George Varigos
Sebaceous glands secrete a lipid rich sebum which functions in the skin as maintaining the microbiome, skin integrity, thermoregulatory and UV protection. These glands a pivotal role in secreting a variety of lipids and cellular products, antimicrobial peptides and forming an important immune protective barrier.
Recent evidence is pointing to the increase in Sebaceous activity, as a mobilisation of lipids from fat containing tissues. An important cytokine, Thymic Stromal Lymphopoietin (TSLP) modulates the sebum secretion and in animal studies, the energy used is sufficient to cause significant loss of white adipose tissue and loss of weight. The research is showing TSLP over expression results in smaller sebaceous glands with an increase in sebocyte turnover and a result of increase in progenitor cells. The consumption of lipids from tissues has been evidenced with these sebaceous glands, illustrating another important aspect of the sebaceous gland function. TSLP is being studied to affect the lipids in the future.
This paper presents the recent studies above and highlights the likely explanation that we are witness to in our daily treatment of ACNE.
As we commence treatment with the Isotretinoin or Vit A,we eventually reduce size and activity of sebaceous glands, measured clinically by reduced acne and surface dryness. However the common occurrence of elevation of Lipids in 10 to 40% of these patients, which often correlates with effectiveness of treatment may be otherwise explained by this new understanding of sebaceous gland and lipid mobilisation.
As we measure these lipids ongoing and find that those patients with elevation, on isotretinoin, are the ones who eventually have higher lipids in adult life, is an interesting scenario. The presentation will highlight the sebaceous gland and fat loss.