormal mosaicism is the coexistence of cells with at least two genotypes, by the time of birth, in an individual derived from a single zygote, which leads to a disease phenotype. Somatic mosaicism can be further categorized into segmental mosaicism and nonsegmental somatic mosaicism. Acne is a chronic illness characterized by inflammatory changes around and in the pilosebaceous units, commonly due to hormone- and inflammatory signaling-mediated factors. Several systemic disorders, such as congenital adrenal hyperplasia, polycystic ovarian syndrome, and seborrhoea-acne-hirsutism-androgenetic alopecia syndrome have classically been associated with acne. Autoinflammatory syndromes, including PAPA, PASH, PAPASH, PsAPASH, PsaPSASH, PASS, and SAPHO syndromes include acneiform lesions as a key manifestation. Mosaic germline mutations in the FGFR2 gene have been associated with Apert syndrome and nevus comedonicus, two illnesses that are accompanied by acneiform lesions. In this review, we summarize the concept of cutaneous mosaicism and elaborate on acne syndromes, as well as acneiform mosaicism.
Collapse
Affiliation(s)
- Sumer Baroud
- Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, 06847 Dessau, Germany; (S.B.); (J.W.)
- College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Jim Wu
- Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, 06847 Dessau, Germany; (S.B.); (J.W.)
| | - Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, 06847 Dessau, Germany; (S.B.); (J.W.)
- Correspondence: ; Tel.: +49-340-501-4000
| |
Collapse
|
2
|
Szymańska A, Budzisz E, Erkiert-Polguj A. The Anti-Acne Effect of Near-Infrared Low-Level Laser Therapy. Clin Cosmet Investig Dermatol 2021; 14:1045-1051. [PMID: 34471368 PMCID: PMC8403573 DOI: 10.2147/ccid.s323132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/16/2021] [Indexed: 12/11/2022]
Abstract
Background Acne vulgaris is a skin problem affecting many people of different ages. Phototherapy is one of the acne treatment options. The aim of the study was to assess the effect of near-infrared low-level laser therapy on acne lesions. Materials and Methods The prospective study involved a total number of 27 women, aged 18 to 45 years, with mild to severe acne. All the participants underwent a series of six treatments with the use of a 785 nm low-level laser with the power density 80mW/cm2, performed every two weeks. The analysis of the effectiveness of the performed procedures was based on sebumetric examination, photographic documentation and assessment of the change in the number of acne lesions. Results Significant improvements in acne lesions (assessed as non-inflammatory and inflammatory lesion counts) and a significant decrease in skin sebum excretion were observed after the treatment. No adverse effects were reported. Conclusion A series of six treatments using a near-infrared low-level laser represents a safe and effective non-invasive therapy option for acne vulgaris.
Collapse
Affiliation(s)
- Anna Szymańska
- Department of Cosmetic Raw Materials Chemistry, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Elzbieta Budzisz
- Department of Cosmetic Raw Materials Chemistry, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Anna Erkiert-Polguj
- Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
3
|
Teng Y, Fan Y, Ma J, Lu W, Liu N, Chen Y, Pan W, Tao X. The PI3K/Akt Pathway: Emerging Roles in Skin Homeostasis and a Group of Non-Malignant Skin Disorders. Cells 2021; 10:cells10051219. [PMID: 34067630 PMCID: PMC8156939 DOI: 10.3390/cells10051219] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/20/2022] Open
Abstract
The phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway regulates cell proliferation, differentiation, and migration, along with angiogenesis and metabolism. Additionally, it could mediate skin development and homeostasis. There is much evidence to suggest that dysregulation of PI3K/Akt pathway is frequently associated with several human cutaneous malignancies like malignant melanoma (MM), basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (SCC), as well as their poor outcomes. Nevertheless, emerging roles of PI3K/Akt pathway cascade in a group of common non-malignant skin disorders including acne and psoriasis, among others, have been recognized. The enhanced understanding of dysfunction of PI3K/Akt pathway in patients with these non-malignant disorders has offered a solid foundation for the progress of updated therapeutic targets. This article reviews the latest advances in the roles of PI3K/Akt pathway and their targets in the skin homeostasis and progression of a wide range of non-malignant skin disorders and describes the current progress in preclinical and clinical researches on the involvement of PI3K/Akt pathway targeted therapies.
Collapse
Affiliation(s)
- Yan Teng
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China; (Y.T.); (Y.F.); (J.M.); (W.L.)
| | - Yibin Fan
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China; (Y.T.); (Y.F.); (J.M.); (W.L.)
| | - Jingwen Ma
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China; (Y.T.); (Y.F.); (J.M.); (W.L.)
| | - Wei Lu
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China; (Y.T.); (Y.F.); (J.M.); (W.L.)
| | - Na Liu
- Graduate School of Bengbu Medical College, Bengbu 233000, China; (N.L.); (Y.C.)
| | - Yingfang Chen
- Graduate School of Bengbu Medical College, Bengbu 233000, China; (N.L.); (Y.C.)
| | - Weili Pan
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China; (Y.T.); (Y.F.); (J.M.); (W.L.)
- Correspondence: (W.P.); (X.T.)
| | - Xiaohua Tao
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China; (Y.T.); (Y.F.); (J.M.); (W.L.)
- Correspondence: (W.P.); (X.T.)
| |
Collapse
|
4
|
Ottaviani M, Flori E, Mastrofrancesco A, Briganti S, Lora V, Capitanio B, Zouboulis C, Picardo M. Sebocyte differentiation as a new target for acne therapy: an
in vivo
experience. J Eur Acad Dermatol Venereol 2020; 34:1803-1814. [DOI: 10.1111/jdv.16252] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022]
Affiliation(s)
- M. Ottaviani
- Cutaneous Physiopathology and Integrated Center of Metabolomics Research San Gallicano Dermatological Institute IRCCS Rome Italy
| | - E. Flori
- Cutaneous Physiopathology and Integrated Center of Metabolomics Research San Gallicano Dermatological Institute IRCCS Rome Italy
| | - A. Mastrofrancesco
- Cutaneous Physiopathology and Integrated Center of Metabolomics Research San Gallicano Dermatological Institute IRCCS Rome Italy
| | - S. Briganti
- Cutaneous Physiopathology and Integrated Center of Metabolomics Research San Gallicano Dermatological Institute IRCCS Rome Italy
| | - V. Lora
- Cutaneous Physiopathology and Integrated Center of Metabolomics Research San Gallicano Dermatological Institute IRCCS Rome Italy
- Pediatric Dermatology San Gallicano Dermatological Institute IRCCS Rome Italy
| | - B. Capitanio
- Pediatric Dermatology San Gallicano Dermatological Institute IRCCS Rome Italy
| | - C.C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Thedore Fontane Dessau Germany
| | - M. Picardo
- Cutaneous Physiopathology and Integrated Center of Metabolomics Research San Gallicano Dermatological Institute IRCCS Rome Italy
| |
Collapse
|
5
|
Philpott MP. Culture of the human pilosebaceous unit, hair follicle and sebaceous gland. Exp Dermatol 2019; 27:571-577. [PMID: 29693730 DOI: 10.1111/exd.13669] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 12/25/2022]
Abstract
Terence Kealey first pioneered the isolation and organ maintenance of human eccrine and sebaceous glands in the early to mid-1980. This led to subsequent methods describing the isolation and culture of human hair follicles, the human pilosebaceous unit as well as the sebaceous duct. The importance of these models in the study of the biology of human skin glands and appendages has been demonstrated in numerous publications and their importance as models for animal replacement, refinement and reduction (3Rs) is increasingly important. In particular, in vitro (ex vivo) hair follicle culture has played a significant part in helping elucidate the role of signalling molecules in regulating hair growth and hair fibre formation and has been especially useful in understanding metabolic aspects of hair growth. However, obtaining sufficient numbers of hair follicles is becoming increasingly difficult as plastic surgery becomes less invasive and smaller skin samples provided. There is therefore an urgent requirement for the next generation of in vitro models using cell lines and tissue engineering, and this has led to the development of immortalised cell lines as well as attempts to model hair follicle embryogenesis in vitro and development of skin on a chip.
Collapse
Affiliation(s)
- Michael P Philpott
- Centre for Cell Biology and Cutaneous Research Blizard Institute, Queen Mary University London, London, UK
| |
Collapse
|
6
|
Li WH, Fassih A, Binner C, Parsa R, Southall MD. Low-level red LED light inhibits hyperkeratinization and inflammation induced by unsaturated fatty acid in anin vitromodel mimicking acne. Lasers Surg Med 2017; 50:158-165. [DOI: 10.1002/lsm.22747] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Wen-Hwa Li
- The Johnson & Johnson Skin Research Center; Johnson & Johnson Consumer Inc.; Skillman New Jersey
| | - Ali Fassih
- The Johnson & Johnson Skin Research Center; Johnson & Johnson Consumer Inc.; Skillman New Jersey
| | - Curt Binner
- The Johnson & Johnson Skin Research Center; Johnson & Johnson Consumer Inc.; Skillman New Jersey
| | - Ramine Parsa
- The Johnson & Johnson Skin Research Center; Johnson & Johnson Consumer Inc.; Skillman New Jersey
| | - Michael D. Southall
- The Johnson & Johnson Skin Research Center; Johnson & Johnson Consumer Inc.; Skillman New Jersey
| |
Collapse
|
7
|
Lichtenberger R, Simpson MA, Smith C, Barker J, Navarini AA. Genetic architecture of acne vulgaris. J Eur Acad Dermatol Venereol 2017; 31:1978-1990. [PMID: 28593717 DOI: 10.1111/jdv.14385] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/18/2017] [Indexed: 01/14/2023]
Abstract
Acne vulgaris is a ubiquitary skin disease characterized by chronic inflammation of the pilosebaceous unit resulting from bacterial colonization of hair follicles by Propionibacterium acnes, androgen-induced increased sebum production, altered keratinization and inflammation. Here, we review our current understanding of the genetic architecture of this intriguing disease. We analysed genomewide association studies (GWAS) and candidate genes studies for acne vulgaris. Moreover, we included GWAS studies for the associated disease polycystic ovary syndrome (PCOS). Overall, the available data revealed sixteen genetic loci flagged by single nucleotide polymorphisms (SNPs), none of which has been confirmed yet by independent studies. Moreover, a GWAS for PCOS identified 21 susceptible loci. The genetic architecture is complex which has been revealed by GWAS. Further and larger studies in different populations are required to confirm or disprove results from candidate gene studies as well to identify signals that may overlap between different populations. Finally, studies on rare genetic variants in acne and associated diseases like PCOS may deepen our understanding of its pathogenesis.
Collapse
Affiliation(s)
- R Lichtenberger
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - M A Simpson
- Division of Genetics and Molecular Medicine, King's College, London, UK
| | - C Smith
- Division of Genetics and Molecular Medicine, King's College, London, UK
| | - J Barker
- Division of Genetics and Molecular Medicine, King's College, London, UK
| | - A A Navarini
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Division of Genetics and Molecular Medicine, King's College, London, UK
| |
Collapse
|
8
|
Li WH, Zhang Q, Flach CR, Mendelsohn R, Southall MD, Parsa R. In vitro modeling of unsaturated free fatty acid-mediated tissue impairments seen in acne lesions. Arch Dermatol Res 2017; 309:529-540. [DOI: 10.1007/s00403-017-1747-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 01/24/2017] [Accepted: 05/23/2017] [Indexed: 01/04/2023]
|
9
|
Rittié L, Tejasvi T, Harms PW, Xing X, Nair RP, Gudjonsson JE, Swindell WR, Elder JT. Sebaceous Gland Atrophy in Psoriasis: An Explanation for Psoriatic Alopecia? J Invest Dermatol 2016; 136:1792-1800. [PMID: 27312025 DOI: 10.1016/j.jid.2016.05.113] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 05/20/2016] [Accepted: 05/30/2016] [Indexed: 12/17/2022]
Abstract
In a transcriptome study of lesional psoriatic skin (PP) versus normal skin, we found a coexpressed gene module (N5) enriched 11.5-fold for lipid biosynthetic genes. We also observed fewer visible hairs in PP skin, compared with uninvolved nonlesional psoriatic skin or normal skin (P < 0.0001). To ask whether these findings might be due to abnormalities of the pilosebaceous unit, we carried out three-dimensional morphometric analysis of paired PP and nonlesional psoriatic skin biopsies. Sebaceous glands were markedly atrophic in PP versus nonlesional psoriatic skin (91% average reduction in volume, P = 0.031). Module N5 genes were strongly downregulated in PP versus normal skin (fold change < 0.25, 44.4-fold) and strongly upregulated in sebaceous hyperplasia (fold change > 4, 54.1-fold). The intersection of PP-downregulated and sebaceous hyperplasia-upregulated gene lists generated a gene expression signature consisting solely of module N5 genes, whose expression in PP versus normal skin was inversely correlated with the signature of IL17-stimulated keratinocytes. Despite loss of visible hairs, morphometry identified elongated follicles in PP versus nonlesional psoriatic skin (average 1.7 vs. 1.2 μm, P = 0.020). These results document sebaceous gland atrophy in nonscalp psoriasis, identify a cytokine-regulated set of sebaceous gland signature genes, and suggest that loss of visible hair in PP skin may result from abnormal sebaceous gland function.
Collapse
Affiliation(s)
- Laure Rittié
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rajan P Nair
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - William R Swindell
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - James T Elder
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA.
| |
Collapse
|
10
|
Gozali MV, Yi F, Zhang JA, Liu J, Wu HJ, Xu Y, Luo D, Zhou BR. Photodynamic therapy inhibit Fibroblast Growth Factor-10 induced keratinocyte differentiation and proliferation through ROS in Fibroblast Growth Factor Receptor-2b pathway. Sci Rep 2016; 6:27402. [PMID: 27273653 PMCID: PMC4895211 DOI: 10.1038/srep27402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/18/2016] [Indexed: 12/22/2022] Open
Abstract
5-aminolevulinic acid-photodynamic therapy (ALA-PDT) is known to be effective in several skin diseases such as acne, actinic keratoses, condyloma acuminata. However, some detailed mechanisms of ALA-PDT to treat these skin diseases still remain elusive. In this study, we aimed to investigate mechanism of ALA-PDT in in-vitro and in-vivo models. For in vitro, we use human keratinocyte cell line (HaCaT) cells. CCK-8 was used to detect cell proliferation activity, immunofluorescence and western blotting method to detect the content of keratin (K)1, K6, K16, protein kinase C (PKC), fibroblast growth factor receptor-2b (FGFR2b) protein, ELISA and RT-PCR to detect expression of interleukin (IL) 1α in the cell supernatant, and detect reactive oxygen species (ROS). For in vivo, we use 20 rabbits to induce hyperkeratosis acne model in their ear. Dermatoscope was used to see follicle hyperkeratosis and skin biopsy to analyze histology and immunohistochemical of PKC, FGFR2b, K1, K6 and K16. Results from this study suggest that ROS stimulated by ALA-PDT lead to inhibition of FGFR2b pathway in PKC downstream to cause reduction of IL1α expression, and eventually, keratinocytes differentiation and proliferation. Our data thus reveal a treatment mechanism of ALA-PDT underlying hyperkeratosis related dermatoses.
Collapse
Affiliation(s)
- Maya Valeska Gozali
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Fei Yi
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jia-An Zhang
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Juan Liu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hong-Jin Wu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yang Xu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Dan Luo
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Bing-Rong Zhou
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| |
Collapse
|
11
|
Dreno B, Gollnick H, Kang S, Thiboutot D, Bettoli V, Torres V, Leyden J. Understanding innate immunity and inflammation in acne: implications for management. J Eur Acad Dermatol Venereol 2015; 29 Suppl 4:3-11. [DOI: 10.1111/jdv.13190] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/14/2015] [Indexed: 02/06/2023]
Affiliation(s)
- B. Dreno
- Department of Dermato Cancerology; University of Nantes; Nantes France
| | - H.P.M. Gollnick
- Department of Dermatology and Venereology; Medical Faculty; Otto-Von-Guericke-Universitat; Magdeburg Germany
| | - S. Kang
- Department of Dermatology; Johns Hopkins Medicine; Baltimore MD USA
| | - D. Thiboutot
- Department of Dermatology; Pennsylvania State University College of Medicine; Hershey PA USA
| | - V. Bettoli
- Department of Dermatology; Arcispedale S. Anna, University of Ferrara; Ferrara Italy
| | - V. Torres
- Department of Dermatology; Juarez Hospital; Mexico City Mexico
| | - J. Leyden
- Department of Dermatology; University of Pennsylvania School of Medicine; Philadelphia PA USA
| | | |
Collapse
|
12
|
Li WH, Zhang L, Lyte P, Rodriguez K, Cavender D, Southall MD. p38 MAP Kinase Inhibition Reduces Propionibacterium acnes-Induced Inflammation in Vitro. Dermatol Ther (Heidelb) 2015; 5:53-66. [PMID: 25749612 PMCID: PMC4374066 DOI: 10.1007/s13555-015-0072-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Indexed: 12/16/2022] Open
Abstract
Introduction Propionibacterium acnes, a ubiquitous skin bacterium, stimulates keratinocytes to produce a number of proinflammatory cytokines and may contribute to inflammatory acne. The aim of the study was to investigate whether P. acnes-induced proinflammatory cytokine release is mediated by P. acnes-induced activation of p38 mitogen-activated protein kinase (p38 MAPK or p38) in human keratinocytes. Methods Immunohistochemistry was used to evaluate p38 phosphorylation in human skin samples with or without acne. Primary human keratinocytes and epidermal skin equivalents were exposed to viable P. acnes. Phosphorylation of MAPKs without or with p38 inhibitors was examined by Western blot and cytokine secretion was detected by Enzyme-Linked Immunosorbent Assay (ELISA). Results Increased levels of phospho-p38 were observed in human acne lesions, predominantly in follicular and perifollicular keratinocytes. Exposure of cultured human keratinocytes to viable P. acnes resulted in phosphorylation of multiple members of the MAPK family, including rapid and transient activation of p38 and extracellular signal-related kinase (ERK1/2) and relatively slow but sustained activation of c-Jun N-terminal kinases (JNK1/2). Viable P. acnes induced the secretion of interleukin-1α (IL-1α), tumor necrosis factor-α (TNF-α), and IL-8 from human keratinocytes. The phosphorylation of p38 (phospho-p38) and the secretion of cytokines induced by P. acnes in cultured keratinocytes were inhibited by SB203580, a p38α/β inhibitor. Furthermore, SCIO-469, a selective inhibitor of p38α, showed similar effects in cultured keratinocytes. Topical treatment of SCIO-469 inhibited the P. acnes-induced phospho-p38 and cytokine secretion in human epidermal equivalents. Conclusion The data demonstrate that P. acnes induces p38-dependent inflammatory responses in keratinocytes, and suggest that p38 may play an important role in the pathogenesis of inflammatory acne. Funding Johnson & Johnson. Electronic supplementary material The online version of this article (doi:10.1007/s13555-015-0072-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Wen-Hwa Li
- Department of Skin Biology and Pharmacology, The Johnson & Johnson Skin Research Center, Johnson & Johnson Consumer and Personal Products Worldwide, Division of Johnson and Johnson Consumer Companies, Inc., 199 Grandview Road, Skillman, NJ, 08558, USA,
| | | | | | | | | | | |
Collapse
|
13
|
Das S, Reynolds RV. Recent advances in acne pathogenesis: implications for therapy. Am J Clin Dermatol 2014; 15:479-88. [PMID: 25388823 DOI: 10.1007/s40257-014-0099-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Acne pathogenesis is a multifactorial process that occurs at the level of the pilosebaceous unit. While acne was previously perceived as an infectious disease, recent data have clarified it as an inflammatory process in which Propionibacterium acnes and innate immunity play critical roles in propagating abnormal hyperkeratinization and inflammation. Alterations in sebum composition, and increased sensitivity to androgens, also play roles in the inflammatory process. A stepwise approach to acne management utilizes topical agents for mild to moderate acne (topical retinoid as mainstay ± topical antibiotics) and escalation to oral agents for more resistant cases (oral antibiotics or hormonal agents in conjunction with a topical retinoid or oral isotretinoin alone for severe acne). Concerns over antibiotic resistance and the safety issues associated with isotretinoin have prompted further research into alternative medications and devices for the treatment of acne. Radiofrequency, laser, and light treatments have demonstrated modest improvement for inflammatory acne (with blue-light photodynamic therapy being the only US FDA-approved treatment). However, limitations in study design and patient follow-up render these modalities as adjuncts rather than standalone options. This review will update readers on the latest advancements in our understanding of acne pathogenesis and treatment, with emphasis on emerging treatment options that can help improve patient outcomes.
Collapse
|
14
|
Fabbrocini G, Saint Aroman M. Cosmeceuticals based on Rhealba®
Oat plantlet extract for the treatment of acne vulgaris. J Eur Acad Dermatol Venereol 2014; 28 Suppl 6:1-6. [DOI: 10.1111/jdv.12791] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/19/2014] [Indexed: 12/26/2022]
Affiliation(s)
- G. Fabbrocini
- Department of Dermatology and Venerology; University of Naples Federico II; Naples Italy
| | | |
Collapse
|
15
|
Deciphering the functions of the hair follicle infundibulum in skin physiology and disease. Cell Tissue Res 2014; 358:697-704. [DOI: 10.1007/s00441-014-1999-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/04/2014] [Indexed: 12/22/2022]
|
16
|
Abstract
The mechanisms of inflammation in acne are currently subject of intense investigation. This study focused on the activation of adaptive and innate immunity in clinically early visible inflamed acne lesions and was performed in two independent patient populations. Biopsies were collected from lesional and non-lesional skin of acne patients. Using Affymetrix Genechips, we observed significant elevation of the signature cytokines of the Th17 lineage in acne lesions compared to non-lesional skin. The increased expression of IL-17 was confirmed at the RNA and also protein level with real-time PCR (RT-PCR) and Luminex technology. Cytokines involved in Th17 lineage differentiation (IL-1β, IL-6, TGF-β, IL23p19) were remarkably induced at the RNA level. In addition, proinflammatory cytokines and chemokines (TNF-α, IL-8, CSF2 and CCL20), Th1 markers (IL12p40, CXCR3, T-bet, IFN-γ), T regulatory cell markers (Foxp3, IL-10, TGF-β) and IL-17 related antimicrobial peptides (S100A7, S100A9, lipocalin, hBD2, hBD3, hCAP18) were induced. Importantly, immunohistochemistry revealed significantly increased numbers of IL-17A positive T cells and CD83 dendritic cells in the acne lesions. In summary our results demonstrate the presence of IL-17A positive T cells and the activation of Th17-related cytokines in acne lesions, indicating that the Th17 pathway is activated and may play a pivotal role in the disease process, possibly offering new targets of therapy.
Collapse
|
17
|
Li ZJ, Choi DK, Sohn KC, Seo MS, Lee HE, Lee Y, Seo YJ, Lee YH, Shi G, Zouboulis CC, Kim CD, Lee JH, Im M. Propionibacterium acnes activates the NLRP3 inflammasome in human sebocytes. J Invest Dermatol 2014; 134:2747-2756. [PMID: 24820890 DOI: 10.1038/jid.2014.221] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/27/2014] [Accepted: 04/30/2014] [Indexed: 01/15/2023]
Abstract
Propionibacterium acne and sebaceous glands are considered to have an important role in the development of acne. Although information regarding the activation of innate immunity by P. acnes in the sebaceous gland is limited, different P. acnes phylotypes and a higher prevalence of follicular P. acnes macrocolonies/biofilms in sebaceous follicles of skin biopsies from acne compared with control skin and occasionally single P. acnes clusters in single sebaceous glands have been detected. In this study, we investigated whether P. acnes activates the inflammasome in human sebaceous glands in vivo and in vitro. We found that IL-1β expression was upregulated in sebaceous glands of acne lesions. After stimulation of human sebocytes with P. acnes, the activation of caspase-1 and secretion of IL-1β were enhanced significantly. Moreover, knocking down the expression of NLRP3 abolished P. acnes-induced IL-1β production in sebocytes. The activation of the NLRP3 inflammasome by P. acnes was dependent on protease activity and reactive oxygen species generation. Finally, we found that NALP3-deficient mice display an impaired inflammatory response to P. acnes. These results suggest that human sebocytes are important immunocompetent cells that induce the NLRP3 inflammasome, and that P. acnes-induced IL-1β activation in sebaceous glands may have a role in combating skin infections and in acne pathogenesis.
Collapse
Affiliation(s)
- Zheng Jun Li
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Dae Kyoung Choi
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Kyung Cheol Sohn
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Min Seok Seo
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Hae Eul Lee
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Joon Seo
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Ho Lee
- Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Ge Shi
- Department of Dermatology, The Affiliated hospital of Guangdong Medical College, Zhanjiang, China
| | - Christos C Zouboulis
- Department of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Chang Deok Kim
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeung Hoon Lee
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Myung Im
- Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea.
| |
Collapse
|
18
|
Thiboutot DM. Inflammasome activation by Propionibacterium acnes: the story of IL-1 in acne continues to unfold. J Invest Dermatol 2014; 134:595-597. [PMID: 24518111 DOI: 10.1038/jid.2013.528] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Insights into the immune mechanisms at play in skin diseases including acne continue to be made. In this issue, Kistowska et al. confirm that Propionibacterium acnes activates inflammasomes leading to the production of IL-1β and they further identify putative mechanisms by which this process occurs. These data raise interesting questions regarding a multipronged approach by which P. acnes elicits inflammation in early versus late acne and putative differences in the effects of IL-1α and IL-1β in this disease process.
Collapse
Affiliation(s)
- Diane M Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
| |
Collapse
|
19
|
Selway JL, Kurczab T, Kealey T, Langlands K. Toll-like receptor 2 activation and comedogenesis: implications for the pathogenesis of acne. BMC DERMATOLOGY 2013; 13:10. [PMID: 24011352 PMCID: PMC3846817 DOI: 10.1186/1471-5945-13-10] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 08/28/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acne is a common disorder of the human pilosebaceous unit, yet the mechanisms underlying hyperkeratinisation and subsequent inflammation (comedogenesis) remain to be determined, although cutaneous pathogens are implicated. Previously, it was reported that the release of the cytokine interleukin-1α (IL-1α) by keratinocytes of the sebaceous duct was pivotal in the life cycle of the comedone, mediating both its development and its spontaneous resolution. Toll-like receptors are a family of molecules that recognise pathogen associated molecular patterns (PAMPs) presented by microorganisms, initiating a signalling cascade terminating in the release of antimicrobial compounds and cytokines. METHODS We used ex vivo sebaceous gland and primary monolayer keratinocyte culture, alongside ELISAs, immunohistochemistry, Western blotting and RT-PCR to investigate the contribution of TLR activation to acne pathogenesis. RESULTS We found TLR2 to be expressed in basal and infundibular keratinocytes, and sebaceous glands, and its activation provoked the release of IL-1α from primary human keratinocytes in vitro. The exposure of microdissected human sebaceous glands to PAMPs specific for TLR2 in vitro resulted in a pattern of IL-1α like cornification after seven days of exposure. CONCLUSIONS TLR activation and secretion of IL-1α from keratinocytes may be initiating steps in comedogenesis and, therefore, critical to the pathophysiology of acne.
Collapse
Affiliation(s)
- Joanne Louise Selway
- The Clore Laboratory, University of Buckingham, Hunter Street, Buckingham MK18 1EG, UK
| | - Tomasz Kurczab
- The Clore Laboratory, University of Buckingham, Hunter Street, Buckingham MK18 1EG, UK
| | - Terence Kealey
- The Clore Laboratory, University of Buckingham, Hunter Street, Buckingham MK18 1EG, UK
| | - Kenneth Langlands
- The Clore Laboratory, University of Buckingham, Hunter Street, Buckingham MK18 1EG, UK
| |
Collapse
|
20
|
TNF-α increases lipogenesis via JNK and PI3K/Akt pathways in SZ95 human sebocytes. J Dermatol Sci 2012; 65:179-88. [DOI: 10.1016/j.jdermsci.2011.11.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 11/11/2011] [Accepted: 11/12/2011] [Indexed: 01/19/2023]
|
21
|
Common JEA, Brown SJ, Haines RL, Goh CSM, Chen H, Balakrishnan A, Munro CS, Tan AWH, Tan HH, Tang MBY, Lane EB. Filaggrin null mutations are not a protective factor for acne vulgaris. J Invest Dermatol 2011; 131:1378-80. [PMID: 21326297 PMCID: PMC3094589 DOI: 10.1038/jid.2011.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
22
|
Szabó K, Kemény L. Studying the genetic predisposing factors in the pathogenesis of acne vulgaris. Hum Immunol 2011; 72:766-73. [PMID: 21669244 DOI: 10.1016/j.humimm.2011.05.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 04/28/2011] [Accepted: 05/13/2011] [Indexed: 02/04/2023]
Abstract
Acne is one of the most common dermatologic diseases in the developed regions of the world, affecting a large percentage of the population. Despite the great improvement in the number and quality of studies of the molecular etiology of this disease in the past 3 decades, the detailed molecular pathogenesis and the cause of the large individual variations in severity of skin symptoms remain unknown. The roles of genetic inheritance and special genetic susceptibility and protective factors have been suggested for over 100 years, but their identification and determination started only in the 1990s. To date, only a small number of genetic polymorphisms affecting the expression and/or function of a handful of genes have been investigated. This review surveys the major findings of the classic and molecular genetic studies that have been conducted in this field, draws conclusions, and indicates how the available data help our current understanding of the pathogenesis of this common skin disease.
Collapse
Affiliation(s)
- Kornélia Szabó
- Dermatological Research Group of the Hungarian Academy of Sciences, Szeged, Hungary.
| | | |
Collapse
|
23
|
Balagula Y, Hensley JR, Gerami P, Lacouture ME. Acneiform Rash as a Reaction to Radiotherapy in a Breast Cancer Patient. ACTA ACUST UNITED AC 2010; 8:268-71. [DOI: 10.1016/j.suponc.2010.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
24
|
Szabó K, Tax G, Kis K, Szegedi K, Teodorescu-Brinzeu DG, Diószegi C, Koreck A, Széll M, Kemény L. Interleukin-1A +4845(G> T) polymorphism is a factor predisposing to acne vulgaris. ACTA ACUST UNITED AC 2010; 76:411-5. [PMID: 20630038 DOI: 10.1111/j.1399-0039.2010.01530.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Acne vulgaris is a common chronic inflammatory skin disease of multifactorial origin. The aim of this study was to clarify whether known polymorphisms of the interleukin-1A (IL1A) and IL1RN genes play a role in the pathogenesis of acne vulgaris. A positive association was found between the minor T allele of the IL1A +4845(G>T) single nucleotide polymorphism (SNP) and acne, whereas no association was found with respect to any alleles of the variable number of tandem repeats (VNTR) polymorphism of the IL1RN gene. The severity of inflammatory acne symptoms correlated with the percentage of individuals carrying the homozygote T/T genotype. These results may help to elucidate the molecular events leading to the development of acne.
Collapse
Affiliation(s)
- K Szabó
- Dermatological Research Group of the Hungarian Academy of Sciences, Szeged, Hungary.
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Dessinioti C, Katsambas AD. The role of Propionibacterium acnes in acne pathogenesis: facts and controversies. Clin Dermatol 2010; 28:2-7. [PMID: 20082942 DOI: 10.1016/j.clindermatol.2009.03.012] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We have come a long way since 1896, when it was first suggested that Propionibacterium acnes, found in acne lesions, was the cause of acne. Although several lines of evidence suggest the direct role of P acnes in acne, the mechanism by which P acnes contributes to the pathogenesis of acne is debated. The importance of P acnes in the induction and maintenance of the inflammatory phase of acne has been established. Emerging data that inflammatory events occur in the very earliest stages of acne development have reopened the debate about the potential involvement of this microorganism in comedogenesis and acne initiation.
Collapse
Affiliation(s)
- Clio Dessinioti
- Department of Dermatology, Andreas Sygros Hospital, University of Athens, 5, I.Dragoumi Street, 16121, Athens, Greece
| | | |
Collapse
|
26
|
Han SS, Lee M, Park GH, Bang SH, Kang YK, Kim TW, Lee JL, Chang HM, Ryu MH. Investigation of papulopustular eruptions caused by cetuximab treatment shows altered differentiation markers and increases in inflammatory cytokines. Br J Dermatol 2009; 162:371-9. [PMID: 19903175 DOI: 10.1111/j.1365-2133.2009.09536.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) critically regulates tumour cell division, survival and metastasis. Agents that inhibit EGFR have been used in the treatment of advanced-stage malignancies, but cause variable cutaneous side-effects, most often papulopustular eruptions and xerosis. OBJECTIVES We assayed expression of inflammatory cytokines [interleukin (IL)-1alpha, tumour necrosis factor (TNF)-alpha, interferon (IFN)-gamma, human leucocyte antigen (HLA)-DR and intercellular adhesion molecule (ICAM)-1], differentiation markers (filaggrin, involucrin and loricrin) and phosphorylated EGFRs (pEGFRs) in papulopustular eruptions to determine the association between these markers and the eruptions caused by cetuximab. PATIENTS/METHODS Twelve papulopustular lesion biopsies were selected from patients with colon cancer who had received cetuximab treatment. Immunohistochemistry and immunofluorescence with a confocal laser scanning microscopy were performed. RESULTS Filaggrin expression decreased and expression of involucrin, various inflammatory markers (IL-1alpha, TNF-alpha, ICAM-1 and HLA-DR) increased and the expression of pEGFR was markedly downregulated in papulopustular eruptions. In perilesions, decreased pEGFR expression was noted in hair follicles compared with interfollicular epidermis. The increase of IL-1alpha and TNF-alpha was observed in perilesions as in the lesions. CONCLUSIONS The early inflammatory events (IL-1alpha and TNF-alpha expression) seen, and the lack of pEGFR in perilesional follicles, indicate that inflammatory events induced by EGFR inhibition may initiate papulopustular eruptions along with the altered differentiations. The decrease of filaggrin may contribute to the pathogenesis of the xerosis caused by cetuximab.
Collapse
Affiliation(s)
- S S Han
- Department of Dermatology, Asan Medical Center, SongPa-Gu PyongNab-Dong, Seoul 138-736, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Laffert MV, Helmbold P, Wohlrab J, Fiedler E, Stadie V, Marsch WC. Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis*. Exp Dermatol 2009; 19:533-7. [DOI: 10.1111/j.1600-0625.2009.00915.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
28
|
Akaza N, Akamatsu H, Kishi M, Mizutani H, Ishii I, Nakata S, Matsunaga K. Effects of Propionibacterium acnes on various mRNA expression levels in normal human epidermal keratinocytes in vitro. J Dermatol 2009; 36:213-23. [PMID: 19348660 DOI: 10.1111/j.1346-8138.2009.00626.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Propionibacterium acnes is one of the most significant pathogenic factors of acne vulgaris. This bacteria relates to acne by various pathways. It has also been reported that P. acnes influences pro-inflammatory cytokine production in keratinocytes in vitro. However, the influence on the differentiation of keratinocytes by P. acnes has not been studied extensively. We analyzed the expression of keratinocyte differentiation-specific markers, keratins, and pro-inflammatory cytokines in normal human epidermal keratinocytes (NHEK) exposed to P. acnes in vitro. All P. acnes strains used in this study increased transglutaminase (TGase), keratin 17 (K17) and interleukin (IL) mRNA expression levels in NHEK, and decreased K1 and K10 expression levels. Some P. acnes strains increased involucrin and K6 mRNA expression levels in NHEK and decreased filaggrin, K6 and K16 expression levels in vitro. This experiment clarified that P. acnes influences the differentiation of NHEK in vitro. As a result, P. acnes influenced the expression of not only pro-inflammatory cytokines but also some keratinocyte differentiation-specific markers and keratins in NHEK. Our results suggest that P. acnes relates to acne pathogenesis by not only the induction of inflammation but also in the differentiation of keratinocytes. Moreover, it was considered that the reaction of NHEK to P. acnes may be different depending on the type of bacteria.
Collapse
Affiliation(s)
- Narifumi Akaza
- Department of Dermatology, Fujita Health University School of Medicine, Nagoya, Japan.
| | | | | | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
- D. M. Thiboutot
- Section of Dermatology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
30
|
Melnik BC. Role of FGFR2-signaling in the pathogenesis of acne. DERMATO-ENDOCRINOLOGY 2009; 1:141-56. [PMID: 20436882 PMCID: PMC2835907 DOI: 10.4161/derm.1.3.8474] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 03/18/2009] [Indexed: 01/10/2023]
Abstract
It is the purpose of this review to extend our understanding of the fibroblast growth factor (FGF) receptor-2b-signaling network in the pathogenesis of acne. A new concept of the role of FGFR2b-signaling in dermal-epithelial interaction for skin appendage formation, pilosebaceous follicle homeostasis, comedogenesis, sebaceous gland proliferation and lipogenesis is presented. The FGFR2-gain-of-function mutations in Apert syndrome and unilateral acneiform nevus are most helpful model diseases pointing the way to androgen-dependent dermalepithelial FGFR2-signaling in acne. Androgen-mediated upregulation of FGFR2b-signaling in acne-prone skin appears to be involved in the pathogenesis of acne vulgaris. In organotypic skin cultures, keratinocyte-derived interleukin-1alpha stimulated fibroblasts to secrete FGF7 which stimulated FGFR2b-mediated keratinocyte proliferation. Postnatal deletion of FGFR2b in mice resulted in severe sebaceous gland atrophy. The importance of FGFR2b in sebaceous gland physiology is further supported by the mode of action of anti-acne agents which have been proposed to attenuate FGFR2b-signaling. Downregulation of FGFR2b-signaling by isotretinoin explains its therapeutic effect in acne. Downregulation of FGFR2b-signaling during the first trimester of pregnancy disturbs branched morphogenesis and explains retinoid embryotoxicity. Insulin-like growth factor-1 (IGF-1), the mediator of growth hormone during puberty, intracts with androgen-dependent FGFR2b-signaling and links androgen- and FGF-mediated signal transduction important in sebaceous gland homeostasis. The search for a follicular defect in the dermalepithelial regulation of growth factor-signaling in acne-prone skin appears to be a most promising approach to clarify the pathogenesis of acne.
Collapse
Affiliation(s)
- Bodo C Melnik
- Department of Dermatology; Environmental Medicine and Health Theory; University of Osnabrück; Germany
| |
Collapse
|
31
|
Abstract
A staple clinical skill in a dermatologist's repertoire is the ability to treat acne vulgaris effectively. Light-based therapies such as photodynamic therapy (PDT) widen the therapeutic options available for acne. Numerous review articles have agreed on the answer to core questions such as: 'Does PDT work?' and 'Which acne lesions respond best to PDT?' They conclude that PDT is especially useful in inflammatory acne and may be superior to light therapy alone. This literature review seeks to offer guidance regarding treatment-specific queries about the photosensitizer, route of administration, treatment intervals, light sources and patient selection. Ovid Medline, PubMed and EMBASE database searches were executed between January 2007 and March 2008. Due to the scarcity of data, all five randomized trials, four of which were at least investigator blinded and controlled, 12 open clinical studies, two case reports and two abstracts published in English were considered. Four hundred and nineteen patients were recruited. As the quality of the data was suboptimal in a significant number of articles, the conclusions are drawn in very broad strokes: topical short-contact (90 min or less) 5-aminolaevulinic acid or methyl aminolaevulinate using a noncoherent light source at 2-4-week intervals for a total of two to four treatments produces the greatest clinical effect. Papulopustular acne is more responsive and all Fitzpatrick skin types are eligible. However, patients with skin types I-III have a reduced risk of postinflammatory hyperpigmentation seen in darker skin types. These treatment parameters demonstrate a good side-effect profile resulting in acne remission for at least 3 months to a year in a relatively cost-effective manner. Well-designed nonsplit-face randomized controlled trials would offer further guidance, especially for queries surrounding the light source and illumination schemes.
Collapse
Affiliation(s)
- M N Taylor
- Department of Dermatology, Cardiff University, UK.
| | | |
Collapse
|
32
|
|
33
|
Jarrousse V, Castex-Rizzi N, Khammari A, Charveron M, Dréno B. Modulation of integrins and filaggrin expression by Propionibacterium acnes extracts on keratinocytes. Arch Dermatol Res 2007; 299:441-7. [PMID: 17684752 DOI: 10.1007/s00403-007-0774-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Revised: 06/28/2007] [Accepted: 07/20/2007] [Indexed: 11/25/2022]
Abstract
Propionibacterium acnes plays an important role in the pathogenesis of acne and it is established that this bacteria is involved in the induction and maintenance of the inflammatory phase of acne. The aim of our work was to determine if P. acnes extracts could modulate integrins and filaggrin in vitro expression by keratinocytes. Integrins and filaggrin expression was examined using immunohistochemistry technique both on Normal Human Epiderminal Keratinocytes (NHEK) and on deep-frozen sections of normal human skin explants incubated with three different P. acnes extracts. In addition, the expression of filaggrin was investigated on biopsies of acne lesions and by western-blot associated with its precursor profilaggrin. We demonstrated that P. acnes extracts induced beta1 integrin expression significantly on both proliferating keratinocytes and differentiated keratinocytes. In addition, P. acnes induced alpha3, alpha6s and alphaVbeta6 integrin expression and filaggrin expression on differentiated keratinocytes. Finally P. acnes extracts increased filaggrin expression by suprabasal layer of epidermis of explants. Western-blot confirmed that total amount of filaggrin was increased. These results indicate that P. acnes extracts are directly able to modulate the differentiation of keratinocytes suggesting that this bacteria play a role not only in the development of inflammatory acne lesions but also in the formation of the microcomedo.
Collapse
Affiliation(s)
- V Jarrousse
- INSERM U601, 9 quai Moncousu, 44093 Nantes Cedex 01, France
| | | | | | | | | |
Collapse
|
34
|
Bull JJ, Pelengaris S, Hendrix S, Chronnell CMT, Khan M, Philpott MP. Ectopic expression of c-Myc in the skin affects the hair growth cycle and causes an enlargement of the sebaceous gland. Br J Dermatol 2005; 152:1125-33. [PMID: 15948972 DOI: 10.1111/j.1365-2133.2005.06458.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The hair follicle continually undergoes dynamic remodelling in a cyclical manner involving tightly coordinated patterns of cell proliferation, differentiation and apoptosis. The oncoprotein c-Myc is a key regulator of these events in epidermal keratinocytes, but its importance in the hair growth cycle has not previously been determined. OBJECTIVES To determine the role of c-Myc in the hair growth cycle. METHODS We characterized the hair follicle phenotype of transgenic mice that permit expression of a switchable form of c-Myc (c-Myc-ER) in the suprabasal epithelial layers of the epidermis and hair follicle. RESULTS c-Myc activation increased epithelial cell proliferation in the outer root sheath and distal hair follicle, without any substantial alteration in levels of apoptosis. Moreover, chronic c-Myc activation resulted in marked desynchronization of the murine hair growth cycle, uncoupling of hair cycle-related skin thickness and enlargement of the sebaceous gland. CONCLUSIONS These data implicate c-Myc in the control of hair growth cycling and hair cycle-related epidermal and sebaceous gland homeostasis. We suggest that c-Myc may be activating follicular stem cells either directly or indirectly and that this has important implications for control of the 'hair cycle clock', hair growth and epidermal maintenance.
Collapse
Affiliation(s)
- J J Bull
- Centre for Cutaneous Research, Barts and The London School of Medicine and Dentistry, Queen Mary College, London E1 2AT, UK
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
Acne is a disease that develops in pilosebaceous follicles. Acne was long considered was an infectious disease related to Propionibac-terium acnes, but studies show that the production of inflammatory substances in situ was much more important to the action of this bacterium than was simple infection. It was once thought that only the androgens could stimulate the seba-ceous gland, but today we know that neuromediators can also stimulate sebum production. This finding provides physiological support to the clinical observation that stress can induce acne.
Collapse
Affiliation(s)
- Brigitte Dréno
- Service de dermatologie, Hôtel Dieu, place Alexis Ricordeau, 44093 Nantes Cedex 01.
| |
Collapse
|
36
|
Downie MMT, Guy R, Kealey T. Advances in sebaceous gland research: potential new approaches to acne management. Int J Cosmet Sci 2004; 26:291-311. [DOI: 10.1111/j.1467-2494.2004.00238.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
37
|
Abstract
An important feature in the etiology of acne is the presence of pilosebaceous ductal hypercornification, which can be seen histologically as microcomedones (Fig 1) and clinically as blackheads, whiteheads, and other forms of comedones, such as macrocomedones. There is a significant correlation between the severity of acne and the number and size of microcomedones (follicular casts), the presence of which is a measure of comedogenesis. This correlation can be demonstrated by skin surface biopsy using cyanoacrylate gel. In this procedure, microcomedones are sampled by applying cyanoacrylate gel to the skin surface. A glass microscopic slide is then applied on top of the gel and pressed firmly onto the skin for 1 minute(1-3). The glass slide is gently removed, taking with it the upper part of the stratum corneum and microcomedones, which are then analyzed by low-power microscopy or digital image analysis.(1-3)
Collapse
|
38
|
Abstract
The pathogenesis of acne is complex, with strong evidence supporting the involvement of sebaceous hyperplasia, follicular hyperkeratinisation, bacterial hypercolonisation, as well as immune reactions and inflammation. High sebum concentrations and follicular hyperkeratinisation lead to a change of the follicular milieu with consecutive proliferation of bacteria, chiefly Propionibacterium acnes. This leads to further increased production of the pro-inflammatory cytokines interleukin-1alpha and tumour necrosis factor alpha by T cells and keratinocytes, leading to proliferation of both cell types. Follicular keratinocytes fail to differentiate by apoptosis and produce hypergranulosis similar to the impermeable skin outer layer, resulting in the formation of microcomedones. Further inflammatory responses lead to the development of increasing degrees of severity in inflammatory forms of acne. Retinoids aid the differentiation and reduce the hyperproliferation of keratinocytes, and can inhibit the migration of leucocytes. Combination therapy using retinoids plus benzoyl peroxide or antibacterials can treat existing acne lesions faster than the individual agents alone and can also prevent the development of new lesions. The new retinoids (e.g. adapalene) have not only the typical potent comedolytic activity but also anti-inflammatory effects. When added to antibacterial therapy, topical retinoids demonstrate faster and significantly greater reduction of inflammatory acne lesions and comedones than antibacterials alone.
Collapse
Affiliation(s)
- Harald Gollnick
- University Clinic for Dermatology and Venereology, Otto-von-Guericke-University, Magdeburg, Germany.
| |
Collapse
|
39
|
Jeremy AHT, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol 2003; 121:20-7. [PMID: 12839559 DOI: 10.1046/j.1523-1747.2003.12321.x] [Citation(s) in RCA: 283] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The earliest subclinical acne "lesion" is a microcomedone, of which hyperproliferation of the follicular epithelium is a characteristic feature. Inflammatory cells have been observed at the periphery of these "lesions". This study investigated whether inflammatory events occur pre or post hyperproliferative changes. Cellular, vascular, and proliferative markers were examined by immunohistochemical techniques on biopsies of clinically normal follicles from uninvolved skin and early inflamed lesions from acne patients. Control follicles were obtained from non-acne subjects. Follicles from uninvolved skin exhibited no microcomedonal features. Proliferation in the epithelium was comparable to controls and was significantly lower than in inflamed lesions. Numbers of CD3+, CD4+ T cells were elevated in the perifollicular and papillary dermis although levels were not equivalent to those in papules. The number of macrophages was also greatly increased and similar to those in papules. There were no changes in blood vessel numbers or vascular intercellular adhesion molecule 1 expression but E-selectin expression was increased to levels found in papules and vascular adhesion molecule 1 levels were upregulated. Levels of the pro-inflammatory cytokine interleukin-1 were also upregulated perifollicularly. Moreover, aberrant integrin expression was demonstrated in the epidermis around these uninvolved follicles and inflamed lesions whereas the basement membrane was still intact. These results provide novel evidence for vascular endothelial cell activation and involvement of inflammatory responses in the very earliest stages of acne lesion development.
Collapse
|
40
|
Koreck A, Pivarcsi A, Dobozy A, Kemény L. The role of innate immunity in the pathogenesis of acne. Dermatology 2003; 206:96-105. [PMID: 12592074 DOI: 10.1159/000068476] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Acne is a multifactorial disease of the pilosebaceous follicle. The most significant pathogenetic factors of acne are: abnormal ductal keratinization, increased sebum secretion, abnormalities of the microbial flora and inflammation. The pilosebaceous unit is an immunocompetent organ. Keratinocytes and sebocytes may act as immune cells capable of pathogen recognition and abnormal lipid presentation, and they might have an important role in initiating and perpetuating the activation of both innate and adaptive immune responses. The elements of the skin immune system are involved in the development of both noninflammatory and inflammatory acne lesions.
Collapse
Affiliation(s)
- A Koreck
- Department of Dermatology and Allergology, University of Szeged, Hungary.
| | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND Acne lesions spontaneously remit, but the mechanism of this remission has not been elaborated. It is known, however, that the remission is associated with a de-differentiation of sebocytes, causing a cessation of sebum secretion specific to that particular pilosebaceous unit. We have previously described the cytokines that will promote in vitro the lesions of acne. OBJECTIVES To show that those same cytokines may also promote a de-differentiation of sebocytes analogous to that seen during remission of some lesions. METHODS Human chest sebaceous glands were maintained in vitro as whole organs. We then chronicled the effects of the appropriate cytokines and growth factors on the glandular rates of (i) lipogenesis and (ii) DNA synthesis, as well as on (iii) glandular morphology, (iv) the expression patterns of the proliferation marker Ki-67, (v) keratinocyte-specific markers, and (vi) the sebocyte marker epithelial membrane antigen. RESULTS We have shown that the same cytokines that promote comedogenesis (interleukin-1alpha), expression of infundibular intercellular adhesion molecule-1 and human leucocyte-associated antigen-DR (tumour necrosis factor-alpha and interferon-gamma), and infundibular disruption (epidermal growth factor/transforming growth factor-alpha) in human infundibula in vitro, will also inhibit sebaceous lipogenesis in vitro and will also induce, histologically, a de-differentiation of human sebocytes into a keratinocyte-like phenotype. CONCLUSIONS These results confirm our hypothesis that the cytokines that induce the infundibular changes in acne may also inhibit the secretion of lipid from the sebaceous gland and thus, on diffusing down to the gland, contribute to the remission of the individual lesions. These findings help to explain the known natural history of the disease.
Collapse
Affiliation(s)
- M M T Downie
- Department of Clinical Biochemistry, University of Cambridge, Addenbrooke's Hospital Box 232, Hills Road, Cambridge CB2 2QR, U.K.
| | | | | |
Collapse
|
42
|
Affiliation(s)
- W J Cunliffe
- Skin Research Centre, Department of Dermatology, the General Infirmary at Leeds, UK.
| |
Collapse
|