Valente Duarte de Sousa Isabel Cristina
Private Dermatology Practice , Manzanas 44, Piso 5, Col. Tlacoquemecatl, Del. Benito Juarez, 03200 DF México, Mexico City , Mexico +5215510056226 ;
Expert Opin Investig Drugs. 2014 Oct;23(10):1389-410. doi: 10.1517/13543784.2014.923401. Epub 2014 Jun 2.
Acne vulgaris is the most common skin disease worldwide; yet, current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms, involved in the appearance of acne lesions, is paramount to treatment success.
The authors discuss and evaluate the pathogenic pathways related to the mechanisms of action of novel molecules, which are currently under investigation for the treatment of acne vulgaris. The manuscript is based on comprehensive searches made through PubMed, GoogleScholar and ClinicalTrial.gov, using different combination of key words, which include acne vulgaris, pathogenesis, treatment, sebogenesis and Propionibacterium acnes.
In the near future, more effective treatments with fewer side effects are expected. The use of topical antiandrogens, acetylcholine inhibitors and PPAR modulators seem to be promising options for controlling sebum production. Retinoic acid metabolism-blocking agents and IL-1α inhibitors have the potential to become legitimate alternative options to retinoid therapy in the management of infundibular dyskeratosis. Indeed, the authors believe that there will likely be a decline in the use of antibiotics for controlling P. acnes colonization and targeting the inflammation cascade.
寻常痤疮是全球最常见的皮肤病；然而，目前的治疗方法虽然有效，但会带来不良副作用、病程迁延、复发和再发等问题。充分控制痤疮皮损出现所涉及的四种致病机制是治疗成功的关键。
作者讨论并评估了与新型分子作用机制相关的致病途径，这些分子目前正处于治疗寻常痤疮的研究阶段。该手稿基于通过PubMed、GoogleScholar和ClinicalTrial.gov进行的全面检索，使用了不同关键词组合，包括寻常痤疮、发病机制、治疗、皮脂生成和痤疮丙酸杆菌。
在不久的将来，有望出现副作用更少的更有效治疗方法。局部使用抗雄激素药物、乙酰胆碱抑制剂和PPAR调节剂似乎是控制皮脂分泌的有前景的选择。维甲酸代谢阻断剂和IL-1α抑制剂有可能成为治疗漏斗部角化异常时类维生素A疗法的合理替代选择。事实上，作者认为用于控制痤疮丙酸杆菌定植和针对炎症级联反应的抗生素使用可能会减少。
