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New developments in our understanding of acne pathogenesis and treatment.
Exp Dermatol. 2009 Oct; 18(10):821-32.ED

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.

Authors+Show Affiliations

Department of Dermatology, Mie Universtity Graduate School of Medicine, Tsu, Mie, Japan. kuroichi@clin.medic.mie-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19555434

Citation

Kurokawa, Ichiro, et al. "New Developments in Our Understanding of Acne Pathogenesis and Treatment." Experimental Dermatology, vol. 18, no. 10, 2009, pp. 821-32.
Kurokawa I, Danby FW, Ju Q, et al. New developments in our understanding of acne pathogenesis and treatment. Exp Dermatol. 2009;18(10):821-32.
Kurokawa, I., Danby, F. W., Ju, Q., Wang, X., Xiang, L. F., Xia, L., Chen, W., Nagy, I., Picardo, M., Suh, D. H., Ganceviciene, R., Schagen, S., Tsatsou, F., & Zouboulis, C. C. (2009). New developments in our understanding of acne pathogenesis and treatment. Experimental Dermatology, 18(10), 821-32. https://doi.org/10.1111/j.1600-0625.2009.00890.x
Kurokawa I, et al. New Developments in Our Understanding of Acne Pathogenesis and Treatment. Exp Dermatol. 2009;18(10):821-32. PubMed PMID: 19555434.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New developments in our understanding of acne pathogenesis and treatment. AU - Kurokawa,Ichiro, AU - Danby,F William, AU - Ju,Qiang, AU - Wang,Xiuli, AU - Xiang,Leihong Flora, AU - Xia,Longqing, AU - Chen,Wenchieh, AU - Nagy,István, AU - Picardo,Mauro, AU - Suh,Dae Hun, AU - Ganceviciene,Ruta, AU - Schagen,Silke, AU - Tsatsou,Fragkiski, AU - Zouboulis,Christos C, Y1 - 2009/06/23/ PY - 2009/6/27/entrez PY - 2009/6/27/pubmed PY - 2009/12/22/medline SP - 821 EP - 32 JF - Experimental dermatology JO - Exp. Dermatol. VL - 18 IS - 10 N2 - 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. SN - 1600-0625 UR - https://www.unboundmedicine.com/medline/citation/19555434/New_developments_in_our_understanding_of_acne_pathogenesis_and_treatment_ L2 - https://doi.org/10.1111/j.1600-0625.2009.00890.x DB - PRIME DP - Unbound Medicine ER -