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膳食蛋白质缺乏与自噬失调:早期衰老、皮肤及毛发疾病发病机制中的临床诊断新视角

Dietary Protein Deficit and Deregulated Autophagy: A New Clinico-diagnostic Perspective in Pathogenesis of Early Aging, Skin, and Hair Disorders.

作者信息

Garg Suruchi, Sangwan Ankita

机构信息

Department of Dermatology, Aesthetic Surgery and Intervention Dermatology, AURA Skin Institute, Chandigarh, India.

出版信息

Indian Dermatol Online J. 2019 Mar-Apr;10(2):115-124. doi: 10.4103/idoj.IDOJ_123_18.

Abstract

BACKGROUND

Diet has an important role to play in the well-being of human body.

AIMS

The study intends to establish the "hypothesis of conscious, selective, and self-destruction i.e., deregulated autophagy of skin and hair in low dietary protein scenario" by determining the facial profile, clinical presentation, and histopathological correlation of deficient protein intake and missing of meals in a tertiary care aesthetic skin institute.

METHODS

A total of 98 patients of skin- and hair-related complaints were enrolled in the study and a histopathological correlation was established by skin and scalp biopsies in high and low protein groups.

RESULTS

A significant number of subjects (68.4%) were taking less than half of the recommended daily allowance of proteins and faced problems like hair fall, acne, pigmentation, vitiligo, hirsutism, melasma, and premature aging. Subjects missing breakfast were found to have hypothyroidism, diffuse hairfall, autoimmune disorders like vitiligo, lichen planus, and alopecia areata. Histopathological images from submental area showed loose and fragmented collagen in high carbohydrate group in comparison to high protein group where thick, uniformly stained collagen bundles were found in dermis. Histopathology of scalp tissue showed chronic perifollicular inflammatory infiltrate and fibrosis in high carbohydrate group which was absent in histopathology specimen of high protein group. Patients taking early and nutrient-rich breakfast had higher mean protein intakes and less severe skin and hair problems suggesting a role of circadian rhythm as well.

CONCLUSION

Dietary protein adequacy and early breakfast have significant role in preventing self-destruction or deregulated autophagy in trichology and cosmetic dermatology and may prevent various autoimmune, inflammatory, and metabolic diseases.

摘要

背景

饮食对人体健康起着重要作用。

目的

本研究旨在通过在一家三级医疗美容皮肤机构中确定低蛋白饮食情况下蛋白质摄入不足和不进食的面部特征、临床表现以及组织病理学相关性,来建立“有意识、选择性和自我破坏假说,即低饮食蛋白情况下皮肤和毛发自噬失调”。

方法

共有98名有皮肤和毛发相关问题的患者参与本研究,并通过对高蛋白组和低蛋白组进行皮肤和头皮活检建立组织病理学相关性。

结果

相当数量的受试者(68.4%)蛋白质摄入量低于推荐每日摄入量的一半,并面临脱发、痤疮、色素沉着、白癜风、多毛症、黄褐斑和早衰等问题。不吃早餐的受试者被发现患有甲状腺功能减退、弥漫性脱发、白癜风、扁平苔藓和斑秃等自身免疫性疾病。与高蛋白组相比,颏下区域的组织病理学图像显示高碳水化合物组的胶原蛋白疏松且碎片化,高蛋白组的真皮中可见粗大、均匀染色的胶原束。头皮组织的组织病理学显示高碳水化合物组有慢性毛囊周围炎性浸润和纤维化,而高蛋白组的组织病理学标本中没有。吃营养丰富的早餐的患者平均蛋白质摄入量更高,皮肤和毛发问题也不那么严重,这也表明昼夜节律起了作用。

结论

饮食蛋白质充足和早餐早吃在预防毛发学和美容皮肤病学中的自我破坏或自噬失调方面具有重要作用,并且可能预防各种自身免疫性、炎症性和代谢性疾病。

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