Department of Medicine, Pennsylvania State University College of Medicine, Hershey
17033, USA.
Source
J Invest Dermatol, 105: 2, 1995 Aug, 209-14
Abstract
The presence of 5 alpha-reductase (5 alpha-R) in skin may indicate that the androgen
regulation of sebaceous glands and sebum production requires the local conversion of
testosterone to dihydrotestosterone. The goals of this study were to identify which
isozyme of 5 alpha-R (type 1 or type 2) is expressed in sebaceous glands from facial
areas, scalp, and non-acne-prone areas; to determine if 5 alpha-R activity is concentrated
in sebaceous glands; to assess whether there are regional differences in this enzyme's
activity; and to test the effects of azasteroid inhibitors and 13-cis retinoic acid on 5
alpha-R in these tissues. Sebaceous glands were microdissected from facial skin, scalp,
and non-acne-prone skin (arm, breast, abdomen, leg), and the activity of 5 alpha-R was
determined. A total of 49 samples from 23 male and 21 female subjects without acne (age
range, 16 to 81 years, 56 +/- 20 years [mean +/- SD]) was analyzed. The biochemical
properties of the enzyme in each of the samples tested are consistent with those of the
type 1 5 alpha-R. Minimal to no type 2 5 alpha-R was detected. The level of 5 alpha-R
activity was significantly higher in the sebaceous glands compared to whole skin in facial
skin (p = 0.047), scalp (p = 0.039), and non-acne-prone skin (p = 0.04). Enzyme activity
in sebaceous glands from facial skin and scalp was significantly higher than in a
comparable amount of sebaceous gland material obtained from non-acne-prone areas (32 +/- 6
[mean +/- SEM]), 35 +/- 7 (mean +/- SEM) versus 6.0 +/- 3.0 (mean +/- SEM) pmol/min/mg
protein, p = 0.014 and 0.007, respectively). Finasteride and 13-cis retinoic acid were
poor inhibitors of the enzyme with 50% inhibitory concentration values greater than 500
nM. These data demonstrate that in the skin from older patients without acne the type 1
isozyme of 5 alpha-R predominates, its activity is concentrated in sebaceous glands and is
significantly higher in sebaceous glands from the face and scalp compared to
non-acne-prone areas, and the action of 13-cis retinoic acid in the control of acne is not
at the level of 5 alpha-R. Furthermore, we suggest that specific inhibition of the type 1
5 alpha-R may offer a viable approach to the management of sebum production and, hence,
acne.