1
|
Reynolds WJ, Eje N, Christensen P, Li W, Daly SM, Parsa R, Chavan B, Birch‐Machin MA. Biological effects of air pollution on the function of human skin equivalents. FASEB Bioadv 2023; 5:470-483. [PMID: 37936922 PMCID: PMC10626160 DOI: 10.1096/fba.2023-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 07/13/2023] [Accepted: 09/14/2023] [Indexed: 11/09/2023] Open
Abstract
The World Health Organization reports that 99% of the global population are exposed to pollution levels higher than the recommended air quality guidelines. Pollution-induced changes in the skin have begun to surface; however, the effects require further investigation so that effective protective strategies can be developed. This study aimed to investigate some of the aging-associated effects caused by ozone and particulate matter (PM) on human skin equivalents. Full-thickness skin equivalents were exposed to 0.01 μg/μL PM, 0.05 μg/μL PM, 0.3 ppm ozone, or a combination of 0.01 μg/μL PM and 0.3 ppm ozone, before skin equivalents and culture medium were harvested for histological/immunohistochemical staining, gene and protein expression analysis using qPCR, Western blotting, and ELISA. Markers include MMP-1, MMP-3, COL1A1, collagen-I, 4-HNE, HMGCR, and PGE2. PM was observed to induce a decrease in epidermal thickness and an enhanced matrix building phenotype, with increases in COL1A1 and an increase in collagen-I protein expression. By contrast, ozone induced an increase in epidermal thickness and was found to induce a matrix-degrading phenotype, with decreases in collagen-I gene/protein expression and increases in MMP-1 and MMP-3 gene/protein expression. Ozone was also found to induce changes in lipid homeostasis and inflammation induction. Some synergistic damage was also observed when combining ozone and 0.01 μg/μL PM. The results presented in this study identify distinct pollutant-induced effects and show how pollutants may act synergistically to augment damage; given individuals are rarely only exposed to one pollutant type, exposure to multiple pollutant types should be considered to develop effective protective interventions.
Collapse
Affiliation(s)
- Wil J. Reynolds
- Dermatological Sciences, Institute of Translational and Clinical ResearchNewcastle UniversityNewcastle upon TyneUK
| | - Ndubuisi Eje
- Bedson Building, Newcastle UniversityNewcastle upon TyneUK
| | | | - Wen‐Hwa Li
- Johnson and Johnson Consumer Inc.SkillmanNew JerseyUSA
| | - Susan M. Daly
- Johnson and Johnson Consumer Inc.SkillmanNew JerseyUSA
| | - Ramine Parsa
- Johnson and Johnson Consumer Inc.SkillmanNew JerseyUSA
| | | | - Mark A. Birch‐Machin
- Dermatological Sciences, Institute of Translational and Clinical ResearchNewcastle UniversityNewcastle upon TyneUK
| |
Collapse
|
2
|
Évora AS, Abiakam N, Zhang Z, Johnson SA, Adams MJ, Bader DL, Worsley PR. Characterisation of superficial corneocyte properties over category I pressure ulcers: Insights into topographical and maturation changes. J Dermatol Sci 2023; 112:63-70. [PMID: 37953180 DOI: 10.1016/j.jdermsci.2023.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/19/2023] [Accepted: 08/31/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Pressure ulcers (PUs) are chronic wounds that are detrimental to the quality of life of patients. Despite advances in monitoring skin changes, the structure and function of skin cells over the site of pressure ulcers are not fully understood. OBJECTIVE The present study aims to evaluate local changes in the properties of superficial corneocytes in category 1 PU sites sampled from a cohort of hospitalised patients. METHODS Cells were collected from a PU-compromised site and an adjacent control area and their topographical, maturation and mechanical properties were analysed. RESULTS Corneocytes at the PU-compromised site were characterised by higher levels of immature cornified envelopes (p < 0.001) and greater amounts of desmoglein-1 (corneodesmosomal protein) (p < 0.001) compared to the adjacent control area. The cells at the control site presented the typical ridges-and-valleys topographical features of sacrum corneocytes. By contrast, the PU cells presented circular nano-objects at the cell surface, and, for some patients, the cell topography was deformed. CEs at the PU site were also smaller than at the control site. Although differences were not observed in the mechanical properties of the cells, those of the elderly patients were much softer compared with young subjects. CONCLUSION This is the first study investigating the changes in corneocyte properties in category I pressure ulcers. Superficial cells at the PU sites showed altered topographical and maturation characteristics. Further studies are required to elucidate if these changes are a consequence of early loss of skin integrity or a result of mechanical and microclimate insults to the skin surface.
Collapse
Affiliation(s)
- Ana S Évora
- School of Chemical Engineering, University of Birmingham, Birmingham, UK.
| | - Nkemjika Abiakam
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Zhibing Zhang
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Simon A Johnson
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Michael J Adams
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Dan L Bader
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Peter R Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
3
|
Zamani Zakaria A, Jepps OG, Gould T, Anissimov YG. Permeable Cornified Envelope Layer Regulates the Solute Transport in Human Stratum Corneum. J Pharm Sci 2023; 112:1939-1946. [PMID: 36931344 DOI: 10.1016/j.xphs.2023.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023]
Abstract
To unravel the diffusion mechanisms of percutaneous drug delivery, suitable numerical analysis of stratum corneum structure is essential. In this research paper, we accounted for the permeable envelope layer in the brick-and-mortar finite element models of human stratum corneum. Both penetration and desorption experiments for tritiated water were simulated by transient finite element analysis. Rivet-shaped corneodesmosomes were included in the brick and mortar model. Results showed that cornified lipid permeability (Penv) is a determinant in desorption of the solute, while lipid transverse diffusion coefficient (Dlip-trans) is prominent during penetration. These two major unknowns (Penv and Dlip-trans) were obtained by extensive fitting of the finite element model to the experimental water data. Penv and Dlip-trans were determined to be 1×10-2 cm/s and 5.7×10-10 cm2/s, respectively.
Collapse
Affiliation(s)
- Afshin Zamani Zakaria
- School of Environment and Science, Griffith University, Queensland 4111, Australia; Queensland Micro and Nanotechnology Centre, Griffith University, Nathan, Queensland 4111, Australia.
| | - Owen G Jepps
- School of Environment and Science, Griffith University, Queensland 4111, Australia; Queensland Micro and Nanotechnology Centre, Griffith University, Nathan, Queensland 4111, Australia.
| | - Tim Gould
- School of Environment and Science, Griffith University, Queensland 4111, Australia; Queensland Micro and Nanotechnology Centre, Griffith University, Nathan, Queensland 4111, Australia
| | - Yuri G Anissimov
- Queensland Micro and Nanotechnology Centre, Griffith University, Nathan, Queensland 4111, Australia
| |
Collapse
|
4
|
S Évora A, Abiakam N, Jayabal H, Worsley PR, Zhang Z, A Johnson S, J Adams M, Bader DL. Characterisation of superficial corneocytes in skin areas of the face exposed to prolonged usage of respirators by healthcare professionals during COVID-19 pandemic. J Tissue Viability 2023; 32:305-313. [PMID: 36813598 PMCID: PMC9918437 DOI: 10.1016/j.jtv.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/27/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic healthcare workers (HCWs) have used respiratory protective equipment for prolonged periods, which has been associated with detrimental effects on the underlying skin. The present study aims to evaluate changes in the main cells (corneocytes) of the stratum corneum (SC) following prolonged and consecutive use of respirators. METHODS 17 HCWs who wore respirators daily during routine hospital practice were recruited to a longitudinal cohort study. Corneocytes were collected via tape stripping from a negative control site (area outside the respirator) and from the cheek which was in contact with the device. Corneocytes were sampled on three occasions and analysed for the level of positive-involucrin cornified envelopes (CEs) and the amount of desmoglein-1 (Dsg1), as indirect measurements of immature CEs and corneodesmosomes (CDs), respectively. These were compared to biophysical measurements (Transepidermal water loss, TEWL, and SC hydration) at the same investigation sites. RESULTS A large degree of inter-subject variability was observed, with maximum coefficients of variation of 43% and 30% for the level of immature CEs and Dsg1, respectively. Although it was observed that there was not an effect of prolonged respirator usage on the properties of corneocytes, the level of CDs was greater at the cheek than the negative control site (p < 0.05). Furthermore, low levels of immature CEs correlated with greater TEWL values after prolonged respirator application (p < 0.01). It was also noted that a smaller proportion of immature CEs and CDs was associated with a reduced incidence of self-reported skin adverse reactions (p < 0.001). CONCLUSIONS This is the first study that investigated changes in corneocyte properties in the context of prolonged mechanical loading following respirator application. Although differences were not recorded over time, the levels of CDs and immature CEs were consistently higher in the loaded cheek compared to the negative control site and were positively correlated with a greater number of self-reported skin adverse reactions. Further studies are required to evaluate the role of corneocyte characteristics in the evaluation of both healthy and damaged skin sites.
Collapse
Affiliation(s)
- Ana S Évora
- School of Chemical Engineering, University of Birmingham, Birmingham, UK.
| | - Nkemjika Abiakam
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Hemalatha Jayabal
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Peter R Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Zhibing Zhang
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Simon A Johnson
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Michael J Adams
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Dan L Bader
- School of Health Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
5
|
Li Z, Jiang R, Jing C, Liu J, Xu X, Sun L, Zhao D. Protective effect of oligosaccharides isolated from Panax ginseng C. A. Meyer against UVB-induced skin barrier damage in BALB/c hairless mice and human keratinocytes. JOURNAL OF ETHNOPHARMACOLOGY 2022; 283:114677. [PMID: 34562563 DOI: 10.1016/j.jep.2021.114677] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/28/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Skin barrier dysfunction can lead to water and electrolyte loss, triggering homeostatic imbalances that can trigger atopic dermatitis and anaphylaxis. Panax ginseng C.A. Meyer is a traditional Chinese medicinal herb with known therapeutic benefits for the treatment of skin diseases, including photodamage repair effects and reduction of pigmentation. However, few reports exist that describe effectiveness of ginseng active components for repair of skin barrier damage. MATERIALS AND METHODS Ginseng oligosaccharide extract (GSO) was prepared from P. ginseng via water extraction followed by ethanol precipitation and resin and gel purification. GSO composition and structural characteristics were determined using LC-MS, HPLC, FT-IR, and NMR. To evaluate GSO as a skin barrier repair-promoting treatment, skin of UVB-irradiated BALB/c hairless mice was treated with or without GSO then skin samples were evaluated for epidermal thickness, transepidermal water loss (TEWL), and stratum corneum water content. In addition, UVB-exposed skin samples and HaCaT cells were analyzed to assess GSO treatment effects on levels of epidermal cornified envelope (CE) protein and other skin barrier proteins, such as filaggrin (FLG), involucrin (IVL), and aquaporin-3 (AQP3). Meanwhile, GSO treatment was also evaluated for effects on UVB-irradiated hairless mouse skin and HaCaT cells based on levels of serine protease inhibitor Kazal type-5 (SPINK5), trypsin-like kallikrein-related peptidase 5 (KLK5), chymotrypsin-like KLK7, and desmoglein 1 (DSG1). These proteins are associated with UVB-induced skin barrier damage manifesting as dryness and desquamation. RESULTS GSO was shown to consist of oligosaccharides comprised of seven distinct types of monosaccharides with molecular weights of approximately 1 kDa that were covalently linked together via β-glycosidic bonds. In vivo, GSO applied to dorsal skin of BALB/c hairless mice attenuated UVB-induced epidermal thickening and moisture loss. Furthermore, GSO ameliorated UVB-induced reductions of levels of FLG, IVL, and AQP3 proteins. Additionally, GSO treatment led to increased DSG1 protein levels due to decreased expression of KLK7. In vitro, GSO treatment of UVB-irradiated HaCaT cells led to increases of FLG, IVL, and AQP3 mRNA levels and corresponding proteins, while mRNA levels of desquamation-related proteins SPINK5, KLK5, KLK7, and DSG1 and associated protein levels were restored to normal levels. CONCLUSION A P. ginseng oligosaccharide preparation repaired UVB-induced skin barrier damage by alleviating skin dryness and desquamation symptoms, highlighting its potential as a natural cosmetic additive that can promote skin barrier repair after UVB exposure.
Collapse
Affiliation(s)
- Zhenzhuo Li
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, Jilin Province, China; Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Rui Jiang
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Chenxu Jing
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, Jilin Province, China; Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Jianzeng Liu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Xiaohao Xu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, Jilin Province, China; Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Liwei Sun
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China; Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Changchun University of Chinese Medicine, Changchun, Jilin Province, China; Jilin Province Traditional Chinese Medicine Characteristic Health Product Research and Development Cross-regional Cooperation Science and Technology Innovation Center, Changchun University of Chinese Medicine, Changchun, Jilin Province, China.
| | - Daqing Zhao
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, Jilin Province, China; Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Changchun University of Chinese Medicine, Changchun, Jilin Province, China.
| |
Collapse
|
6
|
Rigal A, Michael-Jubeli R, Nkengne A, Baillet-Guffroy A, Bigouret A, Tfayli A. Raman confocal microscopy and biophysics multiparametric characterization of the skin barrier evolution with age. JOURNAL OF BIOPHOTONICS 2021; 14:e202100107. [PMID: 34105894 DOI: 10.1002/jbio.202100107] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
Skin aging is a multifactorial phenomenon that involves alterations at the molecular, cellular and tissue levels. Our aim was to carry out a multiparametric biophysical and Raman characterization of skin barrier between individuals of different age groups (<24 and >70 years old). Our results showed a significant decrease of lipids to proteins ratio overall the thickness of the stratum corneum and higher lateral packing in the outer part of the SC for elderly. This can explain the decrease in trans epidermal water loss measured values rather than only SC thickening. Both age groups showed similar water content at SC surface while elderly presented higher water content in deep SC and viable epidermis. Mechanical measurements showed a decrease in the elasticity and an increase in the fatigability with age and were correlated with partially bound water. Highest correlation and anti-correlation values were observed for the deepest part of the SC and the viable epidermis.
Collapse
Affiliation(s)
- Aline Rigal
- Lipides: Systèmes Analytiques et Biologiques Lip(Sys)2 Interdisciplinary Unit, Faculty of Pharmacy, University Paris-Saclay, Châtenay-Malabry, France
| | - Rime Michael-Jubeli
- Lipides: Systèmes Analytiques et Biologiques Lip(Sys)2 Interdisciplinary Unit, Faculty of Pharmacy, University Paris-Saclay, Châtenay-Malabry, France
| | - Alex Nkengne
- Clarins Laboratories, LEC : Laboratoire d'Evaluation Clinique, Pontoise, France
| | - Arlette Baillet-Guffroy
- Lipides: Systèmes Analytiques et Biologiques Lip(Sys)2 Interdisciplinary Unit, Faculty of Pharmacy, University Paris-Saclay, Châtenay-Malabry, France
| | - Armelle Bigouret
- Clarins Laboratories, LEC : Laboratoire d'Evaluation Clinique, Pontoise, France
| | - Ali Tfayli
- Lipides: Systèmes Analytiques et Biologiques Lip(Sys)2 Interdisciplinary Unit, Faculty of Pharmacy, University Paris-Saclay, Châtenay-Malabry, France
| |
Collapse
|
7
|
Towards Optimal pH of the Skin and Topical Formulations: From the Current State of the Art to Tailored Products. COSMETICS 2021. [DOI: 10.3390/cosmetics8030069] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Acidic pH of the skin surface has been recognized as a regulating factor for the maintenance of the stratum corneum homeostasis and barrier permeability. The most important functions of acidic pH seem to be related to the keratinocyte differentiation process, the formation and function of epidermal lipids and the corneocyte lipid envelope, the maintenance of the skin microbiome and, consequently, skin disturbances and diseases. As acknowledged extrinsic factors that affect skin pH, topically applied products could contribute to skin health maintenance via skin pH value control. The obtained knowledge on skins’ pH could be used in the formulation of more effective topical products, which would add to the development of the so-called products ‘for skin health maintenance’. There is a high level of agreement that topical products should be acidified and possess pH in the range of 4 to 6. However, formulators, dermatologists and consumers would benefit from some more precise guidance concerning favorable products pH values and the selection of cosmetic ingredients which could be responsible for acidification, together with a more extensive understanding of the mechanisms underlaying the process of skin acidification by topical products.
Collapse
|
8
|
Évora AS, Adams MJ, Johnson SA, Zhang Z. Corneocytes: Relationship between Structural and Biomechanical Properties. Skin Pharmacol Physiol 2021; 34:146-161. [PMID: 33780956 DOI: 10.1159/000513054] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/13/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Skin is the interface between an organism and the external environment, and hence the stratum corneum (SC) is the first to withstand mechanical insults that, in certain conditions, may lead to integrity loss and the development of pressure ulcers. The SC comprises corneocytes, which are vital elements to its barrier function. These cells are differentiated dead keratinocytes, without organelles, composed of a cornified envelope and a keratin-filled interior, and connected by corneodesmosomes (CDs). SUMMARY The current review focusses on the relationship between the morphological, structural, and topographical features of corneocytes and their mechanical properties, to understand how they assist the SC in maintaining skin integrity and in responding to mechanical insults. Key Messages: Corneocytes create distinct regions in the SC: the inner SC is characterized by immature cells with a fragile cornified envelope and a uniform distribution of CDs; the upper SC has resilient cornified envelopes and a honeycomb distribution of CDs, with a greater surface area and a smaller thickness than cells from the inner layer. The literature indicates that this upward maturation process is one of the most important steps in the mechanical resistance and barrier function of the SC. The morphology of these cells is dependent on the body site: the surface area in non-exposed skin is about 1,000-1,200 μm2, while for exposed skin, for example, the cheek and forehead, is about 700-800 μm2. Corneocytes are stiff cells compared to other cellular types, for example, the Young's modulus of muscle and fibroblast cells is typically a few kPa, while that of corneocytes is reported to be about hundreds of MPa. Moreover, these skin cells have 2 distinct mechanical regions: the cornified envelope (100-250 MPa) and the keratin matrix (250-500 MPa).
Collapse
Affiliation(s)
- Ana S Évora
- School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Michael J Adams
- School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Simon A Johnson
- School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Zhibing Zhang
- School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
9
|
Lipsky ZW, German GK. Ultraviolet light degrades the mechanical and structural properties of human stratum corneum. J Mech Behav Biomed Mater 2019; 100:103391. [DOI: 10.1016/j.jmbbm.2019.103391] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/26/2019] [Accepted: 08/06/2019] [Indexed: 11/25/2022]
|
10
|
Chan RJ, Blades R, Jones L, Downer TR, Peet SC, Button E, Wyld D, McPhail S, Doolan M, Yates P. A single-blind, randomised controlled trial of StrataXRT® - A silicone-based film-forming gel dressing for prophylaxis and management of radiation dermatitis in patients with head and neck cancer. Radiother Oncol 2019; 139:72-78. [PMID: 31445838 DOI: 10.1016/j.radonc.2019.07.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 01/01/2023]
Abstract
AIM Investigate the effects of StrataXRT® versus 10% Glycerine (Sorbolene cream) for preventing and managing radiation dermatitis in patients with head and neck cancer receiving radical radiotherapy (≥50 Gy) with or without chemotherapy or biotherapy. METHODS A single-blind, randomised controlled, superiority trial was conducted. Patients either received StrataXRT® or Sorbolene (usual care). Skin toxicity, pain, itching and skin-related quality of life scores were collected from baseline, and up to four weeks post-treatment. RESULTS A total of 197 patients were randomised into the study. Skin toxicity was dependent on the treatment group with StrataXRT® patients experiencing lower mean skin toxicity at the end of the radiation treatment (P = 0.002). At the end of treatment, the StrataXRT® arm had a lower percentage of grade 2 (80%) and grade 3 (28%) skin toxicity compared to the sorbolene arm (91% and 45% respectively). After adjustment for Cetuximab, the StrataXRT® arm had a 12% lower risk of experiencing grade 2 skin toxicity (RRR = 0.876, 95% CI: 0.778-0.987, P = 0.031); and a 36% lower risk of experiencing grade 3 skin toxicity (RRR = 0.648, 95% CI: 0.442-0.947, P = 0.025). Cox regression analysis showed that patients receiving StrataXRT® had a 41.0% and 49.4% reduced risks of developing grade 2 and 3 skin toxicity respectively throughout treatment compared to the Sorbolene arm. There were no differences between groups in patient-reported outcomes. No treatment interruptions and study product related adverse events were reported in either arm. CONCLUSION StrataXRT® is effective for preventing, and delaying the development of grade 2 and 3 skin toxicity. TRIAL REGISTRATION ACTRN12616000511437.
Collapse
Affiliation(s)
- Raymond J Chan
- Princess Alexandra Hospital, Metro South Health and Hospital Services, Woolloongabba, Q4102, Queensland, Australia; School of Nursing, Queensland University of Technology, Kelvin Grove, Q4059, Queensland, Australia.
| | - Rae Blades
- School of Nursing, Queensland University of Technology, Kelvin Grove, Q4059, Queensland, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029, Queensland, Australia
| | - Lee Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Q4029, Queensland, Australia
| | - Tai-Rae Downer
- School of Nursing, Queensland University of Technology, Kelvin Grove, Q4059, Queensland, Australia
| | - Samuel C Peet
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029, Queensland, Australia
| | - Elise Button
- School of Nursing, Queensland University of Technology, Kelvin Grove, Q4059, Queensland, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029, Queensland, Australia
| | - David Wyld
- School of Nursing, Queensland University of Technology, Kelvin Grove, Q4059, Queensland, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029, Queensland, Australia
| | - Steven McPhail
- Australian Centre for Health Services Innovation and School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Q4029, Queensland, Australia
| | - Melissa Doolan
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029, Queensland, Australia
| | - Patsy Yates
- Princess Alexandra Hospital, Metro South Health and Hospital Services, Woolloongabba, Q4102, Queensland, Australia; School of Nursing, Queensland University of Technology, Kelvin Grove, Q4059, Queensland, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029, Queensland, Australia
| |
Collapse
|
11
|
Goto H, Tada A, Ibe A, Kitajima Y. Basket-weave structure in the stratum corneum is an important factor for maintaining the physiological properties of human skin as studied using reconstructed human epidermis and tape stripping of human cheek skin. Br J Dermatol 2019; 182:364-372. [PMID: 31077338 DOI: 10.1111/bjd.18123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The normal stratum corneum (SC) has an upper basket-weave (BW) pattern layer and a lower compact layer. The transition from compact to BW SC is well associated with a transition from diffuse to peripheral distributions of corneodesmosomes (CDs). The loss of transition from compact SC to BW SC appears to cause structural and barrier-function impairments. OBJECTIVES To show the involvement of the BW SC in maintaining the physiological properties of the skin. METHODS Reconstructed human epidermis (RHE) with a complete BW structure was created by treatment with prepared emulsion-A, an oil-in-water emulsion. The RHE tissues were subjected to histological analysis, and the distribution of CDs on the SC with or without BW SC was analysed by anti-desmoglein (Dsg)1 antibody immunofluorescence and ultrastructural and Western blotting analyses. Ultrastructural analysis of intercellular lipids was performed. The mechanical properties of the RHE were evaluated. RESULTS Emulsion-A successfully generated the BW SC in the RHE in which the degradation of CDs was promoted. The intercellular space of the BW SC generated by emulsion-A was filled with multilamellar lipid sheets. The softness of the SC with a BW structure formed with emulsion-A was higher than that of the compact SC in RHE. The outermost SC Dsg1 degradation (formation of the BW SC as determined with Dsg1 pixels) was correlated with water-barrier functions and the SC softness of healthy human cheek, which varied widely. CONCLUSIONS Emulsion-A successfully generated the BW SC in RHE for the first time. This method is suggested to be a useful tool for investigating the physiological significance of the BW SC in vitro. Determination of Dsg1 content in the SC obtained by tape stripping from human skin allows study of the effects of external stimulants, such as creams and ointments, including cosmetics, on the completeness of the BW SC in situ without biopsy. What's already known about this topic? The normal stratum corneum (SC) has two layers, an upper basket-weave (BW) pattern layer and a lower compact layer. Epidermal diseases such as ichthyosis vulgaris and X-linked ichthyosis have an incomplete or no BW SC and impaired SC barrier functions, in which corneodesmosome (CD) degradation in a peripheral distribution is impaired. The roles of the BW SC in the physiological properties of human skin have not been clearly elucidated. What does this study add? Reconstructed human epidermis (RHE) with a complete BW structure was generated for the first time by treatment with oil-in-water emulsion-A. The formation of the BW SC was associated with a decrease in Dsg1 content, which represents the CD number in the SC. The intercellular space of the BW SC generated by emulsion-A, but not compact SC, was filled with multilamellar lipid sheets. The softness of the SC with a BW structure formed by emulsion-A treatment was higher than that of the compact SC in RHE. What is the translational message? RHE with a complete BW SC generated by emulsion-A treatment is suggested to be a useful tool for investigating effects on the physiological functions of the BW SC, as in treatments with creams and ointments including cosmetics. Determination of desmoglein 1 content in the SC obtained by tape stripping from human skin can make it possible to study the effects of external stimulants, such as creams and ointments, including cosmetics, on the completeness of the BW SC in situ without biopsy.
Collapse
Affiliation(s)
- H Goto
- Product Development Department, POLA Chemical Industries, Inc., 560 Kashio-cho, Totsuka-ku, Yokohama, 244-0812, Japan
| | - A Tada
- Product Development Department, POLA Chemical Industries, Inc., 560 Kashio-cho, Totsuka-ku, Yokohama, 244-0812, Japan
| | - A Ibe
- Frontier Research Center, POLA Chemical Industries, Inc., 560 Kashio-cho, Totsuka-ku, Yokohama, 244-0812, Japan
| | - Y Kitajima
- Department of Dermatology, Kizawa Memorial Hospital, 590 Shimokobi, Kobi, Minokamo, Gifu, 505-8503, Japan
| |
Collapse
|