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The Skin and Its Antioxidant Defense System:
The Glutathione (GSH) Cycle
Theodore Hersh, MD, MACG
Professor of Medicine, Emeritus, Emory University
Presented at the Health & Beauty Association, June 1998
While the skin provides a protective barrier over the body surface,
it is continuously exposed to various injuries. These insults in
inflammatory responses, including the generation of toxic oxygen
and other free radical species. The skin has a well developed antioxidant
defense system, with L-glutathione (GSH) as the key antioxidant.
Ultraviolet radiation and atmospheric oxygen elicit cutaneous free
radical reactions. Acute ultraviolet injury causes the erythema
we know as sunburn. Chronic exposure leads to early aging of the
skin called photo-aging and increases the risks of developing basal
cell and squamous cell carcinomas. Malignant melanomas are more
closely associated with intense and intermittent sun exposure particularly
during childhood and are related to appearance of melanocytic nevi
in the UV exposed surfaces. Protection with sun blockers and clothing
is paramount. Free radicals are the culprits, while the antioxidants
in the body and in cosmeceutical preparations with all their additional
cosmetic properties are both preventative and reparative of ultraviolet
radiation induced cutaneous damage. This is the most commonly employed
system fitting our seminar's title: Cosmetics as Therapeutics and
Vice Versa.
It is hypothesized that when tissues are exposed to radiation,
energy is absorbed by water contained within the cells resulting
in breakage of the oxygen-hydrogen covalent bonds of the water molecule
leaving hydrogen and hydroxyl radicals. The latter radical is very
reactive with other biomolecules and is responsible for setting
off other free radical chain reactions.
The skin is a highly vascular organ rich in polyunsaturated fatty
acids. When exposed to therapeutic and ultraviolet radiation, plus
other cutaneous damaging environmental pollutants, including tobacco
smoke, a peroxidation reaction of lipids in the skin occurs, releasing
reactive oxygen species, hydroperoxides and other free radical species.
These reactive oxygen species degrade collagen, depolymerize hyaluronic
acid, disrupt cell membranes and cause breaks in DNA resulting in
mutations which increase the risk of developing cutaneous neoplasias.
In order to combat the free radicals, the skin, like other organs,
has a well developed antioxidant system, including reparative and
chain breaking antioxidants. Enzymes include superoxide dismutase
and catalase. The thiol tripeptide, L-glutathione, in its reduced
form (GSH), protects cells against oxidative stress. Since L-glutathione
is itself oxidized in these reactions with free radicals, it must
act in combination with other enzyme systems and cellular antioxidant
molecules in order to be reduced, so that it may renew its role
as a free radical scavenger.
GSH functions co-ordinately with the enzyme glutathione peroxidase
also to break down hydrogen peroxide and lipid hydroperoxides. GSH
peroxidase uses selenium as a co-factor to exert its biological
functions. Also, other selenium compounds together with GSH have
been shown to scavenge oxygen centered radicals. Thus, the most
abundant tissue thiol, GSH, acts synergistically with the other
endogenous antioxidants to scavenge free radicals from biochemical
reactions and from efforts of therapeutic and ultraviolet radiation
and other environmental pollutants.
The exogenous antioxidants, vitamins C and E, are provided from
foodstuffs, vitamin supplements and topical cosmeceuticals. The
former, as ascorbates, repair oxidizing radicals directly as chain
breaking antioxidants and also stimulate synthesis of collagen.
The latter, tocopherols, act also as chain breaking antioxidants
in the process of lipid peroxidation. Vitamin C, a water soluble
molecule, is located in aqueous phases of cells while vitamin E
is in the lipid portion of the cell membranes. However, together
they function synergistically in addition to their metabolic role
in the glutathione-selenium-GSH peroxidase cascade. GSH is vital
in maintaining the ascorbates of vitamin C and the tocopherols of
vitamin E in their reduced form so that these may properly function
as a defensive cycle as the prime antioxidant system in cells and
body fluids.
A partial list of such preparations might include the aforementioned
compositions with the GSH antioxidant complex to repair radiation
damaged skin and help prevent photoaging. Also, with the addition
of sunscreens, the GSH antioxidant preparations may serve to enhance
preventative aspects to "sunburn". In addition, as the
GSH complex combats free radical species generated by various types
of cutaneous injuries such as chemical, radiation and thermal "burns",
including post-cosmetic laser surgery, other wound healing agents
such as zinc compounds and epidermal cell growth factors may be
incorporated in these compositions. Lastly, a number of cosmetics
which are used as adjuncts in management of signs and symptoms of
various desquamating disorders and these with dry and itchy skin
which are also associated with local inflammatory conditions, may
be supplemented for therapeutic properties of the GSH antioxidant
cycle, plus other agents known to ameliorate these associated cutaneous
symptoms.
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