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01-07-2019 | Insulins | Review

From pathogenesis of acne vulgaris to anti-acne agents

Authors: Tian-Xin Cong, Dan Hao, Xiang Wen, Xiao-Hua Li, Gu He, Xian Jiang

Published in: Archives of Dermatological Research | Issue 5/2019

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, K_DPT, 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.

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Title: From pathogenesis of acne vulgaris to anti-acne agents
Authors: Tian-Xin Cong
Dan Hao
Xiang Wen
Xiao-Hua Li
Gu He
Xian Jiang
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Insulins
Acne
Acne Vulgaris
Insulins
Androgens
Published in: Archives of Dermatological Research / Issue 5/2019
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI: https://doi.org/10.1007/s00403-019-01908-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

From pathogenesis of acne vulgaris to anti-acne agents

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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