Role of the vitamin D3 pathway in healthy and diseased skin - facts, contradictions and hypotheses

被引:75
作者
Lehmann, Bodo [1 ]
机构
[1] Tech Univ Dresden, Dept Dermatol, Carl Gustav Carus Med Sch, D-01307 Dresden, Germany
关键词
calcitriol; keratinocyte; skin; UVB; Vitamin D-3; RETINOID-X-RECEPTOR; ANTIMICROBIAL PROTEIN HCAP18; NORMAL HUMAN KERATINOCYTES; EPIDERMAL-GROWTH-FACTOR; IMMEDIATE-EARLY GENE; 1,25-DIHYDROXYVITAMIN D-3; 1-ALPHA; 25-DIHYDROXYVITAMIN D-3; THYROID-HORMONE; CUTANEOUS SYNTHESIS; CHOLECALCIFEROL VITAMIN-D-3;
D O I
10.1111/j.1600-0625.2008.00810.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Irradiation of human keratinocytes with UVB (280-320 nm) in vitro and in vivo activates the metabolism of 7-dehydrocholesterol to hormonally active calcitriol. The production of calcitriol in the skin strongly depends on the photosynthesis of vitamin D-3 which is biologically inactive in the first instance. Vitamin D-3 serves as the starting substrate for two subsequent enzymatic hydroxylation steps in epidermal keratinocytes. Both the amount of vitamin D-3 and the activity of anabolic and catabolic vitamin D hydroxylases determine the cutaneous level of calcitriol. The hormonally active metabolite of vitamin D-3 regulates a huge number of genes in keratinocytes, and thus acts in an autocrine and/or paracrine manner. This local pathway of vitamin D-3 is unique, but its relevance for healthy and diseased skin is widely unknown, yet. Experimental findings implicate several questions: (1) Is UVB-induced formation of calcitriol involved in regulation of growth and differentaition of epidermal cells as well as immunological and skin protective processes? (2) What endogenous and exogenous factors including drugs affect the cutaneous vitamin D-3 pathway? From a therapeutical point of view, it has been known for a long time that topical application of calcitriol and its analogs can improve hyperproliferative skin diseases like psoriasis. In spite of many encouraging studies in recent years, the fields of the routinely therapeutical application of calcitriol or vitamin D analogs in dermatology (e.g. treatment of immunological, inflammatory, malignancies and infectious skin diseases) have not been intensified. Why is that?.
引用
收藏
页码:97 / 108
页数:12
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