Smoking and skin. Comparison of the appearance, physical qualities, morphology, collagen

81 Pages·2005·2.24 MB·English

SMOKING AND SKIN ANINA
RAITIO
Comparison of the appearance, physical qualities, morphology,
collagen synthesis and extracellular matrix turnover of skin
in smokers and non-smokers Faculty of Medicine,
Department of Dermatology
and Venereology,
University of Oulu
OULU 2005

ANINA RAITIO
SMOKING AND SKIN
Comparison of the appearance, physical qualities,
morphology, collagen synthesis and extracellular matrix
turnover of skin in smokers and non-smokers
Academic Dissertation to be presented with the assent of
the Faculty of Medicine, University of Oulu, for public
discussion in the Auditorium 4 of Oulu University
Hospital, on August 19th, 2005, at 12 noon
OULUN YLIOPISTO, OULU 2005
Copyright © 2005
University of Oulu, 2005
Supervised by
Professor Aarne Oikarinen
Reviewed by
Professor Ilkka Harvima
Professor Veli-Matti Kähäri
ISBN 951-42-7788-0 (nid.)
ISBN 951-42-7789-9 (PDF) http://herkules.oulu.fi/isbn9514277899/
ISSN 0355-3221 http://herkules.oulu.fi/issn03553221/
OULU UNIVERSITY PRESS
OULU 2005
Raitio, Anina, Smoking and skin. Comparison of the appearance, physical qualities,
morphology, collagen synthesis and extracellular matrix turnover of skin in smokers
and non-smokers
Faculty of Medicine, University of Oulu, P.O.Box 5000, FIN-90014 University of Oulu, Finland,
Department of Dermatology and Venereology, University of Oulu, P.O.Box 5000, FIN-90014
University of Oulu, Finland
2005
Oulu, Finland
Abstract
Numerous adverse effects and health problems are associated with smoking, but the mechanisms of
the adverse effects of smoking on skin are not well documented. The aim of the present study was to
elucidate the effects of smoking on the structure, metabolism and appearance of skin.
The study population consisted of 98 Finnish males, of whom 47 were current smokers and 51
non-smokers. The main parameters under evaluation were the appearance and physical qualities of
skin, including skin wrinkling, thickness and elasticity. Biochemical analyses were performed to
assess the rate of type I and III collagen biosynthesis as well as the degradation of the extracellular
matrix (ECM) of skin in terms of matrix metalloproteinase levels (MMPs). To compare the
morphology of skin between the groups, histological and immunohistological studies were
performed, including assessments of the proportional area and width of dermal elastic fibres.
The results revealed decreased synthesis of type I and III collagens in smokers as well as changes
in the regulatory mechanisms which control the turnover of these and other extracellular matrix
proteins. The level of matrix metalloproteinase -8 (collagenase-2), a protease degrading both type I
and type III collagen, in suction blister fluid was significantly higher in smokers, indicating enhanced
degradation of these collagens. In skin tissue samples, the levels of the active forms of MMP-8 and
MMP-9 were significantly lower in smokers compared to non-smokers. Serum levels of MMP-8 were
slightly but not significantly higher in smokers, whereas the levels of the matrix metalloproteinases
MMP-2 and MMP-9 (72-kDa and 92-kDa gelatinase, respectively) were significantly higher in
smokers compared to non-smokers. Salivary MMP-8 and MMP-9 were lower in smokers compared
to non-smokers, but only the latter showed a statistically significant difference. The levels of the
tissue inhibitor of matrix metalloproteinases (TIMP-1) were significantly lower in the suction blister
fluid of smokers compared to non-smokers. In general, there were no significant differences in skin
thickness and elasticity or regeneration of barrier function, nor in the amount or width of elastic fibres
between the groups. We did not observe significant differences in skin wrinkling between smokers
and non-smokers, but smokers looked older than their age compared to non-smokers.
It can be concluded that the rate of type I and III collagen synthesis in skin is decreased and the
regulation of ECM turnover is altered in smokers, which may lead to deterioration of the tensile
strength and resiliency of skin in the long term, even though no morphological changes were detected
in the present study.
Keywords: ageing, collagen, elastin, extracellular matrix, matrix metalloproteinases, skin,
smoking

Acknowledgements
This thesis project was carried out at the Department of Dermatology and Venereology,
University of Oulu, during the years 1998-2005. I wish to express my deepest gratitude to
my supervisor, Professor Aarne Oikarinen, M.D., Ph.D., Head of the Department of
Dermatology and Venereology, for having shared his expertise in the field of connective
tissue research as well as for his patient support and guidance throughout the study. I
would also like to thank Professor Jaakko Karvonen, M.D., Ph.D. for his positive attitude
towards this project.
I am grateful to my co-workers Professor Tuula Salo, D.D.S., Ph.D., from the
Department of Dentistry, Professor Juha Risteli, M.D., Ph.D., from the Department of
Clinical Chemistry, Professor Kirsi Vähäkangas, M.D., Ph.D., from the Department of
Pharmacology and Toxicology, and Docent Matti Kallioinen, M.D., Ph.D, from the
Department of Pathology, all of whom were willing to share their professional expertise
and their experience in scientific work and to help a young researcher with numerous
questions. I am indebted to Professor Timo Sorsa, D.D.S., Ph.D. for his collaboration and
valuable comments.
The reviewers of this work, Professor Ilkka Harvima, M.D., Ph.D. and Professor Veli-
Matti Kähäri, M.D., Ph.D. are thanked for the careful revision and valuable comments on
this work.
I am deeply grateful to all the volunteers who participated in this study. I am thankful
to co-workers Hans Tuomas and Nina Kokkonen from the Department of Dentistry and to
Professor Juha Röning, Dr. Tech., Jukka Kontinen M.Sc. and Mikko Rasi from the
Department of Electrical and Information Engineering as well as to Helmi Wirkkala,
Päivi Annala and Sirpa Kangas for their technical assistance. I also express my gratitude
to Risto Bloigu, M.Sc., for his crucial help in the field of statistics, Ms Sirkka-Liisa
Leinonen, Lic. Phil., for her prompt language revision and Ms Soili Manninen for her
secretarial assistance. I would like to thank Hannu Marjamaa and the staff of the
photography laboratory at Oulu University Hospital for their flexible collaboration
throughout the project. I wish to thank warmly Ms Seija Leskelä for her contribution in
creating graphics of good quality for the publications.
I wish to thank all my colleagues, especially Kirsi-Maria Haapasaari, Riitta Riekki,
and Katriina Lehtinen, for sharing the world of science and the life of a specialising
doctor in the recent years. I would also like to thank chief physician Timo Järvinen, M.D.,
Docent Kaisa Tasanen-Määttä, M.D., Ph.D. and Docent Arto Lahti, M.D., Ph.D. for
supporting my work in both clinical and scientific fields. I express my sincere gratitude to
all my friends, particularly Kati Martikainen, Rita Tarkka and Kaisu Järvinen for sharing
the happy and the sad turns of life with me, and for their interest in the development of
this thesis.
I would like to express my sincere thanks to my mother Maarit Raitio for her love,
patience and guidance in my lifetime. Without her gentle prodding this thesis would have
taken even longer to finish.
My deepest gratitude belongs to my dear husband Trent Fitzgibbon, who has brought
true love and joy into my life and shares my dreams for the future.
This work was financially supported by the University of Oulu, the Finnish Society of
Dermatology and the Finnish Medical Foundation, which are gratefully acknowledged.
Oulu, May 2005 Anina Raitio
Abbreviations
BCC Basal cell carcinoma
COPD Chronic obstructive pulmonary disease
DU Densitometric unit
ECM Extracellular matrix
kDA kilo Dalton
MMP Matrix metalloproteinase
MPa Megapascal
mRNA messenger ribonucleic acid
PINP Aminoterminal propeptide of type I procollagen
PIIINP Aminoterminal propeptide of type III procollagen
P53 53-kilodalton phosphoprotein
RIA Radioimmunoassay
SBF Suction blister fluid
SCC Squamous cell carcinoma
SD Standard deviation
TGF-β Transforming growth factor β
TEWL Transepidermal water loss
TIMP Tissue inhibitor of metalloproteinases
UV Ultraviolet