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Teng Y, Zhong H, Yang X, Tao X, Fan Y. Current and Emerging Therapies for Atopic Dermatitis in the Elderly. Clin Interv Aging 2023; 18:1641-1652. [PMID: 37810952 PMCID: PMC10558003 DOI: 10.2147/cia.s426044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Abstract
Atopic dermatitis (AD) in the elderly has recently emerged as a distinct subgroup of AD, garnering widespread concern due to its increasing global incidence rate. Epidermal barrier dysfunction, inflammatory response, and chronic pruritus interact with each other, contributing to the pathogenesis and pathophysiology of AD in the elderly. Although fundamental medications are essential for managing AD in the elderly, older adults often struggle with regular usage of moisturizing emollients, topical medications, and avoidance of environmental triggers, leading to recurrent or even exacerbated disease progression. Therefore, a systematic medication approach is necessary to control pruritus and skin lesions. Traditional systemic treatments may not adequately meet the treatment needs of moderate and severe AD in the elderly and may even pose certain safety risks. Biologics and Janus kinase (JAK) inhibitors, exhibiting excellent clinical efficacy, have made significant breakthroughs in AD treatment. Existing evidence suggests that dupilumab, a human monoclonal IgG4 antibody, has been confirmed as an effective and safe first-line systematic treatment for moderate to severe AD in the elderly, with no notable differences between adults and the elderly. However, the limited inclusion of elderly patients in related clinical studies hinders the generalizability of these findings. As older patients face a higher risk of adverse events with JAK inhibitors, JAK inhibitors are recommended when no other suitable treatment options are available. Obtaining population-specific data is crucial for making evidence-based treatment choices when managing AD in older adults with JAK inhibitors.
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Affiliation(s)
- Yan Teng
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Huiting Zhong
- Department of Dermatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
| | - Xianhong Yang
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Xiaohua Tao
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Yibin Fan
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
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Dileepan KN, Raveendran VV, Sharma R, Abraham H, Barua R, Singh V, Sharma R, Sharma M. Mast cell-mediated immune regulation in health and disease. Front Med (Lausanne) 2023; 10:1213320. [PMID: 37663654 PMCID: PMC10470157 DOI: 10.3389/fmed.2023.1213320] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 09/05/2023] Open
Abstract
Mast cells are important components of the immune system, and they perform pro-inflammatory as well as anti-inflammatory roles in the complex process of immune regulation in health and disease. Because of their strategic perivascular localization, sensitivity and adaptability to the microenvironment, and ability to release a variety of preformed and newly synthesized effector molecules, mast cells perform unique functions in almost all organs. Additionally, Mast cells express a wide range of surface and cytoplasmic receptors which enable them to respond to a variety of cytokines, chemicals, and pathogens. The mast cell's role as a cellular interface between external and internal environments as well as between vasculature and tissues is critical for protection and repair. Mast cell interactions with different immune and nonimmune cells through secreted inflammatory mediators may also turn in favor of disease promoting agents. First and forefront, mast cells are well recognized for their multifaceted functions in allergic diseases. Reciprocal communication between mast cells and endothelial cells in the presence of bacterial toxins in chronic/sub-clinical infections induce persistent vascular inflammation. We have shown that mast cell proteases and histamine induce endothelial inflammatory responses that are synergistically amplified by bacterial toxins. Mast cells have been shown to exacerbate vascular changes in normal states as well as in chronic or subclinical infections, particularly among cigarette smokers. Furthermore, a potential role of mast cells in SARS-CoV-2-induced dysfunction of the capillary-alveolar interface adds to the growing understanding of mast cells in viral infections. The interaction between mast cells and microglial cells in the brain further highlights their significance in neuroinflammation. This review highlights the significant role of mast cells as the interface that acts as sensor and early responder through interactions with cells in systemic organs and the nervous system.
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Affiliation(s)
- Kottarappat N. Dileepan
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, The University of Kansas Medical Center, Kansas City, KS, United States
| | - Vineesh V. Raveendran
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, The University of Kansas Medical Center, Kansas City, KS, United States
| | - Rishi Sharma
- Department of Medicine, School of Medicine, University of Missouri, Kansas City, MO, United States
| | - Harita Abraham
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, The University of Kansas Medical Center, Kansas City, KS, United States
| | - Rajat Barua
- Cardiology Section, Kansas City Veterans Affairs Medical Center, Kansas City, MO, United States
| | - Vikas Singh
- Neurology Section, Kansas City Veterans Affairs Medical Center, Kansas City, MO, United States
| | - Ram Sharma
- Research and Development Service, Kansas City Veterans Affairs Medical Center, Kansas City, MO, United States
| | - Mukut Sharma
- Research and Development Service, Kansas City Veterans Affairs Medical Center, Kansas City, MO, United States
- Midwest Veterans’ Biomedical Research Foundation (MVBRF), Kansas City VA Medical Center, Kansas, MO, United States
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Zhang Y, Le Y, Guo J, Wu F, Li Q, Lu P. Barrier function and ultrastructure characteristics of epidermis in patients with primary cutaneous amyloidosis. J Dermatol 2023. [PMID: 37157942 DOI: 10.1111/1346-8138.16819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/21/2023] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
Previous studies on primary cutaneous amyloidosis (PCA) have mainly focused on exploring genetic mutation and components of amyloid in patients with PCA. However, studies on skin barrier function in PCA patients are scarce. Here, we detected the skin barrier function in PCA patients and healthy people by using noninvasive techniques and characterized ultrastructural features of PCA lesions compared with healthy people using transmission electron microscopy (TEM). The expression of proteins related to skin barrier function was examined by immunohistochemistry staining. A total of 191 patients with clinically diagnosed PCA and 168 healthy individuals were enrolled in the study. Our analysis revealed that all investigated lesion areas displayed higher transepidermal water loss and pH values, and lower Sebum levels and stratum corneum hydration levels in PCA patients compared with the same site area in healthy individuals. The TEM results showed that the intercellular spaces between the basal cells were enlarged and the number of hemidesmosomes decreased in PCA lesions. Immunohistochemical staining showed that the expression of integrin α6 and E-cadherin in PCA patients was less than that in healthy controls, while no differences in the expression of loricrin and filaggrin were observed. Our study revealed that individuals with PCA displayed skin barrier dysfunction, which may be related to alterations in epidermal ultrastructure and a decrease in the skin barrier-related protein E-cadherin. However, the molecular mechanisms underlying skin barrier dysfunction in PCA remain to be elucidated.
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Affiliation(s)
- Yuling Zhang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Department of Dermatology, The First Hospital of Jilin University, Changchun, China
| | - Ya Le
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Junyi Guo
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Fangfang Wu
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Qing Li
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ping Lu
- Dermatology Hospital, Southern Medical University, Guangzhou, China
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Hu X, Zhou Y, Shi J, Qi M, Li X, Yang Y, Zhu C, Wang C, Tang Z, Ma Y, Yu G. Osthole relieves skin damage and inhibits chronic itch through modulation of Akt/ZO-3 pathway in atopic dermatitis. Eur J Pharmacol 2023; 947:175649. [PMID: 36921706 DOI: 10.1016/j.ejphar.2023.175649] [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: 01/31/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
Atopic dermatitis (AD) is the most prevalent chronic inflammatory skin condition and significantly reduces quality of life. Tight junction (TJ), which is located directly beneath the stratum corneum, maintains skin barrier function and aids in the identification of the cell's "territory". We evaluated seventeen TJ related genes to explore AD related alterations of TJ. Remarkably, we found that the expression of ZO-3, a gene that had not been linked to the development of TJ in AD, was significantly down-regulated in the skin of AD mice and patients. siRNA mediated knock-down of ZO-3 significantly decreased transepithelial electrical resistance in HaCaT cells, demonstrating that ZO-3 is essential to epidermal barrier function. In addition to ZO-3 downregulation, protein kinase B (Akt) phosphorylation was increased in the skin of AD mice. We further confirmed an inverse relationship between Akt phosphorylation and ZO-3 expression in AD using HaCaT cells and mouse model. Finally, we tested the efficacy of osthole as a treatment for AD in mice and HaCaT cells. Osthole inhibits Akt phosphorylation, and thereby enhances ZO-3 expression in mouse models of AD, resulting in greatly lessened AD associated skin damage and chronic itch, and osthole also increased the expression of ZO-3 in HaCaT cells by inhibiting the phosphorylation of Akt. Together, we established that ZO-3 is essential for the development of TJ in AD skin and HaCaT cells, and our findings provide fresh support for osthole's ability to protect ZO-3 expression and the epidermal barrier in AD.
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Affiliation(s)
- Xueqin Hu
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan Zhou
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianxin Shi
- Department of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Mingxin Qi
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Li
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Yang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chan Zhu
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Changming Wang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zongxiang Tang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuxiang Ma
- School of Life Science, China Pharmaceutical University, Nanjing, China.
| | - Guang Yu
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, China.
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Gao JF, Tang L, Luo F, Chen L, Zhang YY, Ding H. Myricetin treatment has ameliorative effects in DNFB-induced atopic dermatitis mice under high-fat conditions. Toxicol Sci 2023; 191:308-320. [PMID: 36575998 DOI: 10.1093/toxsci/kfac138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disorder. Obesity is associated with increased prevalence and severity of AD for reasons that remain poorly understood. Myricetin, a dietary flavonoid found in fruits and vegetables, is known to have anti-inflammatory effects, but its role in AD is unclear. Thus, we investigated the effects of obesity on exacerbation AD lesions and evaluated the effects of myricetin on obese AD. Mice were fed normal diet (ND) or high-fat diet, and then 2,4-dinitrofluorobenzene was used to induce AD-like lesions. We found that obesity exacerbated AD lesions, and myricetin topical administration ameliorated symptoms and skin lesions of obsess AD mice, such as dermatitis scores, scratching behavior, epidermal thickness, and mast cell infiltration. In addition, myricetin reduced the levels of immunoglobulin E and histamine, inhibited the infiltration of CD4+T cells, and modulated the expression of Th1, Th2, Th17, and Th22 cytokines and pro-inflammatory factors (CCL17, CCL22, IL-1β, and TGF-β). Moreover, myricetin restored impaired barrier function by reducing transepidermal water loss, increasing lamellar body secretion, as well as upregulating the mRNA and protein expression of filaggrin. Western blot results showed that significantly increased levels of phosphorylated IκB and NF-κB p65 was observed in the obese AD mice compared with the AD mice fed ND, whereas the myricetin could downregulated the phosphorylations of IκB and NF-κB, and inhibited mRNA expression of iNOS and COX2. Taken together, our results suggest that myricetin treatment exhibits potentially protective effects against the obeseassociated AD by inhibiting inflammatory response and restoring skin barrier function.
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Affiliation(s)
- Jie-Fang Gao
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Liu Tang
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China.,Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, PR China
| | - Fei Luo
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Lu Chen
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Yi-Yuan Zhang
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Hong Ding
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
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Intervening GSK3 Signaling Attenuates Cutaneous Inflammation and Itch in Mice: Implication for Future Therapeutic Development. J Invest Dermatol 2023; 143:335-339.e8. [PMID: 36063886 DOI: 10.1016/j.jid.2022.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 01/25/2023]
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Gabe Y, Uchiyama M, Sasaoka S, Amari N, Imai A, Hachiya A, Kiyomine A. Efficacy of a fine fiber film applied with a water-based lotion to improve dry skin. Skin Res Technol 2022; 28:465-471. [PMID: 35411972 PMCID: PMC9907623 DOI: 10.1111/srt.13149] [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: 11/10/2021] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dry skin can trigger eczema that affects >10% of the US population. Dressing films have been developed to improve diseased skin, but there is limited knowledge about their effects, especially for dry skin-related symptoms. We developed an electrospinning method that creates a coating film, called a fine fiber (FF) film, characterized by the production of a transparent, thin, flexible, and adherent membrane on the skin surface. OBJECTIVE The aim of this pilot study was to examine the effects of the FF film on dry skin. METHODS Three treatments (lotion only, lotion with the FF film, and lotion with an alternative film) were designed to treat subjects with rough skin on their lower legs. Twenty-four females were enrolled and used either a water-based lotion U or a petrolatum-based lotion P and the FF film for 2 weeks followed by a regression phase for 1 week. Skin hydration and roughness scores were assessed as were the subjects' perceptions of the effects. RESULTS When the FF film was applied with lotion U, skin hydration was significantly improved even after 1 week, accompanied by a significant improvement of skin roughness and an increase in skin hydration by the end of the regression phase. An evaluation of moisture permeability suggested that the FF film, especially with lotion U, performed as a semipermeable membrane with optimal moisture healing effects on dry skin. CONCLUSION The FF film together with a water-based lotion is a promising treatment to quickly improve dry skin conditions.
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Affiliation(s)
- Yu Gabe
- Biological Science Research, Kao Corporation, Odawara, Japan
| | | | - Shun Sasaoka
- Analytical Science Research, Kao Corporation, Sumida, Japan
| | - Naomi Amari
- Processing Development Research, Kao Corporation, Haga, Japan
| | - Asuka Imai
- Kao R&D, Kao USA Inc., Cincinnati, Ohio, USA
| | - Akira Hachiya
- Planning and Implementation, Kao Corporation, Sumida, Japan
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Park H, Arellano K, Lee Y, Yeo S, Ji Y, Ko J, Holzapfel W. Pilot Study on the Forehead Skin Microbiome and Short Chain Fatty Acids Depending on the SC Functional Index in Korean Cohorts. Microorganisms 2021; 9:microorganisms9112216. [PMID: 34835341 PMCID: PMC8617931 DOI: 10.3390/microorganisms9112216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 01/05/2023] Open
Abstract
Dry skin is one of the indicators of a compromised skin barrier. An intact skin barrier is not only important to reserve the hydration within the epidermal tissue but also to protect our skin from environmental stressors and inhibit pathogen invasion; damage to the skin barrier may lead to inflammatory skin diseases. Some microbial metabolites such as short chain fatty acids may inhibit or destroy harmful bacteria and regulate the host immune system. The impact of the skin microbiome and short chain fatty acids on skin barrier function was studied in two groups of 75 participants each. The cohort was equally divided in dry and moist skin types, based on stratum corneum (SC) functionality index (SCFI), reflecting the ratio of transepidermal water loss (TEWL). A dry group represents a low SCFI and a moist group a high SCFI. Compared with the dry skin group, propionate and Cutibacterium levels (previously known as Propionibacterium acnes) were significantly higher (p < 0.001) in the moist group. Levels of Cutibacterium were negatively correlated with those of Staphylococcus (p < 0.0001) in both dry and moist groups. The moist group also had a significantly higher propionate concentration (p < 0.001). This study showed that the microbial community and short chain fatty acid concentration may be considered as significant determinants of the SCFI of the skin.
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Affiliation(s)
- Haryung Park
- Department of Advanced Convergence, Handong Global University, Pohang 37554, Korea; (H.P.); (K.A.); (Y.L.); (Y.J.)
- HEM Pharma Inc., Start-Up Incubator, Handong Global University, Pohang 37554, Korea;
| | - Karina Arellano
- Department of Advanced Convergence, Handong Global University, Pohang 37554, Korea; (H.P.); (K.A.); (Y.L.); (Y.J.)
| | - Yuri Lee
- Department of Advanced Convergence, Handong Global University, Pohang 37554, Korea; (H.P.); (K.A.); (Y.L.); (Y.J.)
| | - Subin Yeo
- HEM Pharma Inc., Start-Up Incubator, Handong Global University, Pohang 37554, Korea;
| | - Yosep Ji
- Department of Advanced Convergence, Handong Global University, Pohang 37554, Korea; (H.P.); (K.A.); (Y.L.); (Y.J.)
- HEM Pharma Inc., Start-Up Incubator, Handong Global University, Pohang 37554, Korea;
| | - Joontae Ko
- Boaz Medical Hospital, Handong Global University, Pohang 37554, Korea;
| | - Wilhelm Holzapfel
- Department of Advanced Convergence, Handong Global University, Pohang 37554, Korea; (H.P.); (K.A.); (Y.L.); (Y.J.)
- HEM Pharma Inc., Start-Up Incubator, Handong Global University, Pohang 37554, Korea;
- Correspondence:
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Pruritus Features in Children with End-Stage Renal Disease Underwent Dialysis: A Cross-Sectional Study. Int J Pediatr 2021; 2021:9970321. [PMID: 34367296 PMCID: PMC8337100 DOI: 10.1155/2021/9970321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/06/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Evaluation of the pruritus features in children with end-stage renal disease (ESRD) who underwent dialysis at an academic tertiary pediatric dialysis center. Methods This cross-sectional study was conducted at an academic tertiary pediatric dialysis center, Isfahan, Iran. The reviewed medical records of the children included their characteristics, dialysis properties, and laboratory parameters. The 4-item itch questionnaire was utilized to assess distribution, severity, frequency, and associated sleeping disorders. Results Thirty ESRD patients with pruritus, including 23 males (76.7%) with a mean age of 11.7 ± 3.64 years, were recruited. The most common cause of CKD was nephronophthisis (23.3%). The median total score of pruritus was 5 (range: 3-15). The distribution score of pruritus was directly correlated with the age (Spearman's rho = 0.42, P = 0.02) and serum level of parathyroid hormone (PTH) (Spearman's rho = 0.42, P = 0.04). In the reduced multiple logistic regression model, the increasing level of serum calcium was associated with increased odds of having total pruritus score ≥ 5 (OR (odds ratio): 4.5; 95% CI 1.12 to 18.05). In addition, an increase in age for one year was found to be associated with 50% higher odds of having total pruritus score ≥ 5 (OR: 1.5; 95% CI 1.03 to 2.18). Conclusion Increased level of serum Ca and higher age were associated with increased odds of having more severe pruritus score in children.
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Yoshioka Y, Kamata Y, Tominaga M, Umehara Y, Yoshida I, Matsuoka N, Takamori K. Extract of Scutellaria baicalensis induces semaphorin 3A production in human epidermal keratinocytes. PLoS One 2021; 16:e0250663. [PMID: 33905439 PMCID: PMC8078742 DOI: 10.1371/journal.pone.0250663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
In a disease-state-dependent manner, the histamine-resistant itch in dry skin-based skin diseases such as atopic dermatitis (AD) and xerosis is mainly due to hyperinnervation in the epidermis. Semaphorin 3A (Sema3A) is a nerve repulsion factor expressed in keratinocytes and it suppresses nerve fiber elongation in the epidermis. Our previous studies have shown that Sema3A ointment inhibits epidermal hyperinnervation and scratching behavior and improves dermatitis scores in AD model mice. Therefore, we consider Sema3A as a key therapeutic target for improving histamine-resistant itch in AD and xerosis. This study was designed to screen a library of herbal plant extracts to discover compounds with potential to induce Sema3A in normal human epidermal keratinocytes (NHEKs) using a reporter gene assay, so that positive samples were found. Among the positive samples, only the extract of S. baicalensis was found to consistently increase Sema3A levels in cultured NHEKs in assays using quantitative real-time PCR and ELISA. In evaluation of reconstituted human epidermis models, the level of Sema3A protein in culture supernatants significantly increased by application of the extract of S. baicalensis. In addition, we investigated which components in the extract of S. baicalensis contributed to Sema3A induction and found that baicalin and baicalein markedly increased the relative luciferase activity, and that baicalein had higher induction activity than baicalin. Thus, these findings suggest that S. baicalensis extract and its compounds, baicalin and baicalein, may be promising candidates for improving histamine-resistant itch via the induction of Sema3A expression in epidermal keratinocytes.
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Affiliation(s)
- Yasuko Yoshioka
- Central R&D Laboratory, Kobayashi Pharmaceutical Co. Ltd., Ibaraki, Osaka, Japan
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Yayoi Kamata
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Mitsutoshi Tominaga
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Yoshie Umehara
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Ikuyo Yoshida
- Central R&D Laboratory, Kobayashi Pharmaceutical Co. Ltd., Ibaraki, Osaka, Japan
| | - Nobuya Matsuoka
- Central R&D Laboratory, Kobayashi Pharmaceutical Co. Ltd., Ibaraki, Osaka, Japan
| | - Kenji Takamori
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
- Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
- * E-mail:
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Wierzbicka A, Mańkowska-Wierzbicka D, Cieślewicz S, Stelmach-Mardas M, Mardas M. Interventions Preventing Vaginitis, Vaginal Atrophy after Brachytherapy or Radiotherapy Due to Malignant Tumors of the Female Reproductive Organs-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3932. [PMID: 33918070 PMCID: PMC8070443 DOI: 10.3390/ijerph18083932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Radiotherapy, as a method of treatment of cervical and uterine cancers, may induce severe late-onset vaginal side effects. Unfortunately, little evidence on the management of adverse effects has been presented. This study aimed to evaluate the available interventions which reduce symptoms of vaginitis and vaginal atrophy by improving dyspareunia, mucosal inflammation, vaginal pH and vaginal dryness in women who have undergone brachytherapy or radiotherapy due to uterine or cervical malignancies. MATERIALS AND METHODS A comprehensive literature search was performed following PRISMA guidelines. The systematic search was conducted using electronic databases, namely Scopus, Web of Science and PubMed, between October and November 2020 to identify randomized controlled trials (RCT) and, prospective randomized studies (PRS). RESULTS The analyzed population consists of 376 patients with uterine or cervical cancer, treated with hyaluronic acid, vitamin A, vitamin E, alpha-tocopherol acetate and dienestrol. Intervention with HA along with vitamin A and vitamin E revealed advantage in endpoints such as reduced dyspareunia, vaginal mucosal inflammation, vaginal dryness, bleeding, fibrosis and cellular atypia. Administration of alpha-tocopherol acetate reduced vaginal mucosal inflammation and improved vaginal acanthosis, whereas dienestrol resulted in reduced dyspareunia, vaginal caliber and bleeding. CONCLUSIONS Vaginal suppositories were found to be clinically effective at the management of late-onset vulvovaginal side effects after radiotherapy.
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Affiliation(s)
- Adrianna Wierzbicka
- Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Szamarzewskiego 84 St, 60-569 Poznan, Poland
| | - Dorota Mańkowska-Wierzbicka
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki Hospital, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Stanisław Cieślewicz
- Department of Oncology, Poznan University of Medical Science, Szamarzewskiego 82/84 St, 60-569 Poznan, Poland
| | - Marta Stelmach-Mardas
- Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Szamarzewskiego 84 St, 60-569 Poznan, Poland
| | - Marcin Mardas
- Department of Oncology, Poznan University of Medical Science, Szamarzewskiego 82/84 St, 60-569 Poznan, Poland
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12
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Chen L, Zheng J. Does sensitive skin represent a skin condition or manifestations of other disorders? J Cosmet Dermatol 2020; 20:2058-2061. [PMID: 33159415 PMCID: PMC8359429 DOI: 10.1111/jocd.13829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/25/2022]
Abstract
Sensitive skin or cutaneous sensory syndrome is defined as a skin condition that is hypersensitive to stimuli, presented with itching, irritant, erythema, and dryness. However, is it associated with more than impairment of epidermal functions, psychological stress and topical medication or products? We think that it can be a skin condition or manifestation of other cutaneous or extracutaneous disorders. In this paper, we brief relation of sensitive skin syndrome with cutaneous and extracutaneous disorders, clinically, and pathophysiologically.
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Affiliation(s)
- Lihong Chen
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Zheng
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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13
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Wang B, Tai M, Zhang K, Chen H, Gan X, Che B, Abudukelimu N, Wang G, Xin X, Lin L, Han P, Peng Y, Du Z, Aker Aisa H. Elaeagnus L gum polysaccharides alleviate the impairment of barrier function in the dry skin model mice. J Cosmet Dermatol 2020; 20:647-656. [PMID: 33098181 DOI: 10.1111/jocd.13541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dry skin is a common skin condition caused by reduction of water-holding capacity, which is regulated by skin barrier function. Dry skin can also be a symptom that indicates a more serious diagnosis. There are a number of moisturizers on the market, which play an important role in dermatologic and cosmetic therapies. However, the demand for these products with good and therapeutic efficiency is still growing. AIMS It remains necessary to investigate the effects of Elaeagnus L gum polysaccharides (EAP), which are prepared from gum of Elaeagnus angustifolia L. on the epidermal permeability barrier function and their possible underlying mechanisms. PATIENTS/METHODS EAP were purified, analyzed, and tested on human keratinocyte cell line (HaCaT) and then on the skin in vivo to evaluate their antiinflammatory activities and their impacts on impaired skin barrier function. RESULTS Histological analyses revealed that topical administration with EAP effectively attenuated dryness-like skin condition, including less percutaneous water loss rate, less infiltrate inflammation cells, and less epidermal thickening. Moreover, EAP inhibited the production of various inflammatory mediators and increased AQP-3, FLG, and LOR expression. CONCLUSION Our results indicated that EAP enhances epidermal permeability barrier function, and they can be used as a promising adjuvant agent in skin care cosmetics and in treating some skin disorders characterized by cutaneous inflammation and abnormal barrier function.
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Affiliation(s)
- Bingying Wang
- The School of Biomedical and Pharmaceutical Engineering, Guangdong University of Technology, Guangzhou, China
| | | | - Kun Zhang
- The School of Biomedical and Pharmaceutical Engineering, Guangdong University of Technology, Guangzhou, China
| | - Huixiong Chen
- Chemistry of RNA, Nucleosides, Peptides and Heterocycles, CNRS UMR8601, Université Paris Descartes, PRES Sorbonne Paris Cité, UFR Biomédicale, Paris Cedex 06, France
| | | | - Biao Che
- Infinitus(China) Co. Ltd., Guangzhou, China
| | - N Abudukelimu
- The Key Laboratory of Plant Resources and Chemistry of Arid Zone, China Xinjiang Technical Institute of Physics & Chemistry, Chinese Academy of Sciences, Urumqi, China
| | - Guoping Wang
- The Key Laboratory of Plant Resources and Chemistry of Arid Zone, China Xinjiang Technical Institute of Physics & Chemistry, Chinese Academy of Sciences, Urumqi, China
| | - Xuelei Xin
- The Key Laboratory of Plant Resources and Chemistry of Arid Zone, China Xinjiang Technical Institute of Physics & Chemistry, Chinese Academy of Sciences, Urumqi, China
| | - Li Lin
- Foshan Conney Allan Biotechnology Co. Ltd, Foshan, China
| | - Ping Han
- Foshan Conney Allan Biotechnology Co. Ltd, Foshan, China
| | - Yi Peng
- The School of Biomedical and Pharmaceutical Engineering, Guangdong University of Technology, Guangzhou, China
| | - Zhiyun Du
- The School of Biomedical and Pharmaceutical Engineering, Guangdong University of Technology, Guangzhou, China
| | - Haji Aker Aisa
- The Key Laboratory of Plant Resources and Chemistry of Arid Zone, China Xinjiang Technical Institute of Physics & Chemistry, Chinese Academy of Sciences, Urumqi, China
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14
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Hu XQ, Tang Y, Ju Y, Zhang XY, Yan JJ, Wang CM, Yang Y, Zhu C, Tang ZX, Zhou Y, Yu G. Scratching damages tight junctions through the Akt-claudin 1 axis in atopic dermatitis. Clin Exp Dermatol 2020; 46:74-81. [PMID: 32668051 DOI: 10.1111/ced.14380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a common, chronic, severely pruritic, eczematous skin disease that seriously deteriorates the quality of life of patients. Scratching is a cardinal symptom of AD. Although the vicious itch-scratch cycle continues and aggravates skin barrier dysfunction in AD, how scratching induces skin barrier dysfunction through tight junctions remains unclear. AIM To study the effect of scratching on tight junctions in the itch-scratch cycle. METHODS Scratching behaviour and skin barrier dysfunction on the neck and back in an AD mouse model were assessed. The expression of tight junction proteins was compared between the neck and back mice, and the mechanisms underlying the involvement of Akt/CLDN1 pathways in this process were explored. RESULTS We used oxazolone to induce AD on the neck or back of mice. There was significantly more scratching behaviour and more pronounced skin barrier dysfunction with the neck than with the back. Downregulation of claudin-1 (CLDN1) and upregulation of Akt phosphorylation in skin were well correlated with scratching behaviour in this AD model. Furthermore, SC79, an agonist of Akt phosphorylation, could downregulate CLDN1 expression in HaCaT cells. An antagonist of Akt phosphorylation (LY294002) was used to treat the AD mice; this treatment rescued CLDN1 expression through inhibiting Akt phosphorylation in skin, and importantly, also inhibited the scratching behaviour induced by AD. CONCLUSION The results reveal the underlying mechanism of tight junction damage promoted by scratching in the itch-scratch cycle of AD, and opens a new avenue to pruritus management in AD, through Akt antagonists.
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Affiliation(s)
- X Q Hu
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Y Tang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Y Ju
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - X Y Zhang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - J J Yan
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - C M Wang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Y Yang
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - C Zhu
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Z X Tang
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Y Zhou
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - G Yu
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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15
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Investigation Utilizing the HLB Concept for the Development of Moisturizing Cream and Lotion: In-Vitro Characterization and Stability Evaluation. COSMETICS 2020. [DOI: 10.3390/cosmetics7020043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The current study aims to utilize the concept of the hydrophilic–lipophilic balance (HLB) value of ingredients for the development of a stable emulsion-based moisturizing cream and lotion for cosmetic application. The combination of a hydrophilic and lipophilic emulsifier such as glyceryl stearate (HLB value 3.8) and PEG-100 stearate (HLB value 18.8) were found to be effective to emulsify the chosen oil phase system at a specific concentration to achieve the required HLB for the development of the stable emulsion-based system. The developed formulation was characterized for pH, viscosity, spreadability, rheology, and droplet morphology. The influence of carbopol® ETD 2020 and the concentration of the oil phase on the rheology of the product was investigated and found to be significant to achieve the required thickening to convert the lotion into a cream. The formulation system developed through utilizing the concept of HLB was compared to a product developed through the conventional approach. It was observed that the utilization of the HLB method for the development of an emulsion-based product is a promising strategy compared to the conventional method. The physical stability and thermodynamic stability tests were carried out under different storage conditions. It was observed that the developed formulation was able to retain its integrity without showing any signs of instability during storage.
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16
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Golpanian RS, Kim HS, Yosipovitch G. Effects of Stress on Itch. Clin Ther 2020; 42:745-756. [PMID: 32147148 DOI: 10.1016/j.clinthera.2020.01.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/25/2020] [Accepted: 01/28/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE Psychological stress and ensuing modulation of the immune and nervous systems can have a significant impact on itch. Stress can exacerbate itch and vice versa, resulting in a vicious cycle that can greatly impair a patient's quality of life. This review summarizes the association between stress and itch, elucidates the mechanism by which these two phenomena influence one another, and explores treatment modalities that aim to reduce stress-induced itch. METHODS A complete search of the PubMed and Google Scholar databases was completed and literature pertinent to this review was compiled. FINDINGS Both acute and chronic stress can significantly affect itch in healthy individuals and in those diagnosed with itchy skin diseases as well as systemic diseases, thus resulting in a vicious cycle in which stress exacerbates itch and vice versa. The mechanisms by which stress induces or aggravates itch include both central and peripheral activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. Activation of these systems, in turn, affects the mast cells, keratinocytes, and nerves that secrete neuropeptides, such as substance P, nerve growth factor, acetylcholine, histamine, and itchy cytokines. A dysfunctional parasympathetic response is thought to be involved in the chronic stress/itch response. Brain structures associated with emotion, such as the limbic system and periaqueductal gray, which work on the descending facilitation of itch, play a significant role in stress-induced itch. IMPLICATIONS As specific brain structures are associated with stress, drug treatments targeting these areas (ie, γ-aminobutyric acid-ergic drugs, serotonin and norepinephrine reuptake inhibitors) may help to modulate itch. Stress can also be combatted using nonpharmacologic treatments such as cognitive-behavioral therapies and stress-relieving holistic approaches (eg, yoga, acupuncture).
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Affiliation(s)
- Rachel Shireen Golpanian
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hei Sung Kim
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Gil Yosipovitch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA.
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17
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Abstract
Atopic dermatitis (AD) in older adults (elderly AD) has recently emerged as a newly defined subgroup of AD. When selecting treatment options, clinical characteristics of elderly AD and age-specific factors of older patients must be considered. As in other age groups, regular application of moisturizers in combination with topical corticosteroids and calcineurin inhibitors, adjunctive administration of oral antihistamines/anti-allergic drugs, and avoidance of exacerbating factors comprise basic treatments for elderly AD. For moderate-to-severe cases and/or in those with a decreased ability to use topical treatments, powerful anti-inflammatory treatments may become necessary as additional treatment options. While low-dose oral corticosteroids may be useful for cases of elderly AD, careful attention should be paid to adverse effects. Oral cyclosporine (ciclosporin) is less commonly used due to the increased risk of malignancy and organ toxicity in older patients with AD. Narrow-band ultraviolet B phototherapy may also be useful for older patients, although the necessity of frequent hospital visits for irradiation therapy may become a burden of disease for such patients. As a biologic, dupilumab therapy markedly improves skin lesions and itch in older patients with AD, with a rapid response and non-serious adverse effects. Nevertheless, injection pain, expensive medical care, and regular follow-up every 2 weeks are disadvantages of dupilumab therapy. Therefore, clinicians must prioritize individualized treatment options that will reduce the burden of disease for cases of elderly AD.
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Affiliation(s)
- Ryoji Tanei
- Department of Dermatology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakaecho, Itabashi, Tokyo, 173-0015, Japan.
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18
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Iwamoto S, Tominaga M, Kamata Y, Kawakami T, Osada T, Takamori K. Association Between Inflammatory Bowel Disease and Pruritus. CROHN'S & COLITIS 360 2020; 2:otaa012. [PMID: 36777956 PMCID: PMC9802076 DOI: 10.1093/crocol/otaa012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 12/24/2022] Open
Abstract
Background Inflammatory bowel disease (IBD) is often complicated by extraintestinal manifestations. We frequently encounter IBD patients with pruritus; however, clinical evidence for the association of these conditions is lacking. Therefore, the present study investigated the incidence of pruritus in IBD patients. Methods Seventy-one IBD outpatients, including 55 with ulcerative colitis (UC) and 16 with Crohn disease, and 39 healthy volunteers (HVs) were surveyed about their pruritus symptoms using a visual analogue scale (VAS). Disease activities in UC and Crohn disease patients were classified according to partial Mayo and IOIBD (International Organization for the Study of inflammatory Bowel Disease) scores, respectively. Skin barrier condition was examined by measuring transepidermal water loss and stratum corneum hydration. The distribution of intraepidermal nerve fibers in skin samples from 9 UC patients was examined immunohistochemically using an antiprotein gene product (PGP) 9.5 antibody. Results Visual analogue scale scores were higher in IBD patients than in HV (P < 0.001). Active stage IBD patients had more severe pruritus VAS scores than those in the remission stage (P = 0.036). Transepidermal water loss was higher in IBD patients (P < 0.001) and active stage IBD patients (P = 0.004), while stratum corneum hydration was lower in IBD patients (P = 0.019) and active stage IBD patients than in HV (P = 0.019). A relationship was observed between the degree of pruritus and number of PGP9.5-immunoreactive intraepidermal nerve fibers in UC patients. Conclusions Inflammatory bowel disease patients, particularly active stage patients, frequently exhibit symptoms of pruritus and dry skin. This result may have predictive and therapeutic implications for the treatment of IBD symptoms.
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Affiliation(s)
- Shiho Iwamoto
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Mitsutoshi Tominaga
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Anti-aging Skin Research Laboratory, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Yayoi Kamata
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Anti-aging Skin Research Laboratory, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Tomohiro Kawakami
- Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Taro Osada
- Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Kenji Takamori
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Anti-aging Skin Research Laboratory, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Department of Dermatology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan,Address correspondence to: Kenji Takamori, MD, PhD, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan ()
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19
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Walsh CM, Hill RZ, Schwendinger-Schreck J, Deguine J, Brock EC, Kucirek N, Rifi Z, Wei J, Gronert K, Brem RB, Barton GM, Bautista DM. Neutrophils promote CXCR3-dependent itch in the development of atopic dermatitis. eLife 2019; 8:48448. [PMID: 31631836 PMCID: PMC6884397 DOI: 10.7554/elife.48448] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/17/2019] [Indexed: 12/12/2022] Open
Abstract
Chronic itch remains a highly prevalent disorder with limited treatment options. Most chronic itch diseases are thought to be driven by both the nervous and immune systems, but the fundamental molecular and cellular interactions that trigger the development of itch and the acute-to-chronic itch transition remain unknown. Here, we show that skin-infiltrating neutrophils are key initiators of itch in atopic dermatitis, the most prevalent chronic itch disorder. Neutrophil depletion significantly attenuated itch-evoked scratching in a mouse model of atopic dermatitis. Neutrophils were also required for several key hallmarks of chronic itch, including skin hyperinnervation, enhanced expression of itch signaling molecules, and upregulation of inflammatory cytokines, activity-induced genes, and markers of neuropathic itch. Finally, we demonstrate that neutrophils are required for induction of CXCL10, a ligand of the CXCR3 receptor that promotes itch via activation of sensory neurons, and we find that that CXCR3 antagonism attenuates chronic itch. Chronic itch is a debilitating disorder that can last for months or years. Eczema, or atopic dermatitis, is the most common cause for chronic itch, affecting one in ten people worldwide. Many treatments for the condition are ineffective, and the exact cause of the disease is unknown, but many different types of cells are likely involved. These include skin cells and inflammation-promoting immune cells, as well as nerve cells that detect inflammation, relay itch and pain information to the brain, and regulate the immune system. Learning more about how these cells interact in eczema may help scientists find better treatments for the condition. So far, a lot of research has focused on static ‘snapshots’ of mature eczema lesions from human skin or animal models. These studies have identified abnormalities in genes or cells, but have not revealed how these genes and cells interact over time to cause chronic itch and inflammation. Now, Walsh et al. reveal that immune cells called neutrophils trigger chronic itch in eczema. The experiments involved mice with a condition that mimics eczema, and showed that removing the neutrophils in these mice alleviated their itching. They also showed that dramatic and rapid changes occur in the nervous system of mice suffering from the eczema-like condition. For example, excess nerves grow in the animals’ damaged skin, genes in the nerves that detect sensations become hyperactive, and changes occur in the spinal cord that have been linked to nerve pain. When neutrophils are absent, these changes do not take place. These findings show that neutrophils play a key role in chronic itch and inflammation in eczema. Drugs that target neutrophils, which are already used to treat other diseases, might help with chronic itch, but they would need to be tested before they can be used on people with eczema.
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Affiliation(s)
- Carolyn M Walsh
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | - Rose Z Hill
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | | | - Jacques Deguine
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | - Emily C Brock
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | - Natalie Kucirek
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | - Ziad Rifi
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | - Jessica Wei
- Vision Science Program, School of Optometry, University of California, Berkeley, Berkeley, United States
| | - Karsten Gronert
- Vision Science Program, School of Optometry, University of California, Berkeley, Berkeley, United States
| | - Rachel B Brem
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, United States.,Buck Institute for Research on Aging, Novato, United States
| | - Gregory M Barton
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States
| | - Diana M Bautista
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, United States.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, United States
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20
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Water-Soluble Extract from Actinidia arguta (Siebold & Zucc.) Planch. ex Miq. and Perilla frutescens (L.) Britton, ACTPER, Ameliorates a Dry Skin-Induced Itch in a Mice Model and Promotes Filaggrin Expression by Activating the AhR Signaling in HaCaT Cells. Nutrients 2019; 11:nu11061366. [PMID: 31216667 PMCID: PMC6627490 DOI: 10.3390/nu11061366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 01/17/2023] Open
Abstract
With a complex etiology involving multiple factors, the condition known as itch is a primary symptom of many skin diseases. Current treatment methods are ineffective for addressing itches caused by dry skin, for example. We developed a botanical extract, ACTPER, made from a mixture of Actinidia arguta and Perilla frutescens, which have traditionally been used to treat itch. The quality of ACTPER as a research agent was controlled in our experiment by cell-based bioassays, as well as by high-performance liquid chromatography (HPLC), using two chemical markers. In the acetone-induced dry skin mice model, the oral administration of ACTPER alleviated dry skin-related skin properties and itching behavior. The RNA and protein expression of the filament aggregating protein (filaggrin) gene, a key factor involved in the regulation of skin barrier function, was significantly increased, as measured by quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence assay. To understand the underlying mechanism(s) at the molecular level, HaCaT cells, a human keratinocyte-derived cell line, were treated with various concentrations of ACTPER. We found that the protein expression of filaggrin was indeed upregulated by ACTPER in a dose dependent manner. Data from experiments involving the reporter plasmid containing the xenobiotic response element (XRE), and the chemical antagonist for the aryl hydrocarbon receptor (AhR), indicated that the ACTPER-mediated upregulation of filaggrin was controlled through the activation of the AhR signaling pathway. The molecular docking simulation study predicted that ACTPER might contain chemical compounds that bind directly to AhR. Taken together, our results suggest that ACTPER may provide the platform, based upon which a variety of safe and effective therapeutic agents can be developed to treat itch.
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21
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Anti-melanization effects and inhibitory kinetics of tyrosinase of bird's nest fern (Asplenium australasicum) frond extracts on melanoma and human skin. J Biosci Bioeng 2019; 127:738-743. [DOI: 10.1016/j.jbiosc.2018.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/02/2018] [Accepted: 11/09/2018] [Indexed: 12/13/2022]
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22
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Kang MC, Cho K, Lee JH, Subedi L, Yumnam S, Kim SY. Effect of Resveratrol-Enriched Rice on Skin Inflammation and Pruritus in the NC/Nga Mouse Model of Atopic Dermatitis. Int J Mol Sci 2019; 20:ijms20061428. [PMID: 30901835 PMCID: PMC6471349 DOI: 10.3390/ijms20061428] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/15/2019] [Accepted: 03/17/2019] [Indexed: 01/07/2023] Open
Abstract
Resveratrol-enriched rice (RR) was developed using genetic engineering to combine the properties of resveratrol and rice. To evaluate the effect of RR on pruritic skin inflammation in atopic dermatitis (AD)-like skin lesions, we used dinitrochlorobenzene (DNCB)-induced NC/Nga mice and an in vitro 3D skin model. Normal rice (NR), resveratrol, and RR were topically applied to mice dorsal skin, following which the dermatitis index and scratching frequency were calculated. Histological examination was performed by hematoxylin and eosin and immunohistochemistry staining of IL-31 level. The level of immunoglobulin E (IgE) and IL-31 in the serum was determined by enzyme-linked immunosorbent assay (ELISA). The cytotoxicity of RR and the expression levels of pro-inflammatory cytokines were also determined in cultured human keratinocytes and a 3D skin model. RR significantly reduced scratching frequency, decreased the dermatitis severity and trans-epidermal water loss (TEWL) and improved skin hydration in DNCB-induced NC/Nga mice. RR also significantly decreased serum IL-31 and IgE levels and suppressed the production of IL-6 in human keratinocytes and the 3D skin model. Our study indicates that the synergistic effect of rice and resveratrol manifested by the topical application of RR can serve as a potential alternative therapy for chronic skin inflammatory diseases such as AD.
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Affiliation(s)
- Min Cheol Kang
- College of Pharmacy, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.
| | - Kyohee Cho
- College of Pharmacy, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.
| | - Jae Hyuk Lee
- College of Pharmacy, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.
| | - Lalita Subedi
- College of Pharmacy, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.
| | - Silvia Yumnam
- College of Pharmacy, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.
| | - Sun Yeou Kim
- College of Pharmacy, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.
- Gachon Institute of Pharmaceutical Science, Gachon University, Yeonsu-gu, Incheon 21565, Korea.
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Itching and its related factors in subtypes of eczema: a cross-sectional multicenter study in tertiary hospitals of China. Sci Rep 2018; 8:10754. [PMID: 30018382 PMCID: PMC6050257 DOI: 10.1038/s41598-018-28828-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 06/28/2018] [Indexed: 01/31/2023] Open
Abstract
Itching is a leading symptom of eczema or dermatitis and has a great impact on patients' lives. Previous studies on itching have focused mostly on atopic dermatitis (AD). A cross-sectional multicenter study was conducted among outpatients with eczema from 39 tertiary hospitals in mainland China from July 1 to September 30, 2014. This work elaborates on itching in different types of eczema. Itching was very common (97%, 8499/8758) in outpatients with eczema. The severity of the itch increased with age and disease duration (P < 0.001). The top three subtypes of dermatitis with severe itching were atopic dermatitis (30.4%), widespread eczema (30.1%), and asteatotic eczema (27.9%). Widespread eczema refers to the involvement of more than three body parts, without clinical features of other specific types of eczema. The proportion of outpatients without itching was highest in hand eczema (6.8%). Positive correlations were observed between the severity of itching and the proportions of different diseases based on trend tests, including atopic dermatitis (P < 0.001), widespread eczema (P < 0.001), asteatotic eczema (P < 0.001), and autosensitization dermatitis (P < 0.001). Eczema outpatients with older age, longer disease duration, and, especially, a history of allergic diseases might be more prone to itching.
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Shevchenko A, Valdes-Rodriguez R, Yosipovitch G. Causes, pathophysiology, and treatment of pruritus in the mature patient. Clin Dermatol 2017; 36:140-151. [PMID: 29566918 DOI: 10.1016/j.clindermatol.2017.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Chronic itch is a common and debilitating health condition in the elderly. There are several common causes of itch in the mature population, such as skin xerosis, immunosenescence, and neuropathic changes. In addition, skin diseases, such as seborrheic dermatitis and stasis dermatitis, systemic conditions (end-stage renal disease and diabetes), or psychogenic derailments, such as depression, anxiety, and dementia, can all serve as triggers of pruritus. Polypharmacy, a common occurrence among the elderly population, may also serve as a cause of itch that may or may not be accompanied by dermatitis. Such medications as μ opioids and calcium channel blockers have been found to have a connection with pruritus in the advanced aging population. Determining the exact trigger for pruritus in the elderly may be especially challenging, because itch can be idiopathic in many cases. The role of treatments should not only take into account elimination of various underlying cutaneous, systemic, or psychogenic conditions associated with itch but also focus on the skin changes that are characteristic of the aging process. Development of such treatment options can be guided by elucidation of the mechanisms underlying the pathophysiology of itch in the geriatric population.
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Affiliation(s)
- Alina Shevchenko
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Rodrigo Valdes-Rodriguez
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Gil Yosipovitch
- Department of Dermatology & Miami Itch Center at the University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA.
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Luo J, Feng J, Yu G, Yang P, Mack MR, Du J, Yu W, Qian A, Zhang Y, Liu S, Yin S, Xu A, Cheng J, Liu Q, O'Neil RG, Xia Y, Ma L, Carlton SM, Kim BS, Renner K, Liu Q, Hu H. Transient receptor potential vanilloid 4-expressing macrophages and keratinocytes contribute differentially to allergic and nonallergic chronic itch. J Allergy Clin Immunol 2017; 141:608-619.e7. [PMID: 28807414 DOI: 10.1016/j.jaci.2017.05.051] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/05/2017] [Accepted: 05/24/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Chronic itch is a highly debilitating symptom that underlies many medical disorders with no universally effective treatments. Although unique neuronal signaling cascades in the sensory ganglia and spinal cord have been shown to critically promote the pathogenesis of chronic itch, the role of skin-associated cells remains poorly understood. OBJECTIVE We sought to examine the cutaneous mechanisms underlying transient receptor potential vanilloid 4 (TRPV4)-mediated allergic and nonallergic chronic itch. METHODS Expression of TRPV4 in chronic itch and healthy control skin preparations was examined by using real-time RT-PCR. Trpv4eGFP mice were used to study the expression and function of TRPV4 in the skin by means of immunofluorescence staining, flow cytometry, calcium imaging, and patch-clamp recordings. Genetic and pharmacologic approaches were used to examine the role and underlying mechanisms of TRPV4 in mouse models of dry skin-associated chronic itch and spontaneous scratching associated with squaric acid dibutylester-induced allergic contact dermatitis. RESULTS TRPV4 is selectively expressed by dermal macrophages and epidermal keratinocytes in mice. Lineage-specific deletion of TRPV4 in macrophages and keratinocytes reduces allergic and nonallergic chronic itch in mice, respectively. Importantly, TRPV4 expression is significantly increased in skin biopsy specimens from patients with chronic idiopathic pruritus in comparison with skin from healthy control subjects. Moreover, TRPV4-dependent chronic itch requires 5-hydroxytryptamine (5-HT) signaling secondary to activation of distinct 5-HT receptors in mice with allergic and those with nonallergic chronic itch conditions. CONCLUSION Our study reveals previously unrecognized mechanisms by which TRPV4-expressing epithelial and immune cells in the skin critically and dynamically mediate chronic itch and unravels novel targets for therapeutics in the setting of chronic itch.
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Affiliation(s)
- Jialie Luo
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo
| | - Jing Feng
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo
| | - Guang Yu
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo; School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Pu Yang
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo
| | - Madison R Mack
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo
| | - Junhui Du
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, Tex
| | - Weihua Yu
- Department of Anatomy, Chongqing Medical University, Chongqing, China
| | - Aihua Qian
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yujin Zhang
- Department of Biochemistry and Molecular Biology, University of Texas Medical School at Houston, Houston, Tex
| | - Shenbin Liu
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo
| | - Shijin Yin
- College of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Amy Xu
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo
| | - Jizhong Cheng
- Department of Medicine, Baylor College of Medicine, Houston, Tex
| | - Qingyun Liu
- Brown Foundation Institute of Molecular Medicine and Texas Therapeutics Institute, University of Texas Health Science Center at Houston, Houston, Tex
| | - Roger G O'Neil
- Department of Integrative Biology and Pharmacology, the University of Texas Medical School at Houston, Houston, Tex
| | - Yang Xia
- Department of Biochemistry and Molecular Biology, University of Texas Medical School at Houston, Houston, Tex
| | - Liang Ma
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Susan M Carlton
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, Tex
| | - Brian S Kim
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Kenneth Renner
- Center for Brain and Behavior Research, Biology Department, University of South Dakota, Vermillion, SD
| | - Qin Liu
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo.
| | - Hongzhen Hu
- Center for the Study of Itch, Department of Anesthesiology, Washington University School of Medicine, St Louis, Mo.
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Prevalence and Clinical Characteristics of Itch in Vitiligo and Its Clinical Significance. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5617838. [PMID: 28828385 PMCID: PMC5554571 DOI: 10.1155/2017/5617838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/26/2017] [Accepted: 07/03/2017] [Indexed: 01/24/2023]
Abstract
Objective Vitiligo usually presented as asymptomatic depigmented macules and patches. Little is known regarding itch in vitiligo. This study aimed to evaluate the prevalence and characteristics of itch in vitiligo patients. Patients and Methods A cross-sectional study was conducted on vitiligo patients. Itch character and intensity were determined through questionnaires. Evaluation was also made by dermatologists to define vitiligo subtype, body surface area, Koebner phenomenon (KP), and so on. Data were assessed by computer software. Results were considered statistically significant if p < 0.05. Results Among 402 patients, itch on vitiliginous lesion presented in 20.2%. Prevalence of itch was most common in focal vitiligo (29.4%), followed by segmental vitiligo (20.3%) and nonsegmental vitiligo (19.6%), respectively. Tingling sensation was the most common itch-related symptom (82.7%). The median itch intensity is 5 by 10-point visual analog scale. Daily activity and sleep disturbance were observed in 60.5% and 39.5% of patients who experience itch. Itch occurred approximately 3 days prior to the development of lesions in 48.1% of patients. Thirty-two patients (78.1%) with both itch and KP type IIb had active disease. Conclusions Itch in vitiligo is not uncommon. The presence of itch with KP type IIb may warrant the active vitiligo.
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Misawa E, Tanaka M, Saito M, Nabeshima K, Yao R, Yamauchi K, Abe F, Yamamoto Y, Furukawa F. Protective effects of Aloe sterols against UVB-induced photoaging in hairless mice. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:101-111. [PMID: 27995657 DOI: 10.1111/phpp.12286] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Aloe vera is a traditional medical plant whose gel has been widely used in skin care. Previously, we have identified Aloe sterols from Aloe vera as active ingredients. This study investigated the protective effects of Aloe sterols without polysaccharides, against ultraviolet B (UVB)-induced skin photoaging in mice using Aloe vera gel extract (AVGE) obtained by supercritical fluid extraction. METHODS Aloe vera gel extract was supplemented in the diet (12 or 120 ppm), and HR-1 hairless mice were exposed to UVB irradiation for 7 weeks. Skin measurements and histological and analytical studies were performed. RESULTS Repeated UVB irradiation induced rough wrinkling of skin with water content reduction and hyperkeratosis. AVGE administration resulted in the significant improvement of UVB-induced skin dryness, epidermal thickness, and wrinkle formation. The AVGE group also suppressed the degenerations of dermal collagen fibers and the appearance of cutaneous apoptosis cells induced by UVB. Furthermore, AVGE administration reduced the excess elevation of pro-inflammatory cytokines (IL-1β and TNF-α) and matrix metalloproteinases (MMP-2, MMP-9, MMP-12, and MMP-13) in UVB-exposed skin. CONCLUSION The dietary ingestion of Aloe sterols protected against chronic UVB damage in mouse skin, and our results suggest that Aloe sterols may prevent skin photoaging through the anti-inflammation and MMP regulation.
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Affiliation(s)
- Eriko Misawa
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Miyuki Tanaka
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Marie Saito
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Kazumi Nabeshima
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Ruiqing Yao
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Kouji Yamauchi
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Fumiaki Abe
- Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Yuki Yamamoto
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Fukumi Furukawa
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
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Murota H, Katayama I. Exacerbating factors of itch in atopic dermatitis. Allergol Int 2017; 66:8-13. [PMID: 27863904 DOI: 10.1016/j.alit.2016.10.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 01/01/2023] Open
Abstract
Atopic dermatitis (AD) displays different clinical symptoms, progress, and response to treatment during early infancy and after childhood. After the childhood period, itch appears first, followed by formation of well-circumscribed plaque or polymorphous dermatoses at the same site. When accompanied with dermatitis and dry skin, treatment of skin lesions should be prioritized. When itch appears first, disease history, such as causes and time of appearance of itch should be obtained by history taking. In many cases, itch increases in the evening when the sympathetic nerve activity decreased. Treatment is provided considering that hypersensitivity to various external stimulations can cause itch. Heat and sweating are thought to especially exacerbate itch. Factors causing itch, such as cytokines and chemical messengers, also induce itch mainly by stimulating the nerve. Scratching further aggravates dermatitis. Skin hypersensibility, where other non-itch senses, such as pain and heat, are felt as itch, sometimes occurs in AD. Abnormal elongation of the sensory nerve into the epidermis, as well as sensitizing of the peripheral/central nerve, are possible causes of hypersensitivity, leading to itch. To control itch induced by environmental factors such as heat, treatment for dermatitis is given priority. In the background of itch exacerbated by sweating, attention should be given to the negative impact of sweat on skin homeostasis due to 1) leaving excess sweat on the skin, and 2) heat retention due to insufficient sweating. Excess sweat on the skin should be properly wiped off, and dermatitis should be controlled so that appropriate amount of sweat can be produced. Not only stimulation from the skin surface, but also visual and auditory stimulation can induce new itch. This "contagious itch" can be notably observed in patients with AD. This article reviews and introduces causes of aggravation of itch and information regarding how to cope with such causes.
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Epidermal Expression of Filaggrin/Profilaggrin Is Decreased in Atopic Dermatitis: Reverse Association With Mast Cell Tryptase and IL-6 but Not With Clinical Severity. Dermatitis 2016; 26:260-7. [PMID: 26551604 DOI: 10.1097/der.0000000000000143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND A decrease in filaggrin expression contributes to the pathogenesis of atopic dermatitis (AD) and can be modified by inflammatory factors. OBJECTIVES The aim of this study was to determine the correlation of (pro)filaggrin (filaggrin and profilaggrin) expression with clinical severity in AD and with mast cell (MC) tryptase, chymase, and IL-6. METHODS Punch biopsies were collected from 17 patients with moderate-to-severe AD and from 10 psoriatic patients. Atopic dermatitis severity was measured using different clinical parameters. (Pro)filaggrin, MC tryptase, chymase, and IL-6 were stained using immunohistochemical, enzymehistochemical, and sequential double-staining methods. RESULTS (Pro)filaggrin expression was lower in the lesional than in the nonlesional granular layer in AD and was correlated negatively with itch severity but not with other severity parameters. (Pro)filaggrin expression was also decreased in the psoriatic lesions. In AD, (pro)filaggrin expression correlated negatively with the number of tryptase MCs in the nonlesional granular layer and with IL-6 MCs in both the nonlesional and lesional granular layers. CONCLUSION (Pro)filaggrin expression is decreased in AD and is reversely associated with MC tryptase and IL-6. However, it does not associate with disease severity, and it was also decreased in psoriasis.
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Abstract
Chronic itch in the elderly is a common problem, with a significant impact on quality of life and sleep in elderly patients. Chronic itch may be attributable to several causes, including dry skin, immunosenescence and neural degeneration. Itch may also be caused by skin diseases, such as seborrhoeic dermatitis and stasis dermatitis; systemic conditions, such as end-stage renal disease and diabetes; and psychogenic conditions, such as depression and anxiety. The use of polypharmacy may also cause itch, with or without a rash. Specifically, thiazides and calcium channel blockers have been known to cause itch in elderly patients. Management should be tailored according to the underlying dermatological or systemic aetiology of itch. Topical treatment is the mainstay of therapy, providing special emphasis on skin hydration and barrier repair. In addition, topical and oral medications that target the nervous system and reduce neuronal hypersensitization, such as gabapentin and selective antidepressants, have a role in treating patients with severe chronic itch. Furthermore, management must account for changes in metabolism and pharmacokinetics of drugs in the aging population in order to prevent the occurrence of adverse effects.
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31
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What happens in the skin? Integrating skin permeation kinetics into studies of developmental and reproductive toxicity following topical exposure. Reprod Toxicol 2015; 58:252-81. [DOI: 10.1016/j.reprotox.2015.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 08/31/2015] [Accepted: 10/07/2015] [Indexed: 02/07/2023]
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Manage chronic pruritus in the elderly with various agents depending on the pathophysiology and aetiology of the condition. DRUGS & THERAPY PERSPECTIVES 2015. [DOI: 10.1007/s40267-015-0223-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mazzio E, Georges B, McTier O, Soliman KFA. Neurotrophic Effects of Mu Bie Zi (Momordica cochinchinensis) Seed Elucidated by High-Throughput Screening of Natural Products for NGF Mimetic Effects in PC-12 Cells. Neurochem Res 2015; 40:2102-12. [PMID: 25862192 DOI: 10.1007/s11064-015-1560-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 12/22/2022]
Abstract
Post-mitotic central nervous system (CNS) neurons have limited capacity for regeneration, creating a challenge in the development of effective therapeutics for spinal cord injury or neurodegenerative diseases. Furthermore, therapeutic use of human neurotrophic agents such as nerve growth factor (NGF) are limited due to hampered transport across the blood brain barrier (BBB) and a large number of peripheral side effects (e.g. neuro-inflammatory pain/tissue degeneration etc.). Therefore, there is a continued need for discovery of small molecule NGF mimetics that can penetrate the BBB and initiate CNS neuronal outgrowth/regeneration. In the current study, we conduct an exploratory high-through-put (HTP) screening of 1144 predominantly natural/herb products (947 natural herbs/plants/spices, 29 polyphenolics and 168 synthetic drugs) for ability to induce neurite outgrowth in PC12 dopaminergic cells grown on rat tail collagen, over 7 days. The data indicate a remarkably rare event-low hit ratio with only 1/1144 tested substances (<111.25 µg/mL) being capable of inducing neurite outgrowth in a dose dependent manner, identified as; Mu Bie Zi, Momordica cochinchinensis seed extract (MCS). To quantify the neurotrophic effects of MCS, 36 images (n = 6) (average of 340 cells per image), were numerically assessed for neurite length, neurite count/cell and min/max neurite length in microns (µm) using Image J software. The data show neurite elongation from 0.07 ± 0.02 µm (controls) to 5.5 ± 0.62 µm (NGF 0.5 μg/mL) and 3.39 ± 0.45 µm (138 μg/mL) in MCS, where the average maximum length per group extended from 3.58 ± 0.42 µm (controls) to 41.93 ± 3.14 µm (NGF) and 40.20 ± 2.72 µm (MCS). Imaging analysis using immunocytochemistry (ICC) confirmed that NGF and MCS had similar influence on 3-D orientation/expression of 160/200 kD neurofilament, tubulin and F-actin. These latent changes were associated with early rise in phosphorylated extracellular signal-regulated kinase (ERK) p-Erk1 (T202/Y204)/p-Erk2 (T185/Y187) at 60 min with mild changes in pAKT peaking at 5 min, and no indication of pMEK involvement. These findings demonstrate a remarkable infrequency of natural products or polyphenolic constituents to exert neurotrophic effects at low concentrations, and elucidate a unique property of MCS extract to do so. Future research will be required to delineate in depth mechanism of action of MCS, constituents responsible and potential for therapeutic application in CNS degenerative disease or injury.
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Affiliation(s)
- E Mazzio
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Room 104, Dyson Pharmacy Building, 1520 ML King Blvd, Tallahassee, FL, 32307, USA
| | - B Georges
- Department of Biology, Florida A&M University, Tallahassee, FL, 32307, USA
| | - O McTier
- Department of Biology, Florida A&M University, Tallahassee, FL, 32307, USA
| | - Karam F A Soliman
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Room 104, Dyson Pharmacy Building, 1520 ML King Blvd, Tallahassee, FL, 32307, USA.
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Valtcheva MV, Samineni VK, Golden JP, Gereau RW, Davidson S. Enhanced nonpeptidergic intraepidermal fiber density and an expanded subset of chloroquine-responsive trigeminal neurons in a mouse model of dry skin itch. THE JOURNAL OF PAIN 2015; 16:346-56. [PMID: 25640289 DOI: 10.1016/j.jpain.2015.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 01/08/2015] [Accepted: 01/16/2015] [Indexed: 12/13/2022]
Abstract
UNLABELLED Chronic pruritic conditions are often associated with dry skin and loss of epidermal barrier integrity. In this study, repeated application of acetone and ether followed by water (AEW) to the cheek skin of mice produced persistent scratching behavior with no increase in pain-related forelimb wiping, indicating the generation of itch without pain. Cheek skin immunohistochemistry showed a 64.5% increase in total epidermal innervation in AEW-treated mice compared to water-treated controls. This increase was independent of scratching, because mice prevented from scratching by Elizabethan collars showed similar hyperinnervation. To determine the effects of dry skin treatment on specific subsets of peripheral fibers, we examined Ret-positive, calcitonin gene-related peptide (CGRP)-positive, and glial cell line-derived neurotrophic factor family receptor α3 (GFRα3)-positive intraepidermal fiber density. AEW treatment increased Ret-positive fibers but not CGRP-positive or GFRα3-positive fibers, suggesting that a specific subset of nonpeptidergic fibers could contribute to dry skin itch. To test whether trigeminal ganglion neurons innervating the cheek exhibited altered excitability after AEW treatment, primary cultures of retrogradely labeled neurons were examined using whole-cell patch clamp electrophysiology. AEW treatment produced no differences in measures of excitability compared to water-treated controls. In contrast, a significantly higher proportion of trigeminal ganglion neurons was responsive to the nonhistaminergic pruritogen chloroquine after AEW treatment. We conclude that nonpeptidergic, Ret-positive fibers and chloroquine-sensitive neurons may contribute to dry skin pruritus. PERSPECTIVE This study examines the underlying neurobiological mechanisms of persistent dry skin itch. Our results indicate that nonpeptidergic epidermal hyperinnervation and nonhistaminergic pruritic receptors are potential targets for chronic pruritus.
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Affiliation(s)
- Manouela V Valtcheva
- Washington University Pain Center and Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri; Medical Scientist Training Program, Washington University in St. Louis, St. Louis, Missouri
| | - Vijay K Samineni
- Washington University Pain Center and Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Judith P Golden
- Washington University Pain Center and Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Robert W Gereau
- Washington University Pain Center and Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Steve Davidson
- Washington University Pain Center and Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri.
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Yong A, Cao T, Tan V, Yosipovitch G, Tey H. Skin physiology in pruritus of advanced ageing. J Eur Acad Dermatol Venereol 2015; 30:549-50. [DOI: 10.1111/jdv.12948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - T. Cao
- National Skin Centre; Singapore
| | - V. Tan
- National Skin Centre; Singapore
| | - G. Yosipovitch
- Department of Dermatology; Temple University Medical Centre; Philadelphia PA USA
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Disturbed skin barrier in children with chronic kidney disease. Pediatr Nephrol 2015; 30:333-8. [PMID: 25127919 PMCID: PMC4282711 DOI: 10.1007/s00467-014-2932-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 07/22/2014] [Accepted: 07/24/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND There are limited data on skin lesions in children with end-stage renal failure. The aim of the study was an evaluation of the skin barrier in children with different stages of chronic kidney disease (CKD). The prevalence of xerosis, its severity, as well as its link selected demographic factors, were examined. METHODS The study included 103 children: 72 with CKD stages 3-5 (38 on conservative treatment and 34 on dialysis) and 31 patients with primary monosymptomatic nocturnal enuresis as a control group. Initially, the study subjects described the localisation and severity of dry skin by themselves. Next, clinical evaluation of xerosis, non-invasive corneometric assessment of epidermis moisturising and the measurement of transepidermal water loss were performed. RESULTS Most CKD children reported dry skin. The problem of xerosis was identified more frequently in patients on dialysis (67.6 %) than on conservative treatment (42.1 %) (p = 0.01). CKD patients divided according to skin dryness did not differ with regards to age, sex, initial kidney disease and CKD duration. CONCLUSIONS Disturbed skin barrier is an important concern of children with CKD, intensifying as the disease progresses. This symptom occurs on early stages of CKD and it should be taken into consideration in the CKD management.
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Zhao ZQ, Huo FQ, Jeffry J, Hampton L, Demehri S, Kim S, Liu XY, Barry DM, Wan L, Liu ZC, Li H, Turkoz A, Ma K, Cornelius LA, Kopan R, Battey JF, Zhong J, Chen ZF. Chronic itch development in sensory neurons requires BRAF signaling pathways. J Clin Invest 2014; 123:4769-80. [PMID: 24216512 DOI: 10.1172/jci70528] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 08/12/2013] [Indexed: 12/17/2022] Open
Abstract
Chronic itch, or pruritus, is associated with a wide range of skin abnormalities. The mechanisms responsible for chronic itch induction and persistence remain unclear. We developed a mouse model in which a constitutively active form of the serine/threonine kinase BRAF was expressed in neurons gated by the sodium channel Nav1.8 (BRAF(Nav1.8) mice). We found that constitutive BRAF pathway activation in BRAF(Nav1.8) mice results in ectopic and enhanced expression of a cohort of itch-sensing genes, including gastrin-releasing peptide (GRP) and MAS-related GPCR member A3 (MRGPRA3), in nociceptors expressing transient receptor potential vanilloid 1 (TRPV1). BRAF(Nav1.8) mice showed de novo neuronal responsiveness to pruritogens, enhanced pruriceptor excitability, and heightened evoked and spontaneous scratching behavior. GRP receptor expression was increased in the spinal cord, indicating augmented coding capacity for itch subsequent to amplified pruriceptive inputs. Enhanced GRP expression and sustained ERK phosphorylation were observed in sensory neurons of mice with allergic contact dermatitis– or dry skin–elicited itch; however, spinal ERK activation was not required for maintaining central sensitization of itch. Inhibition of either BRAF or GRP signaling attenuated itch sensation in chronic itch mouse models. These data uncover RAF/MEK/ERK signaling as a key regulator that confers a subset of nociceptors with pruriceptive properties to initiate and maintain long-lasting itch sensation.
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Lu N, Chandar P, Tempesta D, Vincent C, Bajor J, McGuiness H. Characteristic differences in barrier and hygroscopic properties between normal and cosmetic dry skin. I. Enhanced barrier analysis with sequential tape-stripping. Int J Cosmet Sci 2014; 36:167-74. [PMID: 24397786 DOI: 10.1111/ics.12112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/02/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cosmetic dry skin often has a lower hydration level but a similar apparent barrier function, as measured by transepidermal water loss (TEWL), than that of the normal skin. To investigate the intrinsic difference in barrier property and moisture-holding ability between the cosmetic dry and normal skin, we developed a new clinical and data analysis procedure based on sequential tape-stripping with TEWL measurement, coupled with chemical analysis for protein and natural moisturizing factors (NMF) in the stratum corneum. METHODS A clinical study consisting of 64 healthy Caucasian female subjects with normal and cosmetic dry skin was conducted according to our clinical and data collection protocols. After the baseline visual dryness assessment, 20 tape-strips were placed and removed on each test site using D-Squame tapes. TEWL was measured at baseline and after the 5th, 10th, 15th and 20th tape-strips. All tapes were analysed for protein mass via chemical extraction and the Pierce BCA protein assay, as well as using an infrared densitometry device SquameScan 850A. The stratum corneum thickness and barrier quality (water transport resistance per thickness of the stratum corneum) were decoupled from the apparent barrier function using the TEWL and protein data. RESULTS A linear relationship between 1/TEWL and cumulative protein removal was observed for both normal and cosmetic dry skin. However, the slope of the linear relation was significantly steeper for normal skin, and significantly more protein was removed from cosmetic dry skin. The results showed that on average, the barrier quality of the stratum corneum of the normal skin is about 40% higher than that of the dry skin, whereas the stratum corneum of the dry skin is about 30% thicker than that of the normal skin. In addition, the amount of SC removal in sequential tape-stripping is generally non-uniform. CONCLUSION Our results demonstrated that there are characteristic differences in the barrier property between normal and cosmetic dry skin. In comparison to the normal skin, the stratum corneum of the cosmetic dry skin is considerably thicker, however, with a lower barrier quality. The results also showed that the amount of the SC removal in sequential tape-stripping is generally non-uniform. Therefore, the number of tape strips is not a good indicator for the tape-stripping depth.
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Affiliation(s)
- N Lu
- Unilever Research and Development Trumbull, 40 Merritt Boulevard, Trumbull, CT, 06611, U.S.A
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Tominaga M, Takamori K. Recent advances in pathophysiological mechanisms of itch. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.10.7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kim HS, Yosipovitch G. An aberrant parasympathetic response: a new perspective linking chronic stress and itch. Exp Dermatol 2013; 22:239-44. [PMID: 23528208 DOI: 10.1111/exd.12070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2012] [Indexed: 12/23/2022]
Abstract
Perceived stress has long been known to alter the dynamic equilibrium established between the nervous, endocrine and immune system and is widely recognised to trigger or enhance pruritus. However, the exact mechanism of how the major stress response systems, such as the hypothalamus-pituitary adrenal (HPA) axis and the autonomic nervous system induce or aggravate chronic itch, has not been elucidated. The limbic regions of the brain such as the prefrontal cortex and hippocampus are deeply involved in the regulation of the stress response and intersect with circuits that are responsible for memory and reward. According to the 'Polyvagal Theory', certain limbic structures that serve as a 'higher brain equivalent of the parasympathetic nervous system' play a foremost role in maintaining body homoeostasis by functioning as an active vagal brake. In addition, the limbic system has been postulated to regulate two distinct, yet related aspects of itch: (i) the sensory-discriminative aspect; and (ii) the affective-cognitive aspect. Chronic stress-induced itch is hypothesised to be caused by stress-related changes in limbic structure with subsequent rewiring of both the peripheral and central pruriceptive circuits. Herein, we review data suggesting that a dysfunctional parasympathetic nervous system associated with chronic stress may play a critical role in the regulatory control of key candidate molecules, receptors and brain structures involved in chronic itch.
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Affiliation(s)
- Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
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Abstract
Chronic itch is a debilitating condition that affects one in 10 people. Little is known about the molecules that mediate chronic itch in primary sensory neurons and skin. We demonstrate that the ion channel TRPA1 is required for chronic itch. Using a mouse model of chronic itch, we show that scratching evoked by impaired skin barrier is abolished in TRPA1-deficient animals. This model recapitulates many of the pathophysiological hallmarks of chronic itch that are observed in prevalent human diseases such as atopic dermatitis and psoriasis, including robust scratching, extensive epidermal hyperplasia, and dramatic changes in gene expression in sensory neurons and skin. Remarkably, TRPA1 is required for both transduction of chronic itch signals to the CNS and for the dramatic skin changes triggered by dry-skin-evoked itch and scratching. These data suggest that TRPA1 regulates both itch transduction and pathophysiological changes in the skin that promote chronic itch.
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Hashizume E, Nakano T, Kamimura A, Morishita K. Topical effects of N-acetyl-L-hydroxyproline on ceramide synthesis and alleviation of pruritus. Clin Cosmet Investig Dermatol 2013; 6:43-9. [PMID: 23430142 PMCID: PMC3575122 DOI: 10.2147/ccid.s39370] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose N-acetyl-l-hydroxyproline (AHYP) is an acetylated form of l-hydroxyproline that is used to treat skin ulcers and porphyria cutanea tarda. Its other biological and physiological effects on the skin have not been elucidated. We investigated the effects of AHYP on the skin-barrier function, focusing on ceramide synthesis and the effects of topical AHYP on atopic dermatitis. Materials and methods AHYP was applied to a three-dimensional cultured skin model. Ceramides were quantified by high-performance thin-layer chromatography. Serine palmitoyltransferase (SPT) is the rate-limiting enzyme in de novo ceramide synthesis, and the mRNA of its long-chain base subunit 1 (SPTLC1) was evaluated by quantitative reverse-transcription polymerase chain reaction. A clinical trial in the form of an intraindividual, comparative, double-blind, randomized, vehicle-controlled test involving 15 female subjects suffering from slight atopic dermatitis was performed. Subjects applied 1% (w/w) AHYP cream to one forearm and a control cream to the other forearm twice daily for 4 weeks. Skin condition was evaluated by measuring transepidermal water loss (TEWL). Dermatological observations were made by a dermatologist, and subjects evaluated their own pruritus intensity before beginning treatment and 4 weeks after the start of treatment. Results SPTLC1 expression and ceramide synthesis were significantly increased in an AHYP-treated skin model (P < 0.05). In the clinical trial, no adverse effects were observed in any subjects. TEWL was increased in the control-treated region of the forearm (P < 0.05) after 4 weeks’ application, whereas there was no change in the AHYP-treated region of the forearm. Pruritus intensity declined in the AHYP-treated forearms between 0 and 4 weeks (P < 0.05), but there was no change in the control-treated forearms. Conclusion AHYP increased ceramide synthesis by upregulating SPTLC1 in a three-dimensional cultured skin model, and it prevented TEWL increase and alleviated pruritus in human subjects with slight atopic dermatitis.
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Affiliation(s)
- Erika Hashizume
- Healthcare Products Development Center, Kyowa Hakko Bio, Tsukuba, Ibaraki, Japan
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Okawa T, Yamaguchi Y, Takada S, Sakai Y, Numata N, Nakamura F, Nagashima Y, Ikezawa Z, Aihara M. Oral administration of collagen tripeptide improves dryness and pruritus in the acetone-induced dry skin model. J Dermatol Sci 2012; 66:136-43. [DOI: 10.1016/j.jdermsci.2012.02.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 02/05/2012] [Accepted: 02/08/2012] [Indexed: 02/04/2023]
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Ikarashi N, Ogiue N, Toyoda E, Kon R, Ishii M, Toda T, Aburada T, Ochiai W, Sugiyama K. Gypsum fibrosum and its major component CaSO4 increase cutaneous aquaporin-3 expression levels. JOURNAL OF ETHNOPHARMACOLOGY 2012; 139:409-413. [PMID: 22138657 DOI: 10.1016/j.jep.2011.11.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/15/2011] [Accepted: 11/15/2011] [Indexed: 05/31/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE We have previously reported that Byakkokaninjinto improves cutaneous pruritus by increasing the expression level of aquaporin-3 (AQP3). In this study, we examined the effect of Gypsum fibrosum (main component: CaSO(4)), which is the main component of Byakkokaninjinto, on the cutaneous AQP3 expression level. MATERIALS AND METHODS KKAy mice were given a diet containing 0.3% Gypsum fibrosum extract, or a diet containing 0.3% CaSO(4) for 4 weeks. The urine volume, plasma glucose levels, cutaneous AQP3 protein expression, and the Ca(2+) content were measured. RESULTS The 24-h urine volumes and the plasma glucose levels in the Gypsum fibrosum extract group were not significantly different from those in the control group. In the Gypsum fibrosum extract group, the cutaneous AQP3 protein levels increased significantly, by approximately 3.2-fold, compared to the control group. The cutaneous Ca(2+) content in the control group was approximately 35μg/g. In the Gypsum fibrosum extract group, the Ca(2+) content increased to approximately 51μg/g, which was significant compared to the control group. In the CaSO(4) group, an increase in the AQP3 protein expression levels and Ca(2+) content were observed; the extent of these increases were similar to those in the Gypsum fibrosum extract group. CONCLUSIONS The results of this study suggest that Gypsum fibrosum plays an important role in the increased levels of cutaneous AQP3 expression enhanced by Byakkokaninjinto. The results also indicate that the increase in AQP3 caused by Gypsum fibrosum is attributable to an increase in the cutaneous Ca(2+) content from its main component, CaSO(4).
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Affiliation(s)
- Nobutomo Ikarashi
- Department of Clinical Pharmacokinetics, Hoshi University, Shinagawa-ku, Tokyo, Japan
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Fujii M, Shimizu T, Nakamura T, Endo F, Kohno S, Nabe T. Inhibitory Effect of Chitosan-Containing Lotion on Scratching Response of Hairless Mice with Atopic Dermatitis-Like Dry Skin. Biol Pharm Bull 2011; 34:1890-4. [DOI: 10.1248/bpb.34.1890] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Masanori Fujii
- Department of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University
| | - Tatsuo Shimizu
- Research and Development Institute, High Performance Functional Plastics Company, Sekisui Chemical Co., Ltd
| | - Takeshi Nakamura
- Department of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University
| | - Fumiko Endo
- Department of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University
| | - Shigekatsu Kohno
- Department of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University
| | - Takeshi Nabe
- Department of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University
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Induction of Prostaglandin D2 through the p38 MAPK Pathway Is Responsible for the Antipruritic Activity of Sertaconazole Nitrate. J Invest Dermatol 2010; 130:2448-56. [DOI: 10.1038/jid.2010.152] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Papoiu ADP, Yosipovitch G, Shihabi Z. Capillary electrophoresis of the proteolytic activity of the stratum corneum obtained by tape stripping. Electrophoresis 2010; 31:3346-51. [DOI: 10.1002/elps.201000221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Akiyama T, Carstens IM, Carstens E. Enhanced scratching evoked by PAR-2 agonist and 5-HT but not histamine in a mouse model of chronic dry skin itch. Pain 2010; 151:378-383. [PMID: 20709455 DOI: 10.1016/j.pain.2010.07.024] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2010] [Revised: 06/17/2010] [Accepted: 07/20/2010] [Indexed: 12/26/2022]
Abstract
Chronic itch is a symptom of many skin conditions and systemic disease, and it has been hypothesized that the chronic itch may result from sensitization of itch-signaling pathways. We induced experimental chronic dry skin on the rostral back of mice, and observed a significant increase in spontaneous hindlimb scratches directed to the dry skin. Spontaneous scratching was significantly attenuated by a PAR-2 antibody and 5-HT2A receptor antagonist, indicating activation of these receptors by endogenous mediators released under dry skin conditions. We also observed a significant increase in the number of scratch bouts evoked by acute intradermal injections of a protease-activated receptor (PAR)-2 agonist and serotonin (5-HT), but not histamine. We additionally investigated if pruritogen-evoked activity of dorsal root ganglion (DRG) neurons is enhanced in this model. DRG cells from dry skin mice exhibited significantly larger responses to the PAR-2 agonist and 5-HT, but not histamine. Spontaneous scratching may reflect ongoing itch, and enhanced pruritogen-evoked scratching may represent hyperknesis (enhanced itch), both potentially due to sensitization of itch-signaling neurons. The correspondence between enhanced behavioral scratching and DRG cell responses suggest that peripheral pruriceptors that respond to proteases and 5-HT, but not histamine, may be sensitized in dry skin itch.
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Affiliation(s)
- T Akiyama
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, CA, USA
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Akiyama T, Carstens MI, Carstens E. Spontaneous itch in the absence of hyperalgesia in a mouse hindpaw dry skin model. Neurosci Lett 2010; 484:62-5. [PMID: 20709155 DOI: 10.1016/j.neulet.2010.08.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 08/05/2010] [Accepted: 08/06/2010] [Indexed: 10/19/2022]
Abstract
We presently investigated if chronic dry skin treatment of the mouse hindpaw results in itch-related behavior, with or without accompanying hyperalgesia and allodynia. Following a 10-day period of treatment of one hindpaw with a mixture of acetone-diethylether-water (AEW), mice exhibited a significant increase in spontaneous biting behavior directed to the treated hindpaw compared to control animals in which one hindpaw was similarly treated with water only (W). Biting in the AEW group was significantly attenuated by the μ-opioid antagonist naltrexone but was unaffected by the μ-agonist morphine. There were no significant differences in hindpaw heat withdrawal latency, mechanical withdrawal threshold, or cold-plate latency between W and AEW treatment groups. These results indicate that chronic AEW treatment induces spontaneous itch but does not alter pain sensitivity, supporting the utility of this model for studies of chronic dry skin itch.
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Affiliation(s)
- Tasuku Akiyama
- Dept. of Neurobiology, Physiology and Behavior, University of California, Davis, 1 Shields Ave., Davis, CA 95616, USA
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