Cui Quanrui, Wang Heping
Department of Dermatology, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China.
Department of Dermatology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China.
Clin Cosmet Investig Dermatol. 2025 Sep 9;18:2229-2242. doi: 10.2147/CCID.S543849. eCollection 2025.
The management of complex dermatological disorders, including chronic inflammatory diseases, non-healing wounds, and skin malignancies, often faces significant challenges. These include limited efficacy against chronic or relapsing conditions, the emergence of drug-resistant pathogens, and significant side effects from long-term therapies. This clinical gap highlights the urgent need for novel therapeutic agents. Resveratrol (RES), a natural polyphenol with pleiotropic bioactivities, has emerged as a compelling candidate substantiated by its diverse modulatory effects on cutaneous pathophysiology. This review aims to critically synthesize the evidence for RES's efficacy, dissect its foundational mechanisms, and explore innovations in drug delivery designed to overcome its clinical limitations. This review critically synthesizes evidence of the efficacy of RES in managing challenging dermatological conditions, including chronic wounds, psoriasis, atopic dermatitis, melanoma, acne, and herpes simplex virus infections, by dissecting its foundational antioxidant, anti-inflammatory, and immunomodulatory mechanisms. Its therapeutic action is mediated through critical molecular pathways, notably the activation of SIRT1/AMPK and suppression of NF-κB, which collectively mitigate oxidative stress, normalize cellular proliferation, and recalibrate immune responses. Although systemic bioavailability limitations have historically hindered RES's clinical translation, innovative delivery systems, including nanoparticles, hydrogels, and advanced transdermal formulations, are now revolutionizing its topical application and markedly enhancing its localized efficacy and stability. This review consolidates robust preclinical evidence from animal models demonstrating RES-driven accelerated wound healing, diminished inflammatory markers, and significant tumor suppression while also appraising nascent yet promising clinical trial data that indicate good tolerability and initial efficacy in human subjects. Ultimately, this synthesis crystallizes RES as a versatile and promising therapeutic agent in dermatology, concurrently underscoring the imperative for continued innovation in delivery methodologies and execution of large-scale stringently designed clinical trials to fully unlock its therapeutic potential.
复杂皮肤病的管理，包括慢性炎症性疾病、难愈合伤口和皮肤恶性肿瘤，常常面临重大挑战。这些挑战包括对慢性或复发性疾病疗效有限、耐药病原体的出现以及长期治疗产生的显著副作用。这一临床差距凸显了对新型治疗药物的迫切需求。白藜芦醇（RES）是一种具有多效生物活性的天然多酚，因其对皮肤病理生理学的多种调节作用，已成为引人注目的候选药物。本综述旨在批判性地综合关于RES疗效的证据，剖析其基本机制，并探索旨在克服其临床局限性的药物递送创新。本综述通过剖析RES的基本抗氧化、抗炎和免疫调节机制，批判性地综合了其在治疗包括慢性伤口、银屑病、特应性皮炎、黑色素瘤、痤疮和单纯疱疹病毒感染等具有挑战性的皮肤病方面疗效的证据。其治疗作用是通过关键分子途径介导的，特别是SIRT1/AMPK的激活和NF-κB的抑制，这些共同减轻氧化应激、使细胞增殖正常化并重新校准免疫反应。尽管全身生物利用度的限制历来阻碍了RES的临床转化，但包括纳米颗粒、水凝胶和先进透皮制剂在内的创新递送系统正在彻底改变其局部应用，并显著提高其局部疗效和稳定性。本综述整合了来自动物模型的有力临床前证据，证明RES可加速伤口愈合、减少炎症标志物并显著抑制肿瘤，同时还评估了新出现但很有前景的临床试验数据，这些数据表明其在人类受试者中具有良好的耐受性和初步疗效。最终，这一综合分析明确了RES是皮肤病学中一种通用且有前景的治疗药物，同时强调了在递送方法上持续创新以及开展大规模严格设计的临床试验以充分释放其治疗潜力的必要性。
