title: NADPH oxidase enzymes in skin fibrosis: molecular targets and therapeutic agents.
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.
authors.affiliation: Department of Dermatology, University of California at Davis, 3301 C Street, Sacramento, CA 95816, USA.|Dermatology Service, Sacramento VA Medical Center, Mather, CA 95655, USA.
authors.forename: Olubukola
authors.initials: O
authors.lastname: Babalola
authors.affiliation: Department of Dermatology, University of California at Davis, 3301 C Street, Sacramento, CA 95816, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mamalis
authors.affiliation: Department of Dermatology, University of California at Davis, 3301 C Street, Sacramento, CA 95816, USA.|Dermatology Service, Sacramento VA Medical Center, Mather, CA 95655, USA.
authors.forename: Hadar
authors.initials: H
authors.lastname: Lev-Tov
authors.affiliation: Department of Dermatology, University of California at Davis, 3301 C Street, Sacramento, CA 95816, USA.|Dermatology Service, Sacramento VA Medical Center, Mather, CA 95655, USA.|Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY 11203.
authors.forename: Jared
authors.initials: J
authors.lastname: Jagdeo
mesh_terms: D000975:Antioxidants / Q000494:pharmacology; D005355:Fibrosis / Q000188:drug therapy / Q000201:enzymology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D019255:NADPH Oxidases / Q000037:antagonists & inhibitors / Q000378:metabolism*; D018384:Oxidative Stress; D011720:Pyrazoles / Q000494:pharmacology; D047069:Pyrazolones; D011725:Pyridines / Q000494:pharmacology; D011728:Pyridones; D017382:Reactive Oxygen Species / Q000378:metabolism*; D012867:Skin / Q000201:enzymology* / Q000473:pathology*; D012871:Skin Diseases
chemical_list: D000975:Antioxidants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011720:Pyrazoles; D047069:Pyrazolones; D011725:Pyridines; D011728:Pyridones; D017382:Reactive Oxygen Species; C576694:setanaxib; D019255:NADPH Oxidases; C060505:neutrophil cytosolic factor 1