The research team from the Xiangya Hospital Skin Disease Department and the Furong Laboratory of Central South University has introduced new insights into the prevention and treatment of skin diseases in middle-aged and older women. Drawing on nearly a decade of research involving natural populations and specialized skin disease cohorts, alongside the latest international advancements, their findings were published as a special review in the prestigious journal The Lancet on September 25, 2024 (Impact Factor: 98.4). Professors Chen Xiang and Shen Minxue served as corresponding authors, with Associate Researcher Xiao Yi as the first author.
Based on a self-established cohort of natural populations and specialized skin disease research in China, the team has highlighted internationally that early menopause and reduced exposure to endogenous estrogen are significant factors contributing to late-onset psoriasis and psoriatic arthritis in women. This discovery provides a new perspective for achieving precision treatment by identifying these factors as major controllable causes of these conditions.
Renowned scholars, including Professor Vinod Chandran, President of the Canadian Rheumatology Association, have commended this research, emphasizing its importance in understanding the causes and potential interventions for late-onset psoriasis in women. Subsequent studies targeting various late-onset inflammatory skin diseases have revealed that significant hormonal and immune system changes after menopause are key contributors to the peak incidence of conditions like psoriasis and atopic dermatitis. These peaks are closely linked to estrogen stability and decline—a crucial clinical phenomenon that has not been systematically reported before.
Moreover, the review points out that menopause, as a major physiological event in women’s aging, involves complex social and cultural factors that profoundly affect skin health. Therefore, the medical community should broaden its understanding of late-onset inflammatory skin diseases and develop differentiated prevention and treatment strategies for this demographic, aiming to improve overall skin health in middle-aged and older women. This publication not only showcases the research capabilities of Xiangya Hospital in dermatology but also provides a fresh perspective for related fields globally.
Since 2015, the public health team at the Xiangya Hospital Skin Disease Department, led by Professors Chen Xiang and Su Juan, has established a cohort of over 200,000 individuals for studying natural populations and specialized skin diseases. Core team members, including Professor Shen Minxue and Associate Researcher Xiao Yi, have been pioneers in reporting and updating the epidemiological characteristics and disease burden of inflammatory skin diseases like psoriasis, urticaria, and atopic dermatitis in various Chinese populations.
By adopting a comprehensive approach of “establishing cohorts and exploring new causes” alongside “subclassifying conditions and precision treatment”, the team has systematically revealed controllable causes of inflammatory skin diseases. Their research specifically focuses on how environmental exposures influence the development of skin diseases through immune system regulation. They have published over 30 papers in authoritative journals, including J Am Acad Dermatol, Allergy, J Eur Acad Dermatol Venereol, and J Invest Dermatol, shedding light on the common and specific causes of the second peak incidence of diseases like psoriasis.
The team has also introduced a novel theory that metabolic factors play a significant role in driving the second peak of psoriasis, identifying triglycerides and high-density lipoprotein as common causes, while reduced endogenous estrogen serves as a specific factor for women. They have discovered that arsenic exposure is a local cause of chronic itching in older adults and have conducted intervention and evaluation studies on this issue. These findings were recognized in the International Psoriasis Association's top ten papers of 2022 for “Changing Disease Understanding” and have won prestigious awards, including the First Prize for Medical Science and Technology from the Chinese Medical Association. Moving forward, the team aims to conduct clinical intervention studies to translate scientific discoveries into evidence-based practices, ultimately enhancing skin health among the Chinese population.
For the original article, visit: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01711-2/fulltext
(Reviewed by Liu Juan, Li Ruijun, Huang Zhijun)
