Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Exp Dermatol. 2011 Dec;20(12):969-74. doi: 10.1111/j.1600-0625.2011.01364.x. Epub 2011 Oct 20.
Uncontrolled chronic hyperglycaemia including type 2 diabetes mellitus (DM) induces many skin problems related to chronic impaired skin barrier state. However, little is known about the skin barrier state of chronic hyperglycaemia patients, the dysfunction of which may be a major cause of their skin problems. In this study, we investigated whether a long-standing hyperglycaemic condition including type 2 DM impairs skin barrier homoeostasis in proportion to the duration and its pathomechanism. We utilized the Otsuka Long-Evans Tokushima Fatty (OLETF) rats as an animal model of long-standing hyperglycaemia and Long-Evans Tokushima Otsuka rats as a control strain. We confirmed that a long-standing hyperglycaemia delayed skin barrier homoeostasis, which correlated with haemoglobin A1c levels. OLETF rats as a long-standing hyperglycaemia model exhibited decreased epidermal lipid synthesis and antimicrobial peptide expression with increasing age. Decreased epidermal lipid synthesis accounted for decreased lamellar body production. In addition, OLETF rats had significantly higher serum levels of advanced glycation end products (AGEs) and elevated levels of the receptor for AGE in the epidermis. A long-standing hyperglycaemic condition impairs skin barrier function including permeability and antimicrobial barriers by accelerating skin ageing process in proportion to the duration of hyperglycaemia, which could be a major pathophysiology underlying cutaneous complications of DM.
未控制的慢性高血糖症,包括 2 型糖尿病(DM),会引起许多与慢性受损皮肤屏障状态相关的皮肤问题。然而,对于慢性高血糖症患者的皮肤屏障状态知之甚少,其功能障碍可能是他们皮肤问题的主要原因。在这项研究中,我们研究了包括 2 型 DM 在内的长期高血糖是否会损害皮肤屏障的内稳态,以及其发病机制。我们利用 Otsuka Long-Evans Tokushima Fatty(OLETF)大鼠作为长期高血糖的动物模型,以及 Long-Evans Tokushima Otsuka 大鼠作为对照品系。我们证实,长期高血糖会延迟皮肤屏障的内稳态,这与血红蛋白 A1c 水平相关。随着年龄的增长,OLETF 大鼠作为长期高血糖模型,表皮脂质合成和抗菌肽表达减少。表皮脂质合成减少导致板层小体生成减少。此外,OLETF 大鼠的血清中晚期糖基化终产物(AGEs)水平显著升高,表皮中 AGE 受体水平升高。长期高血糖状态通过加速皮肤老化过程,从而损害皮肤屏障功能,包括通透性和抗菌屏障,这可能是 DM 皮肤并发症的主要病理生理学基础。