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:脊柱外科、脊柱微创技术、显微创伤外科、腰椎间盘突出症脊柱侧弯等。
熟练掌握了骨科常见病、多发病及疑难病症的诊治技术,成功抢救了各种多发伤、多发骨折等急诊、危重病人。能够熟练应用各种新型内固定材料手术治疗四肢及关节复杂骨折、复杂骨盆及髋臼骨折、骨不连等,手外伤的急诊手术、关节置换及翻修术、关节镜下手术,以及骨肿瘤、脊柱手术等各类骨科手术、手术治疗效果良好。能够熟练应用DHS、DCS、PFNA、髋动力锁定钢板、各种交锁髓内钉、解剖钢板及Liss钢板治疗四肢及关节复杂骨折、复杂骨盆及髋臼骨折手术、骨不连手术及手外伤的急诊手术、关节置换及翻修术、膝关节镜下半月板切除及交叉韧带重建术,以及骨肿瘤、脊柱手术等各类骨科手术、对创伤骨科微创治疗具有丰富的临床经验。
临床工作经验丰富,具有极为熟练的外科技能,在骨科各领域有较深的造诣。尤其在关节外科方面,已开展全身六大关节的关节镜检查和镜下手术,总体水平在广东领先,率先在广东开展关节镜下膝关节前、后交叉韧带重建术、膝关节半月板修补术、关节内骨折关节镜监视下复位固定术等高难度手术。并已开展四肢大关节的人工关节置换术,被广东省定为人工关节置换术指导专家。在复杂关节畸形的人工关节置换方面颇有研究。
擅长:危重烧伤救治/重度吸入性损伤的救治/小儿重度烧伤救治/严重皮肤撕脱伤及复合伤救治/烧伤瘢痕整复及功能重建/糖尿病足保肢治疗。
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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