scholarly journals Skin Barrier Function and Its Importance at the Start of the Atopic March

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Mary Beth Hogan ◽  
Kathy Peele ◽  
Nevin W. Wilson
Keyword(s):  
Clinical Trials ◽  
Atopic Dermatitis ◽  
Food Allergy ◽  
Immune System ◽  
Barrier Function ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
Allergen Sensitization ◽  
Epidermal Barrier ◽  
Atopic March

Atopic dermatitis can be due to a variety of causes from nonatopic triggers to food allergy. Control of egress of water and protection from ingress of irritants and allergens are key components of cutaneous barrier function. Current research suggests that a degraded barrier function of the skin allows the immune system inappropriate access to environmental allergens. Epidermal aeroallergen exposure may allow sensitization to allergen possibly initiating the atopic march. Further research into connections between epidermal barrier function and possible allergen sensitization will be important to undertake. Future clinical trials focused on skin barrier protection may be of value as a possible intervention in prevention of the initiation of the atopic march.

scholarly journals PEBBLES study protocol: a randomised controlled trial to prevent atopic dermatitis, food allergy and sensitisation in infants with a family history of allergic disease using a skin barrier improvement strategy

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024594 ◽  
Author(s):  
Adrian Lowe ◽  
John Su ◽  
Mimi Tang ◽  
Caroline J Lodge ◽  
Melanie Matheson ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Family History ◽  
Randomised Controlled Trial ◽  
Barrier Function ◽  
Controlled Trial ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
History Of ◽  
Randomised Controlled

IntroductionThe skin is an important barrier against environmental allergens, but infants have relatively impaired skin barrier function. There is evidence that impaired skin barrier function increases the risk of allergic sensitisation, atopic dermatitis (AD) and food allergy. We hypothesise that regular prophylactic use of emollients, particularly those that are designed to improve skin barrier structure and function, will help prevent these conditions. With the aim of determining if application of a ceramide-dominant emollient two times per day reduces the risk of AD and food allergy, we have commenced a multicentre phase III, outcome assessor blinded, randomised controlled trial of this emollient applied from birth to 6 months.Methods and analysisInfants (n=760) with a family history of allergic disease will be recruited from maternity hospitals in Melbourne. The primary outcomes are as follows: the presence of AD, assessed using the UK Working Party criteria, and food allergy using food challenge, in the first 12 months of life as assessed by a blinded study outcome assessor. Secondary outcomes are as follows: food sensitisation (skin prick test), skin barrier function, AD severity, the presence of new onset AD after treatment cessation (between 6 and 12 months) and the presence of parent reported AD/eczema. Recruitment commenced in March 2018.Ethics and disseminationThe PEBBLES Study is approved by the Human Research Ethics Committees of the Royal Children’s Hospital (RCH) (#37090A) and the Mercy Hospital for Women (2018–008). Parents or guardians will provide written informed consent. Outcomes will be disseminated through peer-reviewed publications and presented at scientific conferences.Trial registration numbersACTRN12617001380381 andNCT03667651.

scholarly journals Clinical efficacy of modern emollients in atopic dermatitis: case report

2018 ◽  
Vol 15 (4) ◽  
pp. 76-82
Author(s):  
E V Smolnikov ◽  
A O Litovkina ◽  
O G Elisyutina ◽  
E S Fedenko
Keyword(s):  
Atopic Dermatitis ◽  
Barrier Function ◽  
Immune Therapy ◽  
Skin Irritation ◽  
Treatment Strategies ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
Inflammatory Disorder ◽  
Epidermal Barrier ◽  
Chronic Inflammatory Disorder

Atopic dermatitis is the common chronic inflammatory disorder, characterized by skin irritation, itch, often accompanied by respiratory allergy symptoms - allergic rhinitis and bronchial asthma. AD prevalence varies between 15-30% in children and 2-14% in adults in industrialized countries. The pathophysiology of atopic dermatitis is complex encompassing genetic predisposition to allergy, dysregulation of innate and adaptive immunity and environmental risk factors. Recent genetic and molecular research has focused interest on skin barrier function and it’s role in AD pathogenesis. It has been established that disruption of the epidermal barrier leads to increased permeability of the epidermis, pathological inflammation in the skin, and percutaneous sensitization to allergens. Thus, most novel treatment strategies seek to target immune therapy, repair of epidermal barrier and prevention of sensibilization and atopic march. The article is devoted to skin barrier function disruption in AD and beneficial role of emollients in skin care; clinical case is presented.

scholarly journals The Influence of Microbiome Dysbiosis and Bacterial Biofilms on Epidermal Barrier Function in Atopic Dermatitis—An Update

2021 ◽  
Vol 22 (16) ◽  
pp. 8403
Author(s):  
Leszek Blicharz ◽  
Lidia Rudnicka ◽  
Joanna Czuwara ◽  
Anna Waśkiel-Burnat ◽  
Mohamad Goldust ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Barrier Function ◽  
Biofilm Formation ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
Bacterial Biofilms ◽  
Epidermal Barrier ◽  
Microbial Dysbiosis ◽  
Inflammatory Dermatosis ◽  
Barrier Defect

Atopic dermatitis (AD) is a common inflammatory dermatosis affecting up to 30% of children and 10% of adults worldwide. AD is primarily driven by an epidermal barrier defect which triggers immune dysregulation within the skin. According to recent research such phenomena are closely related to the microbial dysbiosis of the skin. There is growing evidence that cutaneous microbiota and bacterial biofilms negatively affect skin barrier function, contributing to the onset and exacerbation of AD. This review summarizes the latest data on the mechanisms leading to microbiome dysbiosis and biofilm formation in AD, and the influence of these phenomena on skin barrier function.

scholarly journals Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity

2021 ◽  
Vol 10 (2) ◽  
pp. 359 ◽  
Author(s):  
Trinidad Montero-Vilchez ◽  
María-Victoria Segura-Fernández-Nogueras ◽  
Isabel Pérez-Rodríguez ◽  
Miguel Soler-Gongora ◽  
Antonio Martinez-Lopez ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Water Loss ◽  
Barrier Function ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Diagnostic Tools ◽  
Psoriatic Skin ◽  
Skin Barrier Function ◽  
Healthy Controls

Multiple diagnostic tools are used to evaluate psoriasis and atopic dermatitis (AD) severity, but most of them are based on subjective components. Transepidermal water loss (TEWL) and temperature are skin barrier function parameters that can be objectively measured and could help clinicians to evaluate disease severity accurately. Thus, the aims of this study are: (1) to compare skin barrier function between healthy skin, psoriatic skin and AD skin; and (2) to assess if skin barrier function parameters could predict disease severity. A cross-sectional study was designed, and epidermal barrier function parameters were measured. The study included 314 participants: 157 healthy individuals, 92 psoriatic patients, and 65 atopic dermatitis patients. TEWL was significantly higher, while stratum corneum hydration (SCH) (8.71 vs. 38.43 vs. 44.39 Arbitrary Units (AU)) was lower at psoriatic plaques than at uninvolved psoriatic skin and healthy controls. Patients with both TEWL > 13.85 g·m−2h−1 and temperature > 30.85 °C presented a moderate/severe psoriasis (psoriasis area severity index (PASI) ≥ 7), with a specificity of 76.3%. TEWL (28.68 vs. 13.15 vs. 11.60 g·m−2 h−1) and temperature were significantly higher, while SCH (25.20 vs. 40.95 vs. 50.73 AU) was lower at AD eczematous lesions than uninvolved AD skin and healthy controls. Patients with a temperature > 31.75 °C presented a moderate/severe AD (SCORing Atopic Dermatitis (SCORAD) ≥ 37) with a sensitivity of 81.8%. In conclusion, temperature and TEWL values may help clinicians to determine disease severity and select patients who need intensive treatment.

scholarly journals Changes in nano-mechanical properties of human epidermal cornified cells in children with atopic dermatitis

2020 ◽  
Vol 5 ◽  
pp. 97
Author(s):  
Marek Haftek ◽  
Maeve A McAleer ◽  
Ivone Jakasa ◽  
WH Irwin McLean ◽  
Sanja Kezic ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Atopic Dermatitis ◽  
Elastic Modulus ◽  
Barrier Function ◽  
Degradation Products ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
Healthy Children ◽  
Healthy Controls ◽  
Strongly Correlated

Background: Impaired skin barrier is an important etiological factor in atopic dermatitis (AD). The structural protein filaggrin (FLG) plays a major role in maintenance of the competent skin barrier and its deficiency is associated with enhanced susceptibility to mechanical injury. Here we examined biomechanical characteristics of the corneocytes in children with AD and healthy controls. Methods: We recruited 20 children with AD and 7 healthy children. They were genotyped for filaggrin gene (FLG) loss-of-function mutations. Stratum corneum was collected from clinically unaffected skin by adhesive tapes. Cell stiffness (apparent elastic modulus, Ea) was determined by atomic force microscopy and filaggrin degradation products (NMF) by liquid chromatography. Skin barrier function was assessed through trans-epidermal water loss (TEWL) and disease severity by the SCORing Atopic Dermatitis (SCORAD) tool. Results:  Corneocytes collected from AD patients showed a decreased elastic modulus which was strongly correlated with NMF and TEWL, but not with SCORAD. As compared with healthy controls, AD patients had reduced TEWL and NMF levels regardless of FLG mutations. NMF was strongly correlated with TEWL. Conclusion: Our findings demonstrate that AD patients have decreased corneocyte stiffness which correlates with reduced levels of filaggrin degradation products, NMF and skin barrier function. Altered mechanical properties of the corneocytes likely contribute to the loss of mechanical integrity of the SC and to reduced skin barrier function in AD.

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