Fabbrocini Gabriella, Kaya Gürkan, Caseiro Silverio Patricia, De Vita Valerio, Kaya Aysin, Fontao Fabienne, Sorg Olivier, Saurat Jean-Hilaire
Department of Dermatology, University of Naples Federico II, Naples, Italy.
Dermatology. 2015;231(4):334-8. doi: 10.1159/000439402. Epub 2015 Oct 7.
Dioxins are persistent organic pollutants present in the environment. They exert their biological effects by binding to an intracellular receptor, the aryl hydrocarbon receptor (AhR). Activation of AhR leads to the induction of cytochrome p450 1A1 (CYP1A1). Expression of CYP1A1 in human skin is a key marker for AhR activation, and it may induce comedogenesis resulting in acne-like lesions known as chloracne/metabolising acquired dioxin-induced skin hamartomas (MADISH). The contribution of this pathway in patients seen in a busy acne clinic is unknown.
We explored the expression of CYP1A1 by immunohistochemistry in the acne lesions of 16 patients living in the region of Naples, Italy, where epidemiological studies have suggested a possibly increased exposure to environmental dioxins. A composite score to outline potential components of the chloracne/MADISH histological pattern was used.
CYP1A1 expression was observed in 11 lesions (69%) and was distributed in sebaceous glands, follicular epithelium, cystic wall and endothelial cells. The histological score for chloracne/MADISH was 'likely' in 3 cases and 'possible' in 11 cases. Compared to current data on CYP1A1 expression in the skin of 67 patients with proven exposure to AhR agonists, these data indicate a high incidence of AhR activation in this series.
This is the first study analysing AhR activation in skin in a series of patients from a hospital-based acne clinic. It provides information for future controlled prospective studies. The significance of CYP1A1 expression in terms of AhR ligand exposure is discussed.
二噁英是环境中存在的持久性有机污染物。它们通过与细胞内受体芳烃受体（AhR）结合发挥生物学效应。AhR的激活导致细胞色素P450 1A1（CYP1A1）的诱导。CYP1A1在人皮肤中的表达是AhR激活的关键标志物，它可能诱导粉刺形成，导致类似痤疮的病变，即氯痤疮/代谢性获得性二噁英诱导的皮肤错构瘤（MADISH）。在繁忙的痤疮诊所就诊的患者中，该途径的作用尚不清楚。
我们通过免疫组织化学方法，对居住在意大利那不勒斯地区的16例患者的痤疮病变中CYP1A1的表达进行了研究。该地区的流行病学研究表明，当地居民可能更多地接触环境二噁英。我们使用了一个综合评分来勾勒氯痤疮/MADISH组织学模式的潜在组成部分。
在11个病变（69%）中观察到CYP1A1表达，其分布于皮脂腺、毛囊上皮、囊壁和内皮细胞。氯痤疮/MADISH的组织学评分在3例中为“可能”，在11例中为“疑似”。与目前关于67例已证实接触AhR激动剂患者皮肤中CYP1A1表达的数据相比，这些数据表明该系列患者中AhR激活的发生率较高。
这是第一项分析来自医院痤疮诊所的一系列患者皮肤中AhR激活情况的研究。它为未来的对照前瞻性研究提供了信息。文中讨论了CYP1A1表达在AhR配体暴露方面的意义。
