Bikowski Joseph B
Bikowski Skin Care Center, Sewickley Station, Sewickley, PA 15143-1051, USA.
J Drugs Dermatol. 2005 Jan-Feb;4(1):41-7.
Retinoids comprise a family of compounds with structures and mechanisms of action that resemble those of vitamin A (retinol), an essential nutrient which plays a role in cell growth and differentiation. The retinoids, which interact with nuclear receptors and affect gene transcription, have enormous therapeutic potential, particularly if they are receptor- and function-selective. Tretinoin was the first topical retinoid employed for the treatment of acne. In recent years, other topical retinoids for the treatment of acne have been designed from a disease-specific approach, with enhanced receptor and function selectivity, which translates to improved therapeutic effects and more favorable tolerability. The properties that differentiate the topical retinoids tretinoin, adapalene, and tazarotene have permitted clinicians to tailor acne treatment regimens for maximum therapeutic outcomes. Tretinoin (all-trans-retinoic acid), considered a first-generation retinoid, acts by altering the milieu of the microcomedo and influences desquamation of abnormal epithelium. Two receptor-selective synthetic retinoids, adapalene and tazarotene, may be classified as third-generation retinoids. Adapalene, a derivative of naphthoic acid, has comedolytic, antiproliferative, and anti-inflammatory properties. Tazarotene is a prodrug metabolized to tazarotenic acid that modulates cellular differentiation, desquamation, and inflammation.
维甲酸类化合物是一类结构和作用机制与维生素A(视黄醇)相似的化合物,维生素A是一种必需营养素,在细胞生长和分化中发挥作用。维甲酸类化合物与核受体相互作用并影响基因转录,具有巨大的治疗潜力,特别是如果它们具有受体和功能选择性。维甲酸是第一种用于治疗痤疮的外用维甲酸类药物。近年来,其他用于治疗痤疮的外用维甲酸类药物是从疾病特异性方法设计的,具有增强的受体和功能选择性,这转化为改善的治疗效果和更良好的耐受性。区分外用维甲酸类药物维甲酸、阿达帕林和他扎罗汀的特性使临床医生能够定制痤疮治疗方案以获得最大治疗效果。维甲酸(全反式维甲酸)被认为是第一代维甲酸,其作用是改变微粉刺的环境并影响异常上皮的脱屑。两种受体选择性合成维甲酸,阿达帕林和他扎罗汀,可归类为第三代维甲酸。阿达帕林是萘甲酸的衍生物,具有溶粉刺、抗增殖和抗炎特性。他扎罗汀是一种前药,代谢为他扎罗汀酸,可调节细胞分化、脱屑和炎症。
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