Die Rolle der Hormone für die Hautalterung - Aktuelle Aspekte

Zusammenfassung

Die intrinsische Hautalterung spiegelt Abbauprozesse wider, die auch in anderen Körperorganen stattfinden. Hormone sind maßgeblich am Prozess der intrinsischen Alterung beteiligt, der mit einer verminderten Sekretion hypophysärer, adrenaler und gonadaler Hormone einhergeht. Man verbringt aktuell ein Drittel des Lebens (Frauen - Menopause) bzw. mindestens 20 Jahre (Männer - PADAM) unter Östrogen- bzw. Androgenmangel. Weitere Hormone, die mit zunehmendem Alter abnehmen sind Melatonin, Wachstumshormon (GH), Dehydroepiandrosteron und Insulin-like-Growth-Factor-l (IGF-I). Bei den Frauen nimmt neben den Östrogenen auch das Progesteron in der Menopause ab. Da Progesteron die Androgene kontrolliert, kommt es mit zunehmendem Alter bei den Frauen zu einem relativen peripheren Hyperandrogenismus. Eine partielle Prävention oder Unterbrechung des intrinsischen Hautalterungsprozesses ist nach der aktuellen Datenlage durch eine Östrogensubstitution in der Menopause realisierbar. Bei der männlichen Seneszenz sind weitere umfangreiche Untersuchungen notwendig, bevor der klinische Einsatz einer hormonellen Substitution empfohlen werden kann. Erste Hinweise sprechen für einen positiven Einfluss der Testosteron-Substitution bei Männern mit sekundärem Hypogonadismus. Allerdings vermehren sich die Daten darüber, dass GH und IGF-I die eigentlich vom Testosteron erwartete Rolle beim alternden Mann übernehmen. IGF-I scheint dabei bei beiden Geschlechtern eine zentrale Rolle zu spielen. Da die Haut nicht nur eine schützende Funktion für den Organismus hat, sondern auch ein aktives peripheres endokrines Organ ist, das sogar wirksame Hormone im Kreislauf freisetzt, könnten lokale Substitutionswege in der Zukunft interessant werden.

Abstract

Intrinsic skin ageing reflects degradation processes, which also take place in other body organs. Hormones are substantially involved in the process of intrinsic ageing, which occurs along with reduced secretion of pituitary, adrenal and gonadal hormones. One third of human life (women - menopause) or at least 20 years (men - PADAM) run under estrogen or androgen deficiency. Further hormones, which are reduced with advancing age are melatonin, growth hormone (GH), dehydroepiandrosterone and insulin-like growth factor I (IGF-I). Besides estrogens, progesterone is also reduced in menopause. Since progesterone controls the androgens, a relative peripheral hyperandrogenism occurs with advancing age. Partial prevention or interruption of the intrinsic skin ageing process can be achieved by hormonal substitution, however this is currently not widely practicable due the current data status. Further extensive studies of the male senescence are required before hormonal substitution can be recommended. First data hint on a positive influence of testosterone substitution among men with secondary hypogonadism. Accumulating data indicate that GH and IGF I overtake the role expected for testosterone in ageing male. IGF-I actually seems to play a central role in the ageing process in both sexes. Since the skin has not only a protective function for the human organism but is also an active peripheral endocrine organ, which even releases active hormones in the circulation, topical hormonal substitution may become an interesting regimen in the future.

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