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Tang W, Peng Y, Dou Y, Zhang Y, Zhang X, Wang L, Li M, Yan W, Ye Y. Changes in skin barrier over the first four days of life: a cross-sectional study. Pediatr Res 2024:10.1038/s41390-024-03530-8. [PMID: 39215196 DOI: 10.1038/s41390-024-03530-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/13/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND We aimed to evaluate the trajectory of skin barrier properties in full-term newborns during the first four days after birth. METHODS Based on the MKNFOAD cohort (NCT02889081), transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin pH, and sebum content at five anatomical sites (cheek, forehead, volar forearm, abdomen, and dorsal lower leg) were examined once within 96 h after birth in 384 full-term infants. Multivariable linear regression analysis was performed to assess variations in these skin barrier parameters with age adjusted for gestational age, neonate's sex, parents' allergy history, delivery mode, amniotic fluid characteristics, and birth weight. The regression coefficient (ß) and 95% confidence interval were reported. RESULTS We analyzed a total of 384 neonates including 198 (51.6%) boys. TEWL values remained stable and showed no significant association with age (days). pH values exhibited a declining trend with age (p for trend <0.001). Both SCH values and sebum content grew with age (p for trend <0.001). CONCLUSION During the first four days after birth, the skin TEWL remained stable, pH decreased, and the SCH and sebum content increased over time. These findings provide insights into the neonatal skin physiological development at the beginning of life. IMPACT From birth to 96 h, TEWL was stable, pH showed a steep decline, SCH and sebum content increased. This study provides the first evidence of skin adaptation in the newborn due to changes in utero to after birth in the first 4 days of life in an Asian population. These findings will provide a new theoretical basis for neonatal skin physiology and clinical strategies for guiding newborn skin care.
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Affiliation(s)
- Weitao Tang
- Department of Dermatology, Children's Hospital of Fudan University &National Children Medical Center, Shanghai, China
| | - Yuanzhou Peng
- Department of Clinical Epidemiology, Children's Hospital of Fudan University & National Children Medical Center, Shanghai, China
| | - Yalan Dou
- Department of Clinical Epidemiology, Children's Hospital of Fudan University & National Children Medical Center, Shanghai, China
| | - Yi Zhang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University & National Children Medical Center, Shanghai, China
| | - Xiaohua Zhang
- Department of Obstetrics, Shanghai Minhang Maternal and Children Health Care Hospital, Shanghai, China
| | - Liuhui Wang
- Department of Dermatology, Children's Hospital of Fudan University &National Children Medical Center, Shanghai, China
| | - Ming Li
- Department of Dermatology, Children's Hospital of Fudan University &National Children Medical Center, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University & National Children Medical Center, Shanghai, China
| | - Ying Ye
- Department of Dermatology, Children's Hospital of Fudan University &National Children Medical Center, Shanghai, China.
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2
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Braun C, Coutier L, Bégin P, Nosbaum A. Skin-centered strategies in food allergy prevention. Pediatr Allergy Immunol 2024; 35:e14130. [PMID: 38693814 DOI: 10.1111/pai.14130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/19/2024] [Accepted: 04/03/2024] [Indexed: 05/03/2024]
Abstract
While the early introduction of food allergens in the infant diet has been shown to be effective at preventing the development of food allergy (FA), its implementation in real life has been associated with various challenges. Interventions aimed at correcting skin barrier dysfunction have been explored in recent decades as a distinct or complementary mean to prevent allergic sensitization through the skin and subsequent development of FA. Studies assessing the application of emollient from birth have yielded conflicting results, and meta-analyses have demonstrated either no effect or only a slight positive effect on FA prevention. However, a careful review of the clinical trials reveals that different emollients were used, which may have explained some of the discrepancies between study results. Emollient application protocols also varied widely between studies. While firm conclusions cannot be drawn with regard to their overall efficacy at preventing FA, the available data provide valuable insight into the characteristics that could be associated with a more effective intervention. Namely, successful trials tended to use emollients with an acidic pH of 5.5, applied over the entire body, and combined with topical corticosteroids in affected areas. Consensus on the optimal strategy to restore skin barrier function could help improve the homogeneity and clinical relevance of future trials on this topic. In the meantime, clinicians should avoid products associated with worse outcomes.
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Affiliation(s)
- Camille Braun
- Section of Allergy and Clinical Immunology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Pediatrics, Pneumology, Allergy, Cystic Fibrosis, Hôpital Femme Mère Enfant, Bron, France
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, Université Lyon 1, Lyon, France
| | - Laurianne Coutier
- Department of Pediatrics, Pneumology, Allergy, Cystic Fibrosis, Hôpital Femme Mère Enfant, Bron, France
- INSERM U1028 CNRS UMR 5292, Université Lyon 1, Lyon, France
| | - Philippe Bégin
- Section of Allergy and Clinical Immunology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Medicine, Section of Allergy and Clinical Immunology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Audrey Nosbaum
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, Université Lyon 1, Lyon, France
- Department of Allergy and Clinical Immunology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
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3
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Liu H, Li D, Yuan H, Sun T, Li P, Cai Z, Shen C. Improved Short-Term Prognosis of Pediatric Partial-Thickness Burns: Emergency Conservative Debridement Under Topical Anesthesia. Pediatr Emerg Care 2024; 40:390-394. [PMID: 38459619 DOI: 10.1097/pec.0000000000003098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Early wound management for pediatric patients with partial-thickness burns in the emergency department remains debatable. This study aims to evaluate the value of emergency conservative debridement under topical anesthesia in improving short-term prognosis of pediatric partial-thickness burns. METHODS This retrospective cohort study enrolled children with partial-thickness thermal burns presenting to the emergency department within 6 hours postburn. All the enrolled patients were divided into 2 groups: the debridement group and the dressing group. The associations between emergency conservative debridement and time to reepithelialization was analyzed by using Kaplan-Meier curves with log rank test and multivariate Cox regression analysis. Moreover, the associations between emergency conservative debridement and in-hospital cost and length of stay were also evaluated. RESULTS All baseline characteristics between groups were comparable (all P > 0.05). Emergency conservative debridement under topical anesthesia significantly decreased the median value of time to reepithelialization (13 vs 14 days, P = 0.02). Cox regression analysis showed that emergency conservative debridement significantly improved wound reepithelialization after adjusting for burn size (odds ratio, 4.07; 95% confidence interval, 1.64-10.11; P < 0.01). The mean length of stay of patients receiving conservative wound debridement was lower than that of patients in the wound dressing group (14.3 ± 7.3 vs 18.8 ± 10.4 days, P < 0.01), but not in terms of mean in-hospital cost per 1% total body surface area (2.8 ± 1.9 vs 3.0 ± 2.1 × 103 RMB per 1% total body surface area, P = 0.58). CONCLUSIONS Emergency conservative debridement of pediatric partial-thickness burns under topical anesthesia significantly improves the wound healing outcomes without increasing health care burden.
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Affiliation(s)
- Hailiang Liu
- From the Department of Burns and Plastic Surgery, the Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
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4
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Stamatas GN, Roux PF, Boireau-Adamezyk E, Lboukili I, Oddos T. Skin maturation from birth to 10 years of age: Structure, function, composition and microbiome. Exp Dermatol 2023; 32:1420-1429. [PMID: 37302006 DOI: 10.1111/exd.14843] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
Infant and adult skin physiology differ in many ways; however, limited data exist for older children. To further investigate the maturation processes of healthy skin during childhood. Skin parameters were recorded in 80 participants of four age groups: babies (0-2 years), young children (3-6 years), older children (7-<10 years) and adults (25-40 years). Overall, skin barrier function continues to mature, reaching adult levels of transepidermal water loss (TEWL), lipid compactness, stratum corneum (SC) thickness and corneocyte size by the age of about 6 years. Higher levels of lactic acid and lower levels of total amino acids in the SC of babies and young children further indicate higher cell turnover rates. In all age groups, TEWL and skin surface hydration values remain higher on the face compared with the arm. Skin becomes darker and contains higher levels of melanin with increasing age. The composition of skin microbiome of the dorsal forearm in all children groups is distinct from that in adults, with Firmicutes predominating in the former and Proteobacteria in the latter. Skin physiology, along with the skin microbiome, continues to mature during early childhood in a site-specific manner.
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Affiliation(s)
- Georgios N Stamatas
- Translational Science, Johnson & Johnson Santé Beauté France, Issy-les-Moulineaux, France
| | - Pierre-Francois Roux
- Translational Science, Johnson & Johnson Santé Beauté France, Issy-les-Moulineaux, France
| | - Elise Boireau-Adamezyk
- Translational Science, Johnson & Johnson Santé Beauté France, Issy-les-Moulineaux, France
| | - Imane Lboukili
- Translational Science, Johnson & Johnson Santé Beauté France, Issy-les-Moulineaux, France
| | - Thierry Oddos
- Translational Science, Johnson & Johnson Santé Beauté France, Issy-les-Moulineaux, France
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5
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Fife A, Larsen K. Causal Inference in Traumatic Brain Injury: A Case of Head Trauma and Mismatched Symptoms. J Pediatr Pharmacol Ther 2023; 28:365-367. [PMID: 37795283 PMCID: PMC10547044 DOI: 10.5863/1551-6776-28.4.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 07/27/2022] [Indexed: 10/06/2023]
Abstract
We present a case of a 14-month-old female presenting to the emergency department with head trauma. When her symptoms deviated from those associated with typical head trauma, the emergency department pharmacy team recognized a vital clue that directed the medical team toward the actual mechanism of injury and appropriate treatment of the child.
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Affiliation(s)
- Alexandra Fife
- Emergency Department (AF), Primary Children’s Hospital, Salt Lake City, Utah
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6
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Pressure Injury Risk Assessment in Pediatric Intensive Care: A Prospective Validation Study of the Glamorgan Scale and Predictive Comparison with the Braden Q Scale. Adv Skin Wound Care 2023; 36:1-7. [PMID: 36806282 DOI: 10.1097/01.asw.0000918880.95690.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To validate the Glamorgan Scale and compare its predictive ability in assessing pressure injury risk among patients in a pediatric ICU (PICU) with that of the Braden Q Scale. METHODS A prospective cohort study was performed to validate the Glamorgan Scale and compare its predictive ability with the Braden Q Scale in a PICU population. A total of 83 patients admitted in the PICU between February and July 2020 met the inclusion criteria and were included in the study, leading to 639 measurements. The authors tested the psychometric properties of the Glamorgan Scale to validate whether the characteristics of the original version were preserved. To this end, reliability (internal consistency) and concurrent and predictive validity (sensitivity and specificity) were assessed. For the predictive comparison, the authors performed the same tests with the Braden Q Scale. RESULTS The predictive validity, as assessed by the receiver operator characteristic curve and calculation of the area under the curve, showed satisfactory performance for the Glamorgan Scale (0.77; CI, 0.72-0.82); the Braden Q Scale values were similar (0.78; CI 0.73-0.84). The Spearman correlation coefficient showed a strong correlation between the total scores of the Glamorgan Scale (ρ = -0.76; P < .01), corroborating its validation. CONCLUSIONS The Glamorgan Scale was validated and showed good accuracy and consistency for pressure injury risk assessment in critically ill pediatric patients in Brazil. Its accuracy was similar to that of the Braden Q Scale.
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7
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Thoma G, Duthaler RO, Waelchli R, Hauchard A, Bruno S, Strittmatter-Keller U, Orjuela Leon A, Viebrock S, Aichholz R, Beltz K, Grove K, Hoque S, Rudewicz PJ, Zerwes HG. Discovery and Characterization of the Topical Soft JAK Inhibitor CEE321 for Atopic Dermatitis. J Med Chem 2023; 66:2161-2168. [PMID: 36657024 DOI: 10.1021/acs.jmedchem.2c01977] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The JAK kinases JAK1, JAK2, JAK3, and TYK2 play key roles in cytokine signaling. Activation of the JAK/STAT pathways is linked to many diseases involving the immune system, including atopic dermatitis. As systemic JAK inhibitor pharmacology is associated with side effects, topical administration to the skin has been considered to locally restrict the site of action. Several orally bioavailable JAK inhibitors repurposed for topical use have been recently approved or are in clinical development. Here, we disclose our clinical candidate CEE321, which is a potent pan JAK inhibitor in enzyme and cellular assays. In contrast to repurposed oral drugs, CEE321 does not display high potency in blood and has a high clearance in vivo. Therefore, we consider CEE321 to be a "soft drug". When applied topically to human skin that was stimulated with the cytokines IL4 and IL13 ex vivo, CEE321 potently inhibited biomarkers relevant to atopic dermatitis.
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Affiliation(s)
- Gebhard Thoma
- Global Discovery Chemistry, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Rudolf O Duthaler
- Global Discovery Chemistry, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Rudolf Waelchli
- Global Discovery Chemistry, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Alice Hauchard
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Sandro Bruno
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Ulrike Strittmatter-Keller
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Anette Orjuela Leon
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Sabine Viebrock
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Reiner Aichholz
- PK Sciences, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Karen Beltz
- PK Sciences, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Kerri Grove
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Shaila Hoque
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Patrick J Rudewicz
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Hans-Guenter Zerwes
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
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8
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Darlenski R, Fluhr JW. How do the skin barrier and microbiome adapt to the extra-uterine environment after birth? Implications for the clinical practice. Int J Cosmet Sci 2023. [PMID: 36692960 DOI: 10.1111/ics.12844] [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: 10/30/2022] [Revised: 01/10/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
The multiple protective functions of the skin derive from the interactions between epithelial skin and immune cells as well as the commensal microbiota. Developed in the last trimester of intra-uterine life, the skin barrier adapts dynamically after birth. Specific differences in the structure and physiology have been disclosed between infant and adult skin. The stratum corneum of infants is thinner and structured by thicker corneocytes with a more anisotropic surface in comparison to adult skin. Lower levels of the natural moisturizing factor and its constituents, together with the increased protease activity in the epidermis result in dry baby skin and ongoing adaptation of the desquamation to the extra-uterine environment. Infant epidermis is characterized by an accelerated proliferation rate and clinically competent permeability barrier in term neonates, despite the higher baseline values of transepidermal water loss in infants. The skin surface of newborns is less acidic, which could increase susceptibility to diaper and atopic dermatitis. Immediately after birth, skin is colonized by commensal bacteria-a process dependent on the mode of delivery and of major importance for the maturation of the immune system. Skin bacterial diversity and dysbiosis have been related to different pathology such as atopic and seborrheic dermatitis. This paper focuses on the ongoing structural, functional and biochemical adaptation of the human skin barrier after birth. We discuss the interactions on the 'skin barrier/ microbiota/ immune system' axis and their role in the development of competent functional integrity of the epidermal barrier.
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Affiliation(s)
- Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital Sofia, Sofia, Bulgaria.,Department of Dermatology and Venereology, Trakia University-Stara Zagora, Stara Zagora, Bulgaria
| | - Joachim W Fluhr
- Department of Dermatology, Charité Universitätsmedizin, Berlin, Germany
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9
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Ciprandi G, Crucianelli S, Grussu F, Spuntarelli G, Marino SFM, Urbani U, Bernaschi P, Sisto A, Rizzo MI, Zama M. Meeting the Challenges in Pediatric Wound Care: Our 15-Year Experience with Dialkylcarbamoyl Chloride-Coated Dressing Technology in Acute and Chronic Wounds. CHRONIC WOUND CARE MANAGEMENT AND RESEARCH 2022. [DOI: 10.2147/cwcmr.s376889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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10
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Treating allergies via skin - Recent advances in cutaneous allergen immunotherapy. Adv Drug Deliv Rev 2022; 190:114458. [PMID: 35850371 DOI: 10.1016/j.addr.2022.114458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 01/24/2023]
Abstract
Subcutaneous allergen immunotherapy has been practiced clinically for decades to treat airborne allergies. Recently, the cutaneous route, which exploits the immunocompetence of the skin has received attention, which is evident from attempts to use it to treat peanut allergy. Delivery of allergens into the skin is inherently impeded by the barrier imposed by stratum corneum, the top layer of the skin. While the stratum corneum barrier must be overcome for efficient allergen delivery, excessive disruption of this layer can predispose to development of allergic inflammation. Thus, the most desirable allergen delivery approach must provide a balance between the level of skin disruption and the amount of allergen delivered. Such an approach should aim to achieve high allergen delivery efficiency across various skin types independent of age and ethnicity, and optimize variables such as safety profile, allergen dosage, treatment frequency, application time and patient compliance. The ability to precisely quantify the amount of allergen being delivered into the skin is crucial since it can allow for allergen dose optimization and can promote consistency and reproducibility in treatment response. In this work we review prominent cutaneous delivery approaches, and offer a perspective on further improvisation in cutaneous allergen-specific immunotherapy.
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11
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Stockfleth E, Revol O. Encouraging sun protection early in life: from a successful prevention programme in children to the identification of psychological barriers in adolescents. J Eur Acad Dermatol Venereol 2022; 36 Suppl 6:12-21. [PMID: 35738808 DOI: 10.1111/jdv.18194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
Children and adolescents have high rates of sunburn and high levels of ultraviolet radiation (UVR) exposure and are therefore at risk of developing skin cancer in later life. Minimizing UVR exposure in childhood and adolescence may be the most important component of skin cancer prevention efforts. Thus, age-adapted prevention campaigns, targeting children, adolescents and caregivers, are needed to change sun protection behaviour among individuals in these age groups. In the first part of this review, we describe the 'SunPass' programme, which was initiated in Germany in 2010 as the first nationwide educational intervention for sun safety designed to teach kindergarten children and their caregivers how to protect themselves from overexposure to the sun. Implemented in 55 kindergartens, this programme has been shown to be effective at improving sun protection behaviour (P < 0.001) and hat use (P = 0.029) among kindergarten children, as well as at improving shade practices and increasing demand for protective clothing (P < 0.001). Up to 40 000 children, 50 000 parents/grandparents and 2500 kindergarten caregivers took part in the SunPass programme in Germany from 2019 to June 2021. The programme has also been adapted and implemented in several other European countries and could be readily adapted for use elsewhere. In the second part of this review, we discuss the specific challenges faced by adolescents and consider how these issues may impact their sun protection behaviour. Adolescents have difficulties suppressing responses to reward-related cues and projecting themselves into the future. They also place a lot of importance on social acceptance and cosmetic appearance, and their higher risk of depression, addiction and impulsivity make them vulnerable to tanning addiction. These specificities need to be acknowledged by dermatologists, so they can adapt their therapeutic relationship and develop effective sun protection interventions for this generation.
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Affiliation(s)
- E Stockfleth
- Klinik für Dermatologie und Ruhr-Universität Bochum, Gudrunstrasse 52, Bochum, Germany
| | - O Revol
- Child Development Unit, Hospices Civils de Lyon, Bron, France
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12
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Landers JJ, Janczak KW, Shakya AK, Zarnitsyn V, Patel SR, Baker JR, Gill HS, O'Konek JJ. Targeted allergen-specific immunotherapy within the skin improves allergen delivery to induce desensitization to peanut. Immunotherapy 2022; 14:539-552. [PMID: 35196877 PMCID: PMC9043875 DOI: 10.2217/imt-2021-0206] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
Aim: Epicutaneous immunotherapy (EPIT) with peanut has been demonstrated to be safe but efficacy may be limited by allergen uptake through the skin barrier. To enhance allergen uptake into the skin, the authors used peanut-coated microneedles and compared them with EPIT in a peanut allergy mouse model. Methods: Sensitized mice were treated with peanut-coated microneedles or peanut-EPIT and then challenged with peanut to determine protection. Results: Treatment with peanut-coated microneedles was safe and showed enhanced desensitization to peanut compared with peanut-EPIT administered via a similar schedule. Protection was associated with reduced Th2 immune responses and mast cell accumulation in the intestine. Conclusion: Peanut-coated microneedles have the potential to present a safe method of improving allergen delivery for cutaneous immunotherapy.
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Affiliation(s)
- Jeffrey J Landers
- Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Katarzyna W Janczak
- Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI 48109, USA
| | | | | | | | - James R Baker
- Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Harvinder Singh Gill
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Jessica J O'Konek
- Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI 48109, USA
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13
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Yun YE, Calderon-Nieva D, Hamadeh A, Edginton AN. Development and Evaluation of an In Silico Dermal Absorption Model Relevant for Children. Pharmaceutics 2022; 14:pharmaceutics14010172. [PMID: 35057066 PMCID: PMC8780349 DOI: 10.3390/pharmaceutics14010172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/14/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023] Open
Abstract
The higher skin surface area to body weight ratio in children and the prematurity of skin in neonates may lead to higher chemical exposure as compared to adults. The objectives of this study were: (i) to provide a comprehensive review of the age-dependent anatomical and physiological changes in pediatric skin, and (ii) to construct and evaluate an age-dependent pediatric dermal absorption model. A comprehensive review was conducted to gather data quantifying the differences in the anatomy and physiology of child and adult skin. Maturation functions were developed for model parameters that were found to be age-dependent. A pediatric dermal absorption model was constructed by updating a MoBi implementation of the Dancik et al. 2013 skin permeation model with these maturation functions. Using a workflow for adult-to-child model extrapolation, the predictive performance of the model was evaluated by comparing its predicted rates of flux of diamorphine, phenobarbital and buprenorphine against experimental observations using neonatal skin. For diamorphine and phenobarbital, the model provided reasonable predictions. The ratios of predicted:observed flux in neonates for diamorphine ranged from 0.55 to 1.40. For phenobarbital, the ratios ranged from 0.93 to 1.26. For buprenorphine, the model showed acceptable predictive performance. Overall, the physiologically based pediatric dermal absorption model demonstrated satisfactory prediction accuracy. The prediction of dermal absorption in neonates using a model-based approach will be useful for both drug development and human health risk assessment.
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Saeki H, Tsunemi Y, Arai S, Ichiyama S, Katoh N, Kikuchi K, Kubo A, Terui T, Nakahara T, Futamura M, Murota H, Igarashi A. English version of guidelines for the management of asteatosis 2021 in Japan. J Dermatol 2021; 49:e77-e90. [PMID: 34970776 DOI: 10.1111/1346-8138.16293] [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: 11/30/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022]
Abstract
This is the English version of guidelines for the management of asteatosis 2021 in Japan. Asteatosis is a synonym of xerosis found in a wide range of diseases that induce dry skin through impaired functions of either water retention of the stratum corneum or skin covering with acid mantle. Patients with asteatosis may be accompanied by pruritus. Moisturizers are the first-line treatment for asteatosis and their adequate use must be recommended. The main purpose of the present guidelines is to define skin symptoms requiring treatment with moisturizers for medical use in patients with asteatosis. If the deterioration of marked scaling or scratch marks is predicted, therapeutic intervention with moisturizers for medical use should be considered even in the absence of pruritus. Regarding six important points requiring decision-making in clinical practice (clinical questions), we evaluated the balance between the benefits and harm of medical interventions in reference to previous reports of clinical research, and presented the recommendation grades and evidence levels to optimize the patient outcome by medical interventions.
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Affiliation(s)
- Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Yuichiro Tsunemi
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Satoru Arai
- Department of Dermatology, St. Luke's International Hospital, Tokyo, Japan
| | - Susumu Ichiyama
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Norito Katoh
- Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | | | - Akiharu Kubo
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Takeshi Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaki Futamura
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Department of Allergy, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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15
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Roux PF, Oddos T, Stamatas G. Deciphering the role of skin surface microbiome in skin health: an integrative multi-omics approach reveals three distinct metabolite-microbe clusters. J Invest Dermatol 2021; 142:469-479.e5. [PMID: 34343557 DOI: 10.1016/j.jid.2021.07.159] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/26/2022]
Abstract
The advent of 16S RNA profiling and shotgun metagenomics has enabled a holistic approach to the study of the skin microbiome composition. Despite the interesting findings in this rapidly developing scientific area, the big question remains: What role does the microbiome play in skin physiology? To begin answering this question, we employed an integrative methodology for microbiome and metabolome analysis of skin surface samples collected from the volar forearm of healthy 3 to 6-month-old infants. While the infant skin metabolome was dominated by amino acids, lipids, and xenobiotics, the primary phyla of the microbiome were Firmicutes, Actinobacteria, and Proteobacteria. Zooming in on the species level revealed a large contribution of commensals belonging to the Cutibacterium and Staphylococcus genera, including Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus. This heterogeneity was further highlighted when combining the microbiome with metabolome data. Integrative analyses delineated the co-existence of three distinct metabolite-microbe clusters: one dominated by Cutibacterium linked to hydrophobic elements of the skin barrier, one associating Staphylococcus genus with amino acids relevant to the water holding capacity and pH regulation of the skin surface and one characterized by Streptococcus and independent of any particular metabolomic profile.
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Affiliation(s)
| | - Thierry Oddos
- Johnson & Johnson Santé Beauté France, Issy-les-Moulineaux, France
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16
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Ye Y, Zhao P, Dou L, Zhang Y, Ken K, Gu H, Dou Y, Gao W, He L, Chen X, Huang X, Zhang L, Li Y, Wang L, Yan W. Dynamic trends in skin barrier function from birth to age 6 months and infantile atopic dermatitis: A Chinese prospective cohort study. Clin Transl Allergy 2021; 11:e12043. [PMID: 34262694 PMCID: PMC8254580 DOI: 10.1002/clt2.12043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/03/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Skin barrier functions develop after birth and may be related to skin disorders in infants. We aimed to assess associations between dynamic trends of four skin barrier functional parameters in early life with infant atopic dermatitis (AD). METHODS Based on the prospective cohort MKNFOAD (NCT02889081), we examined transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin pH, and sebum content at five anatomical sites (cheek, forehead, forearm, abdomen, and lower leg) in 418 term infants at birth, 42 days, and 6 months. Trend differences by sex and association with AD at age 1 year were tested using variance analyses. Associations of the parameters with AD risk were tested using discrete time survival analysis, adjusting extensive covariates including parental history of allergy, infant's sex, birth weight (kg), and delivery mode. Odds ratios (ORs) and 95% confidence interval (CIs) were reported. RESULTS Overall TEWL and SCH appeared trends of increase while skin surface pH and sebum content showed trends of decrease within the first six postnatal months. Sex differences were significant for sebum content only (p < 0.001). After adjustment for parental and children covariates, cheek TEWL at birth (OR = 1.26, 95% CI 1.00-1.57, p = 0.045) and 42 days (OR = 1.52, 95% CI 1.17-1.97, p = 0.002) were significantly associated with increased AD risk. Associations were not observed between SCH, skin pH, and sebum content at birth or 42 days with AD. CONCLUSIONS Skin barrier functions of Chinese term infants varied nonlinearly after birth. Higher postnatal TEWL levels in early life indicate higher risk of early-onset AD.
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Affiliation(s)
- Ying Ye
- Department of Clinical EpidemiologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
- Department of DermatologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Piaoping Zhao
- Department of DermatologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Limin Dou
- Department of DermatologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Yi Zhang
- Department of Clinical EpidemiologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Kaku Ken
- Department of Research & DevelopmentPigeon Maternal and Infant Skin Care Research InstituteShanghaiChina
| | - Hongjian Gu
- Department of Research & DevelopmentPigeon Maternal and Infant Skin Care Research InstituteShanghaiChina
| | - Yalan Dou
- Department of Clinical EpidemiologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Wei Gao
- Department of DermatologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Lingfeng He
- Department of DermatologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Xiaotian Chen
- Department of Clinical EpidemiologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Xiangyuan Huang
- Department of Clinical EpidemiologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Lei Zhang
- Shanghai Minhang Maternal and Children Health Care HospitalShanghaiChina
| | - Yun Li
- Shanghai Minhang Maternal and Children Health Care HospitalShanghaiChina
| | - Liuhui Wang
- Department of DermatologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
| | - Weili Yan
- Department of Clinical EpidemiologyChildren’s Hospital of Fudan University & National Children Medical CenterShanghaiChina
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17
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Vocci MC, Fontes CMB, Abbade LPF. Cultural adaptation of the Glamorgan Scale to Brazilian Portuguese: Pressure Injury in Pediatrics. Rev Lat Am Enfermagem 2021; 29:e3424. [PMID: 33852689 PMCID: PMC8040784 DOI: 10.1590/1518-8345.4083.3424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/21/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE to describe the methodological process of cultural adaptation of the Glamorgan Scale to Brazilian Portuguese. METHOD a methodological study of translation and cultural adaptation of the Glamorgan Scale, following the six stages: initial translation, synthesis of translations, back-translation, committee of experts, pre-test, and submission of the adapted version to the author for approval. The committee of experts was composed of five physicians and, during evaluation, a semantic, idiomatic, cultural and conceptual analysis was carried out. The agreement and representativeness of the items were assessed using the Content Validity Index. A minimum value of 80% agreement was considered. RESULTS all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation made by the committee of experts, all items obtained an agreement greater than 80% in the first evaluation round. The pre-test stage allowed for a critical overview of the instrument, where few modifications were suggested by the participants. CONCLUSION the Glamorgan Scale was translated and culturally adapted to Brazilian Portuguese. Future psychometric studies are necessary to validate the scale.
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Affiliation(s)
- Marcelli Cristine Vocci
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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18
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Madhu R, Chandran V, Anandan V, Nedunchelian K, Thangavelu S, Soans ST, Shastri DD, Parekh BJ, Kumar RR, Basavaraja GV. Indian Academy of Pediatrics Guidelines for Pediatric Skin Care. Indian Pediatr 2020. [DOI: 10.1007/s13312-021-2133-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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19
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Yang M, Zhou M, Wang H, Yang M, Gao Y, Jia Y. Lipidomics reveals the role of glycoceramide and phosphatidylethanolamine in infantile acne. J Cosmet Dermatol 2020; 20:947-954. [PMID: 33128854 DOI: 10.1111/jocd.13823] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Infantile acne refers to a skin disease that usually occurs on the face from 6 weeks to 1 year old, and the etiology of infantile acne is different from that of puberty acne. The change of skin surface lipid (SSL) is an important factor in the occurrence of acne. OBJECTIVES Comparison of facial skin lipid changes in healthy and acne-prone infants, screening for possible groupings of substances, to explore factors associated with the development of acne in infants, such as gender and frequency of face washing. METHODS A questionnaire was used to obtain information about the infant, facial lipids were affixed with adhesive tape, and the samples were analyzed using Ultraperformance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS), with subsequent data analyzed by single-factor and multifactor analysis. RESULTS It was observed that some lipids followed the trend of lipid master classes, subclasses and were significantly different. Galactosylceramides, glycosylceramides and phosphatidylethanolamine were screened as the majority of differentiating lipid species. Additionally, it was emphasized that the frequency of face washing and parent's acne was independent with the severity of acne in infant by clinical characteristics, whereas the skin type and gender can affect the severity of acne statistically. CONCLUSIONS Facial lipids change significantly between infantile acne and healthy infants, suggesting that qualitative and quantitative changes in lipids are strongly associated with the development of acne and may exacerbate the environment in which acne occurs.
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Affiliation(s)
- Manli Yang
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China.,Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China
| | - Mingyue Zhou
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China.,Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China
| | - Hecong Wang
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China.,Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China
| | - Ming Yang
- Children' Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Ying Gao
- Children' Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yan Jia
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China.,Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China
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20
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Kawada S, Futamura M, Hashimoto H, Ono M, Akita N, Sekimizu M, Hattori H, Goto M, Horibe K, Maeda N. Association between sites and severity of eczema and the onset of cow's milk and egg allergy in children. PLoS One 2020; 15:e0240980. [PMID: 33075082 PMCID: PMC7571679 DOI: 10.1371/journal.pone.0240980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
Background Cow’s milk allergy (CMA) and egg allergy (EA) are common and can reduce quality of life in children. Infantile eczema is a well-established risk factor for the onset of food allergy via transdermal sensitization; however, various types of infantile eczema have not yet been evaluated. Therefore, we assessed the association between CMA and EA and the sites and the severity of infantile eczema. Methods This retrospective study was based on data from patients aged 2–19 years with atopic disease who were treated between July 2015 and March 2019 in a pediatric allergy clinic in Japan. Data regarding the history of IgE-mediated symptoms, eczema in the first year of life, parental history of atopic diseases, and infantile nutrition were collected. Results A total of 289 patients were included in the study, of which 81 and 111 children had IgE-mediated CMA and EA, respectively. The rates of CMA and EA were higher in the children with infantile eczema than in those without (30% vs. 9% and 42% vs. 21%). The rate of CMA was also higher in children with eczema on the face. Significant differences were noted in the rate of CMA among children with facial eczema of exudation (adjusted odds ratio 2.398; P = 0.017) and papules (adjusted odds ratio 2.787; P = 0.008), using multivariate analysis. Conclusion The rate of IgE-mediated CMA was high among children with atopic disease having severe facial eczema during infancy.
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Affiliation(s)
- Shiori Kawada
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masaki Futamura
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- * E-mail:
| | - Hiroya Hashimoto
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Manabu Ono
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Nobuhiro Akita
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroyoshi Hattori
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masahiko Goto
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Keizo Horibe
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Naoko Maeda
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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21
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Shakya AK, Lee CH, Gill HS. Microneedle-Mediated Allergen-Specific Immunotherapy for the Treatment of Airway Allergy in Mice. Mol Pharm 2020; 17:3033-3042. [DOI: 10.1021/acs.molpharmaceut.0c00447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Akhilesh Kumar Shakya
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Chang Hyun Lee
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Harvinder Singh Gill
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, United States
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22
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Duan Y, Ma L, Galzote C, Kong FQ, Shen CP. A Randomized Pilot Clinical Assessment Of Three Skincare Regimens On Skin Conditions In Infants. Clin Cosmet Investig Dermatol 2019; 12:895-909. [PMID: 31908513 PMCID: PMC6930520 DOI: 10.2147/ccid.s204216] [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: 02/20/2019] [Accepted: 10/10/2019] [Indexed: 01/20/2023]
Abstract
Introduction Few data are available on the comparison between the effects on infant skin of skin care products and those of water alone. Patients and methods In this single-center, evaluator-blind, parallel-group pilot study, healthy infants were randomized to near-daily washing for 12 weeks (starting in the summer and finishing in the winter months) with a mild liquid baby wash followed by use of baby lotion (wash+lotion), water followed by baby lotion (water+lotion), or water alone. Clinical and instrumental assessments of skin moisturization and barrier function were made. Results As expected the skin condition in all groups was affected by the change of the season. The skin of infants in all groups was mildly deteriorated (clinical grading) and with reduced moisture levels and increased barrier function. Instrumental measurements indicated that skin moisture and barrier function were better maintained in the wash+lotion and water+lotion groups than in the water-only group at week 12. Clinical assessment scores increased slightly over 12 weeks in all groups (P<0.05). At week 12, the wash+lotion group (n = 44) had significantly less change from baseline in overall skin condition and softness (lower scores) than did the water+lotion (n = 43) or water-only (n = 43) groups. The wash+lotion regimen maintained stable erythema and rash scores with lower mean values over time than in the other groups. Conclusion A regimen of a liquid baby wash and a baby skin lotion for 12 weeks resulted in less detrimental changes in instrumental and clinical measures of skin than using water and lotion or water alone.
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Affiliation(s)
- Yuanyuan Duan
- Johnson & Johnson Asia Pacific Skin Testing Center, Minhang, Shanghai, People's Republic of China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, MOE Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
| | - Carlos Galzote
- Johnson & Johnson International (Singapore) Pte. Ltd., Singapore, Singapore
| | - Fan-Qi Kong
- Johnson & Johnson Asia Pacific Skin Testing Center, Minhang, Shanghai, People's Republic of China
| | - Chun-Ping Shen
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, MOE Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
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23
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Monteiro Rodrigues L, Fluhr JW. EEMCO Guidance for the in vivo Assessment of Biomechanical Properties of the Human Skin and Its Annexes: Revisiting Instrumentation and Test Modes. Skin Pharmacol Physiol 2019; 33:44-60. [PMID: 31747675 DOI: 10.1159/000504063] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/10/2019] [Indexed: 11/19/2022]
Abstract
Biomechanics of the skin is an important subject in skin research. It has been studied for many decades involving various technologies and methods to characterize and quantify mechanical properties of the skin under different in vivo conditions. The present EEMCO paper reviews the current rel-evant information, providing practical orientation to researchers dedicated to in vivo assessment of biomechanics of skin and its annexes. We discuss the available non-invasive instruments, including their principles and variables. A correspondence between the descriptors nomenclature proposed by Agache and the designation for the suction-based standard instruments is proposed. The addressed properties include skin softness/stiffness, firmness, elasticity, elastic and viscoelastic properties, extensibility, resilience, anisotropy, acoustical shock wave hardness, friction (in relation to topographic properties), thickness, fiber/stress mechanics (bending, cyclic, tensile, fatigue, or torsion), and hardness. We provide the relation of these properties to biomechanical descriptors and in some cases to SI units. Practical guidance for the proper use of these instruments, limitations, and possible interpretations are provided, while discussing the meaning of descriptive or "phenomenological" variables. For studies intended to quantify the effect of an intervention with regard to mechanical properties, we recommend a minimum of 30-40 participants, based on normal distribution of the data sets. Some important limitations are recognized, including the lack of standardization of procedures and calibration of instruments, which compromises the relevance and real nature of the descriptors/parameters obtained with these devices. The present work highlights an approach to a better practice and a science-supported biomechanical assessment of human skin, hair, and nails.
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Affiliation(s)
- Luis Monteiro Rodrigues
- CBIOS - Universidade Lusófona Research Centre for Biosciences and Health Technologies, Lisbon, Portugal
| | - Joachim W Fluhr
- Department of Dermatology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany,
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24
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Shakya AK, Ingrole RSJ, Joshi G, Uddin MJ, Anvari S, Davis CM, Gill HS. Microneedles coated with peanut allergen enable desensitization of peanut sensitized mice. J Control Release 2019; 314:38-47. [PMID: 31626861 DOI: 10.1016/j.jconrel.2019.09.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
Abstract
The prevalence of peanut allergies has escalated over the last 20 years, yet there are no FDA approved treatments for peanut allergies. In this study we evaluated the potential of microneedles to deliver peanut protein extract (PE) into skin and assessed if the ensuing immune responses could desensitize mice that were sensitized to peanuts. Peanut sensitized mice were either treated through cutaneous immunotherapy using PE-coated microneedles or not treated, and then orally challenged with PE. After oral challenge, the clinical symptoms of peanut-induced anaphylaxis were significantly lower in the microneedle treated mice as compared to untreated mice, and this was accompanied by down-regulation of systemic anaphylaxis mediators such as histamine and mast cell protease-1 (MCPT-1) in the microneedles treated group. Overall, there was an up-regulation of Th1 cytokines (IL-2 and IFN-γ) as compared to Th2 cytokines (IL-4 and IL-5) in splenocyte culture supernatants of the microneedle treated group as compared to untreated group, suggesting that microneedles promoted immune modulation towards the Th1 pathway. Furthermore, mice treated with PE-coated microneedles were observed to retain integrity of their small intestine villi and had reduced eosinophilic infiltration as compared to the untreated but peanut sensitized mice, which further confirmed the desensitization capability of peanut cutaneous immunotherapy using coated microneedles. Thus, our current study represents a novel minimally invasive microneedle based cutaneous immunotherapy, which may provide a novel route of desensitization for the treatment of peanut allergies.
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Affiliation(s)
| | - Rohan S J Ingrole
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX, 79409, USA
| | - Gaurav Joshi
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX, 79409, USA
| | - Md Jasim Uddin
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX, 79409, USA
| | - Sara Anvari
- Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030, USA
| | - Carla M Davis
- Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030, USA
| | - Harvinder Singh Gill
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX, 79409, USA.
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25
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Francuzik W, Geier J, Schubert S, Worm M. A case-control analysis of skin contact allergy in children and adolescents. Pediatr Allergy Immunol 2019; 30:632-637. [PMID: 31077617 DOI: 10.1111/pai.13069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Contact sensitization in children is increasing. The offending allergens differ depending on patient age and sex. We aimed to determine the sensitization profiles in children (aged 6-12) and adolescents (aged 13-18), to compare these to a control group of adults (aged 60-66), and to evaluate differences in sensitization patterns between working and non-working adolescents. PATIENTS/MATERIALS/METHODS We analyzed Information Network of Departments of Dermatology (IVDK) data from 2009 to 2016 using multiple logistic regression analysis. Of the 99 082 patients documented in the IVDK database, 591 children, 2451 adolescents and 12 122 adults were included in further analysis. RESULTS Nickel was the most frequent contact allergen among all age-groups. Children and adolescents showed significantly lower reaction rates to fragrance mix, methyldibromo-glutaronitrile, methylisothiazolinone, and propolis than adults. Positive reactions to sorbitan sesquioleate and mercapto mix among children and to cobalt among adolescents were significantly more frequent than in adults. Working adolescents had more often positive reactions to methyl(chloro)isothiazolinone (skin lesions predominantly on hands) and paraben mix (skin lesions predominantly on feet) when compared to non-working peers. Patch-tested children were more often diagnosed with atopic dermatitis than adults (P < 0.0001). CONCLUSIONS Contact allergens display age-specific patterns, which should be considered in a standardized series targeting different patient populations (children and adolescents). Employed adolescents should preferably be tested with the baseline series to optimize allergen identification.
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Affiliation(s)
- Wojciech Francuzik
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), University Medical Center Göttingen, Göttingen, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), University Medical Center Göttingen, Göttingen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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26
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Ribet V, Gurdak M, Ferret PJ, Brinio E, Giordano Labadie F, Rossi AB. Stepwise approach of development of dermo-cosmetic products in healthy and atopic dermatitis paediatric population: safety evaluation, clinical development and postmarket surveillance. J Eur Acad Dermatol Venereol 2019; 33:2319-2326. [PMID: 31287596 PMCID: PMC6900091 DOI: 10.1111/jdv.15785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/18/2019] [Indexed: 12/22/2022]
Abstract
Background/objectives Paediatric skin, considered sensitive, and infant skin, more susceptible to percutaneous toxicity, require specially formulated cosmetic products. As recently shown, early use of emollients in infants “at risk” of developing atopic dermatitis has shown controversial results in reducing the incidence of atopic dermatitis. Development of dermo‐cosmetic products for this specific population should especially ensure tolerance and safety. In absence of good clinical practice guideline, we propose here a stepwise approach for the development of paediatric cosmetic skincare products. Methods Our stepwise methodology for cosmetics aimed at paediatrics, starts with in vitro assessment of product's ingredients safety, followed by preclinical and clinical evaluations of the final product, including sequentially: (1) Repeated Open Application Test (ROAT), (2) Human Repeated Insult Patch Test (HRIPT), (3) In‐use dermatological and ophthalmological tolerance studies (sequentially in 3a: healthy adults, 3b: healthy paediatric subjects and finally 3c: paediatric patients). We also describe the integrated cosmetovigilance–toxicological surveillance during the clinical development phase and postmarketing. Results As illustrated with one dermo‐cosmetic product intended to be used as a preventative/maintenance treatment for atopic dermatitis in paediatric population, we show that using this stepwise methodology to test a product reduces potential risks of irritation and contact dermatitis in this sensitive population. Conclusion Standardized ethical stepwise development approach is needed to ensure the commercialization of safe and well‐tolerated dermo‐cosmetics for paediatrics. The approach described here could potentially serve as guidance for evaluation of new paediatric cosmetic products.
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Affiliation(s)
- V Ribet
- Cosmetovigilance, Pierre Fabre Dermo-Cosmetics, Toulouse, France
| | - M Gurdak
- Research and Development, Clinical Development Division, Pierre Fabre Dermo-Cosmetics, Toulouse, France
| | - P-J Ferret
- Research and Development, Toxicology Division, Pierre Fabre Dermo-Cosmetics, Toulouse, France
| | - E Brinio
- Cosmetovigilance, Pierre Fabre Dermo-Cosmetics, Toulouse, France
| | - F Giordano Labadie
- Department of Dermatology, Paul Sabatier University and Larrey Hospital, Toulouse, France
| | - A B Rossi
- Research and Development, Clinical Development Division, Pierre Fabre Dermo-Cosmetics, Toulouse, France.,Department of Dermatology, Paul Sabatier University and Larrey Hospital, Toulouse, France
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27
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Koseki R, Morii W, Noguchi E, Ishikawa M, Yang L, Yamamoto-Hanada K, Narita M, Saito H, Ohya Y. Effect of filaggrin loss-of-function mutations on atopic dermatitis in young age: a longitudinal birth cohort study. J Hum Genet 2019; 64:911-917. [DOI: 10.1038/s10038-019-0628-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/12/2019] [Accepted: 05/30/2019] [Indexed: 01/03/2023]
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28
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Hughes-Formella B, Wunderlich O, Williams R, Fernández J, Kim YZ, Wigger-Alberti W, Pecquet S, Moodycliffe A. Comparison of Skin Structural and Functional Parameters in Well-Nourished and Moderately Undernourished Infants. Skin Pharmacol Physiol 2019; 32:212-223. [PMID: 31167217 DOI: 10.1159/000499434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/05/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Little is known about the impact of nutrition on the development of skin structure and function in infants. METHODS We investigated epidermal, dermal, and subcutis parameters of aged-matched well-nourished and moderately undernourished infants in this single-center, cross-sectional, noninterventional study using noninvasive methods (skin caliper, 20-MHz sonography, transepidermal water loss, skin pH, and corneometry). Plasma fatty acids were determined as an indicator of nutritional differences. 310 infants from different age groups, i.e., 1 week, 4 weeks, and 6, 9, 12, 24, and 36 months were included. Approximately half of each age group was well-nourished (WHO reference values weight-for-height/length Zscore: -0.75 ≤ Z ≤ 0.75) and the other half was moderately undernourished (-3 ≤ Z < -2). RESULTS Structural maturational differences in the deeper dermis and subcutis regions of the skin and subtle functional changes in the epidermis were observed in moderately undernourished infants without notable clinical symptoms. Reduced skin barrier function or skin hydration were not observed in the undernourished infants, and skin pH shifted to more acidic values in this group. CONCLUSION These findings reveal a greater impact of moderate undernutrition on the development of the dermis and subcutis and suggest that critical epidermal functions such as skin barrier and pH are mostly maintained.
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Affiliation(s)
| | | | | | - Josefina Fernández
- El Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Yun Zyong Kim
- El Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
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29
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Albrecht S, Jung S, Müller R, Lademann J, Zuberbier T, Zastrow L, Reble C, Beckers I, Meinke M. Skin type differences in solar‐simulated radiation‐induced oxidative stress. Br J Dermatol 2018; 180:597-603. [DOI: 10.1111/bjd.17129] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2018] [Indexed: 02/04/2023]
Affiliation(s)
- S. Albrecht
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
| | - S. Jung
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
| | - R. Müller
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
| | - J. Lademann
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
| | - T. Zuberbier
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
| | - L. Zastrow
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
| | - C. Reble
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
- Courage + Khazaka Electronic GmbH Mathias‐Brüggen‐Straße 91 50829 Köln Germany
| | - I. Beckers
- Beuth University of Applied Sciences Berlin Luxemburger Straße 10 13353 Berlin Germany
| | - M.C. Meinke
- Department of Dermatology Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Charitéplatz 1 10117 Berlin Germany
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30
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Change in skin properties over the first 10 years of life: a cross-sectional study. Arch Dermatol Res 2017; 309:653-658. [PMID: 28726004 PMCID: PMC5606948 DOI: 10.1007/s00403-017-1764-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 06/28/2017] [Accepted: 07/11/2017] [Indexed: 11/25/2022]
Abstract
This study investigated skin characteristics in healthy Chinese children aged from 1 to 10 years and compared these findings with similar measures from the child’s mothers. Children aged 1, 2, 3, 4, 5, and 10 years (n = 29–30 per age group) and the child’s mothers were enrolled in a single-visit cross-sectional study. Clinical parameters evaluated on the face, ventral forearm, and calf were softness, smoothness, erythema, edema, rash, dryness, and scaling. Instrumental evaluations included transepidermal water loss, moisture content, and water-holding capacity. The clinical evaluations indicated a general decrease in softness, smoothness, and overall skin condition with increased child age. In general, the child’s clinical scores were better than in adults. Children had a more permeable skin barrier that matured to adult values by approximately 5 years of age. Mothers had greater skin moisture than children. Clinical and instrumental measures were consistent with skin being softer and smoother and in better overall condition in younger children. As the skin matured with age, higher scores were observed. Instrumental measures demonstrated a more permeable skin barrier in younger children compared with older children and with adults.
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31
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Casiraghi A, Musazzi UM, Rocco P, Franzè S, Minghetti P. Topical Treatment of Infantile Haemangiomas: A Comparative Study on the Selection of a Semi-Solid Vehicle. Skin Pharmacol Physiol 2016; 29:210-9. [DOI: 10.1159/000447672] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/14/2016] [Indexed: 11/19/2022]
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