Growth stimulation and tumor promotion in skin.

Stimulation of epidermal growth in adult mouse skin can be induced by chemical agents, such as phorbol esters and other skin mitogens, or by mechanical means, such as skin massage and skin wounding. It leads to different kinds of epidermal hyperproliferation, according to interference with mechanisms of endogenous growth control (G1 chalone) and to mediation by endogenous regulatory factors (prostaglandins). Certain phorbol esters and skin wounding induce epidermal hyperproliferation and, in addition, a metaplastic process. Another property of these metaplasiogenic mitogens is their tumor-promoting efficacy in mouse skin, which has been initiated by a carcinogen in a subthreshold dose. Tailor-made phorbol esters allow the subdivision of the process of tumor promotion into two stages. In the first--probably irreversible--stage, a single application of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) or wounding brings about the events critical and obligatory for promotion, whereas in the second--probably reversible--stage, repetitive applications of an "incomplete promoter" evoke epidermal hyperplasia necessary to make the tumors visible. Adult guinea pig epidermis in vivo, as well as primary cell cultures derived from adult guinea pig ear epidermis, responds to the proliferative effects of phorbol esters such as TPA along a similar sequence of biochemical events as mouse skin in vivo. The in vitro approach allows the study of the molecular events involved in the mechanism of action of phorbol esters in more detail.