Ray Jalian H, Tam Joshua, Vuong Linh N, Fisher Jeremy, Garibyan Lilit, Mihm Martin C, Zurakowski David, Evans Conor L, Rox Anderson R
Department of Medicine, Division of Dermatology, University of California, Los Angeles, Division of Dermatology, Los Angeles, California, USA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA.
J Invest Dermatol. 2015 Sep;135(9):2173-2180. doi: 10.1038/jid.2015.148. Epub 2015 Apr 10.
Acne vulgaris is a nearly universal cutaneous inflammatory disease. Excess sebum production is an integral part of disease pathogenesis. Medical therapies that reduce sebum excretion result in clinical improvement of acne. Given the preferential susceptibility of lipid-containing cells to cold, we investigated the hypothesis that controlled local skin cooling causes preferential injury to sebaceous glands, in murine and swine models using a range of temperatures as low as -10 °C, and then on the backs of human subjects. In mouse ears, peak histologic damage occurred 72 hours after treatment; eosinophilic necrotic plugs formed within sebaceous glands, and the number of glands was significantly reduced up to 1 week post treatment. Cooling disrupted sebocyte cell membranes, alkaline phosphatase activity, and significantly reduced sebocyte lipid content. In human volunteers, cooling damaged sebaceous glands and reduced sebum output for 2 weeks, with minimal injury to surrounding tissues. Selective cryolysis of sebaceous glands is achievable through brief, non-invasive skin cooling, suggesting that controlled cooling could be developed as an effective treatment for acne vulgaris.
寻常痤疮是一种几乎普遍存在的皮肤炎症性疾病。皮脂分泌过多是疾病发病机制的一个组成部分。减少皮脂排泄的医学疗法可使痤疮临床症状得到改善。鉴于含脂质细胞对寒冷的优先易感性，我们在小鼠和猪模型中使用低至-10°C的一系列温度，然后在人类受试者背部，研究了可控局部皮肤冷却对皮脂腺造成优先损伤的假说。在小鼠耳朵中，治疗后72小时出现组织学损伤峰值；皮脂腺内形成嗜酸性坏死栓，治疗后1周内腺体数量显著减少。冷却破坏了皮脂腺细胞的细胞膜、碱性磷酸酶活性，并显著降低了皮脂腺细胞的脂质含量。在人类志愿者中，冷却损伤了皮脂腺并使皮脂分泌减少了2周，对周围组织的损伤最小。通过短暂、非侵入性的皮肤冷却可实现皮脂腺的选择性冷冻溶解，这表明可控冷却可开发成为寻常痤疮的一种有效治疗方法。
