Jeffrey Rajkumara Neha Chandana Peter Liob Vivian Shic
a Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA;
b Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;
c Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AK, USA
Keywords
Skin barrier · Barrier disruption · Moisturizers
Abstract
Background: The anatomic layers of the skin are well-defined, and a functional model of the skin barrier has recently been described. Barrier disruption plays a key role in several skin conditions, and moisturization is recommended as an initial treatment in conditions such as atopic dermatitis. This review aimed to analyze the skin barrier in the context of the function model, with a focus on the mechanisms by which moisturizers support each of the functional layers of the skin barrier to promote homeostasis and repair. Summary: The skin barrier is comprised of four interdependent layers – physical, chemical, microbiologic, and immunologic – which maintain barrier structure and function. Moisturizers target disruption affecting each of these four layers through several mechanisms and were shown to improve transepidermal water loss in several studies. Occlusives, humectants, and emollients occlude the surface of the stratum corneum (SC), draw water from the dermis into the epidermis, and assimilate into the SC, re- spectively, in order to strengthen the physical skin barrier. Acidic moisturizers bolster the chemical skin barrier by sup-porting optimal enzymatic function, increasing ceramide production, and facilitating ideal conditions for commensal microorganisms. Regular moisturization may strengthen the immunologic skin barrier by reducing permeability and subsequent allergen penetration and sensitization. Key Messages: The physical, chemical, microbiologic, and im-munologic layers of the skin barrier are each uniquely impacted in states of skin barrier disruption. Moisturizers target each of the layers of the skin barrier to maintain homeostasis and facilitate repair.
Mauro Gitto1,2 · Federica Catapano1,2 · Marco Francone1,2 · Gianluca Mincione1,2 · Vincenzo Scialò1,2 ·Carlo A. Pivato1,2 · Costanza Lisi1,2 · Damiano Regazzoli1,2 · Davide Cao1,2 · Roberta Maria Fiorina1 ·Alessandra Petrelli3,4 · Loredana Bucciarelli4 · Cristian Loretelli3,4 · Gianluigi Condorelli1,2 · Paolo Fiorina3,4,5 · Giulio Stefanini1,2
Received: 4 October 2025 / Accepted: 15 October 2025 / Published online: 4 November 2025 © The Author(s) 2025
Background Despite advances in therapeutic strategies a significant proportion of acute coronary syndrome (ACS) patients experience early coronary artery disease (CAD) progression, particularly those with diabetes.
Aim To evaluate CAD progression in diabetic patients treated with glucagon-like peptide 1 receptor agonists (GLP-1Ra) over 1 year after an ACS.
Methods Patients presenting with non–ST-elevation ACS between 2019 and 2022 were enrolled in a prospective registry and underwent serial coronary computed tomography angiography (CCTA) at baseline (after revascularization, during the index hospitalization) and at 1-year follow-up. The primary endpoint was the absolute change (1 year – baseline) in non-culprit lesion plaque burden (ΔPB) on CCTA, with the absolute change in patient percent atheroma volume (ΔPAV) as a key secondary endpoint. A comprehensive lipidomic, metabolomic, and proteomic plasma assessment was also performed in all GLP-1Ra–treated patients and four randomly selected controls.
Results Of 28 diabetic patients, 7 (25%) with 22 coronary plaques were treated with GLP-1Ra, and 21 (75%) with 65 plaques received other antidiabetic agents. In the 1-year observation frame, both ΔPB (-5.8±12.8% vs. -1.1±13.6%, p=0.041) and ΔPAV (-6.1% [-7.3, -1.8] vs. -0.7% [-2.4, 9.8], p=0.039) were significantly lower in GLP-1Ra-treated patients. Total atheroma volume also showed a numerically greater reduction in the GLP-1Ra cohort (0.7 mm³ [-2.5-8.7] vs. 25.0 mm³ [4.8–39.7]), primarily due to a decrease in plaque fibrofatty volume percentage (-2.9±10.1% vs. 1.0±6.8%, p=0.042). Lipi-domic, metabolomic, and proteomic analyses identified reductions in monoacylglycerols and triacylglycerols, increases in diacylglycerols and phosphatidylethanolamine, a shift from carbohydrate metabolism toward lipid metabolism and hormone regulation, and differential expression of proteins involved in complement activation, endothelial function, and cytoskeletal organization in GLP-1Ra–treated patients compared with controls.
Conclusions In diabetic patients with ACS, GLP-1Ra therapy was associated with a significant regression in coronary plaque burden at 1 year, supported by favorable lipidomic, metabolomic, and proteomic changes. These findings suggest a potential role for GLP-1Ra in modifying atherosclerosis progression beyond glycemic control.
Keywords GLP-1 receptor agonists · Diabetes mellitus · Coronary artery disease · Acute coronary syndrome · Plaque regression
擅长疾病:在烧伤、创伤后瘢痕整形、先天性畸形、面部及躯干美容等方面临床经验丰富,具有较强的解决本专业疑难病例的能力及显微外科手术能力。
擅长领域:(1)耳廓、乳房、阴茎、鼻部等体表器官再造(2)体表软组织肿瘤切除与美容修复(3)脂肪移植与面部年轻化(4)血管瘤、鲜红斑痣等激光美容
对烧伤外科、整形外科及美容外科有较深的造谐,擅长大面积严重烧伤的救治,唇腭裂修复、软组织缺损的修复及各类美容整形和再造整形手术,每年完成大小各类手术360余例。
从事整形外科近30年,留美多年,熟练掌握面部美容、除皱、乳房整形、脂肪抽吸等各类美容整形外科手术及各种非手术美容(如肉毒毒素A注射除皱等),对外生殖器整形与再造,两性畸形和易性症的手术治疗等有较深入研究。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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