Saurat J H
Presse Med. 1994 Nov 5;23(34):1551-3.
The discovery of retinoid receptors has contributed greatly to our understanding of the mechanism of action of vitamin A. The organism produces at least two ligands from ingested vitamin A which act as hormones modulating the activity of numerous genes via their nuclear receptor. These ligands are produced locally by target cells from retinol and retinaldehyde. These advances do not respond to the clinicians' interrogation as to why 13cis retinoic acid blocks sebaceous secretion and cures severe acne while other known retinoids are uneffective. Current research would suggest that the expression of nuclear receptors is not altered in skin diseases but that upstream anomalies in the intracrine system (enzymes and binding proteins) could be involved. Clinically, teratogenic risks are a major obstacle to the oral administration of retinoids and the future in skin diseases lies most likely in topical applications.
类视黄醇受体的发现极大地促进了我们对维生素A作用机制的理解。机体从摄入的维生素A中产生至少两种配体，它们作为激素，通过其核受体调节众多基因的活性。这些配体由靶细胞从视黄醇和视黄醛局部产生。这些进展并未回应临床医生关于为何13 - 顺式维甲酸能阻断皮脂腺分泌并治愈重度痤疮而其他已知类视黄醇却无效的疑问。目前的研究表明，在皮肤病中核受体的表达并未改变，但内分泌系统（酶和结合蛋白）的上游异常可能与之有关。临床上，致畸风险是类视黄醇口服给药的主要障碍，皮肤病治疗的未来很可能在于局部应用。
