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From pathogenesis of acne vulgaris to anti-acne agents
- Source :
- Archives of dermatological research. 311(5)
- Publication Year :
- 2018
-
Abstract
- Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. Four factors play vital roles in acne pathophysiology: hyperseborrhea and dysseborrhea, altered keratinization of the pilosebaceous duct, Cutibacterium acnes (C. acnes) and inflammation. The main hormones responsible for the development of acne vulgaris include androgens, insulin and insulin-like growth factor-1. Other factors involved in this process are corticotropin-releasing hormone, α-melanocyte-stimulating hormone and substance P. Wnt/β-catenin signaling pathway, phosphoinositide 3-kinase (PI3K)/Akt pathway, mitogen-activated protein kinase pathway, adenosine 5′-monophosphate-activated protein kinase pathway and nuclear factor kappa B pathway participate in the modulation of sebocyte, keratinocyte and inflammatory cell (e.g. lymphocytes, monocytes, macrophages, neutrophils) activity. Among all the triggers and pathways mentioned above, IGF-1-induced PI3K/Akt/Forkhead box protein O1/mammalian target of rapamycin (mTOR) C1 pathway is the most important signaling responsible for acne pathogenesis. Commonly used anti-acne agents include retinoids, benzoyl peroxide, antibiotics and hormonal agents (e.g. spironolactone, combination oral contraceptive and flutamide). New approaches including peroxisome proliferator-activated receptor γ modifier, melanocortin receptor antagonists, epigallocatechin-3-gallate, metformin, olumacostat glasaretil, stearoyl-CoA desaturase inhibitor omiganan pentahydrochloride, KDPT, afamelanotide, apremilast and biologics have been developed as promising treatments for acne vulgaris. Although these anti-acne agents have various pharmacological effects against the diverse pathogenesis of acne, all of them have a synergistic mode of action, the attenuation of Akt/mTORC1 signaling and enhancement of p53 signal transduction. In addition to drug therapy, diet with no hyperglycemic carbohydrates, no milk and dairy products is also beneficial for treatment of acne.
- Subjects :
- FOXO1
Dermatology
Pharmacology
Flutamide
030207 dermatology & venereal diseases
03 medical and health sciences
chemistry.chemical_compound
Sebaceous Glands
0302 clinical medicine
Acne Vulgaris
Dietary Carbohydrates
Medicine
Humans
Propionibacterium acnes
Protein kinase B
PI3K/AKT/mTOR pathway
Acne
business.industry
Wnt signaling pathway
Drug Synergism
General Medicine
medicine.disease
Anti-Bacterial Agents
Sebum
chemistry
030220 oncology & carcinogenesis
Dairy Products
Dermatologic Agents
Signal transduction
business
Hormone
Signal Transduction
Subjects
Details
- ISSN :
- 1432069X
- Volume :
- 311
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Archives of dermatological research
- Accession number :
- edsair.doi.dedup.....e0249d993bd3dc06ddfeec23be122a1e