ГОРМОНЫ КАК ДОПОЛНИТЕЛЬНАЯ ТЕРАПЕВТИЧЕСКАЯ МИШЕНЬ В ЛЕЧЕНИИ АКНЕ
Обзорная статья
Дата публикации: апреля 26, 2022
Ключевые слова
акне
гормоны
спиронолактон
гормоны
спиронолактон
Как цитировать
Грязева Н. В., Тамразова А. В., Александрова Е. Б. ГОРМОНЫ КАК ДОПОЛНИТЕЛЬНАЯ ТЕРАПЕВТИЧЕСКАЯ МИШЕНЬ В ЛЕЧЕНИИ АКНЕ // Кремлевская медицина. Клинический вестник. 2022. Т. № 1. С. 66-70.
Аннотация
Акне является одной из самых частых патологий, наблюдаемых на дерматологическом приеме. Несмотря на многолетний опыт изучения данного заболевания, а также наличие внушительного арсенала терапевтических модальностей, в практике дерматовенеролога до сих пор встречаются пациенты, не отвечающие на стандартные методы лечения. Роль гормонов в патогенезе акне не вызывает сомнений, что делает их перспективной терапевтической мишенью. Европейские гайдлайны рекомендуют гормональную терапию вместе с местными или системными антибиотиками при тяжелом пустулезном и умеренном узловато-кистозном акне в качестве альтернативы изотретиноину. Пероральные кортикостероиды в высоких дозах могут помочь пациентам с воспалительными признаками акне, несмотря на любые гормональные причины, в то время как пероральные низкие дозы стероидов подавляют активность надпочечников у пациентов с доказанной гиперактивностью надпочечников. Метформин используется для лечения акне при синдроме поликистозных яичников, HAIR-AN-синдроме, ожирении и биохимических признаках гиперинсулинемии. Понимание метаболизма гормонов в организме человека поможет подобрать наиболее эффективное лечение. Важно знать о доступных гормональных препаратах, оптимальных способах их применения и их относительных и абсолютных противопоказаниях.Литература
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2. George R., Clarke S., Thiboutot D. Hormonal therapy for acne // Semin Cutan Med Surg. – 2008. – V. 27. – P. 188–196.
3. Thiboutot D. Acne: hormonal concepts and therapy // Clin Dermatol. – 2004. – V. 22. – P. 419–428.
4. Lolis M., Bowe W., Shalita A. Acne and systemic disease // Med Clin North Am. – 2009. – V. 93. – № 6. – P. 1161–1181.
5. Chen W., Thiboutot D., Zouboulis C.C. Cutaneous androgen metabolism: basic research and clinical perspectives // J Invest Dermatol. – 2002. – V. 119. – № 5. – P. 992–1007.
6. Gollnick H. From new findings in acne pathogenesis to new approaches in treatment // J Eur Acad Dermatol Venereol. – 2015. – V. 29. – P. 1–7.
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13. Arora M.K., Yadav A., Saini V. Role of hormones in acne vulgaris // Clin Biochem. – 2011. – V. 44. – P. 1035–1040.
14. Balen A.H. et al. Ultrasound assessment of the polycystic ovary: international consensus definitions // Hum Reprod Update. – 2003. – V. 9. – P. 505–514.
15. Zaenglein A.L., Pathy A.L., Schlosser B.J. et al. Guidelines of care for the management of acne vulgaris // J Am Acad Dermatol. – 2016. – V. 74. – P. 945–973.
16. Sato T. et al. Augmentation of gene expression and production of promatrix metalloproteinase 2 by Propionibacterium acnes-derived factors in hamster sebocytes and dermal fibroblasts: a possible mechanism for acne scarring // Biol Pharm Bull. – 2011. – V. 34. – P. 295–299.
17. Bettoli V., Zauli S., Virgili A. Is hormonal treatment still an option in acne today? // Br J Dermatol. – 2015. – V. 172. – P. 37–46.
18. Lin-Su K., Nimkarn S., New M.I. Congenital adrenal hyperplasia in adolescents: diagnosis and management // Ann N Y Acad Sci. – 2008. – V. 1135. – P. 95–98.
19. Knochenhauer E., Azziz R. Ovarian hormones and adrenal androgens during a woman's life span // J Am Acad Dermatol. – 2001. – V. 45. – P. 105–115.
20. Simpson N.B., Cunliffe W.J. Disorders of the sebaceous glands. In: Rook's Textbook of Dermatology. Ed. by T. Burns, S. Breathnach, N. Cox, C. Griffiths. 7th edn. Blackwell Science, 2004.
21. Suh D.H., Kwon H.H. What's new in the physiopathology of acne? // Br J Dermatol. – 2015. – V. 172. – P. 13–19.
22. Kraft J., Freiman A. Management of acne // CMAJ. – 2011. – V. 183. – P. 430–435.
23. Gollnick H.P., Dreno B. Pathophysiology and management of acne // J Eur Acad Dermatol Venereol. – 2015. – V. 29 – P. 1–2.
24. Lai J.J. et al. The role of androgen and androgen receptor in skin-related disorders // Arch Dermatol Res. – 2012. – V. 304. – P. 499–510.
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26. Brown J. et al. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne // Cochrane Database Syst Rev. – 2009. – V. 2. – CD000194
27. Yemisci A., Gorgulu A., Piskin S. Effects and side-effects of spironolactone therapy in women with acne // J Eur Acad Dermatol Venereol. – 2005. – V. 19. – P. 163–166.
28. Shaw J.C. Acne: effect of hormones on pathogenesis and management // Am J Clin Dermatol. – 2002. – V. 3. – P. 571–578.
29. Layton A.M. Top ten list of clinical pearls in the treatment of acne vulgaris // Dermatol Clin. – 2016. – V. 34. – P. 147–157.
30. Van Wayjen R.G., van den Ende A. Experience in the long-term treatment of patients with hirsutism and/or acne with cyproterone acetate-containing preparations: efficacy, metabolic and endocrine effects // Exp Clin Endocrinol Diabetes. – 1995. – V. 103. – P. 241–251.
31. Thiboutot D. et al. A randomized, controlled trial of a low-dose contraceptive containing 20 microg of ethinyl estradiol and 100 microg of levonorgestrel for acne treatment // Fertil Steril. – 2001. – V. 76. – P. 461–468.
32. Adalatkhah H., Pourfarzi F., Sadeghi-Bazargani H. Flutamide versus a cyproterone acetate-ethinyl estradiol combination in moderate acne: a pilot randomized clinical trial // Clin Cosmet Investig Dermatol. – 2011. – V. 4. – P. 117–121.
33. Lowenstein E.J. Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome // Dermatol Ther. – 2006. – V. 19. – P. 210–223.
34. Nast A. et al. Risk of complications due to anticoagulation during dermatosurgical procedures: a systematic review and meta-analysis // J Eur Acad Dermatol Venereol. – 2014. – V. 28. – P. 1603–1609.
35. Husein-El Ahmed H. Management of acne vulgaris with hormonal therapies in adult female patients // Dermatol Ther. – 2015. – V. 28. – P. 166–172.
36. Nast A. et al. European evidence-based (S3) guidelines for the treatment of acne // J Eur Acad Dermatol Venereol. – 2012. – V. 26. – P. 1–29.
37. Beylot C. et al. Propionibacterium acnes: an update on its role in the pathogenesis of acne // J Eur Acad Dermatol Venereol. – 2014. – V. 28. – P. 271–278.
38. Ghosh S. et al. Profiling and hormonal therapy for acne in women // Indian J Dermatol. – 2014. – V. 59. – P. 107–115.
39. Wang Q.Y. et al. Comparison of drospirenone- with cyproterone acetate-containing oral contraceptives, combined with metformin and lifestyle modifications in women with polycystic ovary syndrome and metabolic disorders: a prospective randomized control trial // Chin Med J. – 2016. – V. 129. – P. 883–890.
40. Bubna A.K. Metformin – for the dermatologist // Indian J Pharmacol. – 2016. V. 48. – P. 4–10.
2. George R., Clarke S., Thiboutot D. Hormonal therapy for acne // Semin Cutan Med Surg. – 2008. – V. 27. – P. 188–196.
3. Thiboutot D. Acne: hormonal concepts and therapy // Clin Dermatol. – 2004. – V. 22. – P. 419–428.
4. Lolis M., Bowe W., Shalita A. Acne and systemic disease // Med Clin North Am. – 2009. – V. 93. – № 6. – P. 1161–1181.
5. Chen W., Thiboutot D., Zouboulis C.C. Cutaneous androgen metabolism: basic research and clinical perspectives // J Invest Dermatol. – 2002. – V. 119. – № 5. – P. 992–1007.
6. Gollnick H. From new findings in acne pathogenesis to new approaches in treatment // J Eur Acad Dermatol Venereol. – 2015. – V. 29. – P. 1–7.
7. Lakshmi C. Hormone therapy in acne // Indian J Dermatol Venereol Leprol. – 2013. – V. 79. – P. 322–337.
8. Zouboulis C.C., Jourdan E., Picardo M. Acne is an inflammatory disease and alterations of sebum composition initiate acne lesions // J Eur Acad Dermatol Venereol. – 2014. – V. 28. – P. 527–532.
9. Melnik B.C., John S.M., Plewig G. Acne: risk indicator for increased body mass index and insulin resistance // Acta Derm Venereol. – 2013. – V. 93. – P. 644–649.
10. Arlt W., Stewart P.M. Adrenal corticosteroid biosynthesis, metabolism, and action // Endocrinol Metab Clin North Am. – 2005. – V. 34. – P. 293–298.
11. Böhm M., Ehrchen J., Luger T.A. Beneficial effects of the melanocortin analogue Nle4-D-Phe7-α-MSH in acne vulgaris // J Eur Acad Dermatol Venereol. – 2014. – V. 28. – P. 108–111.
12. Shibata M. et al. Glucocorticoids enhance toll-like receptor 2 expression in human keratinocytes stimulated with Propionibacterium acnes or proinflammatory cytokines // J Invest Dermatol. – 2009. – V. 129. – P. 375–382.
13. Arora M.K., Yadav A., Saini V. Role of hormones in acne vulgaris // Clin Biochem. – 2011. – V. 44. – P. 1035–1040.
14. Balen A.H. et al. Ultrasound assessment of the polycystic ovary: international consensus definitions // Hum Reprod Update. – 2003. – V. 9. – P. 505–514.
15. Zaenglein A.L., Pathy A.L., Schlosser B.J. et al. Guidelines of care for the management of acne vulgaris // J Am Acad Dermatol. – 2016. – V. 74. – P. 945–973.
16. Sato T. et al. Augmentation of gene expression and production of promatrix metalloproteinase 2 by Propionibacterium acnes-derived factors in hamster sebocytes and dermal fibroblasts: a possible mechanism for acne scarring // Biol Pharm Bull. – 2011. – V. 34. – P. 295–299.
17. Bettoli V., Zauli S., Virgili A. Is hormonal treatment still an option in acne today? // Br J Dermatol. – 2015. – V. 172. – P. 37–46.
18. Lin-Su K., Nimkarn S., New M.I. Congenital adrenal hyperplasia in adolescents: diagnosis and management // Ann N Y Acad Sci. – 2008. – V. 1135. – P. 95–98.
19. Knochenhauer E., Azziz R. Ovarian hormones and adrenal androgens during a woman's life span // J Am Acad Dermatol. – 2001. – V. 45. – P. 105–115.
20. Simpson N.B., Cunliffe W.J. Disorders of the sebaceous glands. In: Rook's Textbook of Dermatology. Ed. by T. Burns, S. Breathnach, N. Cox, C. Griffiths. 7th edn. Blackwell Science, 2004.
21. Suh D.H., Kwon H.H. What's new in the physiopathology of acne? // Br J Dermatol. – 2015. – V. 172. – P. 13–19.
22. Kraft J., Freiman A. Management of acne // CMAJ. – 2011. – V. 183. – P. 430–435.
23. Gollnick H.P., Dreno B. Pathophysiology and management of acne // J Eur Acad Dermatol Venereol. – 2015. – V. 29 – P. 1–2.
24. Lai J.J. et al. The role of androgen and androgen receptor in skin-related disorders // Arch Dermatol Res. – 2012. – V. 304. – P. 499–510.
25. Sato K. et al. Anti-androgenic therapy using oral spironolactone for acne vulgaris in Asians // Aesthetic Plast Surg. – 2006. – V. 30. – P. 689–694.
26. Brown J. et al. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne // Cochrane Database Syst Rev. – 2009. – V. 2. – CD000194
27. Yemisci A., Gorgulu A., Piskin S. Effects and side-effects of spironolactone therapy in women with acne // J Eur Acad Dermatol Venereol. – 2005. – V. 19. – P. 163–166.
28. Shaw J.C. Acne: effect of hormones on pathogenesis and management // Am J Clin Dermatol. – 2002. – V. 3. – P. 571–578.
29. Layton A.M. Top ten list of clinical pearls in the treatment of acne vulgaris // Dermatol Clin. – 2016. – V. 34. – P. 147–157.
30. Van Wayjen R.G., van den Ende A. Experience in the long-term treatment of patients with hirsutism and/or acne with cyproterone acetate-containing preparations: efficacy, metabolic and endocrine effects // Exp Clin Endocrinol Diabetes. – 1995. – V. 103. – P. 241–251.
31. Thiboutot D. et al. A randomized, controlled trial of a low-dose contraceptive containing 20 microg of ethinyl estradiol and 100 microg of levonorgestrel for acne treatment // Fertil Steril. – 2001. – V. 76. – P. 461–468.
32. Adalatkhah H., Pourfarzi F., Sadeghi-Bazargani H. Flutamide versus a cyproterone acetate-ethinyl estradiol combination in moderate acne: a pilot randomized clinical trial // Clin Cosmet Investig Dermatol. – 2011. – V. 4. – P. 117–121.
33. Lowenstein E.J. Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome // Dermatol Ther. – 2006. – V. 19. – P. 210–223.
34. Nast A. et al. Risk of complications due to anticoagulation during dermatosurgical procedures: a systematic review and meta-analysis // J Eur Acad Dermatol Venereol. – 2014. – V. 28. – P. 1603–1609.
35. Husein-El Ahmed H. Management of acne vulgaris with hormonal therapies in adult female patients // Dermatol Ther. – 2015. – V. 28. – P. 166–172.
36. Nast A. et al. European evidence-based (S3) guidelines for the treatment of acne // J Eur Acad Dermatol Venereol. – 2012. – V. 26. – P. 1–29.
37. Beylot C. et al. Propionibacterium acnes: an update on its role in the pathogenesis of acne // J Eur Acad Dermatol Venereol. – 2014. – V. 28. – P. 271–278.
38. Ghosh S. et al. Profiling and hormonal therapy for acne in women // Indian J Dermatol. – 2014. – V. 59. – P. 107–115.
39. Wang Q.Y. et al. Comparison of drospirenone- with cyproterone acetate-containing oral contraceptives, combined with metformin and lifestyle modifications in women with polycystic ovary syndrome and metabolic disorders: a prospective randomized control trial // Chin Med J. – 2016. – V. 129. – P. 883–890.
40. Bubna A.K. Metformin – for the dermatologist // Indian J Pharmacol. – 2016. V. 48. – P. 4–10.