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Chen J, Cheng J, Li F, Deng Y, Li Y, Li H, Zeng J, You Y, Zhou X, Chen Q, Luo R, Lai Y, Zhao X. Gut microbiome and metabolome alterations in traditional Chinese medicine damp-heat constitution following treatment with a Chinese patent medicine and lifestyle intervention. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 131:155787. [PMID: 38851100 DOI: 10.1016/j.phymed.2024.155787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/06/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND The gut microbiota is crucial in human health and diseases. Traditional Chinese Medicine Constitution (TCMC) divides people into those with a balanced constitution (Ping-he [PH]) and those with an unbalanced constitution. Dampness-heat constitution (Shi-re [SR]) is a common unbalanced constitution in the Chinese population and is susceptible to diseases. However, unbalanced constitutions can be regulated by Chinese medicine and lifestyle interventions in clinical practice. Ermiao Pill (EMP) is a Chinese medicine known for clearing heat and draining dampness and improving SR. However, the efficacy and mechanism of EMP are unclear. HYPOTHESIS/PURPOSE To determine alterations in the gut microbiota and metabolome in SR and any changes after EMP treatment combined with lifestyle intervention. STUDY DESIGN Randomized clinical trial. METHODS We enrolled 112 healthy SR individuals and evaluated the efficacy of EMP along with lifestyle interventions. We further assessed serum cytokine levels, serum and urinary metabolomes, and the gut microbiota by 16S rRNA gene sequencing analysis before and after the EMP and lifestyle interventions. RESULTS 107 SR individuals (55 in the intervention group and 52 in the control group) completed the 1-month-intervention and 1-year-follow-up. The intervention group significantly improved their health status within 1 month, with a reduced SR symptom score, and the efficacy lasted to the 1-year follow-up. The control group needed a further 6 months to reduce the SR symptom score. The gut microbiota of PH individuals was more diverse and had significantly higher proportions of many bacterial species than the SR. Microbiota co-occurrence network analysis showed that SR enriches metabolites correlating with microbial community structure, consistent with traits of healthy SR-enriched microbiota. CONCLUSION EMP combined with lifestyle intervention produced health benefits in SR individuals. Our study indicates a pivotal role of gut microbiota and metabolome alterations in distinguishing between healthy SR and PH. Furthermore, the study reveals structural changes of gut microbiota and metabolites induced by EMP and lifestyle intervention. The treatment enriched the number of beneficial bacteria, such as Akkermansia muciniphila and Lactobacillus in the gut. Our findings provide a strong indication that several metabolite factors are associated with the gut microbiota. Moreover, the gut microbiome and metabolome might be powerful tools for TCMC diagnosis and personalized therapy.
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Affiliation(s)
- Jieyu Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Jingru Cheng
- Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Fei Li
- Oncology Department, People's Hospital of Boluo County, Huizhou, 516100, China
| | - Yijian Deng
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Yutong Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Haipeng Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Jingyi Zeng
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Yanting You
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Xinghong Zhou
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Qinghong Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Ren Luo
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Yigui Lai
- Department of Traditional Chinese Medicine, People's Hospital of Yangjiang, Yangjiang, 529500, China.
| | - Xiaoshan Zhao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China; Department of Traditional Chinese Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
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Arora A, Bhalla M. Role of cosmetic camouflage in improving quality of life in dermatological disorders: A narrative review. Indian J Dermatol Venereol Leprol 2024; 0:1-8. [PMID: 39152815 DOI: 10.25259/ijdvl_1117_2023] [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: 10/21/2023] [Accepted: 05/15/2024] [Indexed: 08/19/2024]
Abstract
Camouflage is a system of techniques using cosmetics to conceal, diminish and disguise visible disfigurements of pigment or texture of skin mainly over visible areas. A wide variety of options are available which can be used as camouflage cosmetics. Over the years many authors have published studies highlighting the importance of camouflage in different dermatological disorders like pigmentary, vascular, scars, acne vulgaris and many more. In this review we present 15 such studies assessing QOL in patients of dermatological diseases who were given camouflage therapy. The evidence presented here gives us an insight into the positive effects of camouflage/cover up make up when offered to patients with different dermatological conditions.
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Affiliation(s)
- Astha Arora
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
| | - Mala Bhalla
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
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Akdağ N, Atli E, Zhuri D, Sezgi Ner Güler H, Gürsel Ürün Y. A Study of FoxO1, mTOR, miR-21, miR-29b, and miR-98 Expression Levels Regarding Metabolic Syndrome in Acne Vulgaris Patients. Cureus 2024; 16:e56562. [PMID: 38646331 PMCID: PMC11029816 DOI: 10.7759/cureus.56562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Acne vulgaris (AV) is an inflammatory skin disease caused by the mechanistic target of rapamycin complex 1 (mTORC1). forkhead box protein (Fox) O1 is known to regulate the relationship between the mTORC1 signaling pathway and insulin resistance (IR). Increased mTORC1 signaling is known to predispose one to diseases such as insulin resistance (IR), obesity, and diabetes mellitus. One of the major components of mTORC1 is mTOR. FoxO1 and mTOR play key roles in the onset and progression of metabolic syndrome (MetS). In this study, we aimed to elucidate the relationship between AV and MetS through FoxO1 and mTOR signaling pathways and microRNAs (miRs) associated with these signaling pathways. METHODS We examined 20 AV patients without MetS, 16 AV patients with MetS, and 20 healthy controls. The demographic characteristics of the patients, MetS parameters, clinical severity of AV (Global Acne Grading System, GAGS), and the homeostasis model assessment (HOMA) values were compared between the groups. In addition, the expression levels of FoxO1 and mTOR genes, along with the expression levels of miR-21, miR-29b, and miR-98, were assessed in skin biopsy samples from all groups using real-time polymerase chain reaction methods. FoxO1, mTOR, and miRNA expression levels were recorded as fold change. RESULTS The mean age of patients with AV without MetS was statistically lower. In AV patients with MetS, those with moderate GAGS scores had statistically significantly higher HOMA values than those with mild GAGS scores. FoxO1 expression was significantly lower in AV patients compared to controls. The mTOR expression levels of AV patients with MetS were significantly higher than the other two groups. The expression levels of miR-21 and miR-29b were significantly increased in the group of AV patients with MetS compared to the group of AV patients without MetS. CONCLUSIONS These results suggested that the mTOR pathway may play an important role in explaining the relationship between AV and MetS in acne pathogenesis. They also suggested that miR-21 and miR-29b play a role in the inflammatory process of AV.
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Affiliation(s)
- Nazan Akdağ
- Department of Dermatology and Venereology, Trakya University Faculty of Medicine, Edirne, TUR
| | - Engin Atli
- Department of Medical Genetics, Trakya University Faculty of Medicine, Edirne, TUR
| | - Drenushe Zhuri
- Department of Medical Genetics, Trakya University Faculty of Medicine, Edirne, TUR
| | | | - Yıldız Gürsel Ürün
- Department of Dermatology and Venereology, Trakya University Faculty of Medicine, Edirne, TUR
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Bungau AF, Tit DM, Bungau SG, Vesa CM, Radu AF, Marin RC, Endres LM, Moleriu LC. Exploring the Metabolic and Endocrine Preconditioning Associated with Thyroid Disorders: Risk Assessment and Association with Acne Severity. Int J Mol Sci 2024; 25:721. [PMID: 38255795 PMCID: PMC10815585 DOI: 10.3390/ijms25020721] [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: 11/23/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Metabolic preconditioning, characterized by conditions like obesity and insulin resistance syndrome, disrupts hormonal balance. Elevated androgen levels stimulate excessive sebum production and follicular cell proliferation, leading to acne lesions. Similarly, thyroid hormone imbalances affect sebaceous gland activity, epidermal lipid composition, and skin cell turnover, impacting acne occurrence and severity. This study aimed to assess the potential contribution of metabolic and endocrine preconditions to acne development. A total of 389 patients diagnosed with acne were included and divided into three groups: the metabolic precondition group (MPG, N = 163, 41.9%), the endocrine precondition group (EPG, N = 162, 41.65%), and the control group (CG, N = 89, 22.88%). Data related to the degree of acne severity and comorbidities of interest were collected from the patients' medical records. In the groups with concomitant diseases, moderate and severe acne were significantly more prevalent (56.44% and 41.10% in MPG, and 35.80% and 61.11% in EPG) compared to the control group (5.61% and 4.89%). The most prevalent preconditions observed were insulin resistance syndrome in MPG (63.8%) and autoimmune thyroiditis in EPG (95.06%). Significant age-related differences in acne severity were found across all study groups (p < 0.05). In MPG, the age variable was significantly higher in the presence of mild acne, while in EPG, the age variable was significantly lower for the mild acne group. A positive association was observed between the severity of acne and insulin resistance syndrome, obesity, autoimmune thyroiditis, and hypothyroidism (p < 0.05). Risk analysis indicated a significantly higher risk (RR > 1, 95% CI RR > 1, p < 0.001) of developing moderate and severe acne in the presence of these preconditions. The presence of both metabolic and endocrine preconditions significantly increased the likelihood of developing severe acne, leading to the hypothesis that both conditions may be contributing factors to the development of acne.
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Affiliation(s)
- Alexa Florina Bungau
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Delia Mirela Tit
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Simona Gabriela Bungau
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Cosmin Mihai Vesa
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Andrei-Flavius Radu
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | | | - Laura Maria Endres
- Department of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Lavinia-Cristina Moleriu
- Department III of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
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Rohilla R, Grover PK. Comment on: Metabolic Status, Obesity, and Quality of Life in Patients with Acne Vulgaris: A Cross-Sectional Case-Control Study. Indian J Dermatol 2023; 68:332-333. [PMID: 37529481 PMCID: PMC10389136 DOI: 10.4103/ijd.ijd_864_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Affiliation(s)
- Ravi Rohilla
- From the Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India E-mail:
| | - Parneet Kaur Grover
- From the Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India E-mail:
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Carneiro ACA, de Carvalho JF, de Sá DC, Rodrigues CEM. Prevalence of Metabolic Syndrome and Insulin Resistance in Adult Patients with Acne: Association with Traditional Cardiovascular Risk Factors and Acne Severity. Metab Syndr Relat Disord 2023; 21:109-114. [PMID: 36472551 DOI: 10.1089/met.2022.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: Acne is a chronic inflammatory disease that affects the pilosebaceous unit, and there are conflicting evidences regarding its association with metabolic syndrome (MS) and insulin resistance (IR). Methods: A cross-sectional study was performed with 162 acne patients, over 20 years of age, matched for age and sex with 78 healthy controls without acne. The measured parameters included waist circumference (WC), body mass index (BMI), systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol. Acne severity was determined according to the Global Acne Grading System. The criteria used for the diagnosis of MS were those of the Harmonizing the Metabolic Syndrome Statement, adjusted for South Americans, and the IR was calculated using the HOMA-IR. Results: The prevalence of MS was significantly higher in cases, compared to controls (12.3% vs. 2.6%, P = 0.014), as was the prevalence of IR (11.7% vs. 3.8%, P = 0.047). In addition, MS and IR showed a positive correlation with the degree of acne severity (P = 0.011 and P = 0.021, respectively). HDL levels were significantly lower in cases (P = 0.012) and showed an association with acne severity (P = 0.038). In the logistic regression model, the risk factor that independently influenced both MS and IR in patients with acne was the WC (P = 0.001). Conclusions: Adults with acne, especially the most severe cases, are significantly more likely to have MS, IR, and lower HDL levels, compared to controls without acne.
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Affiliation(s)
| | | | | | - Carlos Ewerton Maia Rodrigues
- Postgraduate Program in Medical Sciences, University of Fortaleza (Unifor), Ceará, Brazil.,Federal University of Ceara (UFC), Ceará, Brazil
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Agarwal K, Saikia P, Podder I. Metabolic syndrome and dyslipidemia in xanthelasma palpebrarum and associated risk-2 factors-A case-control study. J Cosmet Dermatol 2022; 21:7018-7024. [PMID: 36057448 DOI: 10.1111/jocd.15353] [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: 03/25/2022] [Revised: 08/11/2022] [Accepted: 09/01/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Xanthelasma palpebrarum (XP) primarily causes cosmetic disfigurement. However, systemic associations like metabolic syndrome (MetS) and dyslipidemia need consideration. OBJECTIVE Determining the prevalence of MetS and dyslipidemia in XP patients and explore risk factors. METHODS Our case-control study included 106 XP patients(cases) and 106 age-and-sex matched healthy controls. All subjects underwent detailed history taking, physical examination, and biochemical investigations. MetS and obesity were diagnosed by NCEP-ATP III criteria and modified BMI classification for Asian-Indians, respectively. RESULTS The odds ratio (OR) and 95% CI for XP patients vs. non-XP controls were 1.6 (95% CI 0.8-3.2, p = 0.1) for MetS, 1.4 (95% CI 0.6-3.1, p = 0.4) for dyslipidemia and 0.2 (95% CI 0.07-0.4, p < 0.0001) for overweight/obesity. Extensive disease, DM, and low serum HDL-C were significantly associated with MetS in XP patients (vs. controls). Normal waist circumference (AOR 21.3, 95% CI 3.5-127.6, p = 0.0008), normal blood glucose (AOR 21.4, 95% CI 3.1-145.1, p = 0.002), and normal blood pressure (AOR 22.3, 95% CI 3.9-124.9, p = 0.0004) significantly reduced the risk of MetS, while bilateral ocular involvement (AOR 4.3, 95% CI 1.1-18.7, p = 0.04) significantly increased the risk of dyslipidemia in XP patients. CONCLUSION Xanthelasma palpebrarum patients are more prone to develop MetS and dyslipidemia and need evaluation, despite being a primarily cosmetic concern. Extensive disease and bilateral ocular involvement are significant risk factors. Adequate counseling and healthy life-style measures are crucial to minimize systemic complications.
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Affiliation(s)
- Komal Agarwal
- Department of Dermatology, Calcutta National Medical College and Hospital, Kolkata, India
| | | | - Indrashis Podder
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, India
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Chandak S, Singh A, Madke B, Jawade S, Khandelwal R. Acne Vulgaris and Metabolic Syndrome: A Possible Association. Cureus 2022; 14:e24750. [PMID: 35677010 PMCID: PMC9166482 DOI: 10.7759/cureus.24750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Acne vulgaris is an androgen-dependent disorder with excessive sebum production and proliferation of Propionibacterium acnes. Metabolic syndrome (MetS) is a multisystem disorder that increases the risk of diabetes mellitus, stroke, and cardiovascular diseases. This study aims to analyze the association of MetS with acne vulgaris. Methods A cross-sectional study was conducted with 65 cases of acne vulgaris and 65 age and sex-matched controls. We used the system provided by the Indian authors for grading acne according to the clinical severity. In addition, the criteria updated according to the joint consensus of 2009 were employed for the diagnosis of MetS. Results On clinical examination, grade 2 was the most prevalent grade of acne. We observed an increased incidence of abnormal waist circumference, triglyceride, HDL, and fasting blood glucose among the cases (p<0.05). Consequently, an increased occurrence of MetS was observed in the case group (p=0.011). While comparing the mean values of the parameters, we noted a significant difference in terms of waist circumference and HDL values. An increased mean value of waist circumference was noted in the case group while an increased mean value of HDL was reported from the control group (p<0.05). Conclusion Patients with acne vulgaris have a greater chance of developing MetS. Hence, an in-depth examination of clinical, anthropometric, and biochemical parameters that may lead to the development of MetS is necessary.
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