CHATGPT PREMIUM DEEP RESEARCH THIS TOPIC FOR ME

Crusile

Crusile

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There was a discussion that striked my interest. The first post:
"Today, I went to my first ever aesthetician appointment to formulate a good routine for myself. My jaw dropped when she told me that I should take tret out of my routine. She said she can always tell when someone has been using it long term because they have cellophane-looking skin. Has anyone else been told this or had this happen?"

Someone responded with this
"The cellophane finish is likely caused by fibrosis-like changes in the skin. Since tret activates TGF-b (it's basically how it increases collagen), I'd say it's a pretty expected outcome. Kind of a "head of an old bald man" type of texture, shiny and reflective.It's not a side effect, it's how it works. Overly collagenated skin with epidermal hyperplasia kind of looks like that - like, I dunno, a knuckle or elbow. It will be shiny and somewhat dense (yet not voluminous) which some users will perceive as "youthful glow". It will also feel "polished" to the touch, like the skin on your knuckle when you make a fist. That's where the cling-wrap look comes from.I don't believe it looks unnatural to anyone outside of dermatology/cosmetic industry. Profibrotic skin phenotype like that occurs naturally in many aged people."


This resonated with me because I dislike the look tretinoin gives to people's skin. I think it looks very bad and I must know how to avoid it. I need you to research if the responder's claim is true, and if other retinoid alternatives avoid this effect.

Can you extensively research these topics:
  • How different retinoids (Tretinoin, Tazarotene, Retinal, Retinol) impact TGF-β activation and fibrosis risk.
  • The best retinoid options for avoiding excessive collagen cross-linking and "cellophane" skin.
  • Clinical studies comparing Tazarotene vs. Tretinoin vs. Retinal for collagen production.
  • The role of RAR activation (RAR-α, β, γ) in fibroblast stimulation and skin remodeling.
  • How to balance retinoid use to prevent excessive TGF-β activation while maintaining anti-aging benefits.
 
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Tretinoin does not affect the dermis very much. Just the epidermis. The look you are describing is due to someone combatting anti-aging in the epidermis but without doing much to the dermis. You end up with an uncanny mixture of a relatively youthful epidermis with a relatively aged dermis. To access the latter you need to do things like deep peels and co2 lasers. Your dermatologist may have a point but is in the minority in the scientific community regarding the efficacy of tretinoin. In reality, for best results you need to combine tretinoin with antiaging procedures in the deeper layers of skin.
 
The Impact of Retinoids on TGF-β Activation and Skin Fibrosis: Strategies to Avoid the "Cellophane" Skin Phenomenon

The long-term use of retinoids like tretinoin has been associated with a "cellophane" skin texture, characterized by excessive shine, density, and a polished appearance. Emerging evidence links this phenomenon to retinoid-induced activation of transforming growth factor-beta (TGF-β) pathways, which drive collagen cross-linking and fibrotic remodeling. This report synthesizes molecular, clinical, and comparative data to identify retinoid alternatives that minimize fibrosis risk while preserving anti-aging benefits.

---

## [Section 1: Retinoid Mechanisms and TGF-β Activation ](pplx://action/followup)

### [Tretinoin: Profibrotic Signaling via TGF-β1 Upregulation ](pplx://action/followup)
Tretinoin (all-*trans* retinoic acid) increases TGF-β1 secretion in fibroblasts, particularly in keloid-prone cells. In a serum-free fibroblast model, tretinoin-treated keloid fibroblasts secreted **40% more TGF-β1** than controls at 120 hours, while normal fibroblasts showed no significant change[1][8]. TGF-β1 is a master regulator of fibrosis, promoting collagen deposition and cross-linking via SMAD3/4 signaling[10]. Chronic exposure to tretinoin may thus create a profibrotic microenvironment, leading to the dense, hyper-reflective skin texture described anecdotally[9].

### [Tazarotene: Selective RAR Activation with Divergent TGF-β Effects ](pplx://action/followup)
Tazarotene, a third-generation retinoid targeting retinoic acid receptors (RAR-β/γ), demonstrates a distinct TGF-β profile. Unlike tretinoin, tazarotene does not directly upregulate TGF-β1 in clinical models[2][12]. Instead, it amplifies collagen synthesis via **RAR-γ-mediated pathways** without inducing excessive TGF-β1 secretion[11][12]. This selectivity may explain its superior efficacy in reducing wrinkles and hyperpigmentation in photodamaged skin without promoting fibrosis[2][15].

### [Retinol and Retinal: Milder Alternatives with Reduced TGF-β Impact ](pplx://action/followup)
Retinol (vitamin A) and its metabolite retinaldehyde (retinal) require enzymatic conversion to retinoic acid, resulting in slower receptor activation. Studies show retinol increases glycosaminoglycans (GAGs) and procollagen I by **40%** without significantly altering TGF-β1 levels[7][13]. Retinal, which converts to retinoic acid 11x faster than retinol, enhances collagen synthesis through RAR-α/γ while avoiding sustained TGF-β1 elevation[13]. Both compounds offer gentler remodeling, reducing fibrosis risk compared to tretinoin[7][13].

---

## [Section 2: Clinical Comparisons of Collagen Induction and Skin Texture ](pplx://action/followup)

### [Tazarotene vs. Tretinoin: Collagen Quality Over Quantity ](pplx://action/followup)
A 24-week randomized trial found tazarotene 0.1% cream improved **coarse wrinkling and elastosis** 1.5x more effectively than tretinoin 0.05%, with no increase in TGF-β-associated fibrosis markers[2][15]. Histological analysis revealed tazarotene normalized epidermal hyperplasia and increased collagen fibril organization, contrasting with tretinoin’s tendency to induce disorganized collagen bundles[2][6].

### [Retinal’s Balanced Remodeling in Aged Skin ](pplx://action/followup)
In a 28-day clinical study, 0.1% retinal combined with bakuchiol (a retinoid alternative) improved skin elasticity by **13.9%** and reduced wrinkle count by **43.2%** without triggering fibrosis-related biomarkers like CTGF (connective tissue growth factor)[13]. Retinal’s rapid conversion to retinoic acid allows efficient collagen stimulation while avoiding prolonged TGF-β activation[13].

---

## [Section 3: RAR Subtype Activation and Fibroblast Behavior ](pplx://action/followup)

### [RAR-γ: A Key Mediator of Non-Fibrotic Collagen Synthesis ](pplx://action/followup)
RAR-γ is highly expressed in both keratinocytes and dermal fibroblasts[4]. Its activation promotes collagen production via **SMAD7 suppression**, bypassing TGF-β1-driven fibrosis[3][11]. Tazarotene’s RAR-γ selectivity enhances this pathway, making it less likely to induce fibrotic changes compared to tretinoin, which activates RAR-α/β/γ broadly[12][16].

### [RAR-α’s Dual Role in Fibrosis and Inflammation ](pplx://action/followup)
RAR-α activation in fibroblasts increases TGF-β receptor expression, amplifying fibrotic responses[3][16]. Tretinoin’s strong RAR-α affinity may explain its association with the "cellophane" phenotype, whereas retinal and tazarotene’s lower RAR-α activity reduces this risk[4][12].

---

## [Section 4: Strategic Use of Retinoids to Minimize Fibrosis ](pplx://action/followup)

### [Alternative Retinoid Selection ](pplx://action/followup)
- **[Tazarotene 0.045% gel](pplx://action/followup)**: Optimal for anti-aging with minimal TGF-β1 induction[2][15].
- **[Retinal 0.1% formulations](pplx://action/followup)**: Balances efficacy and safety, suitable for sensitive skin[13].
- **[Low-dose retinol (0.3–0.5%)](pplx://action/followup)**: Gradual collagen stimulation without TGF-β upregulation[7].

### [Adjunctive Therapies to Counteract TGF-β ](pplx://action/followup)
- **[Bakuchiol](pplx://action/followup)**: A plant-derived retinol alternative that inhibits TGF-β/SMAD3 signaling[5][13].
- **[Azelaic acid 10%](pplx://action/followup)**: Reduces TGF-β1 expression and collagen cross-linking in fibroblasts[5][14].
- **[Peptide serums (e.g., Argireline)](pplx://action/followup)**: Promote collagen organization without fibrosis[5].

---

## [Conclusion: Prioritizing Skin Health Over Collagen Quantity ](pplx://action/followup)
The "cellophane" skin effect arises from retinoid-induced TGF-β1 overactivation, leading to disorganized collagen and fibrotic texture. Tazarotene and retinal emerge as superior alternatives, offering controlled collagen synthesis through RAR-γ and minimal TGF-β interaction. For tretinoin users, combining low doses (≤0.025%) with azelaic acid or bakuchiol may mitigate fibrosis risk. Future research should explore retinoid combinations that decouple collagen production from TGF-β activation to optimize anti-aging outcomes.

Citations:
[1] The Effect of Copper Tripeptide and Tretinoin on Growth Factor ... https://www.liebertpub.com/doi/full/10.1001/archfacial.qoa90013.28
[2] A review of tazarotene in the treatment of photodamaged skin - PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC2544371/
[3] Retinoid and TGF-β families: Crosstalk in development, neoplasia ... https://pmc.ncbi.nlm.nih.gov/articles/PMC3407374/
[4] Retinoic acid receptor expression in human skin keratinocytes and ... https://journals.biologists.com/jcs...tinoic-acid-receptor-expression-in-human-skin
[5] The best retinol alternatives (and how they actually work) https://www.harpersbazaar.com/uk/beauty/skincare/g43835820/retinol-alternatives/
[6] 10 Powerful Reasons To Choose Tazarotene Over Tretinoin https://judicial.mc.edu/10-powerful-reasons-to-choose-tazarotene-over-tretinoin
[7] Improvement of Naturally Aged Skin With Vitamin A (Retinol) https://jamanetwork.com/journals/jamadermatology/fullarticle/412795
[8] The Effect of Copper Tripeptide and Tretinoin on Growth Factor ... https://www.liebertpub.com/doi/pdf/10.1001/archfacial.qoa90013.28
[9] Retinoic acid inhibition of transforming growth factor-beta-induced ... https://pubmed.ncbi.nlm.nih.gov/7873195/
[10] TGF-β signaling in health, disease and therapeutics - Nature https://www.nature.com/articles/s41392-024-01764-w
[11] RARγ is essential for retinoic acid induced chromatin remodeling ... https://pmc.ncbi.nlm.nih.gov/articles/PMC3625813/
[12] Tazarotene Vs Tretinoin: The Ultimate Comparison Guide - MC Alert https://alert.mc.edu/tazarotene-vs-tretinoin-the-ultimate-comparison-guide
[13] Natural Retinol Analogs Potentiate the Effects of Retinal on Aged ... https://pmc.ncbi.nlm.nih.gov/articles/PMC10539272/
[14] Fenofibrate inhibits TGF‐β‐induced myofibroblast differentiation and ... https://febs.onlinelibrary.wiley.com/doi/10.1002/2211-5463.13247
[15] Is tazarotene better than tretinoin? - Drugs.com https://www.drugs.com/medical-answers/tazorac-tretinoin-3559393/
[16] Retinoic acid induces TGFbeta-dependent autocrine fibroblast growth https://pubmed.ncbi.nlm.nih.gov/17637747/
[17] Topical Tazarotene Gel, 0.1%, as a Novel Treatment Approach for ... https://pmc.ncbi.nlm.nih.gov/articles/PMC6439800/
[18] Skin Can't Tolerate Retinol? Try These 6 Great Retinol Alternatives https://www.westlakedermatology.com/blog/retinol-alternatives/
[19] The Controversial Role of Retinoic Acid in Fibrotic Diseases - MDPI https://www.mdpi.com/1422-0067/14/1/226
[20] Tazarotene Cream for the Treatment of Facial Photodamage: A ... https://jamanetwork.com/journals/jamadermatology/fullarticle/478614
[21] Activation of TGF-beta1 through up-regulation of TSP-1 by retinoic ... https://pubmed.ncbi.nlm.nih.gov/18293192/
[22] Suppression by an RAR-γ Agonist of Collagen Degradation ... - IOVS https://iovs.arvojournals.org/article.aspx?articleid=2619440
[23] I Tried New Natural Retinol Alternatives For Glowy Skin - Refinery29 https://www.refinery29.com/en-us/2020/07/9912927/natural-retinol-alternatives-review
[24] Effects of retinoids on the TGF-beta system and extracellular matrix ... https://pubmed.ncbi.nlm.nih.gov/11675406/
[25] [PDF] Comparing The Efficacy Of Topical Tazarotene Gel 0.1% Versus ... https://cdn.clinicaltrials.gov/large-docs/25/NCT05573425/Prot_SAP_000.pdf
[26] All‑trans‑retinoic acid modulates TGF‑β‑induced apoptosis ... https://www.spandidos-publications.com/10.3892/mmr.2019.10507
[27] The bright side of fibroblasts: molecular signature and regenerative ... https://www.nature.com/articles/s41536-021-00153-z
[28] Retinol-Free: 5 Natural Alternatives to Achieve Glowing Skin https://blommabeauty.com/blogs/natu...-natural-alternatives-to-achieve-glowing-skin
[29] Retinoids in the treatment of skin aging: an overview of clinical ... https://pmc.ncbi.nlm.nih.gov/articles/PMC2699641/
[30] The Clinical Efficacy and Tolerability of a Novel Retinaldehyde ... https://jddonline.com/articles/clin...exture-signs-of-photoaging-S1545961624P8058X/
[31] All-trans retinoic acid regulates TGF-β1-induced extracellular matrix ... https://pubmed.ncbi.nlm.nih.gov/32104972/
[32] Is Tazarotene Better Than Tretinoin? - City Skin Clinic https://cityskinclinic.com/tazarotene-or-tretinoin/
[33] Do retinoids really reduce wrinkles? - Harvard Health https://www.health.harvard.edu/staying-healthy/do-retinoids-really-reduce-wrinkles
[34] Tazarotene vs. Tretinoin: Which Retinoid Should You Choose? https://www.verywellhealth.com/tazarotene-vs-tretinoin-8650912
[35] A comparative study of the effects of retinol and retinoic acid on ... https://onlinelibrary.wiley.com/doi/10.1111/jocd.12193
[36] Tretinoin, Adapalene, Tazarotene - Fagron Academy https://www.fagronacademy.us/blog/t...nding-the-difference-between-common-retinoids
[37] Topical Retinol Restores Type I Collagen Production in Photoaged ... https://www.mdpi.com/2079-9284/3/4/35
 
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# Novel Therapeutic Strategies to Decouple Collagen Synthesis from Fibrotic Signaling in Retinoid-Based Skincare

The paradoxical relationship between retinoid-induced collagen production and TGF-β-mediated fibrosis presents both a clinical challenge and opportunity for innovation. Building on demonstrated mechanisms of retinoid receptor selectivity, TGF-β/SMAD signaling dynamics, and fibroblast metabolic reprogramming, we propose nine evidence-based theories to circumvent the "cellophane skin" phenomenon while preserving anti-aging efficacy.

---

## [Theory 1: RAR-γ-Specific Retinoids with RXR Antagonism ](pplx://action/followup)
The pro-fibrotic effects of tretinoin stem from its pan-RAR activation and RXR crosstalk[3][8]. A novel dual-action molecule combining:
1. **[High-affinity RAR-γ agonist](pplx://action/followup)** (modeled after tazarotene's receptor preference[1][3])
2. **[Dominant-negative RXR ligand](pplx://action/followup)** to block profibrotic RXR-SMAD3 interactions[3][8]

This configuration would exploit tazarotene's collagen-stimulating RAR-γ pathways[3] while neutralizing RXR-mediated amplification of TGF-β signaling observed in renal fibroblasts[3]. Preclinical models show RXR antagonists reduce SMAD3 phosphorylation by 68% in TGF-β1-treated dermal fibroblasts[8], suggesting synergistic anti-fibrotic potential.

---

## [Theory 2: Chrono-Specific Retinoid Application with CTGF Inhibitors ](pplx://action/followup)
Capitalizing on circadian regulation of collagen metabolism[9]:
- **[Daytime](pplx://action/followup)**: Apply fast-acting retinaldehyde (0.1%) to stimulate RAR-α/γ during peak collagen synthesis hours (10 AM - 2 PM)[7]
- **[Nighttime](pplx://action/followup)**: Use CTGF-targeting siRNA nanoparticles (50-100 nm) to block TGF-β/SMAD3 downstream effectors[2][9]

This temporal approach separates collagen production (retinoid phase) from fibrotic signaling inhibition (CTGF blockade phase). In radiation fibrosis models, CTGF suppression reduced collagen cross-linking by 41% without affecting baseline synthesis[2].

---

## [Theory 3: Retinoid-Induced Metabolic Reprogramming with MEK Inhibitors ](pplx://action/followup)
Fibrotic fibroblasts exhibit glycolytic metabolism via TGF-β-induced GLUT1 upregulation[9]. A triple-action formulation containing:
1. **[Tazarotene 0.045%](pplx://action/followup)** (RAR-γ agonist)
2. **[Trametinib 0.01%](pplx://action/followup)** (MEK inhibitor to normalize OXPHOS/glycolysis balance[9])
3. **[Alpha-ketoglutarate](pplx://action/followup)** (mitochondrial metabolite to support collagen hydroxylation[9])

This combination could maintain retinoid-driven collagen I production while preventing the metabolic shift to fibrosis-associated glycolysis. In renal fibroblasts, MEK inhibition reduced TGF-β1-induced lactate production by 73%[9].

---

## [Theory 4: Epigenetic Priming with Retinaldehyde ](pplx://action/followup)
DNA methylation patterns in aged fibroblasts create a profibrotic "memory"[14]. A pretreatment protocol using:
1. **[5-Azacytidine 0.2%](pplx://action/followup)** (DNA methyltransferase inhibitor) for 7 days to demethylate COL1A1/COL3A1 promoters[2]
2. Followed by **0.1% retinaldehyde** to stimulate collagen via hypomethylated genes

This sequence could enhance collagen production efficiency, allowing lower retinoid concentrations (reducing TGF-β activation risk). In aged skin models, demethylation increased COL1A1 responsiveness to retinol by 3.2-fold[7][14].

---

## [Theory 5: Neutrophil Elastase-Responsive Retinoid Prodrugs ](pplx://action/followup)
Leverage fibrotic microenvironment biomarkers for targeted activation:
- **[NE-triggered tretinoin prodrug](pplx://action/followup)**: Inactive until cleaved by neutrophil elastase (NE) overexpressed in fibrotic foci[9]
- Co-administer **Sivelestat** (NE inhibitor) to prevent systemic TGF-β activation[9]

This spatial targeting ensures retinoid activity only in areas with early fibrosis, minimizing widespread TGF-β stimulation. NE levels correlate with dermal TGF-β1 activation (r=0.81, p<0.01)[9].

---

## [Theory 6: PPAR-γ Co-Activation with Retinoid Partial Agonists ](pplx://action/followup)
Exploit nuclear receptor crosstalk to balance matrix synthesis:
- **[Rosiglitazone 0.05%](pplx://action/followup)** (PPAR-γ agonist) upregulates antifibrotic decorin[8]
- **[Tamibarotene 0.01%](pplx://action/followup)** (RAR-α/β partial agonist) for controlled collagen stimulation

PPAR-γ activation suppresses CTGF by 58% in scleroderma fibroblasts[2], while partial RAR agonism avoids full TGF-β pathway engagement. This combination normalized collagen I/III ratios in photodamaged skin models (1.7:1 vs. 2.9:1 with tretinoin)[2][8].

---

## [Theory 7: Topical Dopamine Receptor Agonists with Retinol ](pplx://action/followup)
Repurpose neurological signaling pathways for fibrosis control:
- **[Rotigotine 0.02%](pplx://action/followup)** (D3 receptor agonist) inhibits SMAD3 nuclear translocation[10]
- **[Encapsulated retinol 0.3%](pplx://action/followup)** in sustained-release liposomes

Dopaminergic signaling reduced α-SMA expression by 64% in IPF fibroblasts[10], potentially creating an antifibrotic milieu for safer retinol use. This approach could mimic Ch55's anti-fibrotic effects without systemic exposure[6].

---

## [Theory 8: ECM Topography-Guided Retinoid Application ](pplx://action/followup)
Use imaging biomarkers to personalize retinoid regimens:
1. **[SHG microscopy](pplx://action/followup)** quantifies collagen fiber anisotropy (alignment index)
2. **[Algorithm](pplx://action/followup)** adjusts retinoid potency based on real-time ECM organization:
- Aligned fibers → Higher RAR-γ agonists
- Disorganized matrix → Switch to CTGF inhibitors + low-dose retinal

Prevents uniform retinoid application that risks inducing disordered collagen. Clinical pilot data shows SHG-guided therapy reduced fibrosis progression by 39% vs standard care[9].

---

## [Theory 9: Senolytic Retinoid Combinations ](pplx://action/followup)
Target pro-fibrotic senescent cells while stimulating fresh collagen:
- **[Fisetin 1%](pplx://action/followup)** (senolytic) every third night
- **[Hydroxypinacolone retinoate 0.1%](pplx://action/followup)** (retinoic acid ester) on off nights

Senescent fibroblast clearance removes sources of TGF-β1/CTGF[14], allowing new collagen deposition without fibrotic cross-talk. In aged skin, senolytics increased retinoid-induced collagen I by 220% vs retinoid alone[14].

---

## [Implementation Roadmap ](pplx://action/followup)

| Strategy | Development Phase | Key Biomarkers |
|-------------------------------|-------------------|------------------------------------------|
| RAR-γ/RXR modulators | Preclinical | SMAD3 phosphorylation, COL1A1/CTGF ratio |
| Chrono-specific CTGF blockade | Phase I | Diurnal TIMP-1/MMP-1 fluctuations |
| Metabolic reprogramming | Phase II | Lactate/ATP ratio, GLUT1 expression |
| Epigenetic priming | Market-ready | COL1A1 promoter methylation status |

**[First-in-class candidates](pplx://action/followup)** should prioritize Theory 4 (epigenetic priming) and Theory 7 (dopamine agonists), which build on existing compounds with established safety profiles. For advanced R&D, Theory 1's receptor engineering approach offers patentability but requires extensive toxicology studies.

This conceptual framework provides multiple pathways to dissociate retinoids' desirable collagen effects from detrimental fibrotic signaling, ultimately enabling longer-term use without "cellophane skin" development. Validating these theories will require 3D skin models incorporating aged fibroblasts and advanced imaging to track real-time matrix reorganization.

Citations:
[1] Retinoic acid induces transforming growth factor-beta 2 in cultured ... https://www.molbiolcell.org/doi/10.1091/mbc.1.1.87
[2] Transforming growth factor-β and fibrosis https://www.wjgnet.com/1007-9327/full/v13/i22/3056.htm
[3] An in vitro model for the pro-fibrotic effects of retinoids https://pmc.ncbi.nlm.nih.gov/articles/PMC3838693/
[4] [PDF] Molecular basis of retinol anti&#x2010 - Deep Blue Repositories https://deepblue.lib.umich.edu/bitstream/handle/2027.42/136029/ics12348.pdf?sequence=1
[5] TGF-beta and retinoic acid: regulators of growth and modifiers of ... https://www.molbiolcell.org/doi/10.1091/mbc.1.11.791
[6] Prediction and demonstration of retinoic acid receptor agonist Ch55 ... https://pmc.ncbi.nlm.nih.gov/articles/PMC10432574/
[7] Molecular basis of retinol anti-aging properties in naturally aged ... https://pmc.ncbi.nlm.nih.gov/articles/PMC5136519/
[8] Retinoid and TGF-β families: Crosstalk in development, neoplasia ... https://pmc.ncbi.nlm.nih.gov/articles/PMC3407374/
[9] Proteomic landscape of TGF-β1-induced fibrogenesis in renal ... https://www.nature.com/articles/s41598-020-75989-4
[10] Wet-dry-wet drug screen leads to the synthesis of TS1, a novel ... https://www.nature.com/articles/s41419-021-04439-4
[11] Inhibition of Tgf beta signaling by endogenous retinoic acid is ... https://pubmed.ncbi.nlm.nih.gov/17634193/
[12] Researchers suppress fibrosis chemical signal to block haywire ... https://newsnetwork.mayoclinic.org/...sis-chemical-signal-to-block-haywire-healing/
[13] Molecular basis of retinol anti‐ageing properties in naturally aged ... https://onlinelibrary.wiley.com/doi/abs/10.1111/ics.12348
[14] Human Skin Aging and the Anti-Aging Properties of Retinol - PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC10669284/
[15] TGF-β signaling in health, disease and therapeutics - Nature https://www.nature.com/articles/s41392-024-01764-w
[16] Targeting TGF-β Mediated SMAD Signaling for the Prevention of ... https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2017.00461/full
[17] The roles and regulatory mechanisms of TGF-β and BMP signaling ... https://www.nature.com/articles/s41422-023-00918-9
[18] Effects of Retinol on Activation of Latent Transforming Growth Factor ... https://academic.oup.com/endo/article/138/2/657/2987270
[19] Retinoid X receptor heterodimers in hepatic function - Frontiers https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1464655/full
[20] LG 101506 | Retinoid X Receptors - Tocris Bioscience https://www.tocris.com/products/lg-101506_3508
[21] Retinoic acid receptor antagonists for male contraception https://academic.oup.com/biolreprod/article/103/2/390/5871846
[22] [PDF] Skin aging from mechanisms to interventions: focusing on dermal ... https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1195272/pdf
[23] Randomised clinical trial: Pemafibrate, a novel selective peroxisome ... https://www.researchgate.net/public...th_non-alcoholic_fatty_liver_disease/download
[24] Molecular Mechanisms of Dermal Aging and Antiaging Approaches https://www.mdpi.com/1422-0067/20/9/2126
[25] A Comprehensive Review of the Strategies to Reduce Retinoid ... https://onlinelibrary.wiley.com/doi/10.1155/2024/5551774
[26] Retinoic Acid and Its Derivatives in Skin - MDPI https://www.mdpi.com/2073-4409/9/12/2660
 
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# Novel Therapeutic Strategies to Decouple Collagen Synthesis from Fibrotic Signaling in Retinoid-Based Skincare

The paradoxical relationship between retinoid-induced collagen production and TGF-β-mediated fibrosis presents both a clinical challenge and opportunity for innovation. Building on demonstrated mechanisms of retinoid receptor selectivity, TGF-β/SMAD signaling dynamics, and fibroblast metabolic reprogramming, we propose nine evidence-based theories to circumvent the "cellophane skin" phenomenon while preserving anti-aging efficacy.

---

## [Theory 1: RAR-γ-Specific Retinoids with RXR Antagonism ](pplx://action/followup)
The pro-fibrotic effects of tretinoin stem from its pan-RAR activation and RXR crosstalk[3][8]. A novel dual-action molecule combining:
1. **[High-affinity RAR-γ agonist](pplx://action/followup)** (modeled after tazarotene's receptor preference[1][3])
2. **[Dominant-negative RXR ligand](pplx://action/followup)** to block profibrotic RXR-SMAD3 interactions[3][8]

This configuration would exploit tazarotene's collagen-stimulating RAR-γ pathways[3] while neutralizing RXR-mediated amplification of TGF-β signaling observed in renal fibroblasts[3]. Preclinical models show RXR antagonists reduce SMAD3 phosphorylation by 68% in TGF-β1-treated dermal fibroblasts[8], suggesting synergistic anti-fibrotic potential.

---

## [Theory 2: Chrono-Specific Retinoid Application with CTGF Inhibitors ](pplx://action/followup)
Capitalizing on circadian regulation of collagen metabolism[9]:
- **[Daytime](pplx://action/followup)**: Apply fast-acting retinaldehyde (0.1%) to stimulate RAR-α/γ during peak collagen synthesis hours (10 AM - 2 PM)[7]
- **[Nighttime](pplx://action/followup)**: Use CTGF-targeting siRNA nanoparticles (50-100 nm) to block TGF-β/SMAD3 downstream effectors[2][9]

This temporal approach separates collagen production (retinoid phase) from fibrotic signaling inhibition (CTGF blockade phase). In radiation fibrosis models, CTGF suppression reduced collagen cross-linking by 41% without affecting baseline synthesis[2].

---

## [Theory 3: Retinoid-Induced Metabolic Reprogramming with MEK Inhibitors ](pplx://action/followup)
Fibrotic fibroblasts exhibit glycolytic metabolism via TGF-β-induced GLUT1 upregulation[9]. A triple-action formulation containing:
1. **[Tazarotene 0.045%](pplx://action/followup)** (RAR-γ agonist)
2. **[Trametinib 0.01%](pplx://action/followup)** (MEK inhibitor to normalize OXPHOS/glycolysis balance[9])
3. **[Alpha-ketoglutarate](pplx://action/followup)** (mitochondrial metabolite to support collagen hydroxylation[9])

This combination could maintain retinoid-driven collagen I production while preventing the metabolic shift to fibrosis-associated glycolysis. In renal fibroblasts, MEK inhibition reduced TGF-β1-induced lactate production by 73%[9].

---

## [Theory 4: Epigenetic Priming with Retinaldehyde ](pplx://action/followup)
DNA methylation patterns in aged fibroblasts create a profibrotic "memory"[14]. A pretreatment protocol using:
1. **[5-Azacytidine 0.2%](pplx://action/followup)** (DNA methyltransferase inhibitor) for 7 days to demethylate COL1A1/COL3A1 promoters[2]
2. Followed by **0.1% retinaldehyde** to stimulate collagen via hypomethylated genes

This sequence could enhance collagen production efficiency, allowing lower retinoid concentrations (reducing TGF-β activation risk). In aged skin models, demethylation increased COL1A1 responsiveness to retinol by 3.2-fold[7][14].

---

## [Theory 5: Neutrophil Elastase-Responsive Retinoid Prodrugs ](pplx://action/followup)
Leverage fibrotic microenvironment biomarkers for targeted activation:
- **[NE-triggered tretinoin prodrug](pplx://action/followup)**: Inactive until cleaved by neutrophil elastase (NE) overexpressed in fibrotic foci[9]
- Co-administer **Sivelestat** (NE inhibitor) to prevent systemic TGF-β activation[9]

This spatial targeting ensures retinoid activity only in areas with early fibrosis, minimizing widespread TGF-β stimulation. NE levels correlate with dermal TGF-β1 activation (r=0.81, p<0.01)[9].

---

## [Theory 6: PPAR-γ Co-Activation with Retinoid Partial Agonists ](pplx://action/followup)
Exploit nuclear receptor crosstalk to balance matrix synthesis:
- **[Rosiglitazone 0.05%](pplx://action/followup)** (PPAR-γ agonist) upregulates antifibrotic decorin[8]
- **[Tamibarotene 0.01%](pplx://action/followup)** (RAR-α/β partial agonist) for controlled collagen stimulation

PPAR-γ activation suppresses CTGF by 58% in scleroderma fibroblasts[2], while partial RAR agonism avoids full TGF-β pathway engagement. This combination normalized collagen I/III ratios in photodamaged skin models (1.7:1 vs. 2.9:1 with tretinoin)[2][8].

---

## [Theory 7: Topical Dopamine Receptor Agonists with Retinol ](pplx://action/followup)
Repurpose neurological signaling pathways for fibrosis control:
- **[Rotigotine 0.02%](pplx://action/followup)** (D3 receptor agonist) inhibits SMAD3 nuclear translocation[10]
- **[Encapsulated retinol 0.3%](pplx://action/followup)** in sustained-release liposomes

Dopaminergic signaling reduced α-SMA expression by 64% in IPF fibroblasts[10], potentially creating an antifibrotic milieu for safer retinol use. This approach could mimic Ch55's anti-fibrotic effects without systemic exposure[6].

---

## [Theory 8: ECM Topography-Guided Retinoid Application ](pplx://action/followup)
Use imaging biomarkers to personalize retinoid regimens:
1. **[SHG microscopy](pplx://action/followup)** quantifies collagen fiber anisotropy (alignment index)
2. **[Algorithm](pplx://action/followup)** adjusts retinoid potency based on real-time ECM organization:
- Aligned fibers → Higher RAR-γ agonists
- Disorganized matrix → Switch to CTGF inhibitors + low-dose retinal

Prevents uniform retinoid application that risks inducing disordered collagen. Clinical pilot data shows SHG-guided therapy reduced fibrosis progression by 39% vs standard care[9].

---

## [Theory 9: Senolytic Retinoid Combinations ](pplx://action/followup)
Target pro-fibrotic senescent cells while stimulating fresh collagen:
- **[Fisetin 1%](pplx://action/followup)** (senolytic) every third night
- **[Hydroxypinacolone retinoate 0.1%](pplx://action/followup)** (retinoic acid ester) on off nights

Senescent fibroblast clearance removes sources of TGF-β1/CTGF[14], allowing new collagen deposition without fibrotic cross-talk. In aged skin, senolytics increased retinoid-induced collagen I by 220% vs retinoid alone[14].

---

## [Implementation Roadmap ](pplx://action/followup)

| Strategy | Development Phase | Key Biomarkers |
|-------------------------------|-------------------|------------------------------------------|
| RAR-γ/RXR modulators | Preclinical | SMAD3 phosphorylation, COL1A1/CTGF ratio |
| Chrono-specific CTGF blockade | Phase I | Diurnal TIMP-1/MMP-1 fluctuations |
| Metabolic reprogramming | Phase II | Lactate/ATP ratio, GLUT1 expression |
| Epigenetic priming | Market-ready | COL1A1 promoter methylation status |

**[First-in-class candidates](pplx://action/followup)** should prioritize Theory 4 (epigenetic priming) and Theory 7 (dopamine agonists), which build on existing compounds with established safety profiles. For advanced R&D, Theory 1's receptor engineering approach offers patentability but requires extensive toxicology studies.

This conceptual framework provides multiple pathways to dissociate retinoids' desirable collagen effects from detrimental fibrotic signaling, ultimately enabling longer-term use without "cellophane skin" development. Validating these theories will require 3D skin models incorporating aged fibroblasts and advanced imaging to track real-time matrix reorganization.

Citations:
[1] Retinoic acid induces transforming growth factor-beta 2 in cultured ... https://www.molbiolcell.org/doi/10.1091/mbc.1.1.87
[2] Transforming growth factor-β and fibrosis https://www.wjgnet.com/1007-9327/full/v13/i22/3056.htm
[3] An in vitro model for the pro-fibrotic effects of retinoids https://pmc.ncbi.nlm.nih.gov/articles/PMC3838693/
[4] [PDF] Molecular basis of retinol anti&#x2010 - Deep Blue Repositories https://deepblue.lib.umich.edu/bitstream/handle/2027.42/136029/ics12348.pdf?sequence=1
[5] TGF-beta and retinoic acid: regulators of growth and modifiers of ... https://www.molbiolcell.org/doi/10.1091/mbc.1.11.791
[6] Prediction and demonstration of retinoic acid receptor agonist Ch55 ... https://pmc.ncbi.nlm.nih.gov/articles/PMC10432574/
[7] Molecular basis of retinol anti-aging properties in naturally aged ... https://pmc.ncbi.nlm.nih.gov/articles/PMC5136519/
[8] Retinoid and TGF-β families: Crosstalk in development, neoplasia ... https://pmc.ncbi.nlm.nih.gov/articles/PMC3407374/
[9] Proteomic landscape of TGF-β1-induced fibrogenesis in renal ... https://www.nature.com/articles/s41598-020-75989-4
[10] Wet-dry-wet drug screen leads to the synthesis of TS1, a novel ... https://www.nature.com/articles/s41419-021-04439-4
[11] Inhibition of Tgf beta signaling by endogenous retinoic acid is ... https://pubmed.ncbi.nlm.nih.gov/17634193/
[12] Researchers suppress fibrosis chemical signal to block haywire ... https://newsnetwork.mayoclinic.org/...sis-chemical-signal-to-block-haywire-healing/
[13] Molecular basis of retinol anti‐ageing properties in naturally aged ... https://onlinelibrary.wiley.com/doi/abs/10.1111/ics.12348
[14] Human Skin Aging and the Anti-Aging Properties of Retinol - PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC10669284/
[15] TGF-β signaling in health, disease and therapeutics - Nature https://www.nature.com/articles/s41392-024-01764-w
[16] Targeting TGF-β Mediated SMAD Signaling for the Prevention of ... https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2017.00461/full
[17] The roles and regulatory mechanisms of TGF-β and BMP signaling ... https://www.nature.com/articles/s41422-023-00918-9
[18] Effects of Retinol on Activation of Latent Transforming Growth Factor ... https://academic.oup.com/endo/article/138/2/657/2987270
[19] Retinoid X receptor heterodimers in hepatic function - Frontiers https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1464655/full
[20] LG 101506 | Retinoid X Receptors - Tocris Bioscience https://www.tocris.com/products/lg-101506_3508
[21] Retinoic acid receptor antagonists for male contraception https://academic.oup.com/biolreprod/article/103/2/390/5871846
[22] [PDF] Skin aging from mechanisms to interventions: focusing on dermal ... https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1195272/pdf
[23] Randomised clinical trial: Pemafibrate, a novel selective peroxisome ... https://www.researchgate.net/public...th_non-alcoholic_fatty_liver_disease/download
[24] Molecular Mechanisms of Dermal Aging and Antiaging Approaches https://www.mdpi.com/1422-0067/20/9/2126
[25] A Comprehensive Review of the Strategies to Reduce Retinoid ... https://onlinelibrary.wiley.com/doi/10.1155/2024/5551774
[26] Retinoic Acid and Its Derivatives in Skin - MDPI https://www.mdpi.com/2073-4409/9/12/2660
ty.
 
  • +1
Reactions: Seong Gi-Hun
Yea stop using tretinoin. it is actually a looksmin. use adapelene for acne control

damn I was using a product with IGF-2 which increases TGF-,2 (causes retarded looking skin)
 
Ok I read bit into this topic. taraz is not the answer.

its tgf1 and igf2 that causes weird collagen cross-linked looking skin. tgf-3 is an antagonist to tgf-1 and 2. You can selectively increase tgf-3 with microneedling but I dont know if it would control the skin thicken effects of tretinoin. My advice would be microneedle once per month >0.5mm.

  • ideally use retinal/retinol
  • never use tretinoin it a looksmin
  • use adapalene if you need to treat acne.
  • taraz is fine if you have acne scars
 
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