Update: Mechanisms of Topical Retinoids in Acne

Area of Science:

• Dermatology
• Molecular Biology
• Pharmacology

Background:

• Topical retinoids are essential for acne management, targeting multiple pathophysiological aspects.
• Retinoids, vitamin A analogs, regulate skin cell growth and differentiation via retinoic acid receptors (RARs).
• Different RAR subtypes activated by topical retinoids influence cellular responses and clinical outcomes.

Purpose of the Study:

• To review skin physiology affected by topical retinoids in acne therapy.
• To highlight new data on trifarotene, a selective RAR-gamma agonist.
• To explore trifarotene's molecular and genetic impact on resolving acne lesions.

Main Methods:

• Review of existing literature on topical retinoids and acne.
• Analysis of new bioinformatic data comparing gene expression in trifarotene-treated lesions versus spontaneously resolving lesions.
• Focus on trifarotene's selective binding to the RAR-gamma receptor.

Main Results:

• Trifarotene significantly modulates 67 genes not observed in spontaneously resolving acne lesions.
• These modulated genes are implicated in cellular migration, immune activation, inflammation, and matrix reorganization.
• Gene expression changes induced by trifarotene occurred in opposite directions in treated versus resolving lesions, indicating a specific response.

Conclusions:

• Trifarotene's selective RAR-gamma activity influences distinct molecular pathways in acne resolution.
• Understanding these pathways provides insights into the genetic response to trifarotene therapy.
• This highlights the potential of targeted retinoid therapy in acne management.