Topical 11β-Hydroxysteroid Dehydrogenase Type 1 Inhibition Corrects Cutaneous Features of Systemic Glucocorticoid Excess in Female Mice

Endocrinology. 2018 Jan 1;159(1):547-556. doi: 10.1210/en.2017-00607.

Abstract

Glucocorticoid (GC) excess drives multiple cutaneous adverse effects, including skin thinning and poor wound healing. The ubiquitously expressed enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activates mouse corticosterone from 11-dehydrocorticosterone (and human cortisol from cortisone). We previously demonstrated elevated 11β-HSD1 activity during mouse wound healing, but the interplay between cutaneous 11β-HSD1 and systemic GC excess is unexplored. Here, we examined effects of 11β-HSD1 inhibition by carbenoxolone (CBX) in mice treated with corticosterone (CORT) or vehicle for 6 weeks. Mice were treated bidaily with topical CBX or vehicle (VEH) 7 days before wounding and during wound healing. CORT mice displayed skin thinning and impaired wound healing but also increased epidermal integrity. 11β-HSD1 activity was elevated in unwounded CORT skin and was inhibited by CBX. CORT mice treated with CBX displayed 51%, 59%, and 100% normalization of wound healing, epidermal thickness, and epidermal integrity, respectively. Gene expression studies revealed normalization of interleukin 6, keratinocyte growth factor, collagen 1, collagen 3, matrix metalloproteinase 9, and tissue inhibitor of matrix metalloproteinase 4 by CBX during wound healing. Importantly, proinflammatory cytokine expression and resolution of inflammation were unaffected by 11β-HSD1 inhibition. CBX did not regulate skin function or wound healing in the absence of CORT. Our findings demonstrate that 11β-HSD1 inhibition can limit the cutaneous effects of GC excess, which may improve the safety profile of systemic steroids and the prognosis of chronic wounds.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • 11-beta-Hydroxysteroid Dehydrogenase Type 1 / antagonists & inhibitors*
  • 11-beta-Hydroxysteroid Dehydrogenase Type 1 / metabolism
  • Administration, Topical
  • Animals
  • Anti-Inflammatory Agents / poisoning
  • Carbenoxolone / administration & dosage
  • Carbenoxolone / adverse effects
  • Carbenoxolone / therapeutic use*
  • Corticosterone / blood
  • Corticosterone / pharmacokinetics
  • Corticosterone / poisoning*
  • Cytokines / antagonists & inhibitors
  • Cytokines / genetics
  • Cytokines / metabolism
  • Drug Eruptions / drug therapy*
  • Drug Eruptions / etiology
  • Drug Eruptions / metabolism
  • Drug Eruptions / pathology
  • Enzyme Inhibitors / administration & dosage
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use*
  • Epidermis / drug effects
  • Epidermis / immunology
  • Epidermis / metabolism
  • Epidermis / pathology
  • Extracellular Matrix / drug effects
  • Extracellular Matrix / immunology
  • Extracellular Matrix / metabolism
  • Extracellular Matrix / pathology
  • Female
  • Gene Expression Profiling
  • Gene Expression Regulation / drug effects
  • Glucocorticoids / blood
  • Glucocorticoids / pharmacokinetics
  • Glucocorticoids / poisoning*
  • Granulation Tissue / drug effects
  • Granulation Tissue / immunology
  • Granulation Tissue / metabolism
  • Granulation Tissue / pathology
  • Mice, Hairless
  • Organ Size / drug effects
  • Skin / drug effects*
  • Skin / injuries
  • Skin / metabolism
  • Skin / pathology
  • Wound Healing / drug effects

Substances

  • Anti-Inflammatory Agents
  • Cytokines
  • Enzyme Inhibitors
  • Glucocorticoids
  • 11-beta-Hydroxysteroid Dehydrogenase Type 1
  • Carbenoxolone
  • Corticosterone