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Pereda J, Milde Khatib C, Kezic S, Christensen MO, Yang S, Thyssen JP, Chu CY, Riethmüller C, Liao HS, Akhtar I, Ungar B, Guttman-Yassky E, Hædersdal M, Hwu ET. A Review of Atomic-Force Microscopy in Skin Barrier Function Assessment. J Invest Dermatol 2024:S0022-202X(24)00357-9. [PMID: 38888524 DOI: 10.1016/j.jid.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 04/02/2024] [Accepted: 04/13/2024] [Indexed: 06/20/2024]
Abstract
Skin barrier function (SBF) disorders are a class of pathologies that affect a significant portion of the world population. These disorders cause skin lesions with intense itch, impacting patients' physical and psychological well-being as well as their social functioning. It is in the interest of patients that their disorder be monitored closely while under treatment to evaluate the effectiveness of the ongoing therapy and any potential adverse reactions. Symptom-based assessment techniques are widely used by clinicians; however, they carry some limitations. Techniques to assess skin barrier impairment are critical for understanding the nature of the disease and for helping personalize treatment. This review recalls the anatomy of the skin barrier and describes an atomic-force microscopy approach to quantitatively monitor its disorders and their response to treatment. We review a panel of studies that show that this technique is highly relevant for SBF disorder research, and we aim to motivate its adoption into clinical settings.
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Affiliation(s)
- Jorge Pereda
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Casper Milde Khatib
- Department of Dermatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sanja Kezic
- Amsterdam UMC, Coronel Institute of Occupational Health, Amsterdam, The Netherlands
| | | | - Sara Yang
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - Jacob P Thyssen
- Department of Dermatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Hsien-Shun Liao
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - Imtisal Akhtar
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Benjamin Ungar
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emma Guttman-Yassky
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Merete Hædersdal
- Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - En-Te Hwu
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Lyngby, Denmark.
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de Boer FL, van der Molen HF, Kezic S. Epidermal biomarkers of the skin barrier in atopic and contact dermatitis. Contact Dermatitis 2023; 89:221-229. [PMID: 37571977 DOI: 10.1111/cod.14391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Dysfunction of the skin barrier plays a critical role in the initiation and progression of inflammatory skin diseases, such as atopic dermatitis and contact dermatitis. Epidermal biomarkers can aid in evaluating the functionality of the skin barrier and understanding the mechanisms that underlay its impairment. This narrative review provides an overview of recent studies on epidermal biomarkers associated with the function and integrity of the skin barrier, and their application in research on atopic dermatitis and contact dermatitis. The reviewed studies encompass a wide spectrum of molecular, morphological and biophysical biomarkers, mainly obtained from stratum corneum tape strips and biopsies. Lipids, natural moisturizing factors, and structural proteins are the most frequently reported molecular biomarkers. Additionally, corneocyte surface topography and elasticity show potential as biomarkers for assessing the physical barrier of the skin. In contact dermatitis studies, biomarkers are commonly employed to evaluate skin irritation and differentiate between irritant and allergic contact dermatitis. In atopic dermatitis, biomarkers are primarily utilized to identify differences between atopic and healthy skin, for predictive purposes, and monitoring response to therapies. While this overview identifies potential biomarkers for the skin barrier, their validation as epidermal biomarkers for atopic dermatitis and contact dermatitis has yet to be established.
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Affiliation(s)
- F L de Boer
- Public and Occupational Health Department, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research, Amsterdam, The Netherlands
| | - H F van der Molen
- Public and Occupational Health Department, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research, Amsterdam, The Netherlands
| | - S Kezic
- Public and Occupational Health Department, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research, Amsterdam, The Netherlands
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Changes in Skin Barrier Function after Repeated Exposition to Phospholipid-Based Surfactants and Sodium Dodecyl Sulfate In Vivo and Corneocyte Surface Analysis by Atomic Force Microscopy. Pharmaceutics 2021; 13:pharmaceutics13040436. [PMID: 33804924 PMCID: PMC8063842 DOI: 10.3390/pharmaceutics13040436] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/16/2021] [Accepted: 03/20/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: The aim of the study was to evaluate the effect of pure lecithins in comparison to a conventional surfactant on skin in vivo. (2) Methods: Physiological skin parameters were evaluated at the beginning and the end of the study (day 1 and day 4) (n = 8, healthy forearm skin) with an Aquaflux®, skin-pH-Meter, Corneometer® and an Epsilon® sensor. Confocal Raman spectroscopy was employed to monitor natural moisturizing factor, urea and water content of the participants' skin. Tape strips of treated skin sites were taken and the collected corneocytes were subjected to atomic force microscopy. Circular nano objects were counted, and dermal texture indices were determined. (3) Results: Transepidermal water loss was increased, and skin hydration was decreased after treatment with SDS and LPC80. Natural moisturizing factor and urea concentrations within the outermost 10 µm of the stratum corneum were lower than after treatment with S75 or water. Dermal texture indices of skin treated with SDS were higher than skin treated with water (control). (4) Conclusions: Results suggest very good (S75) or good (LPC80) skin-tolerability of lecithin-based surfactants in comparison to SDS and encourage further investigation.
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