Skin Microbiome Compositional Changes in Atopic Dermatitis Accompany Dead Sea Climatotherapy

Dead Sea climatotherapy (DSC) is a well‐established therapeutic modality for the treatment of several diseases, including atopic dermatitis. Skin microbiome studies have shown that skin microbiome diversity is anticorrelated with both atopic dermatitis severity and concurrent Staphylococcus aureus overgrowth. This study aimed to determine whether DSC induces skin microbiome changes concurrent with clinical improvements in atopic dermatitis. We sampled 35 atopic dermatitis patients and ten healthy controls on both the antecubital and popliteal fossa. High‐resolution microbial community profiling was attained by sequencing multiple regions of the 16S rRNA gene. Dysbiosis was observed in both lesional and nonlesional sites, which was partially attenuated following treatment. Severe AD skin underwent the most significant community shifts, and Staphylococcus epidermidis, Streptococcus mitis and Micrococcus luteus relative abundance were significantly affected by Dead Sea climatotherapy. Our study highlights the temporal shifts of the AD skin microbiome induced by Dead Sea climatotherapy and offers potential explanations for the success of climatotherapy on a variety of skin diseases, including AD.     

Effect of cyclodextrin on allergic action of the PiCl-induced in NC/Nga mice

Itching dermatitis, which is very similar to human atopic dermatitis, arises spontaneously in NC/Nga mice. Changes in lesional skin and the plasma concentration of IgE during the development of atopic dermatitis-like disease up to 8 weeks after the start of picryl chloride (PiCl) in NC/Nga mice were examined. In the mice which atopic dermatitis had been induced, 28-day administration of α cyclodextrin (α CD) significantly inhibited aggravation of detmatitis without having effects on body weight. Clinical signs and symptoms seen in PiCl treated NC/Nga mice began with erythema and haemorrhage, following oedema, superficial erosion, deep excoriation, scaling and dryness of the skin. An increase was observed in the number of mast cells and eosinophil infiltration in the lesional skin. Almost human patients with nasal inflammation or bronchial asthmatics symptoms disappeared by oral administration of α CD (5 mg/day) for 2 month. These results suggest that α CD is useful for treatment of human atopic dermatitis.     

Therapeutic effects of recombinant Salmonella typhimurium harboring CCL22 miRNA on atopic dermatitis-like skin in mice

Th-2-biased immune responses are known to play a key role in the pathogenesis of atopic dermatitis. In particular, the macrophage-derived chemokine CCL22 is directly implicated in Th-2-associated skin inflammatory reactions, and its levels are significantly elevated in serum and are correlated with disease severity in atopic dermatitis. In this study, we tested the development of genetic therapeutic options to treat atopic dermatitis using bacteria expressing miRNA. We constructed a recombinant strain of Salmonella typhimurium expressing CCL22 miRNA (ST-miRCCL22) for the in vivo knockdown of CCL22. The CCL22 gene was downregulated with CCL22 miRNA in activated lymphocytes. In mice with a cutaneous disease similar to atopic dermatitis, interleukin-4 was inhibited and interferon-g was induced after treatments with ST-miRCCL22. Furthermore, CCL22 levels were suppressed in the atopic mice treated with ST-miRCCL22. These results suggest that ST-miRCCL22 may be an effective genetic agent for treating atopic dermatitis.     

Quantification of free fatty acids in human stratum corneum using tandem mass spectrometry and surrogate analyte approach

The free fatty acids (FFAs) are one of the major components of the lipids in the stratum corneum (SC), the uppermost layer of the skin. Relative composition of FFAs has been proposed as a biomarker of the skin barrier status in patients with atopic dermatitis (AD). Here, we developed an LC‐ESI‐MS/MS method for simultaneous quantification of a range of FFAs with long and very long chain length in the SC collected by adhesive tape (D‐Squame). The method, based on derivatization with 2‐bromo‐1‐methylpyridinium iodide and 3‐carbinol‐1‐methylpyridinium iodide, allowed highly sensitive detection and quantification of FFAs using multiple reaction monitoring. For the quantification, we applied a surrogate analyte approach and internal standardization using isotope labeled derivatives of FFAs. Adhesive tapes showed the presence of several FFAs, which are also present in the SC, a problem encountered in previous studies. Therefore, the levels of FFAs in the SC were corrected using C12:0, which was present on the adhesive tape, but not detected in the SC. The method was applied to SC samples from patients with atopic dermatitis and healthy subjects. Quantification using multiple reaction monitoring allowed sufficient sensitivity to analyze FFAs of chain lengths C16–C28 in the SC collected on only one tape strip.     

Dead Sea Minerals loaded polymeric nanoparticles

Therapeutic properties of Dead Sea Water (DSW) in the treatment of skin diseases such as atopic dermatitis, psoriasis and photo aging UV damaged skin have been well established. DSW is in fact rich in minerals such as calcium, magnesium, sodium, potassium, zinc and strontium which are known to exploit anti-inflammatory effects and to promote skin barrier recovery. In order to develop a Dead Sea Minerals (DSM) based drug delivery system for topical therapy of skin diseases, polymeric nanoparticles based on Poly (maleic anhydride-alt-butyl vinyl ether) 5% grafted with monomethoxy poly(ethyleneglycol) 2000 MW (PEG) and 95% grafted with 2-methoxyethanol (VAM41-PEG) loaded with DSM were prepared by means of a combined miniemulsion/solvent evaporation process. The resulting nanoparticles were characterized in terms of dimension, morphology, biocompatibility, salt content and release. Cytocompatible spherical nanoparticles possessing an average diameter of about 300 nm, a time controlled drug release profile and a high formulation yield were obtained.     

Glycoproteomic analysis of plasma from patients with atopic dermatitis: CD5L and ApoE as potential biomarkers

Atopic dermatitis (AD) is an inflammatory skin disorder that is both uncomfortable and distressing to patients, and its prevalence has been steadily increasing. It is obvious that the identification of efficient markers of AD in plasma would offer the possibility of effective diagnosis, prevention, and treatment strategies. In this study, a proteomic approach was used to analyze plasma glycoproteins from both children with AD and healthy child donors. Several protein spots showing significant quantitative changes in the AD patients were identified. Through sequential studies, it was confirmed that CD5L and ApoE were significantly up-regulated or down-regulated, respectively, in the plasma from AD patients compared with that from healthy donors. In addition, we suggest that the up-regulated CD5L in AD patients causes eosinophilia by inhibiting apoptosis or promoting the proliferation of eosinophils either in combination with or without IL-5. The glycoproteomic data in this study provides clues to understanding the mechanism of atopic alterations in plasma and suggests AD-related proteins can be used as candidate markers for AD.     

Sunflower trypsin inhibitor (SFTI-1) analogues of synthetic and biological origin via N→S acyl transfer: potential inhibitors of human Kallikrein-5 (KLK5)

Sunflower Trypsin Inhibitor (SFTI-1) analogues have been prepared from simple linear precursors produced either by chemical synthesis or following purification from Escherichia coli. We have shown, for the first time that these linear SFTI-1 derived peptide sequences can be converted to circular peptides via selective consecutive acyl transfer reactions, and that the products derived from synthetic and bacterial origin are identical. Preliminary analysis of the semi-synthetic SFTI-1 analogues confirmed SFTI-I10H as an inhibitor of Kallikrein-5 (KLK5) protease that could also mediate its action on human keratinocytes. The preliminary results obtained serve as a useful starting point for the biological production of SFTI-1 based, selective KLK5 inhibitors for the treatment of atopic dermatitis.     

Analysis and Stability Study of Octyl Nicotinate in Aqueous Solutions and Skin Homogenate by LC

Octyl nicotinate is an ester prodrug which is under development for delivery of nicotinic acid to skin for treatment and prevention of dermatological conditions that involve skin barrier impairment such as chronic photodamage and atopic dermatitis or for mitigating skin barrier impairment that results from therapy such as retinoids or steroids. We report here an isocratic RF-LC method with water/acetonitrile (10:90, v/v) as a mobile phase, for the rapid analysis of octyl nicotinate in aqueous solutions. The method was validated in terms of linearity, precision, accuracy and mean recovery of octyl nicotinate from skin homogenate ranging from 98.8 to 102.6%. Separation and quantification of amounts as low as 0.25 μg mL^?1 octyl nicotinate was accomplished. The kinetic of degradation of octyl nicotinate in aqueous solution at 310, 333, 343, and 353 K was studied. The hydrolysis rate constants for degradation of octyl nicotinate in phosphate buffer and skin homogenate were reported. This method will be effective for routine analysis of octyl nicotinate stability in different formulations in future studies.     

Therapeutic Effects of Full Spectrum Light on the Development of Atopic Dermatitis‐like Lesions in NC/Nga Mice

Full spectrum light (FSL) includes UVA, visible light and infrared light. Many studies have investigated the application of FSL in severe cases of atopic dermatitis (AD) in humans; however, FSL has not yet been studied in an animal model. The purpose of this study was to evaluate the therapeutic effects of FSL on AD‐like skin lesions using NC/Nga mice, with the aim of mitigating itching and attenuating the expression of adhesion molecules. We examined the effects of FSL on mite allergen‐treated NC/Nga mice by assessing skin symptom severity, ear thickness, serum IgE levels, and the cytokine expression. We examined the histology of lesions using hematoxylin–eosin, toluidine blue and immunohistochemical staining. Our findings suggest that FSL phototherapy exerts positive therapeutic effects on Dermatophagoides farinae (Df)‐induced AD‐like skin lesions in NC/Nga mice by reducing IgE levels, thus promoting recovery of the skin barrier. The mechanisms by which FSL phototherapy exerts its effects may also involve the inhibition of scratching behavior, reduction of IL‐6 levels and reductions in adhesion molecule expression. The present study indicates that FSL phototherapy inhibits the development of AD in NC/Nga mice by suppressing cytokine, chemokine and adhesion molecule expression, and thus, could potentially be useful in treating AD.     

Study of interactions between Gallic Acid and Skin Surface using Infrared Spectroscopy

The transdermal transmission of model substance on the pigskin samples was investigated using the attenuated total reflection (ATR) technique of infrared (IR) spectroscopy. The collected vibrational spectroscopic data were evaluated by multidimensional statistical methods as principal component analysis (PCA), linear discriminant analysis (LDA) and partial least squares (PLS) regression which enable detection of individual substances in the skin, their identification and mutual differentiation. Gallic acid (GA), a natural phenolic anti-oxidant with many potential healing properties suitable e.g. for atopic dermatitis treatment, was used as an analyte. Effect of GA on the skin surface was examined for four different solvents namely ethanol (EtOH), methanol (MeOH), dimethyl sulfoxide (DMSO) and ultrahigh purity water (H₂O). Moreover, the effects of temperature related to GA solubility in H₂O were investigated. During the series of experiments, nonsystematic changes of untreated skin samples were observed; while systematic changes are evident after the skin treatment. The systematic effects correspond to structural changes of the skin constituents during substance penetration.     

Topical application of Scutellaria baicalensis suppresses 2,4-dinitrochlorobenzene-induced contact dermatitis

Allergic contact dermatitis (ACD) is a prototypic T-cell-mediated cutaneous inflammatory response. In the present study we describe the anti-allergic effect of topically applied Scutellaria bacalensis aqueous extract (WSBE) in suppressing 2,4-dinitrochlorobenzene (DNCB)-induced ACD in BALB/c mice. Topically applied WSBE attenuated the epidermal thickness and mast cell infiltration into the skin in DNCB-induced contact dermatitis. Furthermore, WSBE suppressed DNCB-induced production of serum IgE as well as IL-4, IFN-γ, and TNF-α in the skin. Topical application of WSBE also ameliorated the significant decrease in dermal glutathione and superoxide dismutase levels. Moreover, present results demonstrated that the baicalin, bioactive compound of WSBE, was able to penetrate into the skin following topical application, which was confirmed by the HPLC analysis using rat model. Taken together, topical application of WSBE exerts beneficial effects in contact dermatitis model, suggesting that WSBE might be a candidate for the treatment of contact dermatitis.     

α‐methylene‐γ‐butyrolactones: versatile skin bioactive natural products

Natural products containing an α‐methylene‐γ‐butyrolactone moiety, mainly of the sesquiterpene type, are widely observed in plants, which upon coming into contact with skin, will induce major skin toxicological side effects or phytodermatitis. Indeed two main dermatological pathologies have been associated with a skin exposure to molecules containing an α‐methylene‐γ‐butyrolactone moiety: allergic contact dermatitis (ACD) and chronic actinic dermatitis (CAD). ACD is an immunologically based disease resulting from modifications of epidermal proteins by sensitizers or haptens. Indeed, α‐methylene‐γ‐butyrolactones are highly electrophilic structures that can act as Michael acceptors towards nucleophilic residues of proteins. Cysteine and lysine are the most modified residues leading, in the case of enantiomerically pure lactones, to the formation of diastereomeric adducts. This chemical enantioselectivity induces an enantiospecificity of the allergic reaction, i.e., an individual sensitized to one enantiomer will not develop clinical symptoms when exposed to the other enantiomer and vice versa. Sesquiterpene lactones have been also associated with another pathology that involves UV irradiation and DNA modifications. Interestingly, it was found that α‐methylene‐γ‐butyrolactones, in addition to their electrophilic properties, were highly photoreactive molecules able to react with thymine/thymidine to form [2 + 2] photoadducts in very high yields. In all cases a syn regioselectivity was observed, probably associated with the polarization of the exomethylenic bond. This high photoreactivity of α‐methylene‐γ‐butyrolactones towards thymidine could be an explanation of the progressive evolution of allergic contact dermatitis towards chronic actinic dermatitis. © 2009 The Japan Chemical Journal Forum and Wiley Periodicals, Inc. Chem Rec 9: 000–000; 2009: Published online in Wiley InterScience ( www.interscience.wiley.com ) DOI 10.1002/tcr.200900013     

Wikstroemiaganpi Extract Improved Atopic Dermatitis-Like Skin Lesions via Suppression of Interleukin-4 in 2,4-Dinitrochlorobenzene-Induced SKH-1 Hairless Mice

Plants of the genus Wikstroemia are used in Chinese traditional medicine to treat inflammatory diseases, such as arthritis, bronchitis, and pneumonia. The present study was designed to determine whether Wikstroemia ganpi (Siebold and Zucc.) Maxim. offers a potential means of treating 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis (AD) in mice. Symptoms such as redness, edema, and keratinization in AD mice induced by DNCB were alleviated by the co-application of an ethanolic extract of W. ganpi for 2 weeks. The severity of skin barrier function damage was evaluated by measuring TEWL (transepidermal water loss). TEWLs of DNCB sensitized mouse dorsal skin were reduced by the application of a W. ganpi ethanolic extract, and skin hydration was increased. In addition, the infiltration of inflammatory cells into the dermis was significantly reduced, as were blood levels of IgE and IL-4, which play an important role in the expression of AD. The results of this experiment suggest that W. ganpi is a potential therapeutic agent for AD.     

离子交换介孔分子筛DEAE-SBA-15的制备及其用于分离纯化粉尘螨主要变应原Derf2

通过3-含氧缩水甘油基-丙基-三甲氧基硅烷(GPTS)将二乙胺基乙基(DEAE)嫁接在介孔分子筛SBA-15的表面,制得弱阴离子交换层析剂DEAE-SBA-15,使其既具有分子筛作用,又具有离子交换作用的特点.经DEAE-SBA-15层析后,从粉尘螨代谢培养基中获得单一的洗脱峰,SDS-PAGE显示一条谱带,其相对分子质量为14000,表明经分离纯化所得到的蛋白质是粉尘螨主要变应原Derf2.对螨性哮喘患者皮肤点刺试验表明,所得Derf2仍具有变应原活性,且仅通过一次柱色谱即得Derf2,表明DEAE-SBA-15是一种较好的离子交换层析剂.     

Development and Validation of Analytical Methods for the Detection and Quantification of a Novel Dimeric Ceramide in Stratum Corneum and Other Layers of the Skin

Ceramides (CERs) are integral parts of the intercellular lipid lamellae of the stratum corneum (SC), which is responsible for the barrier function of the skin. Many skin diseases such as atopic dermatitis and psoriasis are associated with depletion or disturbance of the level of CERs in the SC. Administration of an exogenous novel dimeric ceramide (dCER) deep into the SC may help to stabilize the SC barrier substantially and to treat some skin disease conditions and with the help of the existing technology it might be possible to formulate various pharmaceutical dosage forms that can facilitate penetration of dCER into the SC. However, assessment of the rate and extent of permeability of the exogenous dCER involves appropriate analytical techniques which can discriminately quantify the exogenous dCER in the SC and in the other skin layers. Therefore, an attempt was made to develop an AMD-HPTLC and an HPLC/APCI-MS method for the detection and quantification of exogenous dCER in the SC as well as other skin layers. The method involved synthesis of the dCER and development of appropriate HPTLC and LC/ESI-MS methods for the separation and quantification of the dCER in the SC and deeper layers of the skin. The methods developed were optimized for quantification of a novel dCER. In comparison to the AMD-HPTLC method, the HPLC/MS method offers a higher sensitivity. Both methods could be used for the quantification of dCER in presence of a complex matrix (e.g., skin extract). The developed methods are complementary and could be used for the quantification of dCER in any further stage of substance research and industrial application. The methods developed are robust, linear and sensitive with a low limit of detection (LOD) and low limit of quantification (LOQ).

     

Evaluation of an HPLC Method for the Determination of Natural Moisturizing Factors in the Human Stratum Corneum

The levels of natural moisturizing factors in the skin can be used as a biomarker of hydration, for studying the effect of skin irritants, or as a biomarker of loss-of-function mutations in the filaggrin gene which are the main risk factor for atopic dermatitis. In this study the chromatographic performance and recovery of natural moisturizing factors and proteins from the skin were investigated using different extraction solvents and adhesive tapes. The uppermost layer of the skin stratum corneum, collected by using commercially available D-squame and corneofix adhesive tapes, was extracted by ammonia or potassium hydroxide. Protein levels used to correct for a variable stratum corneum amount on a tape were assessed by measuring optical density of a tape or indirectly by measuring proteins by a spectrophotometric assay. The measured natural moisturizing factors, pyrrolidone-5-carboxylic acid, histidine, tyrosine, trans-urocanic acid, and cis-urocanic acid were determined by ion pair reverse phase HPLC. Sample preparation and chromatographic performance were favorable when ammonia was used as an extraction solvent. Extraction of the natural moisturizing factors with ammonia avoids a time consuming neutralization step as required with extraction procedures using strong base or acid. The only drawback of the ammonia method is incomplete extraction of proteins from the tapes; however this can be avoided by measuring the optical density of stratum corneum-loaded tapes. The sensitivity of the method was sufficiently high to quantify the analytes even in homozygous filaggrin gene carriers. Reduced natural moisturizing factors levels found in the individuals with filaggrin gene mutation or after exposure to a skin irritant sodium lauryl sulfate were consistent with the previously reported studies.     

Development and validation of a simple method for the extraction and quantification of crisaborole in skin layers

Crisaborole is a boron compound recently approved by the US Food and Drug Administration as a 2% ointment for the treatment of mild to moderate atopic dermatitis. This work describes a simple method for the quantification of the drug in the skin layers at the end of in‐vitro permeation experiments. Chromatographic separation was carried out on a reverse‐phase C₁₈ column using a mixture of trifluoroacetic acid 0.05%–acetonitrile (55:45, v/v) as mobile phase, pumped at 1 ml/min. Column temperature was 35°C and UV detection was performed at 250 nm. The method was linear in the range of concentration from 0.06 to 6 μg/ml (R² = 1) and was selective, precise and accurate. Depending on the solvent used, the LOQ ranged from 0.014 to 0.030 μg/ml and the LOD from 0.005 to 0.010 μg/ml. The extraction from all the skin layers was quantitative. The developed method was successfully tested in an in‐vitro permeation study, proving to be an effective tool in the development of new formulations containing crisaborole.     

Salt water bathing prior to UVB irradiation leads to a decrease of the minimal erythema dose and an increased erythema index without affecting skin pigmentation

The combination of salt water baths and solar radiation is known as an effective treatment for patients with psoriasis and atopic dermatitis. To determine whether increased susceptibility to UVB radiation may contribute to this therapeutic effect we have studied the effect of bathing the skin in salt water prior to UVB irradiation. Twelve subjects were phototested on the volar aspects of their forearms with increasing doses of UVB radiation. One forearm was exposed to 5% salt water prior to irradiation. The minimal erythema dose (MED) was determined and the erythema index and skin pigmentation were assessed by photometric measurement. The combination of salt water bath and irradiation yielded a significant decrease of the MED when compared to UVB alone (median 90 mJ/cm2 vs 130 mJ/cm2, P < 0.01). Analysis of variance showed a significant influence of salt water bath on erythema (P < 0.05) but not on skin pigmentation. Within the MED test area the erythema index of the salt water exposed forearms was elevated significantly (P < 0.05) while skin pigmentation was not affected. Thus, bathing the skin in salt water leads to a decreased threshold level for the elicitation of UVB-induced erythema and a selective increase of the erythemal response. This sensitization to the effects of shortwave UVB radiation may increase immunosuppressive effects of UVB radiation and may lead to an increased efficacy of UVB phototherapy. However, there is also an increased sunburn risk when salt water baths are followed by exposure to UV radiation.     

In Vitro Skin Permeation Enhancement of KIOM-MA-128 by Monoolein Cubosomes

Monoolein (MO) cubosomes were investigated in terms of in vitro skin permeation enhancer of KIOM-MA-128 (MA-128), a natural product known to be efficacious against atopic dermatitis. First, an aqueous suspension of MA-128 was prepared by homogenizing the powder in Pluronic F-127 (a dispersant) solution in water. The Pluronic F-127 concentration and the pH have no significant effect on the size and the zeta potential of MA-128 particles. The mean diameters and the zeta potentials fell within 1000–1500 nm and ?10 to ?20 mV, respectively. The sedimentation rate of the particles was lower at a higher concentration of the polymeric dispersant, possibly because the polymeric surfactant can act as a spring and push away approaching particles. The size of MO cubosomes was tens to hundreds of nanometers and exhibited black and white stripes. Cumulative amount of MA-128 permeated through hairless mouse skin was obviously higher when the cubosome was included in the MA-128 suspensions. However, the cumulative permeation amount was inversely proportional to the content of cubosomes, when the contents of cubosome in the suspension increased from 0.5% to 2.0% with MA-128 concentrations kept constant (2%).     

Quantitative measurement of serum allergen-specific IgE on protein chip

Type I allergy is an immunoglobulin E (IgE)-mediated hypersensitivity disease inflicting more than quarter of the world population. In order to identify allergen sources, skin provocation test and IgE serology was performed using allergen extracts. Such process identifies allergen-containing sources but cannot identify the disease-eliciting allergenic molecules. Recently, microarray technology has been developed for allergen-specific IgE detection using rolling circle amplification. This study was carried out to evaluate protein chip technology for the quantitative measurement and limits of sensitivity of multiple allergen-specific IgE by an immunofluorescence assay. Significance of positive calibrators was tested using purified human IgE. Dermatophagoides pteronyssinus (Dp), egg white, milk, soybean, and wheat were used as allergens and human serum albumin as negative control. Sensitivity and clinical efficacy of protein chip were evaluated using allergy immune serum for Dp. The fluorescent intensities for purified human IgE as calibrator were well correlated with the concentrations of human IgE. Two-fold dilution of serum allowed an optimal reaction with Dp (1 mg/ml) at which serum Dp-specific IgE levels by protein chip were compatible with those by UniCap. The sensitivity of protein chip in this study was found at level of 1 IU/ml of IgE. Dp-specific IgE levels by protein chip correlated well with those of UniCap by comparing 10 atopic dermatitis. Additional 18 sera were tested for above multiple antigens other than Dp and significant results were obtained for many antigens as well as Dp. These results indicated that spotting of heterogeneous protein mixture on protein chip and the quantitative measurement of serum allergen-specific IgE levels using immunofluorescence assay can be successfully applied in the clinical laboratory for the diagnosis of allergy and could be applied to diagnosis of autoimmune and infectious diseases