Effects of indomethacin and dexamethasone on mechanical scratching-induced cutaneous barrier disruption in mice

Exploring the roles of prostanoids, leukotriens, and dietary fatty acids in cutaneous inflammatory diseases: Insights from pharmacological and genetic approaches

Prostanoids and leukotrienes (LTs) are representative of ω6 fatty acid-derived metabolites that exert their actions through specific receptors on the cell surface. These lipid mediators, being unstable in vivo, act locally at their production sites; thus, their physiological functions remain unclear. However, recent pharmacological and genetic approaches using experimental murine models have provided significant insights into the roles of these lipid mediators in various pathophysiological conditions, including cutaneous inflammatory diseases. These lipid mediators act not only through signaling by themselves but also by potentiating the signaling of other chemical mediators, such as cytokines and chemokines. For instance, prostaglandin E2 -EP4 and LTB4 -BLT1 signaling on cutaneous dendritic cells substantially facilitate their chemokine-induced migration ability into the skin and play critical roles in the priming and/or activation of antigen-specific effector T cells in the skin. In addition to these ω6 fatty acid-derived metabolites, various ω3 fatty acid-derived metabolites regulate skin immune cell functions, and some exert potent anti-inflammatory functions. Lipid mediators act as modulators of cutaneous immune responses, and manipulating the signaling from lipid mediators has the potential as a novel therapeutic approach for human skin diseases.

Eicosanoids in Skin Wound Healing

Wound healing is an important process in the human body to protect against external threats. A dysregulation at any stage of the wound healing process may result in the development of various intractable ulcers or excessive scar formation. Numerous factors such as growth factors, cytokines, and chemokines are involved in this process and play vital roles in tissue repair. Moreover, recent studies have demonstrated that lipid mediators derived from membrane fatty acids are also involved in the process of wound healing. Among these lipid mediators, we focus on eicosanoids such as prostaglandins, thromboxane, leukotrienes, and specialized pro-resolving mediators, which are produced during wound healing processes and play versatile roles in the process. This review article highlights the roles of eicosanoids on skin wound healing, especially focusing on the biosynthetic pathways and biological functions, i.e., inflammation, proliferation, migration, angiogenesis, remodeling, and scarring.

Pharmacotherapy: Its impact on morphofunctional characteristics of the epidermal barrier

Various pharmaceuticals used for topical and systemic therapy are capable of exerting significant impact on morphological and physiological characteristics of human epidermis, as well as its barrier properties. This may affect the course of dermatologic diseases and the efficacy of their treatment. In this literature review, the author analyzes the impact of various pharmaceutical classes on the morphofunctional characteristics of the epidermal barrier and formulates recommendations for skin disease treatment.

Prostanoids in allergy

Prostanoids, which include prostaglandin and thromboxane, are metabolites of arachidonic acid released in various pathophysiological conditions. They induce a range of actions mediated through their respective receptors expressed on target cells. It has been demonstrated that each prostanoid receptor has multiple functions and that the effect of receptor stimulation can vary depending on context; this sometimes results in opposing effects, such as simultaneous excitatory and inhibitory outcomes. The balance between the production of each prostanoid and the expression of its receptors has been shown to be important for maintaining homeostasis but also involved in the development of various pathological conditions such as allergy. Here, we review the recent findings on the roles of prostanoids in allergy, especially focusing on atopic dermatitis and asthma.

Eicosanoids and Keratinocytes in Wound Healing

Significance: Eicosanoids are biologically active lipid mediators derived from arachidonic acid that are important in injury and inflammatory responses. Cyclooxygenase-1 and cyclooxygenase-2 mediate the production of prostanoids, whereas 5-lipoxygenase mediates the production of leukotrienes and hydroxyeicosatetraenoic acids. These lipid mediators have traditionally been known to recruit cells of the immune system to a site of injury and inflammation. However, they also interact with various cells that are resident to the wound bed, including modulation of keratinocyte activity. Recent Advances: Recent work has identified multiple prostanoid and leukotriene receptors on keratinocytes, indicating that eicosanoids directly interact with them. Recent work also shows that keratinocytes are capable of producing prostanoids and leukotrienes. Critical Issues: Much of the critical work has been performed in cell culture and mouse in vivo models. This has greatly expanded our understanding of the eicosanoid interactions with keratinocytes and wound healing in general. However, few of these in vivo models have been able to critically evaluate keratinocyte migration and re-epithelialization. Future Directions: As research continues in this exciting field, the cellular pathways stimulated by the eicosanoids will become better defined. Future research with excisional wound models in mice and pigs and ex vivo human skin models will better isolate the contribution of eicosanoid-mediated effects on keratinocyte migration and re-epithelialization.

Risk assessment of excess drug and sunscreen absorption via skin with ablative fractional laser resurfacing : optimization of the applied dose for postoperative care

The ablative fractional laser is a new modality used for surgical resurfacing. It is expected that laser treatment can generally deliver drugs into and across the skin, which is toxicologically relevant. The aim of this study was to establish skin absorption characteristics of antibiotics, sunscreens, and macromolecules via laser-treated skin and during postoperative periods. Nude mice were employed as the animal model. The skin received a single irradiation of a fractional CO2 laser, using fluences of 4-10 mJ with spot densities of 100-400 spots/cm(2). In vitro skin permeation using Franz cells was performed. Levels of skin water loss and erythema were evaluated, and histological examinations with staining by hematoxylin and eosin, cyclooxygenase-2, and claudin-1 were carried out. Significant signs of erythema, edema, and scaling of the skin treated with the fractional laser were evident. Inflammatory infiltration and a reduction in tight junctions were also observed. Laser treatment at 6 mJ increased tetracycline and tretinoin fluxes by 70- and 9-fold, respectively. A higher fluence resulted in a greater tetracycline flux, but lower skin deposition. On the other hand, tretinoin skin deposition increased following an increase in the laser fluence. The fractional laser exhibited a negligible effect on modulating oxybenzone absorption. Dextrans with molecular weights of 4 and 10 kDa showed increased fluxes from 0.05 to 11.05 and 38.54 μg/cm(2)/h, respectively. The optimized drug dose for skin treated with the fractional laser was 1/70-1/60 of the regular dose. The skin histology and drug absorption had recovered to a normal status within 2-3 days. Our findings provide the first report on risk assessment of excessive skin absorption after fractional laser resurfacing.

Skin permeation of small-molecule drugs, macromolecules, and nanoparticles mediated by a fractional carbon dioxide laser: the role of hair follicles

PURPOSE

To evaluate skin permeation enhancement mediated by fractional laser for different permeants, including hydroquinone, imiquimod, fluorescein isothiocyanate-labeled dextran (FD), and quantum dots.

METHODS

Skin received a single irradiation of a fractional CO(2) laser, using fluence of 2 or 4 mJ with densities of 100 ∼ 400 spots/cm(2). In vitro and in vivo skin penetration experiments were performed. Fluorescence and confocal microscopies for imaging delivery pathways were used.

RESULTS

The laser enhanced flux of small-molecule drugs 2 ∼ 5-fold compared to intact skin. A laser fluence of 4 mJ with a 400-spot/cm(2) density promoted FD flux at 20 and 40 kDa from 0 (passive transport) to 0.72 and 0.43 nmol/cm(2)/h, respectively. Microscopic images demonstrated a significant increase in fluorescence accumulation and penetration depth of macromolecules and nanoparticles after laser exposure. Predominant routes for laser-assisted delivery may be intercellular and follicular transport. CO(2) laser irradiation produced 13-fold enhancement in follicular deposition of imiquimod. Laser-mediated follicular transport could deliver permeants to deeper strata. Skin barrier function as determined by transepidermal water loss completely recovered by 12 h after irradiation, much faster than conventional laser treatment (4 days).

CONCLUSIONS

Fractional laser could selectively enhance permeant targeting to follicles such as imiquimod and FD but not hydroquinone, indicating the importance of selecting feasible drugs for laser-assisted follicle delivery.

Topical treatment with basic fibroblast growth factor promotes wound healing and barrier recovery induced by skin abrasion

It has been reported that basic fibroblast growth factor (bFGF) promotes the healing of skin ulceration by inducing fibroblast proliferation, yet the role of bFGF on epidermal barrier function, especially from the perspective of scratch-induced skin abrasion, remains unknown. To this end, we initially developed an epidermal abrasion mouse model induced by scratching with a stainless-steel wire brush, and examined the effects of bFGF on the wound healing induced by skin abrasion. This procedure induced a significant elevation of transepidermal water loss (TEWL) in a scratch-count-dependent manner. This elevated TEWL was significantly decreased following topical application of bFGF to the skin. In addition, bFGF increased the expression of Ki67 in keratinocytes following mechanical scratching. These results suggest that bFGF enhances keratinocyte proliferation, which, in turn, repairs the skin barrier disruption and wounds caused by scratching in mice. Consistently, bFGF stimulated proliferation of normal human epidermal keratinocytes (NHEK). Intriguingly, the effect of bFGF and other growth factors on NHEK proliferation was additive. However, high cell density diminished the effect of bFGF on NHEK proliferation. This particular result can be explained by our observation that FGF receptor mRNA expression in NHEK was low under conditions of high cell density. Our findings suggest that bFGF stimulates keratinocyte proliferation, especially in a lower cell density environment, to repair skin wound in accord with skin barrier recovery.

Role of prostaglandins on mechanical scratching-induced cutaneous barrier disruption in mice

The role of prostaglandins (PGs) on mechanical scratching-induced cutaneous barrier disruption in mice was investigated by comparing the observed effects of arachidonic acid (AA) application. Scratching of the mouse skin with a stainless-steel wire brush (mechanical scratching) was associated with significant, scratch-count-dependent elevation of the transepidermal water loss (TEWL) and skin PG levels (especially PGD(2) and PGE(2)). Histological evidence of inflammation (crusta, acanthosis and neutrophilic infiltration) in the skin also became evident 24 h after mechanical scratching. On the other hand, while topical application of 0.1% AA to the mouse skin also increased the skin PG levels, but did not produce any increase of TEWL or histological evidence of inflammation in the skin. Topical application of cyclooxygenase inhibitors (indomethacin, piroxicam, aspirin, diclofenac and ketoprofen) decreased the spontaneous recovery rates from cutaneous barrier disruption. These results suggest that the elevation of cutaneous PG production induced by mechanical scratching is involved in the repair of the skin damage caused by the scratching.

Cyclooxygenase-1 inhibition delays recovery of the cutaneous barrier disruption caused by mechanical scratching in mice

BACKGROUND

Atopic dermatitis is a chronic inflammatory disease characterized by severe pruritus, and cutaneous barrier disruption by scratching contributes to further aggravation of the condition. We have previously shown that indomethacin delayed recovery from the effects of cutaneous barrier disruption caused by mechanical scratching in mice.

OBJECTIVES

This study was designed to assess the role of cyclooxygenase (COX)-1 and COX-2 inhibitors on recovery from the effects of cutaneous barrier disruption induced by mechanical scratching in mice.

METHODS

We examined the effects of SC-560 (a COX-1-selective inhibitor) or NS-398 (a COX-2-selective inhibitor) on recovery from the effects of cutaneous barrier disruption in mice induced by a wire brush, in terms of the skin prostaglandin (PG) levels.

RESULTS

While SC-560 significantly delayed recovery from the effects of cutaneous barrier disruption, NS-398 had no such effect. SC-560 was significantly more effective than NS-398 in reducing skin PG levels at 6 and 24 h after cutaneous barrier disruption. SC-560 strongly inhibited biosynthesis of cutaneous PGD(2) to a greater extent than that of other PGs.

CONCLUSIONS

COX-1-coupled PGD(2) biosynthesis may be an important factor in the recovery of cutaneous barrier disruption.

Effects of TS-022, a newly developed prostanoid DP1 receptor agonist, on experimental pruritus, cutaneous barrier disruptions and atopic dermatitis in mice

TS-022, {4-[(1R, 2S, 3R, 5R)-5-Chloro-2-((S)-3-cyclohexyl-3-hydroxyprop-1-ynyl)-3-hydroxycyclopentyl] butylthio} acetic acid monohydrate, inhibits ADP-induced platelet aggregation, an effect significantly antagonized, as in the case of prostaglandin D(2) by the prostanoid DP(1) receptor antagonist (BW A868C). TS-022 is a prostanoid DP(1) receptor agonist, originally developed as a novel anti-pruritic drug for patients with atopic dermatitis. We examined the effects of TS-022 on experimental pruritus, cutaneous barrier disruption, and atopic dermatitis and in in vitro immune function tests. Topically applied TS-022 significantly suppressed scratching in skin-lesioned NC/Nga mice from a concentration of 2.5 nM, and this scratch-suppressive activity was significantly antagonized by BW A868C. Tacrolimus (FK-506) and dexamethasone, used as reference drugs for atopic dermatitis, also exhibited suppressive effects against scratching, but only at concentrations of 125 and 25,000 microM. TS-022 applied topically, once a day for 2 days, significantly accelerated repair of the cutaneous barrier disruption caused by mechanical scratching, from concentrations of 2.5 nM. This acceleration of repair of the disrupted cutaneous barrier by this drug was also significantly antagonized by BW A868C. FK-506 and dexamethasone showed no beneficial effects on the repair of the disrupted cutaneous barrier. Repeated topical application of 2.5 microM of TS-022 and 12.5 microM of FK-506 once a day for 6 weeks significantly improved the skin inflammation scores in the NC/Nga mice. In regard to the effects of TS-022 in vitro, the inhibitory activity of TS-022 against concanavalin A-induced cytokine production by splenocytes was marginal as compared with that of FK-506 or dexamethasone. These results suggest that the beneficial therapeutic effects of TS-022 in NC/Nga mice with atopic dermatitis are mediated by its suppressive effect on scratching and its effect of accelerating repair of the disrupted cutaneous barrier, both effects being attributable to its prostanoid DP(1) receptor agonistic activity.

Putative mechanism of the itch-scratch circle: repeated scratching decreases the cutaneous level of prostaglandin D2, a mediator that inhibits itching

In atopic dermatitis, scratching of the skin as a reaction to itching causes injury to the skin, which, in turn, further increases the itching resulting in the establishment of the so-called itch-scratch circle. We have shown that prostaglandin (PG) D2 plays an inhibitory role against pruritus in mice with atopic-like dermatitis; therefore, we examined the relationship between scratching and the cutaneous PGD2 level using an artificial scratching model with a wire brush. Mechanical scratching induced a temporary increase of the skin PGs levels (PGE2, PGD2, 6-ketoPGF1alpha, PGF2alpha). The skin PGD2 level and the ability of PGD2 production decreased at 48 h after repeated scratch, compared to that of normal skin, not so after single scratch. Immunohistochemical analysis and Western blotting revealed a decrease in the levels of cyclooxygenase-1 (COX-1) and hematopoietic PGD synthase in mechanically scratched skin. The reduced ability of the skin for PGD2 production following mechanical scratching could be caused by this decrease in the expression levels of COX-1 and PGD2 synthase. The results suggest that repeated scratching in mice decreases the ability of the skin to produce PGD2, which is an endogenous mediator that inhibits pruritus, resulting in the establishment of the itch-scratch circle.

Time course changes of scratching counts, dermatitis symptoms, and levels of cutaneous prostaglandins in NC/Nga mice

NC/Nga (NC) mice are known to develop dermatitis resembling atopic dermatitis (AD) in conventional (Conv) conditions, but not in specific pathogen-free (SPF) conditions. We reported that the ability of skin prostaglandin D(2) (PGD(2)) production, which might be the endogenous inhibitor of itching, was attenuated in skin-lesioned Conv-NC mice. We examined the age-related change in scratching, dermatitis symptoms, and skin PGs of SPF- and Conv-NC mice. In Conv-NC, PGD(2) increased at 7 weeks, at which scratching counts increased, but dermatitis did not develop. PGE(2), PGI(2) and PGF(2alpha) increased at 10 and 13 weeks, at which dermatitis developed. The ability to produce skin PGs was examined by measuring PGs after application of arachidonic acid or after mechanical scratching using a wire brush. In Conv-NC, PGD(2) production at 13 weeks was lower than at 7 weeks. In Conv-NC, hematopoietic PGD synthase (hPGDS) expression in the skin at 13 weeks was lower than at 7 weeks by Western blotting and immunohistochemical analysis. The increase of skin PGD(2) level in the early phase of the development of dermatitis is due to the stress of extensive scratching, but did not increase in spite of the stress of extensive scratching in the late phase, due to decreasing capacity of PGD(2) production attributable to decreasing hPGDS expression in Conv-NC mice. These results suggest that a decreased ability to produce skin PGD(2) production could enhance scratching and aggravate dermatitis in Conv-NC mice.