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Ren X, Sun Y, Zhang Y, Zhou N, Wang Y, Li L, Gao X, Ma Y, Li X, Shu Z, He H, Wang Y. Acne-related UVA-induced facial fluorescence: An exploratory study from physiological properties to tissue structure information. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 260:113042. [PMID: 39383566 DOI: 10.1016/j.jphotobiol.2024.113042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 09/25/2024] [Accepted: 10/01/2024] [Indexed: 10/11/2024]
Abstract
UVA-induced facial fluorescence (UVAF) is recognized as an objective measurement technique to quantify the severity of acne. However, notable inconsistencies in quantitative outcomes have been observed in various studies, possibly due to the fact that different colors of fluorescence represent different pathophysiological implications. This study investigated the pathophysiological importance of UVAF color differences and improved its reliability in assessing acne severity. MIDOO Smart Skin Imager was used to capture UVAF and analyze the correlation between fluorescence colors and acne lesions. Techniques such as two-photon excited fluorescence microscopy, scanning electron microscopy, western blot, and high performance liquid chromatography-mass spectrometry (HPLC-MS/MS) were used to examine the biochemical composition and structure of comedonal plugs and follicular casts associated with different fluorescence colors. We found that green fluorescence correlates with non-inflammatory acne lesions (comedones), while orange-red fluorescence shows no correlation with either type of lesion. Green fluorescence is associated with higher levels of keratin, indicating keratinization, while orange-red fluorescence is associated with porphyrin from S. epidermidis. UVAF color differences - orange-red are from porphyrins and green from keratin. This distinction helps to understand the structural and physiological bases of facial fluorescence, with potential implications for clinical evaluations of acne.
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Affiliation(s)
- Xing Ren
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanan Sun
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Yuxin Zhang
- Tsinghua University, Guangdong Research Center of Polarization Imaging and Measurement Engineering Technology, Shenzhen Key Laboratory for Minimal Invasive Medical Technologies, Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Na Zhou
- Department of Immunology and Microbiology, School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Yunong Wang
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Lishuang Li
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinyu Gao
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuman Ma
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xianyu Li
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhe Shu
- Beijing Cowisdom biotechnology Ltd Com, Beijing, China
| | - Honghui He
- Tsinghua University, Guangdong Research Center of Polarization Imaging and Measurement Engineering Technology, Shenzhen Key Laboratory for Minimal Invasive Medical Technologies, Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Yi Wang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China.
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2
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Xu Y, Cohen E, Johnson CN, Parent CA, Coulombe PA. Repeated stress to the skin amplifies neutrophil infiltration in a keratin 17- and PKCα-dependent manner. PLoS Biol 2024; 22:e3002779. [PMID: 39159283 PMCID: PMC11361748 DOI: 10.1371/journal.pbio.3002779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 08/29/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024] Open
Abstract
Neutrophils are the first immune cells to reach inflamed sites and contribute to the pathogenesis of chronic inflammatory skin diseases. Yet, little is known about the pattern of neutrophil infiltration in inflamed skin in vivo and the mechanisms mediating their recruitment. Here, we provide insight into the dynamics of neutrophil infiltration in skin in response to acute or repeated inflammatory stress, highlighting a novel keratinocyte- and keratin 17 (K17)-dependent mechanism that regulates neutrophil recruitment to inflamed skin. We used the phorbol ester TPA and UVB, alone or in combination, to induce sterile inflammation in mouse skin. A single TPA treatment results in a neutrophil influx in the dermis that peaks at 12 h and resolves within 24 h. A subsequent TPA treatment or a UVB challenge, when applied 24 h but not 48 h later, accelerates, amplifies, and prolongs neutrophil infiltration. This transient amplification response (TAR) is mediated by local signals in inflamed skin, can be recapitulated in ex vivo culture, and involves the K17-dependent sustainment of protein kinase Cα (PKCα) activity and release of chemoattractants by stressed keratinocytes. K17 binds RACK1, a scaffold protein essential for PKCα activity. The N-terminal head domain of K17 is crucial for its association with RACK1 and regulation of PKCα activity. Analysis of RNAseq data reveals a signature consistent with TAR and PKCα activation in inflammatory skin diseases. These findings uncover a novel, keratin-dependent mechanism that amplifies neutrophil recruitment in skin under stress, with direct implications for inflammatory skin disorders.
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Affiliation(s)
- Yang Xu
- Graduate Program in Pharmacology and Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Erez Cohen
- Department of Cell & Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Craig N. Johnson
- Department of Cell & Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Carole A. Parent
- Graduate Program in Pharmacology and Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Department of Cell & Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Life Science Institute, University of Michigan, Ann Arbor, Michigan, United States of America
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Pierre A. Coulombe
- Department of Cell & Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
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3
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Li L, Zhang J, Cheng W, Di F, Wang C, An Q. Saponins of Paris polyphylla for the Improvement of Acne: Anti-Inflammatory, Antibacterial, Antioxidant and Immunomodulatory Effects. Molecules 2024; 29:1793. [PMID: 38675613 PMCID: PMC11052371 DOI: 10.3390/molecules29081793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Acne is a chronic inflammatory skin disease with a recurring nature that seriously impacts patients' quality of life. Currently, antibiotic resistance has made it less effective in treating acne. However, Paris polyphylla (P. polyphylla) is a valuable medicinal plant with a wide range of chemical components. Of these, P. polyphylla saponins modulate the effects in vivo and in vitro through antibacterial, anti-inflammatory, immunomodulatory, and antioxidant effects. Acne is primarily associated with inflammatory reactions, abnormal sebum function, micro-ecological disorders, hair follicle hyperkeratosis, and, in some patients, immune function. Therefore, the role of P. polyphylla saponins and their values in treating acne is worthy of investigation. Overall, this review first describes the distribution and characteristics of P. polyphylla and the pathogenesis of acne. Then, the potential mechanisms of P. polyphylla saponins in treating acne are listed in detail (reduction in the inflammatory response, antibacterial action, modulation of immune response and antioxidant effects, etc.). In addition, a brief description of the chemical composition of P. polyphylla saponins and its available extraction methods are described. We hope this review can serve as a quick and detailed reference for future studies on their potential acne treatment.
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Affiliation(s)
- Luyao Li
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Jiachan Zhang
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Wenjing Cheng
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Feiqian Di
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Changtao Wang
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Quan An
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, China;
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Armillei MK, Lomakin IB, Del Rosso JQ, Grada A, Bunick CG. Scientific Rationale and Clinical Basis for Clindamycin Use in the Treatment of Dermatologic Disease. Antibiotics (Basel) 2024; 13:270. [PMID: 38534705 DOI: 10.3390/antibiotics13030270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Clindamycin is a highly effective antibiotic of the lincosamide class. It has been widely used for decades to treat a range of skin and soft tissue infections in dermatology and medicine. Clindamycin is commonly prescribed for acne vulgaris, with current practice standards utilizing fixed-combination topicals containing clindamycin that prevent Cutibacterium acnes growth and reduce inflammation associated with acne lesion formation. Certain clinical presentations of folliculitis, rosacea, staphylococcal infections, and hidradenitis suppurativa are also responsive to clindamycin, demonstrating its suitability and versatility as a treatment option. This review describes the use of clindamycin in dermatological practice, the mechanism of protein synthesis inhibition by clindamycin at the level of the bacterial ribosome, and clindamycin's anti-inflammatory properties with a focus on its ability to ameliorate inflammation in acne. A comparison of the dermatologic indications for similarly utilized antibiotics, like the tetracycline class antibiotics, is also presented. Finally, this review addresses both the trends and mechanisms for clindamycin and antibiotic resistance, as well as the current clinical evidence in support of the continued, targeted use of clindamycin in dermatology.
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Affiliation(s)
- Maria K Armillei
- Program in Translational Biomedicine, Yale School of Medicine, Yale University, New Haven, CT 06511, USA
| | - Ivan B Lomakin
- Department of Dermatology, Yale University, New Haven, CT 06520, USA
| | - James Q Del Rosso
- College of Osteopathic Medicine, Touro University Nevada, Henderson, NV 89014, USA
- JDR Dermatology Research, Las Vegas, NV 89148, USA
- Clinical Research and Strategic Development, Advanced Dermatology and Cosmetic Surgery, Maitland, FL 32751, USA
| | - Ayman Grada
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Christopher G Bunick
- Program in Translational Biomedicine, Yale School of Medicine, Yale University, New Haven, CT 06511, USA
- Department of Dermatology, Yale University, New Haven, CT 06520, USA
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5
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Xie L, Hamblin MR, Zheng D, Wen X. Die Bedeutung von Mikrokomedonen bei der Akne: Von der Beschreibung bis zum Behandlungsansatz?: The role of microcomedones in acne: Moving from a description to treatment target? J Dtsch Dermatol Ges 2024; 22:9-17. [PMID: 38212912 DOI: 10.1111/ddg.15272_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/11/2023] [Indexed: 01/13/2024]
Abstract
ZusammenfassungEin wichtiger Faktor in der Pathogenese der Akne vulgaris ist die duktale Hyperproliferation der Talgdrüsen. Diese beginnt mit der Bildung unsichtbarer Mikrokomedonen und führt im weiteren Verlauf zur Ausbildung sowohl entzündlicher als auch nicht‐entzündlicher klinischer Läsionen. Die Mikrokomedonen stehen am Anfang der zyklischen Entwicklung einer Akne, die als Komedogenese bezeichnet wird. Mikrokomedonen können mithilfe von Cyanoacrylat‐Hautablösungen, Elektronenmikroskopie, konfokaler Reflexionsmikroskopie und anderen Techniken nachgewiesen werden. Es wird angenommen, dass die Dichte und Größe von Mikrokomedonen positiv mit dem Schweregrad der Akne korreliert. Ziel dieser Übersichtsarbeit ist es, die Ursachen der Akne zusammenzufassen und darauf hinzuweisen, dass die Behandlung von Mikrokomedonen zumindest teilweise Akneläsionen beseitigen und Rückfälle verhindern könnte.
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Affiliation(s)
- Li Xie
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, Südafrika
| | - DanLing Zheng
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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6
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Xie L, Hamblin MR, Zheng D, Wen X. The role of microcomedones in acne: Moving from a description to treatment target? J Dtsch Dermatol Ges 2024; 22:9-16. [PMID: 38123894 DOI: 10.1111/ddg.15272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/11/2023] [Indexed: 12/23/2023]
Abstract
A major factor in the pathogenesis of acne is ductal hyperproliferation in the pilosebaceous glands. This takes the form of invisible microcomedones and leads to the subsequent formation of both inflammatory and non-inflammatory clinical lesions. Microcomedones are the initial stage in the cyclical development of acne, so called comedogenesis. Microcomedones can be detected using cyanoacrylate skin surface stripping, electron microscopy, reflection confocal microscopy and other techniques. It has been proposed that the density and the size of microcomedones are positively correlated with acne severity. Thus, the purpose of this review is to summarize the root causes of acne, and suggest that treatment of microcomedones could, at least in part, resolve acne lesions and prevent relapse.
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Affiliation(s)
- Li Xie
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - DanLing Zheng
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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7
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Xu Y, Cohen E, Johnson CN, Parent CA, Coulombe PA. Keratin 17- and PKCα-dependent transient amplification of neutrophil influx after repeated stress to the skin. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.11.561954. [PMID: 37873256 PMCID: PMC10592713 DOI: 10.1101/2023.10.11.561954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Neutrophils contribute to the pathogenesis of chronic inflammatory skin diseases. Little is known about the source and identity of the signals mediating their recruitment in inflamed skin. We used the phorbol ester TPA and UVB, alone or in combination, to induce sterile inflammation in mouse skin and assess whether keratinocyte-derived signals impact neutrophil recruitment. A single TPA treatment results in a neutrophil influx in the dermis that peaks at 12h and resolves within 24h. A second TPA treatment or a UVB challenge, when applied at 24h but not 48h later, accelerates, amplifies, and prolongs neutrophil infiltration. This transient amplification response (TAR) is mediated by local signals in inflamed skin, can be recapitulated in ex vivo culture, and involves the K17-dependent sustainment of protein kinase Cα (PKCα) activity and release of neutrophil chemoattractants by stressed keratinocytes. We show that K17 binds RACK1, a scaffold essential for PKCα activity. Finally, analyses of RNAseq data reveal the presence of a transcriptomic signature consistent with TAR and PKCα activation in chronic inflammatory skin diseases. These findings uncover a novel, transient, and keratin-dependent mechanism that amplifies neutrophil recruitment to the skin under stress, with direct implications for inflammatory skin disorders.
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8
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Cao J, Xu M, Zhu L, Xiao S. Viaminate Inhibits Propionibacterium Acnes-induced Abnormal Proliferation and Keratinization of HaCat Cells by Regulating the S100A8/S100A9- MAPK Cascade. Curr Drug Targets 2023; 24:1055-1065. [PMID: 37861037 DOI: 10.2174/0113894501243867230928115205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/30/2023] [Accepted: 08/30/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Viaminate, a vitamin A acid drug developed in China, has been clinically used in acne treatment to regulate epithelial cell differentiation and proliferation, inhibit keratinization, reduce sebum secretion, and control immunological and anti-inflammatory actions; however, the exact method by which it works is unknown. METHODS In the present study, acne was induced in the ears of rats using Propionibacterium acnes combined with sebum application. RESULTS After 30 days of treatment with viaminate, the symptoms of epidermal thickening and keratin overproduction in the ears of rats were significantly improved. Transcriptomic analysis of rat skin tissues suggested that viaminate significantly regulated the biological pathways of cellular keratinization. Gene differential analysis revealed that the S100A8 and S100A9 genes were significantly downregulated after viaminate treatment. The results of qPCR and Western blotting confirmed that viaminate inhibited the expression of S100A8 and S100A9 genes and proteins in rat and HaCat cell acne models, while its downstream pathway MAPK (MAPK p38/JNK/ERK1/2) protein expression levels were suppressed. Additional administration of the S100A8 and S100A9 complex protein significantly reversed the inhibitory effect of viaminate on abnormal proliferation and keratinization levels in acne cell models. CONCLUSION In summary, viaminate can improve acne by modulating S100A8 and S100A9 to inhibit MAPK pathway activation and inhibit keratinocyte proliferation and keratinization levels.
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Affiliation(s)
- Junjie Cao
- Department of Dermatology, the Second Affiliated Hospital of Xi 'an Jiaotong University, 157 Xiwu Road, Xi 'an City 710103, Shaanxi Province, China
| | - Meifeng Xu
- Department of Dermatology, the Second Affiliated Hospital of Xi 'an Jiaotong University, 157 Xiwu Road, Xi 'an City 710103, Shaanxi Province, China
| | - Longfei Zhu
- Department of Dermatology, the Second Affiliated Hospital of Xi 'an Jiaotong University, 157 Xiwu Road, Xi 'an City 710103, Shaanxi Province, China
| | - Shengxiang Xiao
- Department of Dermatology, the Second Affiliated Hospital of Xi 'an Jiaotong University, 157 Xiwu Road, Xi 'an City 710103, Shaanxi Province, China
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Pavlovsky M, Peled A, Sarig O, Astman N, Malki L, Meijers O, Assaf S, Schwartz J, Malovitski K, Hansen D, Sprecher E, Samuelov L. Coexistence of pachyonychia congenita and hidradenitis suppurativa: more than a coincidence. Br J Dermatol 2022; 187:392-400. [PMID: 35606927 PMCID: PMC9796395 DOI: 10.1111/bjd.21674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 04/30/2022] [Accepted: 05/21/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The coexistence of pachyonychia congenita (PC) and hidradenitis suppurativa (HS) has been described in case reports. However, the pathomechanism underlying this association and its true prevalence are unknown. OBJECTIVES To determine the genetic defect underlying the coexistence of PC and HS in a large kindred, to delineate a pathophysiological signalling defect jointly leading to both phenotypes, and to estimate the prevalence of HS in PC. METHODS We used direct sequencing and a NOTCH luciferase reporter assay to characterize the pathophysiological basis of the familial coexistence of HS and PC. A questionnaire was distributed to patients with PC registered with the International Pachyonychia Congenita Research Registry (IPCRR) to assess the prevalence of HS among patients with PC. RESULTS Direct sequencing of DNA samples obtained from family members displaying both PC and HS demonstrated a missense variant (c.275A>G) in KRT17, encoding keratin 17. Abnormal NOTCH signalling has been suggested to contribute to HS pathogenesis. Accordingly, the KRT17 c.275A>G variant resulted in a significant decrease in NOTCH activity. To ascertain the clinical importance of the association of HS with PC, we distributed a questionnaire to all patients with PC registered with the IPCRR. Seventy-two of 278 responders reported HS-associated clinical features (25·9%). Disease-causing mutations in KRT17 were most prevalent among patients with a dual phenotype of PC and HS (43%). CONCLUSIONS The coexistence of HS and KRT17-associated PC is more common than previously thought. Impaired NOTCH signalling as a result of KRT17 mutations may predispose patients with PC to HS. What is already known about this topic? The coexistence of pachyonychia congenita (PC) and hidradenitis suppurativa (HS) has been described in case reports. However, the pathomechanism underlying this association and its true prevalence are unknown. What does this study add? A dual phenotype consisting of PC and HS was found to be associated with a pathogenic variant in KRT17. This variant was found to affect NOTCH signalling, which has been previously implicated in HS pathogenesis. HS was found to be associated with PC in a large cohort of patients with PC, especially in patients carrying KRT17 variants, suggesting that KRT17 variants causing PC may also predispose to HS. What is the translational message? These findings suggest that patients with PC have a higher prevalence of HS than previously thought, and hence physicians should have a higher level of suspicion of HS diagnosis in patients with PC.
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Affiliation(s)
- Mor Pavlovsky
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Alon Peled
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Ofer Sarig
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Nadav Astman
- Department of DermatologySheba Medical CenterTel‐HashomerRamat GanIsrael,Israel Defense Forces Medical CorpsRamat GanIsrael
| | - Liron Malki
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Odile Meijers
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Sari Assaf
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | | | - Kiril Malovitski
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - David Hansen
- Pachyonychia Congenita ProjectHolladayUTUSA,Department of DermatologyUniversity of UtahSalt Lake CityUTUSA
| | - Eli Sprecher
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Liat Samuelov
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
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10
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Shang W, Quan Tan AY, van Steensel MAM, Lim X. ABERRANT WNT SIGNALING INDUCES COMEDO-LIKE CHANGES IN THE MURINE UPPER HAIR FOLLICLE. J Invest Dermatol 2021; 142:2603-2612.e6. [PMID: 34929175 DOI: 10.1016/j.jid.2021.11.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 12/20/2022]
Abstract
Stem cell proliferation and differentiation must be carefully balanced to support tissue maintenance and growth. Defective stem cell regulation may underpin diseases in many organs, including the skin. Lrig1-expressing stem cells residing in the HF junction zone (JZ) support sebaceous gland (SG) homeostasis. An emerging hypothesis from observations in both mouse and human holds that imbalances in key stem cell regulatory pathways such as Wnt signaling may lead to abnormal fate determination of these Lrig1+ve cells. They accumulate and form cystic structures in the JZ that are similar to the comedones found in human acne. To test the possible involvement of Wnt signals in this scenario, we used the Lrig1-CreERT2 mouse line to modulate Wnt signaling in JZ stem cells. We observed that persistent activation of Wnt signaling leads to JZ cyst formation with associated SG atrophy. The cysts strongly express stem cell markers and can be partially reduced by all-trans retinoic acid treatment as well as by Hedgehog signaling inhibition. Conversely, loss of Wnt signaling leads to enlargement of JZ, infundibulum and SGs. These data implicate abnormal Wnt signaling in the generation of mouse pathologies that resemble human acne and respond to acne treatments.
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Affiliation(s)
- Wei Shang
- Skin Research Institute of Singapore, Agency for Science, Technology, and Research
| | - Alvin Yong Quan Tan
- Skin Research Institute of Singapore, Agency for Science, Technology, and Research
| | - Maurice A M van Steensel
- Skin Research Institute of Singapore, Agency for Science, Technology, and Research;; Lee Kong Chian School of Medicine, Nanyang Technological University Singapore
| | - Xinhong Lim
- Skin Research Institute of Singapore, Agency for Science, Technology, and Research;.
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11
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Kurokawa I, Layton AM, Ogawa R. Updated Treatment for Acne: Targeted Therapy Based on Pathogenesis. Dermatol Ther (Heidelb) 2021; 11:1129-1139. [PMID: 34115308 PMCID: PMC8322376 DOI: 10.1007/s13555-021-00552-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 12/18/2022] Open
Abstract
Previous approaches to acne management have focused on the four main factors implicated in acne, namely, androgen-mediated sebogenesis (considered integral to acne), hyperkeratinization, colonization with Cutibacterium acnes, and inflammation related to both innate and adaptive mechanisms. Recent advances have facilitated potential novel approaches to acne management, as the pathophysiology and the immunological aspects related to acne and wound healing have evolved. Particular targets that have been shown to be closely involved in acne pathophysiology and wound healing include interleukin (IL)-1β, IL-17, IL-23, and tumor necrosis factor alpha (TNFα). Biological antibodies targeting IL-1β, IL-17, IL-23, and TNFα could provide novel approaches for treating severe acne and related disorders. Acne is primarily a disease associated with sebogenesis. Monosaturated free acids are important components. Insulin growth factor 1 (IGF-1) promotes the proliferation and differentiation of sebocytes and IL-1β. Research into the microbiome may also provide insights into potential future therapeutic options for acne. Scars, both atrophic and hypertrophic, are common sequelae to acne. Risk factors associated with the development of acne scars include genetic, systemic, local, and lifestyle factors. Pro-inflammatory cytokines have been shown to play a crucial role in the development of acne-induced hypertrophic scars. Treatment for extensive inflammatory keloid scarring is limited. Surgery and postoperative radiotherapy are two possible options. Transforming growth factor-β (TGFβ), IL-6, matrix metalloproteinase (MMP), IGF-1, and B cells are found in keloid or hypertrophic scar tissues. Biological antibodies targeting these cytokines may be a potential strategy for the prevention and treatment of this type of scar in the future. Future treatment for acne should embrace approaches that target the main etiological factors of acne. In particular, specific emphasis on aggressive treatment in the acute inflammatory phase to reduce the likelihood of scarring and other clinical sequelae, such as pigmentary changes would be highly desirable. Treatment for established acne-induced sequelae should also be considered.
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Affiliation(s)
- Ichiro Kurokawa
- Department of Dermatology, Meiwa Hospital, 4-31, Agenaruo-cho, Nishinomiya, Hyogo, 663-8186, Japan.
| | - Alison M Layton
- Department of Dermatology, Harrogate and District Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
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Laclaverie M, Rouaud-Tinguely P, Grimaldi C, Jugé R, Marchand L, Aymard E, Closs B. Development and characterization of a 3D in vitro model mimicking acneic skin. Exp Dermatol 2021; 30:347-357. [PMID: 33354825 DOI: 10.1111/exd.14268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/20/2020] [Accepted: 12/18/2020] [Indexed: 12/11/2022]
Abstract
Acne is an inflammatory skin disease of the pilosebaceous unit, involving four essential factors: hyperseborrhoea combined to a modification of sebum composition, colonization by Cutibacterium (C.) acnes, hyperkeratinization and secreted inflammation. Understanding and mimicking compromised skin is essential to further develop appropriate therapeutic solutions. This study aimed to develop new in vitro 3D models mimicking acneic skin, by combining two main factors involved in the physiopathology, namely, altered sebum composition and C. acnes invasion. Normal human keratinocytes were first used to generate reconstructed human epidermis (RHE) that were then left untreated (control) or treated topically with a combination of both peroxidized squalene and C. acnes cultures. Once validated, this model considered relevant to mimic acneic skin, was further improved by using different phylotypes of C. acnes strains specifically isolated from healthy and acneic patients. While both phylotypes IB and II did not significantly alter RHE, C. acnes IA1 strains induce major acneic skin hallmarks such as hyperkeratinization, secreted inflammation and altered barrier function. Interestingly, these results are obtained independently of the origin of IA1 phylotypes (acneic vs. healthy patient), thus suggesting a role of the ecosystem in controlling C. acnes virulence in healthy skin. In conclusion, by combining two major factors involved in the physiopathology of acne, we (1) succeeded to design in vitro 3D models mimicking this skin disorder and (2) highlighted how C. acnes phylotypes can have an impact on epidermal physiology. These relevant models will be suitable for the substantiation of therapeutic molecules dedicated to acne treatment.
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Abstract
Multidisciplinary investigations into the pathogenesis of acne have significantly progressed over the past three years. Studies of the etiology of acne from the perspectives, for example, of sebaceous gland biology, sebum, genetics, keratinization, differentiation, hair cycles, immunology, bacteriology, and wound healing have elucidated its pathogenesis. This has led to the development of new therapies and paved the way for advanced studies that will enable the further evolution of acne treatment.
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Affiliation(s)
- Ichiro Kurokawa
- Department of Dermatology, Acne Clinical Research Center, Meiwa Hospital, Nishinomiya, Hyogo, 663-8186, Japan
| | - Keisuke Nakase
- Department of Microbiology, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, 192-0392, Japan
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Persson G, Johansson-Jänkänpää E, Ganceviciene R, Karadag AS, Bilgili SG, Omer H, Alexeyev OA. No evidence for follicular keratinocyte hyperproliferation in acne lesions as compared to autologous healthy hair follicles. Exp Dermatol 2019; 27:668-671. [PMID: 29582469 DOI: 10.1111/exd.13544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 01/09/2023]
Abstract
Abnormal hyperkeratinization in sebaceous hair follicles has long been believed to play an important role in acne pathogenesis. Several early reports purported to provide histological evidence for hyperproliferation of keratinocytes in acne lesions by showing a higher expression of the Ki67 as well as certain keratins. The evidence is, however, not robust, and a number of methodological and technical limitations can be identified in these studies. In this study, we looked at the expression of proliferation, mitosis and apoptosis markers directly at acne skin lesions in 66 patients with acne vulgaris. Ki67 was assessed using immunohistochemistry and α-tubulin, phospho-histone H3 and cleaved-PARP with immunofluorescence microscopy. Allogenic unaffected hair follicles from the same acne patients were used as an internal control. In both acne and control hair follicles, the α-tubulin staining was universal, approaching 100% cells and showed no signs of changed assembly. Expression of cleaved-PARP-the apoptosis marker-was a rare event. Cell proliferation rate measured by the expression of Ki67 and phospho-histone H3 was virtually identical between acne and the two control groups. Our findings show the absence of increased keratinocyte proliferation in acne vulgaris. Alternative mechanisms are likely responsible for infundibular hyperkeratinization in acne pathogenesis.
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Affiliation(s)
| | | | - Ruta Ganceviciene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
| | - Ayse Serap Karadag
- Department of Dermatology and Venereology, School of Medicine Goztepe, Istanbul Medeniyet University, Istanbul, Turkey
| | - Serap Gunes Bilgili
- Department of Dermatology and Venereology, Dursun Odabaş Tıp Center, Van Yuzuncu Yil Universitesi, Tuşba, Van, Turkey
| | - Hélène Omer
- Department of Pathology, Umeå University, Umeå, Sweden
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15
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Clayton R, Göbel K, Niessen C, Paus R, Steensel M, Lim X. Homeostasis of the sebaceous gland and mechanisms of acne pathogenesis. Br J Dermatol 2019; 181:677-690. [DOI: 10.1111/bjd.17981] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/13/2022]
Affiliation(s)
- R.W. Clayton
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Centre for Dermatology Research University of Manchester, and NIHR Manchester Biomedical Research Centre Manchester U.K
| | - K. Göbel
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Department of Dermatology Cologne Excellence Cluster on Stress Responses in Aging Associated Diseases (CECAD), and Centre for Molecular Medicine Cologne The University of Cologne Germany
| | - C.M. Niessen
- Department of Dermatology Cologne Excellence Cluster on Stress Responses in Aging Associated Diseases (CECAD), and Centre for Molecular Medicine Cologne The University of Cologne Germany
| | - R. Paus
- Centre for Dermatology Research University of Manchester, and NIHR Manchester Biomedical Research Centre Manchester U.K
- Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL U.S.A
| | - M.A.M. Steensel
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Lee Kong Chian School of Medicine Nanyang Technological University Singapore
| | - X. Lim
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Lee Kong Chian School of Medicine Nanyang Technological University Singapore
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Kumtornrut C, Yamauchi T, Koike S, Aiba S, Yamasaki K. Androgens modulate keratinocyte differentiation indirectly through enhancing growth factor production from dermal fibroblasts. J Dermatol Sci 2019; 93:150-158. [PMID: 30792099 DOI: 10.1016/j.jdermsci.2019.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/28/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The main pathogenesis of acne vulgaris is increase in sebum production and abnormal keratinization of the hair infundibulum. The androgens are involved in acne pathogenesis by modulating sebaceous glands to enhance sebum production. However, the molecular mechanisms of abnormal keratinization of the hair infundibulum are not fully elucidated. OBJECTIVE We hypothesized that the androgens affect the dermal fibroblasts, another androgen receptor-positive cells in the skin, resulting in abnormal keratinization through keratinocyte-fibroblast interaction. METHODS We investigated effects of androgens and estrogens on growth factors expressions by RT-PCR and western blot analysis in human fibroblast (hFB), human keratinocyte (hKC), and fibroblast-keratinocyte co-culture. In vivo, we examined the growth factor expression in acne lesions compared to normal hair follicles by laser-assisted confocal microscope. RESULTS In vitro, androgens but not estrogens significantly increased amphiregulin (AREG), epiregulin (EREG), fibroblast growth factor (FGF) 10, and insulin-like growth factor binding protein (IGFBP) 5 mRNA and protein expressions in human fibroblasts but not in keratinocytes. In vivo, AREG, EREG, FGF10, and IGFBP5 were more abundant in acne lesion compared to normal facial skin. FGF10 suppressed cytokeratin 1 and cytokeratin 10 expression in hKC, which was along with the decreased ratio of cytokeratin 10 against cytokeratin 14 in acne lesions compared to normal facial skin. Also, DHT suppressed cytokeratin 1 and cytokeratin 10, in fibroblast-keratinocyte co-culture similarly to the effect of FGF10 to hKC. CONCLUSION These observations suggested that androgens enhance growth factors production from dermal fibroblasts, and growth factors from fibroblasts alter keratinocyte differentiation in acne lesion.
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Affiliation(s)
- Chanat Kumtornrut
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan; Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Takeshi Yamauchi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Saaya Koike
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Kenshi Yamasaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan.
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Choi EJ, Lee HG, Bae IH, Kim W, Park J, Lee TR, Cho EG. Propionibacterium acnes-Derived Extracellular Vesicles Promote Acne-Like Phenotypes in Human Epidermis. J Invest Dermatol 2018; 138:1371-1379. [DOI: 10.1016/j.jid.2018.01.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/10/2018] [Accepted: 01/17/2018] [Indexed: 12/24/2022]
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18
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Muguet Guenot L, Vourc'h Jourdain M, Saint-Jean M, Corvec S, Gaultier A, Khammari A, Le Moigne M, Boisrobert A, Paugam C, Dréno B. Confocal microscopy in adult women with acne. Int J Dermatol 2018; 57:278-283. [DOI: 10.1111/ijd.13910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/15/2017] [Accepted: 12/18/2017] [Indexed: 01/01/2023]
Affiliation(s)
| | | | - Mélanie Saint-Jean
- Dermatology Department; CIC 1413; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Stéphane Corvec
- Bacteriology Department; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Aurélie Gaultier
- PIMESP-SEB; Hôpital Saint Jacques; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Amir Khammari
- Dermatology Department; CIC 1413; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Marie Le Moigne
- Dermatology Department; CIC 1413; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Aurélie Boisrobert
- Dermatology Department; CIC 1413; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Charlotte Paugam
- Dermatology Department; CIC 1413; CRCINA Inserm 1232; CHU Nantes; Nantes France
| | - Brigitte Dréno
- Dermatology Department; CIC 1413; CRCINA Inserm 1232; CHU Nantes; Nantes France
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19
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Kurokawa I, Ohyama M. Revisiting the dogma of acne pathogenesis. Br J Dermatol 2015; 172:851. [PMID: 25827732 DOI: 10.1111/bjd.13654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- I Kurokawa
- Department of Dermatology, Acne Clinical Research Center, Meiwa Hospital, 4-31 Agenaruo-cho, Nishinomiya, Hyogo, 663-8186, Japan.
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20
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Jahns AC, Eilers H, Ganceviciene R, Alexeyev OA. Propionibacterium species and follicular keratinocyte activation in acneic and normal skin. Br J Dermatol 2014; 172:981-7. [PMID: 25279837 DOI: 10.1111/bjd.13436] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND The pathogenesis of acne vulgaris is multifactorial with increased sebum production, alteration in the quality of sebum lipids, dysregulation of the hormone microenvironment, follicular hyperkeratinization and Propionibacterium acnes-driven inflammation as major contributory factors. Hyperproliferation of keratinocytes is believed to contribute to hypercornification and eventually leads to comedone development. While the distribution of P. acnes is relatively well documented in acneic and healthy skin, little is known about P. granulosum and P. avidum. OBJECTIVES To visualize directly the three major Propionibacterium in 117 control and 26 acneic skin samples. In addition, keratinocyte proliferation was evaluated. METHODS Propionibacteria were visualized by immunofluorescence microscopy, and keratinocyte proliferation was assessed by Ki67, keratin (K) 16 and p63 immunochemistry. RESULTS P. acnes was identified in 68 samples (48%), while P. granulosum was identified in 12 (8%) samples; P. avidum was not detected at all. Unexpectedly, acne samples did not show higher keratinocyte proliferation than controls, nor was there any association between bacterial colonization and expression of Ki67/K16/p63. CONCLUSIONS Our findings do not support earlier notions of follicular keratinocyte hyperproliferation as a cause of ductal hypercornification in acneic facial skin. Further studies on the mechanisms underlying hypercornification in acne pathogenesis are needed.
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Affiliation(s)
- A C Jahns
- Department of Medical Biosciences/Pathology, Umeå University, S-90185, Umeå, Sweden
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21
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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]
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22
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Kurokawa I, Konishi T, Kakuno A, Tsubura A. Keratin and filaggrin expression in dermatitis papillaris capilliti. Int J Dermatol 2014; 53:e392-5. [PMID: 24961741 DOI: 10.1111/ijd.12413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ichiro Kurokawa
- Departments of Dermatology, Acne Clinical Research Center, Meiwa Hospital, Hyogo, Japan
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23
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Zouboulis CC, Jourdan E, Picardo M. Acne is an inflammatory disease and alterations of sebum composition initiate acne lesions. J Eur Acad Dermatol Venereol 2013; 28:527-32. [PMID: 24134468 DOI: 10.1111/jdv.12298] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/19/2013] [Indexed: 12/11/2022]
Abstract
Hyperseborrhoea has been considered as a major aetiopathogenetic factor of acne. However, changes in sebaceous gland activity not only correlate with seborrhoea but also with alterations in sebum fatty acid composition. Current findings indicate that sebum lipid fractions with proinflammatory properties and inflammatory tissue cascades are associated in the process of the development of acne lesions. The oxidant/antioxidant ratio of the skin surface lipids and alterations of lipid composition are the main players in the induction of acne inflammation. Nutrition may influence the development of seborrhoea, the fractions of sebum lipids and acne. Acne is an inflammatory disease probably triggered, among others, by proinflammatory sebum lipid fractions.
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Affiliation(s)
- C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
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24
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Hinde E, Haslam IS, Schneider MR, Langan EA, Kloepper JE, Schramm C, Zouboulis CC, Paus R. A practical guide for the study of human and murine sebaceous glandsin situ. Exp Dermatol 2013; 22:631-7. [DOI: 10.1111/exd.12207] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Eleanor Hinde
- Institute of Inflammation and Repair; University of Manchester; Manchester; UK
| | - Iain S. Haslam
- Institute of Inflammation and Repair; University of Manchester; Manchester; UK
| | - Marlon R. Schneider
- Institute of Molecular Animal Breeding and Biotechnology; Gene Center; LMU Munich; Munich; Germany
| | | | | | | | - Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology; Dessau Medical Center; Dessau; Germany
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25
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Palmitic acid induces production of proinflammatory cytokines interleukin-6, interleukin-1β, and tumor necrosis factor-α via a NF-κB-dependent mechanism in HaCaT keratinocytes. Mediators Inflamm 2013; 2013:530429. [PMID: 24078775 PMCID: PMC3774064 DOI: 10.1155/2013/530429] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 01/15/2023] Open
Abstract
To investigate whether palmitic acid can be responsible for the induction of inflammatory processes, HaCaT keratinocytes were treated with palmitic acid at pathophysiologically relevant concentrations. Secretion levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), NF-κB nuclear translocation, NF-κB activation, Stat3 phosphorylation, and peroxisome proliferator-activated receptor alpha (PPARα) mRNA and protein levels, as well as the cell proliferation ability were measured at the end of the treatment and after 24 hours of recovery. Pyrrolidine dithiocarbamate (PDTC, a selective chemical inhibitor of NF-κB) and goat anti-human IL-6 polyclonal neutralizing antibody were used to inhibit NF-κB activation and IL-6 production, respectively. Our results showed that palmitic acid induced an upregulation of IL-6, TNF-α, IL-1β secretions, accompanied by NF-κB nuclear translocation and activation. Moreover, the effect of palmitic acid was accompanied by PPARα activation and Stat3 phosphorylation. Palmitic acid-induced IL-6, TNF-α, IL-1β productions were attenuated by NF-κB inhibitor PDTC. Palmitic acid was administered in amounts able to elicit significant hyperproliferation and can be attenuated by IL-6 blockage. These data demonstrate for the first time that palmitic acid can stimulate IL-6, TNF-α, IL-1β productions in HaCaT keratinocytes and cell proliferation, thereby potentially contributing to acne inflammation and pilosebaceous duct hyperkeratinization.
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Abstract
Keratin 17 (K17) is an intermediate filament protein present in the basal cells of complex epithelia, such as nails, hair follicles, sebaceous glands, and eccrine sweat glands. Studies have shown that it is expressed aberrantly in the suprabasal keratinocytes of psoriatic lesions, compared to in normal epidermis. K17 is also closely associated with the immune system and plays an important role in the pathogenesis of psoriasis. In this review, we present our experimental findings concerning the role of K17 in psoriasis, and compare them to results published in the literature. Our results show that cytokines related to Th17 and IL-22-producing (where Th17 is T helper cells, type 17 and IL is interleukin) CD4(+) T cells, including IL-17A and IL-22, upregulate the expression of K17 in keratinocytes. In addition, K17 stimulates autoreactive T cells and promotes the production of psoriasis-associated cytokines. Our findings lend support to the hypothesis that a K17/T-cell/cytokine autoimmune loop is involved in the pathogenesis of psoriasis. We therefore review the current understanding of the K17 immunoregulation, including its expression and direct/indirect effects on immune responses. Pertinent strategies for the treatment of psoriasis are also discussed.
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Affiliation(s)
- Liang Jin
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
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27
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28
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Kurokawa I, Tsuruta D, Tsubura A, Mizutani H. Keratin and filaggrin expression in comedonal Darier's disease. J Dermatol 2011; 38:1089-1092. [PMID: 22145160 DOI: 10.1111/j.1346-8138.2010.01169.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ichiro Kurokawa
- Department of Dermatology, Mie University Graduate School of Medicine, Mie
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine
| | - Airo Tsubura
- Department of Pathology, Kansai Medical University, Osaka, Japan
| | - Hitoshi Mizutani
- Department of Dermatology, Mie University Graduate School of Medicine, Mie
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29
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Kurokawa I, Takahashi K, Moll I, Moll R. Expression of keratins in cutaneous epithelial tumors and related disorders - distribution and clinical significance. Exp Dermatol 2011; 20:217-28. [DOI: 10.1111/j.1600-0625.2009.01006.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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30
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Abstract
Five main factors play a pivotal role in the pathogenesis of acne: androgen dependence, follicular retention hyperkeratosis, increased sebaceous lipogenesis, increased colonization with P. acnes, and inflammatory events. This paper offers a solution for the pathogenesis of acne and explains all major pathogenic factors at the genomic level by a relative deficiency of the nuclear transcription factor FoxO1. Nuclear FoxO1 suppresses androgen receptor, other important nuclear receptors and key genes of cell proliferation, lipid biosynthesis and inflammatory cytokines. Elevated growth factors during puberty and persistent growth factor signals due to Western life style stimulate the export of FoxO1 out of the nucleus into the cytoplasm via activation of the phos-phoinositide-3-kinase (PI3K)/Akt pathway. By this mechanism, genes and nuclear receptors involved in acne are derepressed leading to increased androgen receptor-mediated signal transduction, increased cell proliferation of androgen-dependent cells, induction of sebaceous lipogenesis and upregulation of Toll-like-receptor-2-dependent inflammatory cytokines. All known acne-inducing factors exert their action by reduction of nuclear FoxO1 levels. In contrast, retinoids, antibiotics and dietary intervention will increase the nuclear content of FoxO1, thereby normalizing increased transcription of genes involved in acne. Various receptor-mediated growth factor signals are integrated at the level of PI3K/Akt activation which finally results in nuclear FoxO1 deficiency.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Enviromental Medicine and Health Theory, University of Osnabrück, Germany.
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31
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Involvement of IGF-1/IGFBP-3 signaling on the conspicuousness of facial pores. Arch Dermatol Res 2010; 302:661-7. [PMID: 20567839 DOI: 10.1007/s00403-010-1062-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 06/08/2010] [Accepted: 06/10/2010] [Indexed: 01/28/2023]
Abstract
Conspicuous facial pores are one type of serious esthetic defects for many women. We previously reported that the severity of impairment of skin architecture around facial pores correlates well with the appearance of facial pores in several ethnic groups. In our last report, we showed that serum levels of insulin-like growth factor-1 (IGF-1) correlate well with facial pore size and with the severity of impairment of epidermal architecture around facial pores. However, our results could not fully explain the implication between facial pores and IGF signaling. In this study, we conducted a histological analysis of facial skin to determine whether potential changes in IGF-1 availability occur in the skin with or without conspicuous pores. Immunohistochemical observations showed that expression of insulin-like growth factor binding protein-3 (IGFBP-3) is limited to the suprapapillary epidermis around facial pores and to basal cells of rete pegs without tips in epidermis with conspicuous pores. In contrast, in basal cells of skin without conspicuous pores, IGFBP-3 expression is very low. Ki-67 and IGF-1 receptor-positive cells are abundant in basal cells in the tips of the rete pegs in skin with typical epidermal architecture around facial pores. No obvious differences were observed in the expression of filaggrin, involucrin, K1, K6 or K17 in skin with or without conspicuous pores. However, increased expression of K16 was observed in skin with conspicuous pores suggesting hyperproliferation. These results suggest that the IGF-1/IGFBP-3 signaling pathway is involved in the formation of conspicuous facial pores due to the epidermal architecture around facial pores.
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Melnik BC, Schmitz G, Zouboulis CC. Anti-Acne Agents Attenuate FGFR2 Signal Transduction in Acne. J Invest Dermatol 2009; 129:1868-77. [DOI: 10.1038/jid.2009.8] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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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.
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Affiliation(s)
- Narifumi Akaza
- Department of Dermatology, Fujita Health University School of Medicine, Nagoya, Japan.
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Kurokawa I, Danby FW, Ju Q, Wang X, Xiang LF, Xia L, Chen W, Nagy I, Picardo M, Suh DH, Ganceviciene R, Schagen S, Tsatsou F, Zouboulis CC. New developments in our understanding of acne pathogenesis and treatment. Exp Dermatol 2009; 18:821-32. [PMID: 19555434 DOI: 10.1111/j.1600-0625.2009.00890.x] [Citation(s) in RCA: 350] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Interest in sebaceous gland physiology and its diseases is rapidly increasing. We provide a summarized update of the current knowledge of the pathobiology of acne vulgaris and new treatment concepts that have emerged in the last 3 years (2005-2008). We have tried to answer questions arising from the exploration of sebaceous gland biology, hormonal factors, hyperkeratinization, role of bacteria, sebum, nutrition, cytokines and toll-like receptors (TLRs). Sebaceous glands play an important role as active participants in the innate immunity of the skin. They produce neuropeptides, excrete antimicrobial peptides and exhibit characteristics of stem cells. Androgens affect sebocytes and infundibular keratinocytes in a complex manner influencing cellular differentiation, proliferation, lipogenesis and comedogenesis. Retention hyperkeratosis in closed comedones and inflammatory papules is attributable to a disorder of terminal keratinocyte differentiation. Propionibacterium acnes, by acting on TLR-2, may stimulate the secretion of cytokines, such as interleukin (IL)-6 and IL-8 by follicular keratinocytes and IL-8 and -12 in macrophages, giving rise to inflammation. Certain P. acnes species may induce an immunological reaction by stimulating the production of sebocyte and keratinocyte antimicrobial peptides, which play an important role in the innate immunity of the follicle. Qualitative changes of sebum lipids induce alteration of keratinocyte differentiation and induce IL-1 secretion, contributing to the development of follicular hyperkeratosis. High glycemic load food and milk may induce increased tissue levels of 5alpha-dihydrotestosterone. These new aspects of acne pathogenesis lead to the considerations of possible customized therapeutic regimens. Current research is expected to lead to innovative treatments in the near future.
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Affiliation(s)
- Ichiro Kurokawa
- Department of Dermatology, Mie Universtity Graduate School of Medicine, Tsu, Mie, Japan.
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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.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology; Environmental Medicine and Health Theory; University of Osnabrück; Germany
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Katsuta Y, Iida T, Hasegawa K, Inomata S, Denda M. Function of oleic acid on epidermal barrier and calcium influx into keratinocytes is associated with N-methyl D-aspartate-type glutamate receptors. Br J Dermatol 2008; 160:69-74. [PMID: 18808414 DOI: 10.1111/j.1365-2133.2008.08860.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Unsaturated fatty acids from sebum affect calcium dynamics in epidermal keratinocytes, disrupt the barrier function and induce abnormal keratinization. However, the mechanisms of these effects have not been clarified. OBJECTIVES To investigate the function of unsaturated fatty acids in epidermis. METHODS Antagonists of calcium channel receptors were applied to mouse skin together with oleic acid. Measurements were made of transepidermal water loss (TEWL), and hyperproliferation was assessed. The effects of the antagonists on calcium influx into cultured normal human keratinocytes and on cytokine production were also evaluated. RESULTS N-methyl-d-aspartate (NMDA) receptor antagonists such as MK801 and D-AP5 specifically inhibited the increase in TEWL caused by oleic acid, and suppressed keratinocyte hyperproliferation. These compounds also inhibited the increase in the intracellular concentration of calcium ions induced by oleic acid. MK801 suppressed the production of interleukin-1alpha by keratinocytes induced by oleic acid. CONCLUSIONS Unsaturated fatty acids such as oleic acid might function via NMDA receptors.
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Affiliation(s)
- Y Katsuta
- Shiseido Research Center, 2-2-1 Hayabuchi, Tsuzuki-ku, Yokohama 224-8558, Japan.
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Computer-assisted alignment and tracking of acne lesions indicate that most inflammatory lesions arise from comedones and de novo. J Am Acad Dermatol 2008; 58:603-8. [DOI: 10.1016/j.jaad.2007.12.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 10/31/2007] [Accepted: 12/18/2007] [Indexed: 11/20/2022]
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Bhawan J, Whren K, Panova I, Yaar M. Keratin 16 Expression in Epidermal Melanocytes of Normal Human Skin. Am J Dermatopathol 2005; 27:476-81. [PMID: 16314702 DOI: 10.1097/01.dad.0000179627.81172.37] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although the prevailing dogma states that keratin filaments are the hallmark of keratinocytes and other epithelial cells, recent publications suggest that they may be expressed by a variety of normal and malignant cells of different embryonic origin. Keratin expression has been reported in fibroblasts and endothelial cells as well as in various sarcomas. Also, some human melanomas express keratins in addition to the traditional diagnostic markers of differentiation, such as S-100 and melanocyte-specific antigens. Many studies have shown that cultured cells obtained from various melanomas express keratin. Most recently, keratin expression has also been shown in cultured melanocytes of normal skin. We now report that normal human melanocytes in vivo express keratin 16 (K16) but not keratins 1, 5, 8, 10, 14, or even keratin 6, the type II partner that is normally expressed with K16 in keratinocytes. Similarly, melanocytes in vitro express K16 but not K6. Keratin 16 expression in vivo was present in basal melanocytes in specimens derived from donors (0-77 years) and from different anatomic locations, suggesting that keratin 16 is constitutively expressed by all melanocytes. It appears that keratin expression may be more prevalent than previously assumed, and that these cytoskeletal filaments may play important roles in tissues and cells other than epithelia.
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Affiliation(s)
- Jag Bhawan
- Dermatopathology Section, Boston University School of Medicine, Boston, MA 02118, USA.
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Herrmann T, Gröne HJ, Langbein L, Kaiser I, Gosch I, Bennemann U, Metzger D, Chambon P, Stewart AF, Stremmel W. Disturbed Epidermal Structure in Mice with Temporally Controlled Fatp4 Deficiency. J Invest Dermatol 2005; 125:1228-35. [PMID: 16354193 DOI: 10.1111/j.0022-202x.2005.23972.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
So far, little is known about the physiological role of fatty acid transport protein 4 (Fatp4, Slc27a4). Mice with a targeted disruption of the Fatp4 gene display features of a human neonatally lethal restrictive dermopathy with a hyperproliferative hyperkeratosis, a disturbed epidermal barrier, a flat dermal-epidermal junction, a reduced number of pilo-sebaceous structures, and a compact dermis, demonstrating that Fatp4 is necessary for the formation of the epidermal barrier. Because Fatp4 is widely expressed, it is unclear whether intrinsic Fatp4 deficiency in the epidermis alone can cause changes in the epidermal structure or whether the abnormalities observed are secondary to the loss of Fatp4 in other organs. To evaluate the functional role of Fatp4 in the skin, we generated a mouse line with Fatp4 deficiency inducible in the epidermis. Mice with epidermal keratinocyte-specific Fatp4 deficiency developed a hyperproliferative hyperkeratosis with a disturbed epidermal barrier. These changes resemble the histological abnormalities in the epidermis of newborn mice with total Fatp4 deficiency. We conclude that Fatp4 in epidermal keratinocytes is essential for the maintenance of a normal epidermal structure.
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Affiliation(s)
- Thomas Herrmann
- Department of Internal Medicine IV, University of Heidelberg, Heidelberg, Germany.
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41
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Holland DB, Jeremy AHT. The Role of Inflammation in the Pathogenesis of Acne and Acne Scarring. ACTA ACUST UNITED AC 2005; 24:79-83. [PMID: 16092795 DOI: 10.1016/j.sder.2005.03.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Evidence now supports a pivotal role for cellular inflammatory events at all stages of acne lesion development, from preclinical initiation to clinical presentation of active lesions through to resolution. The emphasis has moved from acne as a primarily hyperproliferative disorder of the sebaceous follicle to that of an inflammatory skin disorder. However, although the sequence of events leading to lesion formation has become clearer, the triggers for initiation remain speculative. The development of noninvasive techniques to detect preclinical "acne-prone" follicles is essential before triggers for initiation can be defined. Finally, the differences highlighted in the inflammatory profiles of inflamed lesions from patients who scar, as compared with other nonscarring acne patients reinforces the view that acne is a disorder, which embraces a number of pathologies.
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Affiliation(s)
- Diana B Holland
- The Skin Research Centre, School of Biochemistry and Microbiology, University of Leeds, Leeds, United Kingdom.
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42
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Katsuta Y, Iida T, Inomata S, Denda M. Unsaturated Fatty Acids Induce Calcium Influx into Keratinocytes and Cause Abnormal Differentiation of Epidermis. J Invest Dermatol 2005; 124:1008-13. [PMID: 15854043 DOI: 10.1111/j.0022-202x.2005.23682.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abnormal follicular keratinization is involved in comedogenesis in acne vulgaris. We recently demonstrated that calcium influx into epidermal keratinocytes is associated with impaired skin barrier function and epidermal proliferation. Based on these results, we hypothesized that sebum components affect calcium dynamics in the keratinocyte and consequently induce abnormal keratinization. To test this idea, we first observed the effects of topical application of sebum components, triglycerides (triolein), saturated fatty acids (palmitic acid and stearic acid), and unsaturated fatty acids (oleic acid and palmitoleic acid) on hairless mouse skin. Neither triglyceride nor saturated fatty acids affected the skin surface morphology or epidermal proliferation. On the other hand, application of unsaturated fatty acids, oleic acid, and palmitoleic acid induced scaly skin, abnormal keratinization, and epidermal hyperplasia. Application of triglycerides and saturated fatty acids on cultured human keratinocytes did not affect the intracellular calcium concentration ([Ca(2+)](i)), whereas unsaturated fatty acids increased the [Ca(2+)](i) of the keratinocytes. Moreover, application of oleic acid on hairless mouse skin induced an abnormal calcium distribution in the epidermis. These results suggest that unsaturated fatty acids in sebum alter the calcium dynamics in epidermal keratinocytes and induce abnormal follicular keratinization.
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43
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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)
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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.
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Affiliation(s)
- Harald Gollnick
- University Clinic for Dermatology and Venereology, Otto-von-Guericke-University, Magdeburg, Germany.
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45
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Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, Shalita AR, Thiboutot D. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2003; 49:S1-37. [PMID: 12833004 DOI: 10.1067/mjd.2003.618] [Citation(s) in RCA: 413] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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46
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Kurokawa I, Nishijima S, Kusumoto K, Senzaki H, Shikata N, Tsubura A. Immunohistochemical study of cytokeratins in hidradenitis suppurativa (acne inversa). J Int Med Res 2002; 30:131-6. [PMID: 12025520 DOI: 10.1177/147323000203000205] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In 14 cases of hidradenitis suppurativa, cytokeratin (CK) expression was studied immunohistochemically, using six antikeratin antibodies against CK1, CK10, CK14, CK16, CK17 and CK19, respectively. The draining sinus tract epithelium of hidradenitis suppurativa lesions was divided into three components: infundibular-like keratinized epithelium (type A), non-infundibular keratinized epithelium (type B), and non-keratinized epithelium (type C). In type A samples, CK17 (which is found in normal infundibulum) was not detected, suggesting fragility of this epithelial type. Keratin expression in types B and C epithelia was similar to that observed in the outer root sheath in normal hair follicles. Our results suggest that the draining sinus epithelium may possess characteristics of fragility, undifferentiation and hyperproliferation, as shown with CK expression.
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Affiliation(s)
- I Kurokawa
- Department of Dermatology, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan.
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47
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Kurzen H, Esposito L, Langbein L, Hartschuh W. Cytokeratins as markers of follicular differentiation: an immunohistochemical study of trichoblastoma and basal cell carcinoma. Am J Dermatopathol 2001; 23:501-9. [PMID: 11801790 DOI: 10.1097/00000372-200112000-00001] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Trichoblastoma(s) (TB) are benign neoplasms of follicular differentiation frequently found in nevus sebaceus. Many morphologic features are shared with nodular basal cell carcinoma(s) (BCC), sometimes rendering the differential diagnosis difficult. Because both neoplasms can simulate components of mature hair follicles histologically, we attempted to corroborate this by immunohistochemical examination of cytokeratins and hair keratins differentially expressed in the hair follicle. Trichoblastoma(s) and BCC showed homogenous expression of CK14 and CK17. The innermost cells of the tumor nodules in all TB and in 72% of BCC were positive for CK6hf. Using a specific CK15 antibody, 38% of TB showed a focal labeling and all BCC remained negative; 70% of TB and 22% of BCC expressed CK19. CK8 was expressed by numerous Merkel cells present in all TB but in none of the BCC examined. All type I and II hair keratins tested, (especially hHa1, hHa5, and hHa8) remained negative in all tumors examined. Trichoblastoma(s) and BCC show consistent expression of CK6hf, CK14, and CK17; variable expression of CK15 and CK19; and absence of hair keratins. This indicates a differentiation toward the outer root sheath epithelium or the companion layer and not toward the inner root sheath, matrix, or cortex.
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Affiliation(s)
- H Kurzen
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
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48
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Affiliation(s)
- Osamu YAMAMOTO
- Department of Dermatology, University of Occupational and Environmental Health, Japan
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49
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Cunliffe WJ, Holland DB, Clark SM, Stables GI. Comedogenesis: some new aetiological, clinical and therapeutic strategies. Br J Dermatol 2000; 142:1084-91. [PMID: 10848729 DOI: 10.1046/j.1365-2133.2000.03531.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hypercornification is an early feature of acne and precedes inflammation. It is associated with ductal hyperproliferation and there are many controlling factors such as androgens, retinoids and cytokines. Cycling of normal follicles and of comedones may explain the natural resolution of comedones and, in the longer term, resolution of the disease itself. There is a need to tailor treatment according to comedonal type. Suboptimal therapy can often result from inappropriate assessments of comedones, especially microcomedones, missed comedones, sandpaper comedones, submarine comedones and macrocomedones. Macrocomedones can produce devastating acne flares, particularly if patients are inappropriately prescribed oral isotretinoin. Gentle cautery under topical local anaesthesia is a useful therapy in the treatment of such lesions. The newer retinoids and new formulations of all-trans-retinoic acid show a better benefit/risk ratio. Evidence-based studies are required to allow adequate comparisons.
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Affiliation(s)
- W J Cunliffe
- Department of Dermatology, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, U.K
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50
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Kurzen H, Jung EG, Hartschuh W, Moll I, Franke WW, Moll R. Forms of epithelial differentiation of draining sinus in acne inversa (hidradenitis suppurativa). Br J Dermatol 1999; 141:231-9. [PMID: 10468793 DOI: 10.1046/j.1365-2133.1999.02970.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The draining sinus is a late complication of several forms of severe acne, leading to extensive, periodically inflamed lesions that are undermined by a system of fistulas, supposed to be of follicular origin. We investigated the expression of various cytokeratins (CKs) and desmosomal proteins in the draining sinus of acne inversa (hidradenitis suppurativa) using monoclonal antibodies in immunohistochemistry on paraffin-embedded sections. We were able to define three different phenotypes of stratified squamous epithelia covering the sinus tracts. Type I epithelium was cornifying and characterized by the presence of CK 10, desmogleins 1-3 and desmocollins 1-3 in an epidermis-like pattern. Type II epithelium was non-cornifying, negative for CK 10 and positive for CK 13. It was negative for desmocollin 1 but strongly immunopositive for desmoglein 1 suprabasally and for desmoglein 2 in the basal cells. Type III epithelium was non-cornifying and strongly inflamed. It was marked by the presence of CK 7, CK 19 and desmoglein 2 and the absence of CK 10, desmoglein 1 and desmocollin 1. In both type II and III epithelium, desmoglein 3, desmocollin 2 and desmocollin 3 showed an inverted staining pattern as compared with normal epidermis and type I epithelium. Desmoglein 2 and CK 5/14 always remained restricted to the basal cell layer. Antibodies against CK 6 and CK 13/15/16 were immunopositive in all three phenotypes and CK 17 was predominantly immunolocalized to suprabasal layers of type II and III epithelium. The three phenotypes are characterized as pathological stratified squamous epithelia reflecting the dynamic process of inflammation, proliferation and stratification taking place in acne inversa.
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Affiliation(s)
- H Kurzen
- Division of Cell Biology, German Cancer Research Centre, Heidelberg, Germany.
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