Abstract
Fibrosis is characterized by the excessive deposition of extracellular matrix components eventually resulting in organ dysfunction and failure. In dermatology, fibrosis is the hallmark component of many skin diseases, including systemic sclerosis, graft-versus-host disease, hypertrophic scars, keloids, nephrogenic systemic fibrosis, porphyria cutanea tarda, restrictive dermopathy and other conditions. Fibrotic skin disorders may be debilitating and impair quality of life. There are few FDA-approved anti-fibrotic drugs; thus, research in this area is crucial in addressing this deficiency. Recent investigations elucidating the pathogenesis of skin fibrosis have implicated endogenous reactive oxygen species produced by the multicomponent nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) enzyme complex. In this review, we discuss Nox enzymes and their role in skin fibrosis. An overview of the Nox enzyme family is presented and their role in the pathogenesis of skin fibrosis is discussed. The mechanisms by which Nox enzymes influence specific fibrotic skin disorders are also reviewed. Finally, we describe the therapeutic approaches to ameliorate skin fibrosis by directly targeting Nox enzymes with the use of statins, p47phox subunit modulators, or GKT137831, a competitive inhibitor of Nox enzymes. Nox enzymes can also be targeted indirectly via scavenging ROS with antioxidants. We believe that Nox modulators are worthy of further investigation and have the potential to transform the management of skin fibrosis by dermatologists.
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Abbreviations
- CCL:
-
Chemokine ligand
- CTGF:
-
Connective tissue growth factor
- ECM:
-
Extracellular matrix
- EGCG:
-
Epigallocatechin-3-gallate
- EMS:
-
Eosinophilia-myalgia syndrome
- ERK:
-
Extracellular signal-regulated kinase
- FAD:
-
Flavin adenine dinucleotide
- GVHD:
-
Graft-versus-host disease
- HSCT:
-
Hematopoietic stem cell transplantation
- IPF:
-
Idiopathic pulmonary fibrosis
- JAK:
-
Janus kinase
- JNK:
-
c-jun amino-terminal kinase
- MAPK:
-
Mitogen-activated protein kinase
- MMP:
-
Matrix metalloproteinase
- mRNA:
-
Messenger RNA
- NADPH:
-
Nicotinamide adenine dinucleotide phosphate
- Nox:
-
Nicotinamide adenine dinucleotide phosphate oxidase
- NSF:
-
Nephrogenic systemic fibrosis
- PCT:
-
Porphyria cutanea tarda
- PDGF:
-
Platelet-derived growth factor
- PDGFR:
-
Platelet-derived growth factor receptor
- PKC:
-
Protein kinase C
- POLDIP:
-
DNA polymerase delta-interacting protein
- PTP:
-
Protein tyrosine phosphatase
- RAAS:
-
Renin–angiotensin–aldosterone system
- RD:
-
Restrictive dermopathy
- ROS:
-
Reactive oxygen species
- SOD:
-
Superoxide dismutase
- TGF:
-
Transforming growth factor
- TIMP:
-
Tissue inhibitor of metalloproteinase
- TKS:
-
Tyrosine kinase substrate
- TOS:
-
Toxic oil syndrome
- 5-VPTA:
-
N-(5-vinyl-1,3-thiazolidin-2-ylidene)phenylamine
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Acknowledgments
The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1 TR000002 and linked awards TL1 TR000133 and KL2 TR000134. Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number R33AI080604.
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The authors declare that they have no conflict of interest.
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O. Babalola and A. Mamalis contributed equally to the preparation of this manuscript.
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Babalola, O., Mamalis, A., Lev-Tov, H. et al. NADPH oxidase enzymes in skin fibrosis: molecular targets and therapeutic agents. Arch Dermatol Res 306, 313–330 (2014). https://doi.org/10.1007/s00403-013-1416-8
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DOI: https://doi.org/10.1007/s00403-013-1416-8