Passi S, Picardo M, De Luca C, Nazzaro-Porro M
G Ital Dermatol Venereol. 1989 Oct;124(10):455-63.
The physiopathologic mechanism of acne seems to be dependent on four main factors: a) sebum production and excretion; b) type of keratinization of the follicular channel; c) microbial colonization of the pilosebaceous unit and d) inflammatory reaction of the perifollicular area. Azelaic acid is effective in the treatment of acne because it possesses an activity against all of these factors. Azelaic acid is a competitive inhibitor of mitochondrial oxidoreductases and of 5 alpha-reductase, inhibiting the conversion of testosterone to 5-dehydrotestosterone. It also possesses bacteriostatic activity to both aerobic and anaerobic bacteria including Propionibacterium acnes. Azelaic acid is an anti-keratinizing agent, displaying antiproliferative cytostatic effects on keratinocytes and modulating the early and terminal phases of epidermal differentiation.
a）皮脂的产生和排泄；b）毛囊通道的角化类型；c）皮脂腺单位的微生物定植；d）毛囊周围区域的炎症反应。壬二酸对痤疮治疗有效，因为它对所有这些因素均有作用。壬二酸是线粒体氧化还原酶和5α-还原酶的竞争性抑制剂，可抑制睾酮向5-脱氢睾酮的转化。它对包括痤疮丙酸杆菌在内的需氧菌和厌氧菌均具有抑菌活性。壬二酸是一种抗角化剂，对角质形成细胞具有抗增殖的细胞抑制作用，并调节表皮分化的早期和终末阶段。
