微生态制剂对慢性支气管炎的临床疗效和对患者免疫功能的影响

探究微生态制剂对慢性支气管炎的临床疗效和对患者免疫功能的影响。

选择2019年6月至2022年6月我院呼吸内科收治的86例慢性支气管炎患者为研究对象,按照随机分配的原则分为对照组和观察组。对照组患者接受常规治疗,包括平喘药物、抗炎药物和止咳药物;观察组患者在常规治疗的基础上使用微生态制剂进行治疗。比较两组患者治疗后的临床疗效、临床症状持续时间以及相关免疫指标（IL-8、TNF-α、CD4⁺细胞、CRP）水平。

与对照组相比,观察组患者的住院时间、喘息、咳嗽、肺部喘鸣音持续时间显著短于对照组（均P＜0.05）。观察组患者的治疗有效率达95.35%,显著高于对照组的81.40%（P＜0.05）。与治疗前相比,治疗后两组患者IL-8、TNF-α、CRP水平均显著降低,且观察组上述指标水平均低于对照组（均P＜0.05）。

微生态制剂可有效治疗慢性支气管炎,提高临床疗效,改善患者的免疫功能。

     

发酵乳对脓毒症患者肠黏膜屏障功能的影响

观察发酵乳对脓毒症患者肠黏膜屏障功能及炎症指标的影响。

选取60例确诊为脓毒症的患者, 随机分成对照组和发酵乳组, 每组各30例。对照组给予抗生素及营养支持治疗, 治疗组在常规综合治疗的基础上给予口服发酵乳治疗。在治疗前及治疗1周后分别检测并比较两组患者肠黏膜屏障功能、C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平变化, 记录患者APACHEⅡ评分。采用SPSS 22.0软件进行数据统计。

治疗前两组患者的肠屏障功能、PCT和IL-6水平差异无统计学意义(P > 0.05)。治疗1周后, 发酵乳组血清内毒素(LPS)、血清二胺氧化酶(DAO)、D-乳酸、CRP、PCT、TNF-α、IL-6水平和APACHEⅡ评分较治疗前均显著降低(P < 0.05), 较对照组治疗后也降低(P < 0.05)。

脓毒症患者在常规综合治疗基础上加用发酵乳可改善肠粘膜屏障功能, 减轻患者全身炎症反应。

     

糖尿病药物那格列奈促进嗜酸乳杆菌生长的作用

系统评价糖尿病药物对乳杆菌属微生物生长的影响,并进一步探讨糖尿病药物促进乳杆菌属微生物生长的作用机制。

利用体外纯培养法评估糖尿病药物对乳杆菌属微生物生长的影响,筛选出具有促进作用的“药菌组合”,并进一步采用非靶向代谢组学技术检测“药菌组合”培养液上清中的代谢物组;采用结晶紫染色法和RT-qPCR法分别检测特定乳杆菌生物膜形成和细菌素生物合成基因的表达。

10种常见糖尿病药物对乳杆菌的生长主要表现为抑制作用,仅那格列奈可在低浓度下刺激嗜酸乳杆菌的生长,促进率达48.30%。“那格列奈―嗜酸乳杆菌组合”培养液上清中共注释到584种已知代谢物,其中差异代谢物有42个,主要富集在氨基酸代谢和生物合成、氨酰t-RNA生物合成和次生代谢产物生物合成等代谢通路上;同时,那格列奈还促进了嗜酸乳杆菌生物膜的形成以及增加了生物膜的黏附性,并上调细菌素合成结构基因的表达（t = 2.373,P = 0.033）。

糖尿病药物对乳杆菌生长普遍具有抑制作用,但那格列奈可通过调节氨基酸代谢和生物合成、促进生物膜的分泌和细菌素的生物合成来刺激嗜酸乳杆菌的生长。

     

双歧杆菌四联活菌联合常规用药治疗痛风的效果

探究双歧杆菌四联活菌联合常规用药治疗痛风的效果,为该类患者的治疗提供参考。

选取2018年12月至2020年12月我院300例痛风患者作为研究对象进行前瞻性研究,按照随机数字表法按1∶1比例分为联合组和常规组,各150例。常规组患者采用常规治疗,联合组在常规组基础上加用双歧杆菌四联活菌。比较2组患者疗效,治疗前后血尿酸、粪便中尿酸、粪便中细菌分解的尿酸、肠道菌群（双歧杆菌、乳杆菌、拟杆菌、大肠埃希菌）、炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、环氧化酶-2（COX-2）、白细胞介素-6（IL-6）]水平、血管内皮功能[可溶性细胞间黏附分子-1（sICAM-1）、一氧化氮（NO）、内皮素-1（ET-1）]及不良反应发生率。

联合组患者总有效率（91.33%）高于常规组（83.33%）,差异有统计学意义（P＜0.05）。治疗后联合组患者血尿酸、粪便中尿酸水平低于常规组,粪便中细菌分解的尿酸水平高于常规组（均P＜0.05）。治疗后联合组患者肠道双歧杆菌、乳杆菌数量高于常规组,拟杆菌、大肠埃希菌数量低于常规组（均P＜0.05）。治疗后联合组患者血清IL-1β、TNF-α、COX-2、IL-6、sICAM-1、ET-1水平低于常规组,而NO水平高于常规组（均P＜0.05）。2组患者不良反应发生率差异无统计学意义（P＞0.05）。

双歧杆菌四联活菌辅助治疗痛风的效果显著,可有效降低尿酸水平,调节肠道菌群稳定,缓解机体炎症,改善血管内皮功能,安全性较高。

     

不同程度颅脑疾病患者肠道菌群分析

检测不同程度颅脑疾病患者肠道菌群分布情况, 探讨患者肠道菌群分布与疾病的关系, 为该类患者的治疗提供参考。

通过MiSeq PE2x300 bp高通量测序技术对21例重度颅脑损伤患者(G1组, GCS≤8分)和14例轻度颅脑损伤患者(G2组, GCS > 8分)粪便样本中细菌的16S rRNA基因V3-V4可变区进行定性分析, 并对两组患者肠道菌群进行生物学分类比较、多样性分析和组间物种差异分析。

两组患者肠道菌群多样性差异无统计学意义(均P > 0.05)。G1组患者肠道厌氧球菌属(Anaerococcus)、埃希菌-志贺菌属(Escherichia-Shigella)、链球菌属(Streptococcus)、肠球菌属(Enterococcus)、棒状杆菌属(Corynebacterium)数量高于G2组(均P < 0.05)。

颅脑疾病患者肠道菌群紊乱, 其肠道菌群丰度及多样性显著下降, 有害菌数量升高, 有益菌数量下降。

     

清胰汤加减对急性胰腺炎患者肠道菌群及肠黏膜功能的影响

探讨清胰汤加减对急性胰腺炎患者肠道菌群及肠黏膜功能的影响,为该类患者的治疗提供参考。

选取我院2020年1月至2022年6月收治的急性胰腺炎患者108例,随机分为联合组（54例）和常规组（54例）。常规组患者采用常规西药治疗,联合组患者给予清胰汤加减联合常规西药治疗。比较2组患者治疗前后的中医症状积分、肠道菌群数量、肠黏膜功能（D-乳酸、二胺氧化酶、内毒素、白介素-6）情况,比较2组患者临床疗效及不良反应。

治疗后,2组患者主症、次症积分均降低,且联合组低于常规组（均P＜0.05）。治疗后,2组患者肠道大肠埃希菌、葡萄球菌属数量均降低,且联合组上述菌群数量均低于常规组（均P＜0.05）。治疗后,2组患者肠道双歧杆菌属、乳杆菌属数量均升高,且联合组上述菌群数量均高于常规组（均P＜0.05）。治疗后,2组患者血清D-乳酸、二胺氧化酶、内毒素、白介素-6水平均降低,且联合组均低于常规组（均P＜0.05）。联合组患者临床有效率高于常规组（96.30% vs 83.33%,P＜0.05）,而2组患者不良反应发生率比较差异无统计学意义（P＞0.05）。

清胰汤加减对急性胰腺炎患者的治疗效果显著,能够显著改善患者肠黏膜功能,调节肠道菌群水平,安全性较高。

     

支气管镜下冷冻联合镜下给药治疗溃疡型支气管结核的临床效果

探讨支气管镜下冷冻联合局部镜下注药对溃疡型支气管结核的临床效果,为该病的治疗提供参考。

选取2019年1月至2021年1月大连市公共卫生临床中心结核科收治的溃疡坏死型支气管结核患者80例,根据治疗方案分为对照组（n = 40,给予常规规范抗结核治疗）和研究组（n = 40,在对照组基础上给予支气管镜下冷冻联合局部注药治疗）。观察两组患者治疗4周后疗效、痰菌转阴时间及治疗前和治疗4周后第1秒用力呼气量（FEV1）、白细胞介素-10（IL-10）、C反应蛋白（CRP）、血沉（ESR）水平及治疗期间不良反应情况。

研究组患者总有效率高于对照组,痰菌转阴时间短于对照组（均P＜0.05）,但两组患者不良反应发生率比较差异无统计学意义（15.0% vs 12.5%,P＞0.05）。两组患者治疗后FEV1水平较治疗前上升,IL-10、CRP、ESR水平较治疗前下降,研究组患者上述指标水平治疗前后差值大于对照组（均P＜0.05）。

支气管镜下冷冻联合局部镜下注药对溃疡型支气管结核的疗效较好,可抑制机体炎症介质的释放,缩短痰菌转阴时间,安全性较高。

     

慢性胃炎患者肠道菌群分析

探索慢性胃炎（CG）患者肠道菌群变化特点。

采集我院青年CG患者（CG组）和健康人群（NC组）的粪便样品,对其细菌16S rDNA V3—V4区域进行扩增并进行高通量测序,然后运用多种生物信息学手段进行分析。

CG组与NC组对象肠道菌群在门和科水平上均有不同之处,其中CG组对象有较高丰度的Actinobacteriota和较低丰度的Ruminococcaceae。CG组对象肠道菌群多样性及均一度均显著低于NC组（均P＜0.05）,但两者具有相似的丰富度水平。多元方差分析和相似性百分比分析均发现CG组和NC组对象肠道菌群有较大差异。Bifidobacterium、Blautia、Collinsella、Ruminococcus_torques_group和Streptococcus与CG患者密切相关。

CG患者的肠道菌群存在较大变化,其中Bifidobacterium、Blautia等细菌与CG的发生相关。

     

Caspase-4非经典炎症小体对问号钩体诱导THP-1细胞炎症因子分泌水平的影响

了解Caspase-4非经典炎症小体在问号钩体诱导THP-1细胞炎性细胞因子分泌过程中的作用。

采用问号钩体感染THP-1细胞(预先经佛波酯刺激分化为巨噬细胞)建立细胞模型, 用实时荧光PCR扩增检测caspase-4、IL-18、IL-1β和IL-1αmRNA水平, Western blotting检测Caspase-4蛋白表达, ELISA定量检测细胞上清中IL-18、IL-1β和IL-1α分泌情况。

实时荧光PCR和Western blotting显示, 与未感染细胞比较, THP-1细胞Caspase-4 mRNA及蛋白表达水平均升高(t=46.03、29.36, 均P < 0.05), Caspase-4 siRNA转染后, Caspase-4 mRNA及蛋白表达水平显著下降(t=32.48、30.77, 均P < 0.01);钩体感染后, IL-18、IL-1β和IL-1αmRNA水平显著升高(t=25.70、26.13、19.94, 均P < 0.05), 在Caspase-4特异性阻断后显著下降(t=11.55、44.68、15.68, 均P < 0.05);ELISA检测显示, 钩体感染后, IL-18、IL-1β和IL-1α分泌均显著升高(t=50.24、34.17、25.18, 均P < 0.05), 且能被Caspase-4特异性阻断剂有效抑制(t=42.00、17.07、5.03, 均P < 0.05)。

Caspase-4非经典炎症小体参与介导问号钩体诱导人单核-巨噬细胞炎性细胞因子IL-18、IL-1β和IL-1α的分泌。

     

厄贝沙坦片联合益生菌对高血压伴肥胖患者的疗效及对肠道菌群的调控作用

探讨厄贝沙坦片联合益生菌对高血压伴肥胖患者的疗效及对肠道菌群的调控作用。

选取2021年10月—2022年10月本院400例高血压伴肥胖患者。随机法分组：对照组（200例）给予厄贝沙坦治疗,研究组（200例）在对照组基础上联用益生菌。比较两组治疗前后舒张压（DBP）、收缩压（SBP）、C反应蛋白（CRP）、白细胞介素（IL）-6水平和肠道菌群变化,统计治疗期间不良反应发生情况。

治疗后,研究组DBP、SBP、CRP和IL-6水平均低于对照组（P＜0.05）。治疗后,研究组乳杆菌、拟杆菌及双歧杆菌水平高于对照组,肠杆菌及肠球菌水平低于对照组（P＜0.05）。研究组不良反应发生率为3.0%,对照组为4.5%,差异无统计学意义（χ² = 0.623,P = 0.430）。

厄贝沙坦联合益生菌治疗高血压伴肥胖可提升患者血压控制效果,减轻炎症反应,改善肠道紊乱菌群,且不良反应少。

     

青少年痤疮面部皮肤微生物群落结构变化

【背景】青少年痤疮是一种最常见的慢性炎症性损容性皮肤病,与痤疮丙酸杆菌的异常增殖有关。【目的】探究痤疮皮损区与附近无明显皮损区微生物组成与健康对照的差异,为从微生态角度防治痤疮提供理论基础。【方法】利用细菌16S rRNA基因V1-V2区和真菌TIS1高通量测序技术分析北京地区16岁青少年面部痤疮皮肤细菌和真菌群落结构,将痤疮皮损区与附近无明显皮损区微生物组成与健康组进行比较,寻找差异菌群。【结果】痤疮患者面部皮损区与附近无明显皮损区细菌多样性(Shannon指数)较健康对照组显著性降低(P0.001),主要与丙酸杆菌(痤疮丙酸杆菌)和葡萄球菌(表皮葡萄球菌PM221)显著性上升相关,而痤疮皮损区与附近未明显皮损区细菌组成无显著性差异。痤疮患者皮损区与附近无明显皮损区较健康对照组真菌丰富度(Chao1指数)显著性上升(P0.05),与限制性马拉色菌的显著上升相关。【结论】面部皮肤微生物变化与青少年痤疮的发生相关。本研究为从微生物角度防治痤疮提供理论依据。     

A comparative study of the effects of topical application of Aloe vera, thyroid hormone and silver sulfadiazine on skin wounds in Wistar rats

Many research studies report the healing effects of Aloe Vera, thyroid hormone cream and silver sulfadiazine. However, the effects of these therapeutic agents are not well understood and have not been compared in one study. This study aimed at investigating the effects of topical application of an Aloe vera gel, a thyroid hormone cream and a silver sulfadiazine cream on the healing of skin wounds surgically induced in Wistar rats for determining the treatment of choice. In a randomized controlled trial, twelve male rats, aged 120 days and with a mean weight of 250 to 300 g, were divided randomly into 5 groups based on drug treatments: Aloe vera gel (AV), thyroid hormone cream (TC), silver sulfadiazine 1% (S), vehicle (V) and control. To evaluate the efficacy of each treatment technique, a biomechanical approach was used to assess tensile stress after 14 days of treatment. Tensile stress was significantly improved in the Aloe vera gel group as compared with the other four groups (P≤0.05). While the other treatment options resulted in better healing than the control group, this difference was not significant. We conclude that Aloe vera topical application accelerated the healing process more than thyroid hormone, silver sulfadiazine and vehicle in surgically induced incisions in rats.     

6-[2-(adamantylidene)-hydroxybenzoxazole]-O-sulfamate, a steroid sulfatase inhibitor for the treatment of androgen- and estrogen-dependent diseases

Steroid sulfatase (STS) offers a new target for the treatment of steroid hormone-dependent diseases, such as breast and prostate cancer and androgen-dependent skin diseases. We here characterize a novel non-estrogenic inhibitor of the enzyme, namely 6-[2-(adamantylidene)-hydroxybenzoxazole]-O-sulfamate (AHBS), with special attention to its potential use in the treatment of acne. The compound blocks STS activity in homogenates of human skin with IC(50)=16 nM. Following a single oral dose (5 mg/kg) in rats, the compound blocks STS in the skin by 95% at 8 h, followed by recovery of activity over 5 days. Following topical application to the skin, both in vitro and in vivo, AHBS passes through the stratum corneum leading to inhibition of STS activity in the dermal compartment with rapid onset and long duration. Topical application of AHBS to G?ttingen minipigs for a period of 2 weeks does not induce symptoms of ichthyosis as seen in STS-deficient human subjects, but leads to a reduction of sebum secretion to the skin surface. Based on these data, clinical studies with AHBS in acne patients are warranted, in order to verify the hypothesis on the importance of the sulfatase pathway in androgen-dependent skin diseases.     

Further Observations on the Pathogenesis of Acne

The composition of the lipid of the forehead skin surface and the sebum excretion rate were determined in 217 subjects and controls. Acne was associated with an increase in serum excretion rate and in the squalene and wax and sterol esters in surface lipid. The changes in sebum excretion rate and squalene were statistically significant only in women, but acne in men was associated with a significant decrease in the free fatty acid content or surface lipid.The increased amounts of squalene and wax esters may lead to pilosebaceous obstruction in acne subjects. The increased sebum excretion rate in acne may ensure increased production of sebaceous triglyceride substrate available for lipolysis to irritant free fatty acids, which may then mediate the inflammatory changes of acne.     

Taurine bromamine (TauBr) - its role in immunity and new perspectives for clinical use

This review is an attempt to summarize our knowledge about taurine bromamine (TauBr) properties, its role in innate immunity and its therapeutic potential.TauBr and taurine chloramine (TauCl) are major haloamines generated by eosinophils and neutrophils at a site of inflammation. Both haloamines share anti-inflammatory and anti-oxidant properties. TauBr, similarly to TauCl, decreases the production of proinflammatory mediators. Their anti-inflammatory and anti-oxidant activities are enhanced by their ability to induce the expression of heme oxygenase-1 (HO-1). TauCl is more stable than TauBr. On the other hand, only TauBr was found to be highly membrane-permeable showing stronger microbicidal activity than TauCl.In the light of the anti-inflammatory and antimicrobial properties of TauBr we discuss its therapeutic potential in local treatment of inflammation, especially acne vulgaris, the most common inflammatory skin disorder. TauBr, at non-cytotoxic concentrations, is able to kill Propionibacterium acnes, the skin bacteria involved in pathogenesis of acne vulgaris.As topical antibiotics used in the therapy of acne are associated with the emergence of resistant bacteria, topical TauBr seems to be a good candidate for an alternative therapy.Recently, in a double blind trial, the efficacy of TauBr was compared with the efficacy of clindamycin, one of the most common topical antibiotics used in acne therapy. Comparable reduction of acne lesions was observed in the TauBr and clindamycin groups of patients with mild and moderate inflammatory facial acne vulgaris. We conclude that this pilot study supports our concept that TauBr can be used as a topical agent in the treatment of acne vulgaris, especially in patients who have already developed antibiotic resistance. Further studies are necessary to substantiate the more extended use of TauBr as an anti-inflammatory and anti-oxidant agent in human medicine.     

黄芪多糖对咪喹莫特诱导小鼠银屑病样皮炎的干预作用及其机制

目的:探讨黄芪多糖对咪喹莫特诱导的小鼠银屑病样皮炎的干预作用及其机制。方法:40只健康雌性C57BL/6小鼠随机分为空白对照组、模型组、黄芪多糖高剂量组(200 mg/kg)、中剂量组(100 mg/kg)和低剂量组(50 mg/kg),共5组,每组8只,利用5%咪喹莫特乳膏涂抹小鼠背部制备银屑病样皮炎模型,监测各组小鼠PASI评分,并采用ELISA测定小鼠炎症因子分泌的变化,通过流式细胞术检测皮炎中巨噬细胞的浸润程度。结果:与空白对照组比较,模型组小鼠PASI评分明显增加(P<0.05),血清TNF-α、IL-1β和IL-6水平明显升高(P<0.05),皮肤组织中浸润的巨噬细胞明显增加(P<0.05);与模型组比较,黄芪多糖高、中剂量组小鼠PASI评分明显明显减少(P<0.05),小鼠血清TNF-α、IL-1β和IL-6水平明显下调(P<0.05);黄芪多糖高剂量组小鼠皮肤组织中浸润的巨噬细胞明显减少(P<0.05)。结论:黄芪多糖通过抑制皮肤组织中巨噬细胞浸润,降低血清中TNF-α、IL-1β和IL-6的分泌,来改善小鼠银屑病样皮炎。     

Neuroendocrinology and neurobiology of sebaceous glands

The nervous system communicates with peripheral tissues through nerve fibres and the systemic release of hypothalamic and pituitary neurohormones. Communication between the nervous system and the largest human organ, skin, has traditionally received little attention. In particular, the neuro‐regulation of sebaceous glands (SGs), a major skin appendage, is rarely considered. Yet, it is clear that the SG is under stringent pituitary control, and forms a fascinating, clinically relevant peripheral target organ in which to study the neuroendocrine and neural regulation of epithelia. Sebum, the major secretory product of the SG, is composed of a complex mixture of lipids resulting from the holocrine secretion of specialised epithelial cells (sebocytes). It is indicative of a role of the neuroendocrine system in SG function that excess circulating levels of growth hormone, thyroxine or prolactin result in increased sebum production (seborrhoea). Conversely, growth hormone deficiency, hypothyroidism, and adrenal insufficiency result in reduced sebum production and dry skin. Furthermore, the androgen sensitivity of SGs appears to be under neuroendocrine control, as hypophysectomy (removal of the pituitary) renders SGs largely insensitive to stimulation by testosterone, which is crucial for maintaining SG homeostasis. However, several neurohormones, such as adrenocorticotropic hormone and α‐melanocyte‐stimulating hormone, can stimulate sebum production independently of either the testes or the adrenal glands, further underscoring the importance of neuroendocrine control in SG biology. Moreover, sebocytes synthesise several neurohormones and express their receptors, suggestive of the presence of neuro‐autocrine mechanisms of sebocyte modulation. Aside from the neuroendocrine system, it is conceivable that secretion of neuropeptides and neurotransmitters from cutaneous nerve endings may also act on sebocytes or their progenitors, given that the skin is richly innervated. However, to date, the neural controls of SG development and function remain poorly investigated and incompletely understood. Botulinum toxin‐mediated or facial paresis‐associated reduction of human sebum secretion suggests that cutaneous nerve‐derived substances modulate lipid and inflammatory cytokine synthesis by sebocytes, possibly implicating the nervous system in acne pathogenesis. Additionally, evidence suggests that cutaneous denervation in mice alters the expression of key regulators of SG homeostasis. In this review, we examine the current evidence regarding neuroendocrine and neurobiological regulation of human SG function in physiology and pathology. We further call attention to this line of research as an instructive model for probing and therapeutically manipulating the mechanistic links between the nervous system and mammalian skin.     

氨基酮戊酸光动力联合一清片治疗中重度痤疮效果及对血清学指标的影响

摘要 目的：观察氨基酮戊酸光动力联合一清片治疗中重度痤疮疗效以及对血清学指标的影响。方法：将93例中重度痤疮患者进行随机分组,31例为治疗组,31例为参照组1,31例为参照组2。治疗组采用氨基酮戊酸光动力联合一清片治疗,参照组1采用氨基酮戊酸光动力治疗,参照组2采用一清片治疗,观察三组治疗前、后患者痤疮严重程度分级系统(GAGS)评分、痤疮特异性生活质量量表（Qol-Acne）评分变化及性激素结合球蛋白（SHBG）、游离睾酮（FT）、雌二醇（E₂）、补体C3、免疫球蛋白IgG、IgM水平,比较三组临床疗效。结果：治疗组FT水平低于参照组1和参照组2（P＜0.05）,治疗组SHBG、E₂水平高于参照组1和参照组2（P＜0.05）,治疗组补体C3、IgG、IgM水平低于参照组1和参照组2（P＜0.05）,治疗组Qol-Acne评分较参照组1和参照组2高（P＜0.05）,治疗组GAGS评分较参照组1和参照组2低（P＜0.05）,治疗组总有效率（93.55%）高于参照组1（77.42%）和参照组2（64.52%）（P＜0.05）。结论：氨基酮戊酸光动力联合一清片治疗中重度痤疮患者,可调节患者内分泌,改善性激素水平及免疫状态,缓解患者痤疮症状,提升生活质量及临床疗效。     

Sebocytes,multifaceted epithelial cells: Lipid production and holocrine secretion

Sebocytes are highly specialized, sebum-producing epithelial cells that release their content by rupture of the cell membrane and cellular degradation (holocrine secretion). These cells are most commonly found in the skin in association with hair follicles (forming the pilosebaceous unit), where they arise from hair follicle keratinocytes, but there are also sebaceous glands (SGs) not associated with a hair follicle. The latter have special functions as secretion of pheromones or corneal protection. While the full range of sebum functions in human skin remains to be clarified, sebum forms an integral component of the epidermal barrier and the skin immune system. Sebocyte formation is controlled by multiple molecular pathways (e.g. Blimp1, Wnt, C-myc, Hedgehog) and sebum synthesis is strongly regulated by hormones, in particular by androgens. Excessive sebum production is seen in acne vulgaris, one of the most common skin diseases, while deregulated sebocyte differentiation characterizes some rare benign and malignant tumors.     

The combined use of oral and topical lipophilic antioxidants increases their levels both in sebum and stratum corneum

The concentration of Vitamin E (vit E) and ubiquinone (CoQ10), which together with squalene (SQ), play a key role against external oxidative insult, has been shown to decrease significantly during ageing. The aim of the present study is to inquire the effect of the combined use of topical bio-cosmetics containing natural active principles (including sebum-like lipid fractions, sebum and epidermal lipophilic and hydrophilic antioxidants), and oral antioxidant supplements on the antioxidant content of sebum and stratum corneum. We therefore treated the face and the back of 50 female volunteers aged 21-40, daily for two months, with a base cream containing 0.05% ubiquinone, 0.1% vit E, and 1% squalene. In addition 50 mg of CoQ10 + 50 mg of d-RRR-alpha-tocopheryl acetate + 50 microg of selenium were administered orally to half of the volunteers (Group A). Group B was represented by 25 volunteers who were treated only topically. Every 15 days during treatment the levels of CoQ10, vit E and SQ were verified in sebum, stratum corneum, and plasma. The daily topical application of the cream led to a significant increase, that peaked after 60 days, of the levels of CoQ10, d-RRR-alpha-tocopherol and SQ in the sebum (Group B), without significantly affecting the stratum corneum or plasma concentrations of the redox couple CoQ10H2/CoQ10 and vit E. The concomitant oral admistration of antioxidants produced in Group A a significant increase of the levels of CoQ10H2/CoQ10 and vit E both in plasma and stratum corneum after 15 and 30 days treatment respectively, compared to Group B. However the sebum levels of lipophilic antioxidants and SQ did not show a significant increase. After the treatments, the levels of CoQ10H2/CoQ10, vit E and SQ went back to basal levels within 6-8 days in sebum, 12-16 days in the stratum corneum, and 3-6 days in plasma. Therefore topical application of the antioxidants was able to increase their level in sebum, while the concomitant oral administration also affected the levels of vit E and CoQ10 in the stratum corneum.