Hirschel-Scholz S, Siegenthaler G, Saurat J H
Clinique de Dermatologie, Hôpital Cantonal Universitaire, Geneva, Switzerland.
Br J Dermatol. 1989 May;120(5):639-44. doi: 10.1111/j.1365-2133.1989.tb01349.x.
Isotretinoin differs from acitretin and Ro137410 by its striking sebostatic effect in acne after oral, but not topical, administration. The reason for this is not yet understood. Previous studies indicate that cellular retinoic acid binding protein (CRABP) might be implicated in the action of synthetic retinoids. We, therefore, compared the three retinoids for their ability to increase epidermal CRABP levels after systemic and topical treatment. Oral treatment with acitretin and Ro137410 led to a striking increase of epidermal CRABP (from 2.6 +/- 0.9 to 16.2 +/- 2.9, P less than 0.004 and from 2.5 +/- 1.2 to 21.5 +/- 3.4 pmol/mg protein, P less than 0.004, respectively), while isotretinoin failed to induce a comparable rise (3.2 +/- 1.6 before and 3.7 +/- 0.7 pmol/mg protein after treatment), although it displayed in all patients a striking sebostatic effect. After topical application, the increase of CRABP was comparable for all three compounds. The interaction of isotretinoin with the epidermis seems to be different from other synthetic retinoids only after systemic treatment, a finding that parallels clinical observations.
异维A酸与阿维A及Ro137410的不同之处在于，口服而非外用时，它对痤疮有显著的抑制皮脂分泌作用。其原因尚不清楚。以往研究表明，细胞视黄酸结合蛋白（CRABP）可能与合成类视黄醇的作用有关。因此，我们比较了这三种类视黄醇在全身和局部治疗后增加表皮CRABP水平的能力。口服阿维A和Ro137410导致表皮CRABP显著增加（分别从2.6±0.9增至16.2±2.9，P＜0.004；从2.5±1.2增至21.5±3.4 pmol/mg蛋白，P＜0.004），而异维A酸未能诱导出类似的升高（治疗前为3.2±1.6，治疗后为3.7±0.7 pmol/mg蛋白），尽管它在所有患者中都显示出显著的抑制皮脂分泌作用。局部应用后，三种化合物的CRABP增加情况相当。仅在全身治疗后，异维A酸与表皮的相互作用似乎与其他合成类视黄醇不同，这一发现与临床观察结果相符。
