Enhancement of stratum corneum lipid structure improves skin barrier function and protects against irritation in adults with dry, eczema-prone skin

被引:38
作者
Danby, Simon G. [1 ]
Andrew, Paul, V [1 ]
Kay, Linda J. [1 ]
Pinnock, Abigail [1 ]
Chittock, John [1 ]
Brown, Kirsty [1 ]
Williams, Samuel F. [1 ]
Cork, Michael J. [1 ,2 ,3 ]
机构
[1] Univ Sheffield, Med Sch, Sheffield Dermatol Res, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England
[2] Sheffield Childrens NHS Fdn Trust, Sheffield Childrens Hosp, Western Bank, Sheffield, S Yorkshire, England
[3] Sheffield Teaching Hosp NHS Fdn Trust, Royal Hallamshire Hosp, Sheffield, S Yorkshire, England
关键词
TRANSEPIDERMAL WATER-LOSS; PERMEABILITY BARRIER; VITAMIN-E; CERAMIDE; MICROSCOPY; MUTATIONS; HYDRATION;
D O I
10.1111/bjd.20955
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background The skin of patients with atopic dermatitis is characterized by abnormal stratum corneum lipid levels. Consequently, the lamellar matrices are disrupted and skin barrier function is diminished, increasing skin sensitivity to irritants and allergens. Objectives To determine whether a cream containing ceramides, triglycerides and cholesterol in a multivesicular emulsion can reinforce the skin barrier and protect against skin irritation. Methods A randomized observer-blind intrapatient-controlled study in 34 adults with dry, eczema-prone skin was conducted. Each participant underwent 4 weeks of treatment with the test cream on one forearm and lower leg and a reference emollient cream on the other. Skin properties were determined before and after treatment. Lipid structure was assessed by Fourier-transform infrared spectroscopy using a novel interface. Results Skin barrier integrity was greater at sites treated with the test cream [effect size for area under the transepidermal water loss curve -162, 95% confidence interval (CI) -206 to -118]. Skin sensitivity to sodium lauryl sulfate was reduced (-0.5 points visual redness, 97.57% CI -1.00 to -0.25), as was transepidermal water loss (-15.3 g m(-2) h(-1), 95% CI -20.3 to -10.4) compared with the reference. Sites treated with the test cream displayed enhanced lipid chain ordering, which was significantly associated with skin barrier integrity (r = 0.61). Compared with the reference, treatment with the test cream increased hydration (8.61 capacitance units, 95% CI 6.61-10.6) and decreased signs of dryness. Conclusions The test cream facilitates skin barrier restoration and protects the skin from dryness and irritation. Compared with a commonly prescribed emollient in the UK, the test cream is highly suited to the management of dry, sensitive skin.
引用
收藏
页码:875 / 886
页数:12
相关论文
共 37 条
  • [1] Distinct barrier integrity phenotypes in filaggrin-related atopic eczema following sequential tape stripping and lipid profiling
    Angelova-Fischer, Irena
    Mannheimer, Anna-Clara
    Hinder, Anke
    Ruether, Andreas
    Franke, Andre
    Neubert, Reinhard H. H.
    Fischer, Tobias W.
    Zillikens, Detlef
    [J]. EXPERIMENTAL DERMATOLOGY, 2011, 20 (04) : 351 - 356
  • [2] Opposing effects of glycerol on the protective function of the horny layer against irritants and on the penetration of hexyl nicotinate
    Bettinger, J
    Gloor, M
    Peter, C
    Kleesz, P
    Fluhr, J
    Gehring, W
    [J]. DERMATOLOGY, 1998, 197 (01) : 18 - 24
  • [3] Bikowski Joseph, 2006, J Drugs Dermatol, V5, P942
  • [4] Modulation of atopy patch test reactions by topical treatment of human skin with a fatty acid-rich emollient
    Billmann-Eberwein, C
    Rippke, F
    Ruzicka, T
    Krutmann, J
    [J]. SKIN PHARMACOLOGY AND APPLIED SKIN PHYSIOLOGY, 2002, 15 (02): : 100 - 104
  • [5] In vivo assessment of cytological changes by means of reflectance confocal microscopy - demonstration of the effect of topical vitamin E on skin irritation caused by sodium lauryl sulfate
    Casari, Alice
    Farnetani, Francesca
    De Pace, Barbara
    Losi, Amanda
    Pittet, Jean-Christophe
    Pellacani, Giovanni
    Longo, Caterina
    [J]. CONTACT DERMATITIS, 2017, 76 (03) : 131 - 137
  • [6] The Extent of Orthorhombic Lipid Phases in the Stratum Corneum Determines the Barrier Efficiency of Human Skin In Vivo
    Damien, Fabienne
    Boncheva, Mila
    [J]. JOURNAL OF INVESTIGATIVE DERMATOLOGY, 2010, 130 (02) : 611 - 614
  • [7] A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier
    Danby, S. G.
    Chalmers, J.
    Brown, K.
    Williams, H. C.
    Cork, M. J.
    [J]. BRITISH JOURNAL OF DERMATOLOGY, 2016, 175 (05) : 1011 - 1019
  • [8] The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis
    Danby, S. G.
    Chittock, J.
    Brown, K.
    Albenali, L. H.
    Cork, M. J.
    [J]. BRITISH JOURNAL OF DERMATOLOGY, 2014, 170 (04) : 914 - 921
  • [9] An Investigation of the Skin Barrier Restoring Effects of a Cream and Lotion Containing Ceramides in a Multi-vesicular Emulsion in People with Dry, Eczema-Prone, Skin: The RESTORE Study Phase 1
    Danby, Simon G.
    Andrew, Paul V.
    Brown, Kirsty
    Chittock, John
    Kay, Linda J.
    Cork, Michael J.
    [J]. DERMATOLOGY AND THERAPY, 2020, 10 (05) : 1031 - 1041
  • [10] Di Nardo A, 1998, ACTA DERM-VENEREOL, V78, P27