Profilaggrin, Dry Skin, and Atopic Dermatitis Risk: Size Matters

Novel filagrinol-containing emollient

ABSTRACT:In the last decade, there has been a significant increase in interest in the study of the role of epidermal barrier structural integrity in order to determine the prospects for its pathogenetic correction. It is now known that patients with filaggrin gene mutations have increased risk of developing atopic dermatitis, xerosis, ichthyosis, eczema. Filaggrin participates in the formation of a full-fledged stratum corneum, provides formation of a natural moisturizing factor, stabilizing the water balance of the stratum corneum. In Russia, the innovative filaggrin-containing "Admera" has been registered, which opens up prospects in the management impaired skin barrier function diseases. Aims:efficacy and safety of "Admera" emollient in patients with primary and secondary xerosis. Methods:A single-center prospective interventional study December 2021 - March 2022 at the Department of Skin and Venereal Diseases of the Sechenov University. The study included 32 patients (22 - main group, 10 - control group) aged 18 to 60 years (29 9.78), 14 men and 18 women diagnosed with skin xerosis. Patients applied moisturizers 3 times a day for 21 days. Performance was evaluated using vIGA-AD, POEM, EASI, 5D Elman scale, SKINDEX-29, HADS, on Capricorn AI, ANTERA 3D machines. Results:A steady regression of clinical symptoms of xerosis was noted during the study by the dynamics of the study scales. The mean EASI score decreased by 67% from 25.25 18.78 - screening to 7.8 4.41 - control visit (p 0.001). Assessment of POEM index dynamics showed a significant decrease in total score from 18.65 to 6.6 (p 0.001). There was good tolerability of the drug and absence of adverse events. Conclusion:The filagrinol-containing emollient "Admera" demonstrated high efficacy and safety in all patients. This emollient can be recommended as a basic care product for treatment and prevention of primary, secondary xerosis, relapses of atopic dermatitis.

A Biomimetic Combination of Actives Enhances Skin Hydration and Barrier Function via Modulation of Gene Expression: Results of Two Double-Blind, Vehicle-Controlled Clinical Studies

INTRODUCTION

Xerosis cutis is characterized by a decreased stratum corneum (SC) hydration and an impaired skin barrier function. Urea, the most prevalent natural moisturizing factor (NMF), is currently considered the gold standard. Its efficacy can further be increased by combining urea with other NMF and skin barrier lipids (SBLs).

OBJECTIVE

We set out to evaluate physiological effects of a novel functional moisturizer containing 10% urea, additional NMF components, and a combination of SBLs on skin hydration and skin barrier integrity on a cellular and phenotypic level in female volunteers suffering from xerosis.

METHODS

Two double-blind, vehicle-controlled clinical studies were conducted. In the first study, 44 female subjects having very dry body skin applied the moisturizer or its vehicle twice daily to their volar forearms. Twenty-four hours after a single product application as well as 24 h after 2 weeks of treatment, SC hydration was measured by corneometry. Skin barrier function was assessed by transepidermal water loss 24 h and 48 h after 2 weeks of regular use. Twenty-four hours after 2 weeks of application, skin tape stripping was performed, and urea content was determined in the 3rd strip by means of high-performance liquid chromatography/tandem mass spectrometry. In the second study, 22 women with self-reported very dry skin applied the moisturizer or vehicle twice daily to their volar forearms for 2 weeks. Then, suction blister samples were obtained for gene expression analysis using RT-PCR.

RESULTS

Application of the actives led to significantly improved skin hydration and barrier function at all points in time. Compared to the vehicle, application of the moisturizer for 2 weeks resulted in a significant increase in SC urea content. Relative gene expression data revealed significant upregulation of genes associated with skin barrier function, hydration, differentiation, and lipid metabolism compared to the vehicle-treated area.

CONCLUSIONS

Overall, our data demonstrate that the functional moisturizer provides an adequate bioavailability of urea and a beneficial biophysical impact on xerotic skin. Topical treatment with a combination of urea and additional NMF as well as SBL can modify mRNA expression of important epidermal genes stimulating cellular processes and functions. The well-tolerated novel functional moisturizer stimulates molecular mechanisms involved in skin hydration and barrier function and is a profoundly effective treatment option for xerosis cutis.

Anti-allergic and Profilaggrin (ProFLG)-mRNA expression modulatory effects of sacran

Atopic dermatitis (AD) is a skin disorder characterized by filaggrin (FLG) defect. We evaluated sacran's effects on dust-mite extracts (DME)-induced AD-like disease and also its effect on profilaggrin (proFLG) in a murine model of 2,4-dinitroflurobenze (DNFB)-induced contact hypersensitivity. In the murine AD-like disease model, allergic NC/Nga mice (N=60) were randomly divided into five treatment groups of 12 animals each: 0.2% and 1%sacran; 0.1% Tacrolimus; Vaseline and buffer-treated controls. Blood samples were drawn and serum levels of representative Th-1, Th-2 and also Th-17 (IL-17A) cytokines were assayed by Cytometric Bead Array (CBA). In the contact hypersensitivity model, diseased NC/Nga mice (N=20) were divided into four groups of five mice each [0.05%sacran, 0.05% chondroitin sulfate (CS), 0.5% prednisolone (PD), non-treated control group] and were treated for 14days. Skin biopsies were performed for the measurement of proFLG-mRNA by real-time PCR. Sacran solutions and 0.1%Tacrolimus reduced disease severity, suppressed histological changes and decreased the serum Th-1 (IFN-γ, TNF-α, IL-2) and Th-2 (IL-4, IL-6, IL-10) cytokines in allergic mice (vs. controls). Additionally, a marked increase of proFLG-mRNA expression was observed in 0.05%sacran group (vs. control 0.05% CS and 0.5% PD groups). Thus, Sacran might be useful as a natural skin barrier enhancer and anti-allergic agent.

Chinese herbal medicine network and core treatments for allergic skin diseases: Implications from a nationwide database

ETHNO-PHARMACOLOGICAL RELEVANCE

Chinese herbal medicine (CHM) is commonly used to treat skin diseases, but CHM prescription patterns are difficult to understand due to their complexity and inter-connections. This study aimed to demonstrate CHM core treatments and network for treatment of allergic skin diseases by analyzing a nationwide prescription database.

MATERIALS AND METHODS

All CHM prescriptions made for atopic dermatitis (with age limitation ≤ 12 years) and urticaria for the entire year of 2011 were included. Association rule mining (ARM) combined with social network analysis (SNA) were used to analyze CHM prescriptions and explore the CHM prescription pattern and network.

RESULTS

A total of 27,350 and 97,188 prescriptions for atopic dermatitis and urticaria, respectively, were analyzed. Xiao-Feng-San (XFS) was the most commonly used CHM (32% of prescriptions for atopic dermatitis and 47.4% for urticaria) and was the core treatment for both diseases. Moreover, 42 and 82 important CHM-CHM combinations were identified to establish the CHM network, and XFS with Dictamnus dasycarpus Turcz was the most prevalent (6.4% for atopic dermatitis and 9.1% for urticaria). Traditional Chinese Medicine heat syndrome was most prevalent cause. Extensive anti-inflammation, anti-allergy, anti-oxidation, and anti-bacterial effects were also found among the CHMs.

CONCLUSIONS

Network analysis on CHM prescriptions provides graphic and comprehensive illustrations regarding CHM treatment for atopic dermatitis and urticaria. The CHM network analysis of prescriptions is essential to realize the CHM treatments and to select suitable candidates for clinical use or further studies.