title: Targeting the vitamin D endocrine system (VDES) for the management of inflammatory and malignant skin diseases: An historical view and outlook.
abstract: Vitamin D represents one of the major driving factors for the development of life on earth and for human evolution. While up to 10-20 % of the human organism's requirements in vitamin D can be obtained by the diet (under most living conditions in the USA and Europe), approximately 90 % of all needed vitamin D has to be photosynthesized in the skin through the action of the sun (ultraviolet-B (UV-B)). The skin represents a key organ of the human body's vitamin D endocrine system (VDES), being both the site of vitamin D synthesis and a target tissue for biologically active vitamin D metabolites. It was shown that human keratinocytes possess the enzymatic machinery (CYP27B1) for the synthesis of the biologically most active natural vitamin D metabolite 1,25-dihydroxyvitamin D3(1,25(OH)2D3), representing an autonomous vitamin D3pathway. Cutaneous production of 1,25(OH)2D3may exert intracrine, autocrine, and paracrine effects on keratinocytes and on neighboring cells. Many skin cells (including keratinocytes, sebocytes, fibroblasts, melanocytes, and skin immune cells) express the vitamin D receptor (VDR), an absolute pre-requisite for the mediation of genomic effects of 1,25(OH)2D3and analogs. VDR belongs to the superfamily of trans-acting transcriptional regulatory factors, which includes the steroid and thyroid hormone receptors as well as the retinoid X receptors (RXR) and retinoic acid receptors (RAR). Numerous studies, including cDNA microarray analyses of messenger RNAs (mRNAs), indicate that as many as 500-1000 genes may be regulated by VDR ligands that control various cellular functions including growth, differentiation, and apoptosis. The observation that 1,25(OH)2D3is extremely effective in inducing the terminal differentiation and in inhibiting the proliferation of cultured human keratinocytes has resulted in the use of vitamin D analogs for the treatment of psoriasis. This review gives an historical view and summarizes our present knowledge about the relevance of the VDES for the management of inflammatory and malignant skin diseases.
authors.affiliation: Center for Clinical and Experimental Photo-Dermatology and Department of Dermatology, The Saarland University Hospital, Kirrbergerstr, 66421, Homburg, Germany. Joerg.reichrath@uks.eu.
authors.forename: Jörg
authors.initials: J
authors.lastname: Reichrath
authors.affiliation: Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany.
authors.forename: Christos C
authors.initials: CC
authors.lastname: Zouboulis
authors.affiliation: Center for Clinical and Experimental Photo-Dermatology and Department of Dermatology, The Saarland University Hospital, Kirrbergerstr, 66421, Homburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogt
authors.affiliation: Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center, 85 E Newton St M-1013, Boston, MA, 02118, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Holick
mesh_terms: D004703:Endocrine System / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000378:metabolism*; D018167:Receptors, Calcitriol / Q000378:metabolism*; D012867:Skin / Q000378:metabolism*; D012871:Skin Diseases / Q000188:drug therapy / Q000378:metabolism*; D012878:Skin Neoplasms / Q000188:drug therapy / Q000378:metabolism*; D014807:Vitamin D / Q000378:metabolism*
chemical_list: D018167:Receptors, Calcitriol; D014807:Vitamin D
keywords: Melanoma; Psoriasis; Skin; Skin cancer; Skin diseases; Vitamin D; Vitamin D endocrine system; Vitamin D receptor