Measurement of skin pH and its significance in cutaneous diseases

Preventive and Therapeutic Benefits of Natural Ingredients in Photo-Induced Epidermal Dysfunction

BACKGROUND

The skin, particularly the epidermis, is subjected to various external stresses, including ultraviolet (UV) irradiation. UV irradiation, mainly UVB at wavelength of 280-315 nm, can alter several epidermal functions, including cutaneous inflammation, epidermal hyperproliferation, DNA damage, disruption of epidermal permeability barrier and reduction in stratum corneum hydration levels. Because of the negative impacts of UVB irradiation on epidermal functions, great efforts have been made to develop regimens for the protection of alterations in epidermal function induced by UV irradiation.

SUMMARY

While sunscreen can provide physical barrier to UV light, some natural ingredients can also effectively protect the skin from UVB irradiation-induced damages. Studies have demonstrated that either topical or oral administrations of some natural ingredients attenuate UVB irradiation-induced alterations in the epidermal function. The underlying mechanisms by which natural ingredients improve epidermal functions are attributable to antioxidation, stimulation of keratinocyte differentiation, increases in the content of epidermal natural moisturizers and inhibition of inflammation.

KEY MESSAGE

Some natural ingredients exhibit protective and therapeutical benefits in photo-induced epidermal dysfunctions via divergent mechanisms.

Influence of Acidic pH on Wound Healing In Vivo: A Novel Perspective for Wound Treatment

There has been little understanding of acidification functionality in wound healing, highlighting the need to study the efficacy of wound acidification on wound closure and cellular activity in non-infected wounds. This study is focused on establishing the healing potential of wound acidification in non-infected wounds. Acidic buffers, constituting either phosphoric or citric acid, were employed to modify the physiological pH of non-infected full-thickness excisional murine wounds. Acidification of the wound by acidic buffers was found to be an effective strategy to improve wound healing. A significant improvement in wound healing parameters was observed as early as 2 days post-treatment with acidic buffers compared to controls, with faster rate of epithelialization, wound closure and higher levels of collagen at day 7. pH is shown to play a role in mediating the rate of wound healing, with acidic buffers formulated at pH 4 observed to stimulate faster recovery of wounded tissues than pH 6 buffers. Our study shows the importance of maintaining an acidic wound microenvironment at pH 4, which could be a potential therapeutic strategy for wound management.

A Conductive Hydrogel-Based Microneedle Platform for Real-Time pH Measurement in Live Animals

Conventional microneedles (MNs) have been extensively reported and applied toward a variety of biosensing and drug delivery applications. Hydrogel forming MNs with the added ability to electrically track health conditions in real-time is an area yet to be explored. The first conductive hydrogel microneedle (HMN) electrode that is capable of on-needle pH detection with no postprocessing required is presented here. The HMN array is fabricated using a swellable dopamine (DA) conjugated hyaluronic acid (HA) hydrogel, and is embedded with poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) to increase conductivity. The catechol-quinone chemistry intrinsic to DA is used to measure pH in interstitial fluid (ISF). The effect of PEDOT:PSS on the characteristics of the HMN array such as swelling capability and mechanical strength is fully studied. The HMN's capability for pH measurement is first demonstrated using porcine skin equilibrated with different pH solutions ranging from 3.5 to 9. Furthermore, the HMN-pH meter is capable of in vivo measurements with a 93% accuracy compared to a conventional pH probe meter. This HMN technology bridges the gap between traditional metallic electrochemical biosensors and the direct extraction of ISF, and introduces a platform for the development of polymeric wearable sensors capable of on-needle detection.

Skin pH varies among bat species and seasons and between wild and captive bats

Skin is a key aspect of the immune system in the defence against pathogens. Skin pH regulates the activity of enzymes produced both by hosts and by microbes on host skin, thus implicating pH in disease susceptibility. Skin pH varies inter- and intra-specifically and is influenced by a variety of intrinsic and extrinsic variables. Increased skin alkalinity is associated with a predisposition to cutaneous infections in humans and dogs, and inter-specific and inter-individual variation in skin pH is implicated in differential susceptibility to some skin diseases. The cutaneous pH of bats has not been characterized but is postulated to play a role in susceptibility to white-nose syndrome (WNS), a fungal infection that has decimated several Nearctic bat species. We used non-invasive probes to measure the pH of bat flight membranes in five species with differing susceptibility to WNS. Skin pH ranged from 4.67 to 8.59 and varied among bat species, geographic locations, body parts, age classes, sexes and seasons. Wild Eptesicus fuscus were consistently more acidic than wild Myotis lucifugus, Myotis leibii and Perimyotis subflavus. Juvenile bats had more acidic skin than adults during maternity season but did not differ during swarming. Male M. lucifugus were more acidic than females during maternity season, yet this trend reversed during swarming. Bat skin was more acidic in summer compared to winter, a pattern also reported in humans. Skin pH was more acidic in captive than wild E. fuscus, suggesting environmental impacts on skin pH. The pH of roosting substrates affects skin pH in captive bats and may partially explain seasonal patterns in wild bats that use different roost types across seasons. Future research on the influence of pH on microbial pathogenic factors and skin barrier function may provide valuable insights on new therapeutic targets for treating bat skin conditions.

Immunopathogenesis of Dermatophytoses and Factors Leading to Recalcitrant Infections

The pathogenesis of dermatophytic infections involves the interplay of three major factors: the dermatophyte, the inherent host defense, and the adaptive host immune response. The fungal virulence factors determine the adhesion and invasion of the skin while the immune response depends on an interaction of the pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMP) with pattern recognition receptors (PRRs) of the host, which lead to a differential Th (T helper) 1, Th2, Th17, and Treg response. While anthropophilic dermatophytes Trichophyton rubrum and now increasingly by T. interdigitale subvert the immune response via mannans, zoophilic species are eliminated due to a brisk immune response. Notably, delayed-type hypersensitivity (Th1) response of T lymphocytes causes the elimination of fungal infection, while chronic disease caused by anthropophilic species corresponds to toll-like receptor 2 mediated IL (interleukin)-10 release and generation of T-regulatory cells with immunosuppressive potential. Major steps that determine the ultimate clinical course and chronicity include genetic susceptibility factors, impaired epidermal and immunological barriers, variations in the composition of sebum and sweat, carbon dioxide tension, skin pH, and topical steroid abuse. It is important to understand these multifarious aspects to surmount the problem of recalcitrant dermatophytosis when the disorder fails conventional therapeutic agents.

Role of pH Value in Clinically Relevant Diagnosis

As a highly influential physiological factor, pH may be leveraged as a tool to diagnose physiological state. It may be especially suitable for diagnosing and assessing skin structure and wound status. Multiple innovative and elegant smart wound dressings combined with either pH sensors or drug control-released carriers have been extensively studied. Increasing our understanding of the role of pH value in clinically relevant diagnostics should assist clinicians and improve personal health management in the home. In this review, we summarized a number of articles and discussed the role of pH on the skin surface as well as the factors that influence skin pH and pH-relevant skin diseases, but also the relationship of skin pH to the wound healing process, including its influence on the activity of proteases, bacterial enterotoxin, and some antibacterial agents. A great number of papers discussing physiological pH value have been published in recent decades, far too many to be included in this review. Here, we have focused on the impact of pH on wounds and skin with an emphasis on clinically relevant diagnosis toward effective treatment. We have also summarized the differences in skin structure and wound care between adults and infants, noting that infants have fragile skin and poor skin barriers, which makes them more vulnerable to skin damage and compels particular care, especially for wounds.

Preparation and Evaluation of Sunflower Oil Nanoemulsion as a Sunscreen

BACKGROUND:

There are a lot of different types of sunscreen products (oils, sticks, gels, creams, lotions) which can be found on the world’s market. Sunscreen product that contains active chemical ingredients sometimes has harmful effects on the skin. Sunflower oil contains vitamin E and acts as a natural sunscreen which can absorb UVB light. The average droplet size of nanoemulsion is between 100 and 500 nm and do not show the problems of stability (creaming, flocculation, coalescence, and sedimentation), which are commonly associated with macroemulsions.

AIM:

The aim of this study was to prepare and evaluate the sunflower oil nanoemulsion as a sunscreen.

METHODS:

Sunflower oil nanoemulsions were prepared by spontaneous emulsification method with 3 formulas F1 (Tween 80 38%, sorbitol 22%), F2 (Tween 80 36%, sorbitol 24%), F3 (Tween 80 34%, sorbitol 26%) and 5% sunflower oil as a sunscreen substance. The nanoemulsions were evaluated for particle size, physical stability in room temperature (25 ± 2°C), low temperature (4 ± 2°C) and high temperature (40 ± 2°C) during experiment for 12 weeks of storage, centrifugation at 3750 rpm for 5 hours, viscosity, pH, freeze-thaw test and sun protection value (SPF) value by in vitro.

RESULTS:

The results of nanoemulsion evaluation showed that nanoemulsion formula F1 had the smallest average particle size of 124.47 nm with yellowish colour, clear, transparent, pH value (6.5 ± 0.1), viscosity value (225 ± 25 cP), did not show any separation or creaming in the centrifugation, and stable during experiment for 12 weeks of storage at room temperature, low temperature and high temperature. The SPF value of all nanoemulsion preparations was higher than that of the emulsion.

CONCLUSION:

The preparation of the sunflower oil nanoemulsion with a ratio of Tween 80 and sorbitol (38: 22) produces a stable nanoemulsion during the experiment for 12 weeks storage at the room, low and high temperature. The nanoemulsion preparation has higher SPF values compared to the emulsion. This nanoemulsion formulation could be considered more effective in sunscreen cosmetic use compare to the emulsion.

Preparation and Evaluation of Sunscreen Nanoemulsions with Synergistic Efficacy on SPF by Combination of Soybean Oil, Avobenzone, and Octyl Methoxycinnamate

BACKGROUND:

Soybean oil contains vitamin E and acts as a natural sunscreen which can absorb Ultra Violet (UV) B light and has antioxidant properties to reduce the photooxidative damage that results from UV-induced Reactive Oxygen Species production. The UV blocking from most natural oils is insufficient to obtain a high UV protection. The strategies for preparations of sunscreen products with high SPF can be done by nanoemulsion formulation and Ultra Violet filter combinations of Soybean Oil, Avobenzone and Octyl methoxycinnamate.

AIM:

The purpose of this study was to prepare and in vitro efficacy evaluation of sunscreen nanoemulsion containing Soybean oil, Avobenzone and Octyl methoxycinnamate.

METHODS:

The sunscreen nanoemulsions were prepared by the high energy emulsification method. The formulation uses a combination of 3% Avobenzone, 7.5% Octyl methoxycinnamate, with different ratio of Soybean oil and Liquid Paraffin. The nanoemulsion was evaluated for droplet sizes by using particle size analyzer, physical stability in room temperature (25 ± 2°C during experiment for 12 weeks of storage, physical stability (cycling test), phase separation by centrifugation at 3750 rpm for 5 hours, pH, viscosity, and Sun Protection Factor (SPF) value by UV spectrophotometric. The SPF value of sunscreen nanoemulsion was compared to sunscreen nanoemulsion without Soybean Oil and sunscreen emulsion. Particle morphology observation of nanoemulsion by using Transmission Electron Microscope.

RESULTS:

The sunscreen nanoemulsion formulation containing a combination of 3% Avobenzone, 7.5% Octyl methoxycinnamate with a ratio of 2.73% Soybean Oil and 0.27% Paraffin Oil resulted in the smallest average droplet size of 68.47 nm. The sunscreen nanoemulsion without Soybean Oil had an average droplet size of 384.07 nm. The globules size was increased during the experiment for 12 weeks of storage at room temperature, but there was no phase separation after centrifugation. The formulation of sunscreen emulsion, phase separation was formed after centrifugation. The nanoemulsion had a pH value of 7.23 ± 0.06 and a viscosity value of 133.33 ± 7.22 cP. The sunscreen nanoemulsion containing a combination of 3% Avobenzone, 7.5% Octyl methoxycinnamate 2.73%, Soybean Oil, 2.73% and 0.27% Liquid Paraffin had SPF value (21.57 ± 1.21) higher than sunscreen nanoemulsion without Soybean Oil (16.52 ± 0.98) and sunscreen emulsion (15.10 ± 0.22). The TEM analysis of globules morphology showed that the sunscreen nanoemulsion formed a spherical globule.

CONCLUSION:

The sunscreen nanoemulsion containing a combination of 3% Avobenzone, 7.5% Octyl Methoxycinnamate, 2.73% Soybean Oil and 0.27% Liquid Paraffin showed synergistic sunscreen efficacy on SPF. This sunscreen nanoemulsion is more stable than sunscreen emulsion formulation during the experiment for 12 weeks at room temperature.

Borage oil restores acidic skin pH by up-regulating the activity or expression of filaggrin and enzymes involved in epidermal lactate, free fatty acid, and acidic free amino acid metabolism in essential fatty acid-deficient Guinea pigs

Borage oil (BO) reverses a disrupted epidermal lipid barrier and hyperproliferation in essential fatty acid deficiency (EFAD). However, little is known about its effect on skin pH, which is maintained by epidermal lactate, free fatty acids (FFAs), and free amino acids (FAAs) which is generated by lactate dehydrogenase (LDH), secreted phospholipase A2 (sPLA2), or filaggrin degradation with peptidylarginine deiminase-3 (PADI3). We hypothesized that BO restores skin pH by regulating epidermal lactate, FFA metabolism, or FAA metabolism in EFAD. To test this hypothesis, EFAD was induced in guinea pigs by a hydrogenated coconut oil (HCO) diet for 8 weeks, followed by 2 weeks of a BO diet (group HCO + BO). As controls, groups HCO and BO were fed HCO or BO diets for 10 weeks. In group HCO + BO, skin pH, which was less acidic in group HCO, was restored; and epidermal lactate and total FFAs, including palmitate, stearate, linoleate, arachidate, behenate, and lignocerate, were higher than in group HCO. LDH and sPLA2 (mainly the PLA2G2F isoform) activities and protein expressions were similar between groups HCO + BO and BO. Epidermal acidic FAAs, as well as filaggrin and PADI3 protein and mRNA expressions were higher in group HCO + BO than in group HCO. Oleate, total FAAs including other FAAs, and LDH and sPLA2 mRNA expressions were not altered between groups HCO and HCO + BO. Basic FAAs were not altered among groups. Dietary BO restored acidic skin pH and increased epidermal levels of lactate, most FFAs, and acidic FAAs by up-regulating LDH, sPLA2, filaggrin, and PADI3 activities as well as protein or mRNA expressions in EFAD.

Notch Signaling Activity Determines Uptake and Biological Effect of Imatinib in Systemic Sclerosis Dermal Fibroblasts

Tyrosine kinase inhibitors have emerged as a therapeutic option for rheumatic diseases such as systemic sclerosis (SSc). Because tyrosine kinases like c-Abl kinase are important for fibroblast activation and fibrosis development in SSc, the c-Abl inhibitor imatinib was proposed for SSc treatment. Transporters for organic cations have become increasingly recognized as an important determinant for uptake and efficacy of tyrosine kinase inhibitors. Therefore, we investigated the role of organic cation transporters in the uptake of imatinib. Moreover, the influence of important SSc pathogenetic factors, like PDGF and Notch pathway activation on these uptake processes, has been studied. We showed that organic cation transporters OCT1-3, novel organic cation transporters OCTN1/2, and the multidrug and toxin extrusion protein MATE1 are expressed in healthy dermal and SSc fibroblasts. Decreased expression levels of MATE1 and decreased imatinib uptake were measured in SSc fibroblasts. In small interfering RNA experiments, MATE1 was identified as key transporter for imatinib uptake and biological effect in dermal fibroblasts. Furthermore, PDGF reduced imatinib uptake by decreasing MATE1 expression in SSc fibroblasts, but not in healthy fibroblasts. Blocking the Notch pathway in SSc fibroblasts increased MATE1 transporter expression and imatinib uptake. In conclusion, MATE1-mediated transport governs therapeutic efficacy of imatinib in SSc.

Sensitive scalp is associated with excessive sebum and perturbed microbiome

BACKGROUND

Sensitive scalp, one of the most frequent complaints among sensitive skin syndrome, has been described as abnormal and unpleasant sensory reactions of the scalp to environmental stimulus. However, the symptoms are usually objective and hard to diagnose.

OBJECTIVE

This study aimed to reveal the biophysical properties and etiology of sensitive scalp.

METHODS

Sixty-two healthy female subjects were enrolled and divided into nonsensitive scalp (NS) and sensitive scalp (SS) groups according to questionnaires. Noninvasive instruments were used to measure biophysical properties. Ultra-performance liquid chromatography-tandem mass spectrometry and gas chromatography mass spectrometry were introduced to quantify skin lipids profiles, and 16S rRNA sequencing was used to detect the composition of bacteria.

RESULTS

Sensitive scalp showed elevated pH level, more irritated skin, and more fluorescence of porphyrins. Increased sebum production was found in SS group at occiput, among which free fatty acids, cholesteryl ester, and squalene were significantly in higher amount compared with NS. SS also had significantly higher percentage of Propionibacterium, and lower bacterial diversity.

CONCLUSIONS

Taken together, sensitive scalp showed disrupted barrier function, abnormal sebum amount and composition, as well as perturbed microbiome, which might be the direct cause. Products targeting these features could be helpful for the treatment of sensitive scalp.

Putting It All Together to Understand the Role of Malassezia spp. in Dandruff Etiology

Dandruff is a common scalp condition causing both a discomfort and an undesired social image. Various studies dating from early 1900s have investigated the condition, but understanding of underlying mechanisms and etiology of the condition is still in its infancy. Formation of dandruff is a common but complex event which has been associated with numerous causal factors. Physiological conditions such as pH, water content, or sebum secretion are some of the host-related factors. An imbalance between these factors can disturb the physiological equilibrium of the scalp that can lead to dandruff formation. However, severity of the condition is strongly related to the lipophilic yeast of the skin microbiota, Malassezia spp. On the other hand, there are recent publications highlighting the role of other scalp microbiota members on dandruff formation. This review investigates the processes leading to the formation of dandruff to provide an etiological description of the condition, with a focus on Malassezia spp.

Quantitative analysis of povidone-iodine thin films by X-ray photoelectron spectroscopy and their physicochemical properties

In this study, povidone-iodine (PVP-I) has been formulated as a topical spray to produce a thin film for the controlled release of I2. By means of experimental design, 27 formulations containing glycerol, ethanol, PEG 400, copovidone and HFA 134a as a propellant were prepared. The pH values of all formulations were in the range of 6-7. The viscosity was within the range of 11.9-85.9 mPa s. The surface tensions were 20.3 to 24.6 mN m-1 and the contact angles were between 19.3 and 38.7°. The assays for the iodine contents were within acceptable range (80-120 %). X-ray photoelectron spectroscopy analysis revealed the ionized form of iodine was much higher than the unionized form. The MIC and MBC values of the PVP-I sprays against Staphylococcus aureus, S. epidermidis and Pseudomonas aeruginosa were higher than that of commercial PVP-I solution. The cytotoxicity study confirmed that the PVP-I spray had lower toxic effects on keratinocytes and fibroblasts compared to the commercial PVP-I solution. The formulation containing 59 % ethanol, 18 % copovidone and 12 % PEG 400 showed good antibacterial activity.

Covalently-controlled drug delivery via therapeutic methacrylic tissue adhesives

Therapeutic methacrylic (TMA) monomers lend local, covalently-controlled release of therapeutics, tunable mechanical properties, and increased cytocompatibility to cyanoacrylate medical adhesives.

Structural and biophysical characteristics of human skin in maintaining proper epidermal barrier function

The complex structure of human skin and its physicochemical properties turn it into an efficient outermost defence line against exogenous factors, and help maintain homeostasis of the human body. This role is played by the epidermal barrier with its major part – stratum corneum. The condition of the epidermal barrier depends on individual and environmental factors. The most important biophysical parameters characterizing the status of this barrier are the skin pH, epidermal hydration, transepidermal water loss and sebum excretion. The knowledge of biophysical skin processes may be useful for the implementation of prophylactic actions whose aim is to restore the barrier function.

Drug permeation and barrier damage in Leishmania-infected mouse skin

OBJECTIVES

Pathological disorder can disrupt the barrier integrity of the skin, thereby altering the drug delivery from topical formulations to the target site. Cutaneous leishmaniasis (CL) is an infection of the dermal layers of the skin and manifests as a variety of skin lesions from defined nodular forms to plaques and chronic ulcers. The aim of this work was to characterize the physiology and barrier integrity of the Leishmania-infected BALB/c mouse skin and how they impacted delivery of drugs into the skin.

METHODS

A histological evaluation of the structural differences between uninfected and infected skin was performed using haematoxylin/eosin, elastic Van Gieson and Iba-1 stains. As a CL nodule developed and progressed, the skin pH, hydration and trans-epidermal water loss (TEWL) were recorded. Finally, Franz diffusion cells were used to evaluate the influence of the infection on drug delivery through the skin.

RESULTS

We found: (i) structural changes in both the epidermal and dermal layers due to the ingress of inflammatory cells, as shown by immunohistochemistry; (ii) a significant increase in TEWL; and (iii) significantly higher permeation of the model permeants caffeine and ibuprofen and the antileishmanial drugs buparvaquone and paromomycin, for Leishmania-infected skin compared with uninfected skin. The infection had no measurable influence on skin pH and hydration.

CONCLUSIONS

We report profound changes in the skin barrier physiology, function and permeability to drugs of Leishmania-infected skin.

The Importance of Acidification in Atopic Eczema: An Underexplored Avenue for Treatment

Atopic dermatitis is a form of dermatitis commonly seen in children and adults. Its pathophysiology is complex and is centered on the barrier function of the epidermis. An important aspect of the skin’s barrier is pH, which in turn affects a number of parameters such as the skin flora, protease function, and mediators of inflammation and pruritus. Normal pH for non-neonatal skin is acidic and ranges from 4 to 6. Skin pH in atopic dermatitis patients is often increased into the neutral to basic range, and the resulting cascade of changes contributes to the phenotype of atopic dermatitis. Therefore, the maintenance of normal skin pH remains an important topic in understanding and treating atopic dermatitis. This article will review skin pH and its impact on normal barrier function, pathological pH changes in atopic dermatitis, and the therapeutic considerations related to restoring and maintaining pH balance.

Insights into the antimicrobial properties of hepcidins: advantages and drawbacks as potential therapeutic agents

The increasing frequency of multi-drug resistant microorganisms has driven research into alternative therapeutic strategies. In this respect, natural antimicrobial peptides (AMPs) hold much promise as candidates for the development of novel antibiotics. However, AMPs have some intrinsic drawbacks, such as partial degradation by host proteases or inhibition by host body fluid composition, potential toxicity, and high production costs. This review focuses on the hepcidins, which are peptides produced by the human liver with a known role in iron homeostasis, as well by numerous other organisms (including fish, reptiles, other mammals), and their potential as antibacterial and antifungal agents. Interestingly, the antimicrobial properties of human hepcidins are enhanced at acidic pH, rendering these peptides appealing for the design of new drugs targeting infections that occur in body areas with acidic physiological pH. This review not only considers current research on the direct killing activity of these peptides, but evaluates the potential application of these molecules as coating agents preventing biofilm formation and critically assesses technical obstacles preventing their therapeutic application.

Defective maintenance of pH of stratum corneum is correlated with preferential emergence and exacerbation of atopic-dermatitis-like dermatitis in flaky-tail mice

BACKGROUND

Neutralization of stratum corneum (SC) pH, which is induced by a variety of stimuli, such as scratching, use of soap and inflammation, can stimulate activity of serine protease (SPase). Activation of SPase induces production of thymic stromal lymphopoietin (TSLP) through protease-activated receptor-2. Both reduced expression of natural moisturizing factors, which are required for maintenance of SC pH, and the preferential development of atopic dermatitis (AD)-like dermatitis are found in flaky-tail mice (FTM) with a loss-of-function mutation in filaggrin.

OBJECTIVE

We examined possible correlations between disturbance of responses to an exogenous stimulus of SC neutralization and the preferential emergence of AD-like dermatitis in FTM.

METHODS

FTM and wild-type mice (C57BL/6) were subjected to an SC-neutralization stimulus via application of 1,1,3,3-tetramethylguanidine (TMG). TMG was applied to young mice at a time when FTM had not yet developed significant dermatitis, and we examined their ability to maintain SC acidity and several parameters associated with AD-like dermatitis.

RESULTS

The recovery of SC pH after the application of TMG was delayed in FTM, presumably because of unchanged expression of Na(+)/H(+) antiporter 1, which is involved in maintenance of SC acidity. Cutaneous inflammation with elevated SPase activity and serum levels of TSLP, thymus and activation-regulated chemokine and IgE were induced only in TMG-treated FTM.

CONCLUSION

Our results suggest that defective maintenance of pH of SC is correlated with emergence and exacerbation of AD-like dermatitis in FTM.

Antibacterial action of new antibacterial peptides, Nod1 and Nod2, isolated from Nordotis discus discus

Abalone is a valuable seafood in the aquaculture industry worldwide as it is rich in protein. However, to date, research on the functional proteins of abalone is lacking. Herein, we report two peptides with antibacterial activity from Nordotis discus discus . The purification of peptides was performed by solvent extraction, ultrafiltration, and reverse-phase high performance liquid chromatography. The N-terminal amino acid sequences of the isolated antibacterial peptides, named as Nod1 and Nod2, were identified by Edman degradation and did not show any similarity to other proteins and peptides in databases based on results of BLAST homology analysis. Molecular masses of Nod1 and Nod2 were 6145.06 and 6360.07 Da, respectively, as determined by mass spectrometric analysis. The two peptides displayed pH-dependent antibacterial activity against various bacteria that was more potent at pH 5.4 than pH 7.4, but they did not inhibit fungal growth at either pH levels. Their antibacterial activity was due to membranolytic action, which was assayed by SYTOX-green uptake. In addition, both peptides were virtually noncytolytic for human erythrocytes and mammalian cells.

Randomized, parallel-group, double-blind, controlled study to evaluate the efficacy and safety of carbohydrate-derived fulvic acid in topical treatment of eczema

Background

The purpose of this study was to evaluate the efficacy and safety of carbohydratederived fulvic acid (CHD-FA) in the treatment of eczema in patients two years and older.

Methods

In this single-center, double-blind, placebo-controlled, parallel-group comparative study, 36 volunteers with predetermined eczema were randomly assigned to receive either the study drug or placebo twice daily for four weeks.

Results

All safety parameters remained within normal limits, with no significant differences in either group. Significant differences were observed for both severity and erythema in the placebo and CHD-FA treated groups, and a significant difference was observed for scaling in the placebo-treated group. With regard to the investigator assessment of global response to treatment, a significant improvement was observed in the CHD-FA group when compared with the placebo group. A statistically significant decrease in visual analog scale score was observed in both groups, when comparing the baseline with the final results.

Conclusion

CHD-FA was well tolerated, with no difference in reported side effects other than a short-lived burning sensation on application. CHD-FA significantly improved some aspects of eczema. Investigator assessment of global response to treatment with CHD-FA was significantly better than that with emollient therapy alone. The results of this small exploratory study suggest that CHD-FA warrants further investigation in the treatment of eczema.

Buffering capacity of human skin layers: in vitro

BACKGROUND/PURPOSE

The skin possesses buffering capacity to resist acidic/alkaline aggression. Skin components contribute differently to this buffering capacity. This study investigates buffering capacity in three skin layers: intact stratum corneum (SC), epidermis and dermis.

METHODS

Sodium hydroxide (NaOH) and hydrochloric acid (HCl) solutions at 0.025, 0.05 and 0.1 N were applied to skin (3.18 μL/cm(2)). After 30 min, the skin was washed with 1 mL de-ionized water. TEWL and pH measurements were conducted at baseline (before contact with acid or base), 0, 10 and 30 min post exposure, and continued at 0, 10 and 30 min post washing.

RESULTS

Data indicate that immediately following acid or base exposures, the dermis demonstrates the highest buffering capacity, while with time, intact stratum corneum predominates.

CONCLUSION

These findings potentiate advanced understanding of skin's buffering capacity as related to dermatopharmacology and dermatotoxicology.

Potent antimicrobial action of triclosan-lysozyme complex against skin pathogens mediated through drug-targeted delivery mechanism

Triclosan (TCS), an antimicrobial agent that inhibits bacterial fatty acid synthesis by blocking the active site of enoyl-ACP reductase (FabI), is a water-insoluble agent that limits its therapeutic candidacy. We have recently shown that the water solubility and antimicrobial activity of TCS were greatly enhanced when complexed to lysozyme (LZ). This study is to examine the therapeutic potential of triclosan-lysozyme (T-LZ) complex against common skin pathogens expressing different levels of FabI, and to delineate the drug-targeting mechanism by lysozyme. The T-LZ exhibited superior antimicrobial activity against two bacterial skin pathogens, Propionibacterium acnes and Corynebacterium minutissimum, while yeast pathogens, Candida albicans and Malassezia furfur lacking FabI enzyme were insensitive to the complex. Unlike free TCS or LZ, the T-LZ complex exhibited a potent antibacterial activity under a wide range of pH condition and salt concentration. Interestingly, P. acnes expressing greater amount of FabI was more susceptible to the T-LZ complex than C. minutissimum that produces lesser amount of the enzyme. A sensitive assay of FabI activity revealed that P. acnes and C. minutissimum treated with the complex exhibited significant inhibition of the intracellular FabI activity than cells treated with free TCS, indicating the efficiency of lysozyme to specifically deliver TCS to its target (FabI) in the cytoplasm of bacterial cells. These results demonstrate, for the first time, that lysozyme is a potential drug carrier that allows specific targeting to the microbial cells of the water-insoluble triclosan and highlights the potency of the complex for the treatment of skin bacterial infections.

Natural skin surface pH is on average below 5, which is beneficial for its resident flora

Variable skin pH values are being reported in literature, all in the acidic range but with a broad range from pH 4.0 to 7.0. In a multicentre study (N = 330), we have assessed the skin surface pH of the volar forearm before and after refraining from showering and cosmetic product application for 24 h. The average pH dropped from 5.12 +/- 0.56 to 4.93 +/- 0.45. On the basis of this pH drop, it is estimated that the 'natural' skin surface pH is on average 4.7, i.e. below 5. This is in line with existing literature, where a relatively large number of reports (c. 50%) actually describes pH values below 5.0; this is in contrast to the general assumption, that skin surface pH is on average between 5.0 and 6.0. Not only prior use of cosmetic products, especially soaps, have profound influence on skin surface pH, but the use of plain tap water, in Europe with a pH value generally around 8.0, will increase skin pH up to 6 h after application before returning to its 'natural' value of on average below 5.0. It is demonstrated that skin with pH values below 5.0 is in a better condition than skin with pH values above 5.0, as shown by measuring the biophysical parameters of barrier function, moisturization and scaling. The effect of pH on adhesion of resident skin microflora was also assessed; an acid skin pH (4-4.5) keeps the resident bacterial flora attached to the skin, whereas an alkaline pH (8-9) promotes the dispersal from the skin.

Measuring human skin buffering capacity: an in vitro model

BACKGROUND/PURPOSE

It has been thought that skin possesses buffering capacity. This study measured the skin buffering capacity against two model solutions of acid and base at three concentrations with an in vitro system.

METHODS

Ten microliters of model base (sodium hydroxide--NaOH) and acid (hydrochloric acid--HCl) solutions at concentrations of 0.025, 0.05, and 0.1 N was applied to human cadaver skin (3.18 microL/cm(2)) placed onto glass diffusion cells. Phosphate-buffered saline (PBS) was used as a standard buffer solution. Deionized water served as the negative control, whereas untreated skin served as the blank control. Skin pH was read and recorded immediately following dosing (0 time), and at 10 and 30 min of post-dosing. After the 30 min of dosing, each skin, except untreated skin (blank control), was then washed by applying 1 cm(3) of deionized water. The pH on each washed skin was measured immediately following washing, and the pH measurement was repeated at 10 and 30 min of post-washing. Six replicates were conducted.

RESULTS

The pH values sharply significantly increased (P<0.05) immediately following dosing with NaOH at all concentrations (the highest concentration, caused the highest pH), and then decreased closely to baselines within 30 min post-application but still remained at significantly (P<0.05) higher values when compared with the blank control (untreated skin). HCl (acid) significantly (P<0.05) decreased skin pH immediately following dosing with all concentrations (the highest concentration, caused the lowest pH) and then restored rapidly to baseline. There was no significant difference in post-washing procedures on the skins that were pre-treated with the acid (HCI) solutions. However, with all base solutions (NaOH) pre-treated skin, pH values were significantly higher (P<0.05) at all time points post-washing. Furthermore, both PBS and water controls significantly elevated (P<0.05) the pH values following washing.

CONCLUSION

Skin pH and its buffering capacity can be measured on human cadaver skin in vitro, which may partially replicate the response of in vivo skin. Dose-response was noted; i.e. the higher concentration caused larger changes in skin pH. In addition, the restoration of skin pH is relatively faster with acid when compared with base treatment. Clinical implications are offered.

Does preoperative electrical stimulation of the skin alter the healing process?

BACKGROUND

In vitro studies have demonstrated that electrical current may affect fibroblast proliferation and synthesis of collagen fibers. In humans, the application of electrical current by positioning the positive electrode on skin wounds resulted in thinner hypertrophic scars. The aim of this study was to evaluate the effects of preoperative electrical stimulation on cutaneous wound healing in rats.

MATERIALS AND METHODS

Forty rats were divided into two groups of 20 animals each. In the control group, an incision was made on the back of the animals. In the stimulation group, a preoperative electrical stimulation was applied using a rectangular pulse current at a frequency of 7.7 Hz, and intensity of 8 mA, for 30 min, with the positive electrode placed on the back of the animal, and the negative electrode placed on the abdominal wall. Following, an incision was made on their back. Biopsy was carried out on postoperative day 7 and 14, and histologic analysis was performed.

RESULTS

The number of newly formed vessels, fibroblasts, and type III collagen fibers in the stimulation group on postoperative day 7 were greater than those in the control group.

CONCLUSIONS

Preoperative positive-polarity electrical stimulation positively affects angiogenesis and fibroblast proliferation.

Antimicrobial activity of histidine-rich peptides is dependent on acidic conditions

Synthetic peptides composed of multiples of the consensus heparin-binding Cardin and Weintraub sequences AKKARA and ARKKAAKA are antimicrobial. Replacement of lysine and arginine by histidine in these peptides completely abrogates their antimicrobial and heparin-binding activities at neutral pH. However, the antibacterial activity against Gram-negative (Escherichia coli, Pseudomonas aeruginosa) and Gram-positive bacteria (Bacillus subtilis and Staphylococcus aureus) as well as the fungus Candida albicans, was restored at acidic conditions (pH 5.5). Fluorescence microscopy and FACS analysis showed that the binding of the histidine-rich peptides to E. coli and Candida was significantly enhanced at pH 5.5. Likewise, fluorescence studies for assessment of membrane permeation as well as electron microscopy analysis of peptide-treated bacteria, paired with studies of peptide effects on liposomes, demonstrated that the peptides induce membrane lysis only at acidic pH. No discernible hemolysis was noted for the histidine-rich peptides. Similar pH-dependent antimicrobial activities were demonstrated for peptides derived from histidine-rich and heparin-binding regions of human kininogen and histidine-rich glycoprotein. The results demonstrate that the presence of an acidic environment is an important regulator of the activity of histidine-rich antimicrobial peptides.

The Role of First Line of Defence Mechanisms in the Pathogenesis of Cellulitis in Broiler Chickens: Skin Structural, Physiological and Cellular Response Factors

The present study examined several basic attributes of first-line defence mechanisms in the skin as potential factors that may explain the susceptibility of broiler chickens to cellulitis. The variables including structural characteristics of the skin, physicochemical properties and cellular responses to the challenge with pathogens were compared between two categories of chickens, a strain of fast-growing commercial broiler chickens (susceptible to cellulitis) and leghorn chickens (resistant to cellulitis). There were substantial differences between leghorns and broilers with regard to physiological characteristics of the skin. Broiler skin was more amenable to injury and the wound-healing process was slow. Compared with leghorns, the lesions resulting from sub-dermal challenge in broilers were more severe and disseminated over a larger area. Mobilization of phagocytic cells (heterophils and macrophages) in leghorns was brisk even in the areas distant from the site of infection, whereas only few heterophils were recruited in the skin of broilers. The functional competence of heterophils in broilers was inferior when compared with leghorns. Based on the present finding, the predisposition of broilers to cellulitis appears to be primarily associated with the inferior first line of defence of their skin. Broilers in commercial situations may be at higher risk to succumb to even minor infection and eventually develop cellulitis because: (1) structural weaknesses of the skin may predispose broilers to skin injury and thus the risk of skin infection by pathogens is increased; (2) broiler skin surface is more likely to provide a conducive environment for colonization of Escherichia coli; (3) in the event of infection, poor recruitment of phagocytic cells to the site of infection may readily lead to widespread colonization of the tissue by pathogens causing cellulitis and (4) poor functional quality of the phagocytic cells that are mobilized compromise the ability of the host to contain the spread of infection.

Sustained serine proteases activity by prolonged increase in pH leads to degradation of lipid processing enzymes and profound alterations of barrier function and stratum corneum integrity

We showed recently that short-term increases in stratum corneum (SC) pH are accompanied by minor alterations in permeability barrier homeostasis and SC integrity/cohesion. Since prolonged SC neutralization more closely mirrors clinical situations (i.e., neonatal skin, occupational dermatitis conditions), we assessed here whether sustained elevations of SC pH by long-term application of 1,1,3,3-tetramethylguanidine superbase provoke profound alterations in SC function. Sustained SC neutralization altered not only barrier recovery kinetics but also basal permeability barrier function. These abnormalities were attributable to a decrease in beta-glucocerebrosidase (beta-GlcCer'ase) and acidic sphingomyelinase (aSMase) catalytic activity and enzyme degradation consequent to a pH-induced sustained serine protease (SP) activity. The role of SP in this process was shown by the normalization of enzyme activities/content by co-applied SP inhibitors (SPI). To address whether lipid-processing enzymes are potential substrates for the stratum corneum chymotryptic enzyme (SCCE), protein extracts from human SC were treated for 2 h at 37 degrees C with recombinant active SCCE at pH 7.2. Recombinant SCCE induced a significant decrease in the immunoblotting of both beta-GlcCer'ase or aSMase compared with control experiments performed in the absence of the active SCCE. Finally, with sustained SC neutralization, SC integrity/cohesion deteriorated, attributable to SP-mediated degradation of corneodesmosomes (CD) as well as CD constituent proteins, desmoglein 1. These abnormalities were again reversed by co-applied SPI. In conclusion, prolonged SC neutralization provokes profound abnormalities in SC function, due to pH-induced high SP activity that, in turn, degrades lipid processing enzymes and CD proteins.

Evaluation of the Antioxidant Capacity and Preventive Effects of a Topical Emulsion and Its Vehicle Control on the Skin Response to UV Exposure

Supplying topical exogenous antioxidants to the skin may prevent or minimize free radical-induced damaging. This study determines antioxidative capacity of a topical skin care emulsion (an oil-in-water vitamin E-containing formulation) versus its vehicle on human skin that was exposed to ultraviolet radiation (UVR) by utilizing a photochemiluminescence device and biophysical methods. Ten healthy Caucasians (3 male and 7 female; mean age 47 +/- 10 years) were enrolled. In a randomized and double-blind manner, a pH-balanced vitamin E emulsion or its vehicle control was applied onto predesignated forearm prior to UVR exposure. Thirty minutes after application, these test sites were exposed to a UV light to induce the minimal erythema dose. One untreated site served as a blank control. Visual scoring and instrumental measurements were recorded at baseline and at 24 h and 48 h thereafter. At day 3, after completing instrumental measurements, each test site was stripped three times in a consecutive manner with a proprietary adhesive tape disc. These tapes were quantified for antioxidant capacity using a photochemiluminescence device. Vitamin E emulsion and vehicle control significantly (p < 0.05) suppressed visual scores when compared with blank control at day 2 and day 3 after UV exposure. However, vitamin E emulsion showed significantly (p < 0.05) lower visual scores when compared with vehicle control at day 2 and day 3 after UV exposure.Also,vitamin E emulsion and its vehicle control significantly (p < 0.05) diminished skin color measurement (a*) values when compared with blank control at day 2 and day 3 after UV exposure. At day 2 after UV exposure, only vitamin E emulsion significantly (p < 0.05) reduced skin blood flow volume when compared with blank control. Vitamin E emulsion and its vehicle control showed significant (p < 0.05) reduction of blood flow volume when compared with blank control at day 3 after UV exposure. Vitamin E emulsion and its vehicle control proved effective in preventing induction of erythema and reducing inflammatory damage caused by UV exposure. The effect of vitamin E emulsion exceeded that of an 'active control'.

Field Study on Protocols for Evaluation of Teat Skin Conditions

Different protocols to evaluate teat skin status under field conditions based on scoring and on the measurement of pH and hydration of teat skin were evaluated. After determination of the teat score for all eligible animals in a commercial dairy herd, 50 of them were chosen, based on their pre-trial average teat score, and separated in two groups. Two different post-dipping products with the same amount of disinfectant, but with a different concentration of emollient were applied. All four teats were assessed with the corneometer and pH probes. A digital picture of each teat skin and teat orifice was taken with a digital camera. Hydration and pH data were analysed by anova with repeated-measurement factors, while teat skin and apex score patterns, were assessed by the means of Mann-Whitney test; between- and within-group changes were assessed by the mean of Mantel-Haenzel chi-square statistic. Data showed that teat skin pH and hydration could be assessed under field conditions and they were influenced by teat conditioning. The approach based on evaluating odds for scores, stratified for sampling and for treatment, was found to be a sensitive and informative way to compare the changes between and within treatment groups.

Stratum corneum maturation. A review of neonatal skin function

The importance of the stratum corneum and its barrier function for infants, especially for newborns, is clinically evident. Research regarding the maturation of the stratum corneum in neonates, i.e. when full barrier function is obtained, has produced varying results. Based on transepidermal water loss and percutaneous absorption studies, term infants seem to possess stratum corneum with adult barrier properties. Additionally, postnatal life is thought to accelerate stratum corneum maturation, so that even preterm infants have barrier function similar to term infants at 2-3 weeks of gestational age. However, a look at other parameters, such as skin thickness, skin pH and stratum corneum hydration, shows that neonatal skin is always adjusting to the extrauterine environment in contrast to the steady state of adult skin. This suggests that barrier stabilization may be dependent on achieving a balance between different parameters. However, it is still in question, which parameters, what balance and what timing. This paper provides an up-to-date overview on the neonatal skin barrier based on the review of current literature.

Stratum corneum pH in atopic dermatitis: impact on skin barrier function and colonization with Staphylococcus Aureus

Recent studies have provided new insights into the occurrence, causes, and pathogenetic consequences of changes in the skin pH in atopic dermatitis, particularly with respect to skin barrier function and colonization with Staphylococcus aureus. Growing evidence suggests an impaired release of proton donors, such as amino acids, urocanic acid, and lactic acid, to the stratum corneum in atopic dermatitis, as a result of reductions in filaggrin proteolysis and sweat secretion. In addition, an impaired formation of free fatty acids from sebaceous lipids and epidermal phospholipids seems to be involved. Because both lipid organization and lipid metabolism in the stratum corneum requires an acidic pH, these alterations might contribute to the disturbance of skin barrier function observed in atopic dermatitis. Furthermore, bacterial growth and virulence of S. aureus, as well as defensive host mechanisms, have increasingly been delineated as pH dependent, giving rise to a new understanding of the pathophysiology underlying increased skin colonization seen in atopic dermatitis.

Use of the 'ex vivo' test to study long-term bacterial survival on human skin and their sensitivity to antisepsis

AIMS

To determine bacterial survival on human skin and their sensitivity to antisepsis.

METHODS AND RESULTS

An 'ex vivo' protocol which uses human skin samples placed into diffusion cells, and electron microscopy (EM), were used to study the growth of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa inoculated onto skin samples over a 46-h incubation period at 32 degrees C. Concurrently variation in skin pH was evaluated at different time intervals during this period. In addition the antimicrobial activity of three antiseptics against the incubated micro-organisms was assessed quantitatively with the 'ex vivo' test, while their detrimental effects against bacteria were observed by EM. All three bacteria were still present in high number after 46 h inoculation on skin, although the concentration of E. coli and S. aureus were reduced by 2.74 and 1.58 log(10) reduction, respectively, over this period of time. Electron micrographs showed clear evidence of cell division and some bacteria appeared to be embedded into the skin layers. The antiseptics tested had some antibacterial activity against bacteria incubated on skin for 3 and 10 h, and EM evidence showed some morphological damages including cellular blebbing and the presence of fibrillar material around the cells. All micro-organisms had an acidifying effect on skin samples.

CONCLUSIONS

Here, it was shown that bacterial pathogens can survive and grow when incubated on human skin. In addition, it is possible that they can penetrate the stratum corneum, which can provide some protection against antisepsis.

SIGNIFICANCE AND IMPACT OF THE STUDY

The apparent low bactericidal activity of biocides attributed in part to bacterial protection from skin layers is particularly important to assess in order to ensure antisepsis efficacy.

Topical Delivery of Retinyl Ascorbate Co-Drug

Retinyl ascorbate (RA-AsA), an ester co-drug of vitamins A (RA) and C (AsA), is proposed as a topical antioxidant/cell division regulator for reducing UV-induced generation of free radicals and disrupted dermal cell growth. The efficacy of dermatological agents is influenced by their retention within the skin, which is increased by the interaction with skin components. Keratin is the major protein (approximately 95%) in the skin, and this paper reports the binding of RA-AsA, RA, AsA, retinol, ascorbic acid palmitate and retinol palmitate to three tissues-human callus, pig ear skin and bovine horn keratin. Tissue samples were incubated with solutions of compounds and the uptake measured as the ratio of bound/free compound at equilibrium. Binding to keratin was assessed using delipidised tissue, and was much higher for the polar compounds, suggesting dipolar/H-bonding interaction. Binding strength was ranked as human > porcine > bovine, but there was no distinction for highly lipophilic compounds. The binding characteristic of native tissues was complicated by lipid content of the tissues. There seemed to be a dual effect. The binding of very lipophilic materials increased with lipid content, implying that a substantial amount is dissolved in the lipid matrix. For highly polar AsA, lipid content decreased the binding, suggesting that the lipid reduced the strong polar interactions with skin protein/keratin.

Comparison of two in vivo and two ex vivo tests to assess the antibacterial activity of several antiseptics

An ex vivo test was adapted to mimic the in vivo conditions of testing antiseptic activity on human forearms and in the European Standard Hygienic Handwash Test (BSEN 1499). The study was to validate the ex vivo protocols using 4.8% (w/v) para-chloro-meta-xylenol (PCMX, neat Dettol), 0.5% (w/v) triclosan in 70% (v/v) isopropanol, and 2% (v/v) povidone-iodine against a high bacterial inoculum (>10(8) cfu/mL) of Escherichia coli NCTC 10538. Two ex vivo tests using human skin samples, including one introducing a mechanical rubbing effect, were compared with two corresponding in vivo tests (the forearm test and the BSEN handwashing test). All antiseptics assessed in vivo (forearm and handwash tests) produced reductions in bacterial counts that were significantly greater than those for the non-medicated soft soap control. When assessed ex vivo without rubbing, only PCMX and povidone-iodine achieved reductions significantly greater than soft soap. When assessed ex vivo with mechanical rubbing, only PCMX and triclosan achieved reductions significantly greater than soft soap. Overall, the antiseptics at the concentrations tested were more active when tested in vivo than ex vivo. The addition of a mechanical effect, either in vivo by the volunteers washing their hands or ex vivo by a drill rubbing two skin samples against each other, produced a significantly greater reduction in bacterial concentrations. The ex vivo tests were easily adapted to mimic in vivo protocols. The value of such tests, particularly the one that includes a rubbing effect, may be significant as they avoid the need for human volunteers.

Topical delivery of retinyl ascorbate co-drug

A novel synthetic technique was used to synthesise the co-drug retinyl ascorbate (RA-AsA) ester from all-trans-retinyl chloride (RA) and L-ascorbic acid (AsA) suspended in ethanol at low temperature. Its log P, solubility in a Me:PBS, 50/50 at pH 4.8 and degradation constant were determined. The flux and permeation coefficient were determined using heat separated human skin membrane, and skin penetration was determined by tape stripping using full thickness human. All experiments were performed in parallel with retinyl palmitate (Rol-Pal) and ascorbyl palmitate (AsA-Pal), which are used in commercial topical formulations. RA-AsA exhibited favourable log P (2.2), with stability much greater than RA and AsA, but similar stability to Rol-Pal and AsA-Pal. The flux of RA-AsA was lower than for Rol-Pal and AsA-Pal. RA-AsA also demonstrated higher skin retention than the other two esters, but delivered more RA and AsA to the viable epidermis than retinol from Rol-Pal and ascorbic acid from AsA-Pal. Overall, the data suggest the potential value of RA-AsA co-drug for the purpose of treating damage to skin resulting from UV-induced production of free radicals.