Capitanio B, Lora V, Ludovici M, Sinagra J-L, Ottaviani M, Mastrofrancesco A, Ardigò M, Camera E
Pediatric Dermatology, San Gallicano Dermatological Institute (IRCCS), Rome, Italy.
J Eur Acad Dermatol Venereol. 2014 Dec;28(12):1792-7. doi: 10.1111/jdv.12431. Epub 2014 Mar 14.
Sebum plays a key role in the initiation of the acne lesions. Oxidized sebum lipids cause keratynocytes hyperproliferation and inflammatory cytokines release. Association between sebum oxidation and comedogenesis has been little investigated in comedonal acne.
Evaluation of sebum oxidation parameters and levels of inflammatory cytokines (IL-1α) in patients with mild comedonal acne (MCA) before and after the treatment with a mixed RetinSphere® - vitamin E formulation.
Sebum excretion rate (SER), squalene concentration, and oxidation degree of sebum were measured in 18 MCA patients and 10 controls. IL-1α levels in the stratum corneum were measured in both lesional and non-lesional facial areas of MCA patients. Sebum parameters and IL-1α were measured at week 4 of topical treatment. Reflectance confocal microscopy (RCM) was performed in a subset of four patients at the baseline and at week 4 and all patients were assessed clinically before and following the 8 week-treatment.
Sebum excretion rate and squalene concentration were comparable between MCA patients and healthy controls. Lipid peroxidation (LPO) and the percentage of oxidized squalene (SQOX) were significantly elevated in the sebum of MCA patients. The concentration of the proinflammatory cytokine IL-1α in stratum corneum was significantly higher in the lesional area compared with non-lesional area of the MCA patients at the baseline. At week 4, while SER and squalene concentration did not vary significantly, the LPO levels and the SQOX percentage resulted decreased at a significant extent. Following the treatment, IL-1α concentration in the lesional area reached values comparable to those of unaffected areas. Consistent with the biochemical data, RCM showed the reduction of hyperkeratinization and of inflammatory cells infiltration of the adnexal structures epithelium, significant clinical improvement was recorded at week 8.
The data further support the involvement of lipid oxidation and particularly by-products of squalene oxidation in comedogenesis.
皮脂在痤疮皮损的形成中起关键作用。氧化的皮脂脂质会导致角质形成细胞过度增殖并释放炎性细胞因子。在粉刺性痤疮中，皮脂氧化与粉刺形成之间的关联鲜有研究。
评估轻度粉刺性痤疮（MCA）患者在使用混合的RetinSphere®-维生素E制剂治疗前后的皮脂氧化参数及炎性细胞因子（IL-1α）水平。
在18例MCA患者和10例对照者中测量皮脂排泄率（SER）、角鲨烯浓度及皮脂氧化程度。在MCA患者面部的皮损区和非皮损区测量角质层中的IL-1α水平。在局部治疗第4周时测量皮脂参数和IL-1α。对4例患者的亚组在基线和第4周时进行反射共聚焦显微镜检查（RCM），并在8周治疗前后对所有患者进行临床评估。
MCA患者与健康对照者之间的皮脂排泄率和角鲨烯浓度相当。MCA患者皮脂中的脂质过氧化（LPO）和氧化角鲨烯（SQOX）百分比显著升高。在基线时，MCA患者皮损区角质层中促炎细胞因子IL-1α的浓度显著高于非皮损区。在第4周时，虽然SER和角鲨烯浓度无显著变化，但LPO水平和SQOX百分比显著降低。治疗后，皮损区的IL-1α浓度达到与未受影响区域相当的值。与生化数据一致，RCM显示附属器结构上皮的角化过度和炎性细胞浸润减少，在第8周时记录到显著的临床改善。
这些数据进一步支持脂质氧化尤其是角鲨烯氧化副产物参与粉刺形成。
