Genetics of cellulite could inform new treatments

The group led by Dr Enzo Emanuele at the University of Pavia, Italy, has identified a number of genes that differ between women who suffer from cellulite and those who don’t.

Focusing on the genetic makeup of the condition, he says, is a new way of looking at treatment, and has immense implications for the cosmetics industry.

​“We need to treat cellulite in an evidence-based manner and the company that understands this concept will have great marketing advantages over competitors,”​ he told CosmeticsDesign.com USA.

Two genetic variants ​

Emanuele and the team performed genetic association studies on 400 lean healthy women, 200 of whom suffered from cellulite and 200 hundred who did not. In the course of the study, the team noted that genetic variants in ACE and the H1F1A gene are associated with cellulite in healthy women.

The ACE variant associated with the cellulite results in higher levels of ACE (Angiotensin Converting Enzyme) in the serum and tissue. The authors explained that ultimately, these higher enzyme levels could alter the blood flow in the fat tissue just under the skin’s surface, as well as leading to an abnormal proliferation of cells, and an altered architecture of the tissue.

“This in turn would result in the formation of the complex network of hypodermal fibrous strands that characterizes cellulite,”​ the authors wrote.

For Emanuele, one possible treatment could be the topical application of an ACE inhibitor.

“A well designed, evidence-based clinical trial is necessary to confirm or refute this hypothesis. If the results are positive, this would be the first example of an evidence-based approach to cellulite treatment based on the physiological understanding of cellulite,”​ he said.

Ideally, he said, this inhibitor should be a pharmacological agent that is known to inhibit ACE, for example captopril, formulated in a simple cream.

ACE inhibitors such as captopril taken orally are often used to treat hypertension, but according to Emanuele there is evidence that applied topically they can help treat some skin disorders such as keloids (abnormal scar formation), therefore suggesting the active ingredient successfully crosses the skin barrier.

Genetic testing to predict response to treatment​

However, even if successful such an approach may not be a viable option for all cellulite sufferers.

The response to treatment could depend on the genetic makeup of the individual and Emanuele said his team were currently working on the development of a biomarker that could help treatment based on genetic targeting.

A second gene, H1F1 was found to be associated with the development of cellulite in lean healthy women and Emanuele said these findings could be important for ozone therapy or carboxitherapy.

Source: Journal of the European Academy of Dermatology and Venereology​
2010 doi:10.1111/j.1468-3083.2009.03556.x
A multilocus candidate approach identifies ACE and HIF1A as susceptibility genes for cellulite​
E Emanuele, M Bertona, D Geroldi