More and more antihistamines are used in gels or ointments for local antipruritic therapy. Among other factors, the efficacy is dependent on the penetration properties of the respective agents and the optimal choice of vehicle substances. To avoid expensive treatment with unsatisfying success, a reliable efficacy measurement would be desirable prior to the admission of new topical antihistamine preparations. Therefore we reviewed the literature for common methods to assess the efficacy of local antihistamines in healthy volunteers. The principle is to apply the test substance to marked test areas and to challenge the skin after a certain time with a standardised amount of histamine, allergens or mast-cell-degranulating substances. For the test evaluation, the areas of wheal, flare and itch are measured and compared between antihistamine-treated and control fields. Challenge models and most of the described evaluation methods are suited for the preliminary efficacy measurement of antihistamines. However, to be able to compare the results, a standardised procedure used by all investigators would be desirable.
A better understanding of the structure and function of the human skin barrier is a prerequisite for a more rational design of transdermal drug administration systems. The study of biological structural organisation is, however, confronted with many difficulties, and interpretations of skin barrier-related data should therefore be done with caution. The recently developed ‘single gel-phase model’ constitutes an attempt to interpret structural and functional skin barrier data from a biophysical standpoint.
The genetic polymorphism of human N-acetyltransferase 2 (NAT2) divides the human population into groups with rapid, intermediate and slow acetylator status. Slow acetylator status has been considered a predisposing factor for allergic diseases, lupus erythematosus, toxic epidermal necrolysis or Stevens-Johnson syndrome. The aim of this study was to investigate whether Caucasian patients suffering from atopic dermatitis differed from healthy individuals with regard to the genotype and phenotype of NAT2. Twenty unrelated healthy Caucasian volunteers (9 females and 11 males, aged from 22 to 59 years) and twenty unrelated Caucasian patients suffering from atopic dermatitis (9 females and 11 males, aged between 20 and 54 years) participated in this study. For each one, the NAT2 genotype was determined by polymerase chain reaction with DNA extracted from peripheral blood, using specific primers for the wild-type allele (wt) and the 3 most frequent mutated alleles of NAT2 (C481→T, G590→A and G857→A). The NAT2 phenotype was evaluated with dapsone as a test substrate using high-pressure liquid chromatography. Statistical analysis was performed using the χ2 test. Phenotype and genotype were distributed as follows: (1) of the healthy subjects, 60% were rapid acetylators (RA) and 40% were slow acetylators (SA); 10% of the RA and 15% of the SA were homozygous, 50% of the RA and 25% of the SA were heterozygous; (2) of the patients, 55% were RA, 40% were SA and 5% were intermediate acetylators (IA); 10% of the RA and 10% of the SA were homozygous, 45% of the RA and 35% of the SA were heterozygous. No significant statistical difference was found between the two groups for genotypes (p = 0.75) or phenotypes (p = 0.60). The phenotyping and genotyping results of healthy subjects were comparable to those found in previous studies. The absence of a significant statistical difference between healthy subjects and atopic dermatitis patients is in contrast to the results of previous studies. Some authors considered that allergic patients are mostly SAs. This could be explained by the fact that we only considered patients suffering from atopic dermatitis whereas, in other studies, patients suffered from different (one or several associated) allergic diseases. NAT2 polymorphism does not differ between patients suffering from atopic dermatitis and healthy subjects. The importance attributed to the SA status, which was previously considered a predisposing factor for allergic diseases such as atopic dermatitis, should be reviewed.
Lipid model systems consisting of the major components of the stratum corneum intercellular lipid matrix were studied to investigate the ultraviolet-radiation-mediated damage of these biomolecules. Pure lipids and liposomes were irradiated using a lamp emitting a solar radiation spectrum. The influences of the irradiation and the effects of added iron ions were studied by electrospray ionization mass spectrometry (MS) with an ion trap analyser. Exact mass measurements were carried out using a time-of-flight mass spectrometer. Only linolenic acid and cholesterol were found to be subject to oxidative changes caused by UV irradiation whereas the other lipids examined (dipalmitoylphosphatidylcholine, ceramide III and cholesterol sulphate) were stable to oxidative stress. Several lipid adducts were observed upon analysis of the liposomes. The composition of these adducts was identified by MS/MS experiments.
The aim of this work was to study the skin distribution of 5-methoxypsoralen (5-MOP) after application of topical gels, in vitro and in vivo, in both healthy and psoriatic skin sites of 6 psoriatic patients. Drug skin distribution was determined using the thin slicing technique and subsequent HPLC analysis. In the presence of dermatological disease, i.e. psoriasis, the permeability of the tissue changed considerably, leading to an important increase in the cumulative amount of 5-MOP recovered in the skin after topical application. The amount of 5-MOP found in vitro in the human skin was intermediate between those cumulated in healthy and psoriatic skin sites during an in vivo experiment. The gel formulation is an efficacious carrier for the topical photochemotherapy of psoriasis with 5-MOP, since it allows drug penetration in psoriatic skin.
The potential human health risk of UV filters depends on their toxicity and the human systemic exposure which is a function of the extent of percutaneous absorption of the topically applied substance into the human organism. Using a ‘mass balance’ approach, a study was designed to investigate the systemically absorbed dose of [14C]-Mexoryl SX® in humans after topical application of a typical sunscreen emulsion. In addition, to assess the correlation with in vitro experiments, the percutaneous absorption of this UVA filter through isolated human skin was measured under identical exposure conditions. When applied in vivo for a period of 4 h, 89–94% of the applied radioactivity was recovered from the wash-off samples. In urine samples, the radioactivity slightly exceeded background levels and corresponded maximally to 0.014% of the topically applied dose. No radioactivity was measured in blood or faeces sampled up to 120 h after application. In vitro, 24 h after a 4-hour application, [14C]-Mexoryl SX remained primarily on the skin surface. The mean in vitro absorption over 24 h, adding up the amounts found in the dermis and receptor fluid, was 0.16% of the applied dose. It is concluded from the in vivo pharmacokinetic results that the systemically absorbed dose of [14C]-Mexoryl SX is less than 0.1%. The order of magnitude of this value correlates well with the corresponding in vitro data which overestimate the in vivo results as previously observed with other hydrophilic compounds. This study demonstrates that, under realistic exposure conditions, the human systemic exposure to this UVA filter is negligible and poses no risk to human health.
Factors in the treatment of atopic dermatitis include restoring skin moisture and reducing inflammation. This study evaluated a corticoid oil formulation and its components with respect to their skin hydration potential. Ten healthy Caucasians were enrolled. Five test sites on the left and right forearm of each subject were tested: one site served as a normal skin control (without treatment), whereas four were wetted by spraying distilled water (approximately 0.1 ml) over a 3-cm2 skin surface area, and spraying was repeated every 5 min for a total of three applications. Five minutes after the final application, 0.2 ml of the corticoid oil formulation, moisturizing vehicle, and plain peanut oil were applied to each pre-designated site (3 cm2); one site was kept as a blank control (water saturation only). Thirty minutes later, test sites were gently wiped with paper tissues, and visual scoring, transepidermal water loss (TEWL), and capacitance were recorded and repeated at 2 and 3 h. The corticoid oil formulation, plain peanut oil, and moisturizing vehicle significantly increased skin hydration 30 min after each single application, with no statistically significant difference among the treatments at any point. The corticoid oil formulation and plain peanut oil slightly but not significantly elevated TEWL 30 min after application. The results support intuitive dermatologic judgment of advising patients to apply moisturizing medicaments after bathing.
The accurate determination of the mass of the horny layer removed by tape stripping is a decisive prerequisite for the application of this technique in penetration studies. A novel method using optical spectroscopy to determine the amount of stratum corneum (SC) is presented. We could show that the absorbance measured in the visible spectral range accurately reflects the mass of the SC fixed on individual tapes. Furthermore, absorbance measurement allows determination of the absolute mass of corneocyte aggregates on the removed tape strips. Topically applied substances do not disturb the spectroscopic measurements in contrast to the conventionally employed weight determination. Identical results were obtained when performing spectroscopic horny layer quantification independently in two separate institutions. Taken together, this new method is rapid, sensitive, reproducible, and accurate. We anticipate a wide application in penetration studies as well as in dermatopharmacokinetics.
The aim of this study was to investigate the effects of intraperitoneal α-tocopheryl acetate administration on concentration of lipid peroxide (as malonyldialdehyde, MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in plasma, red blood cells (RBC), skin and liver of thermally injured guinea pigs. MDA levels in the plasma, skin and liver were increased at the 15th min after the thermal injury compared to the control group. However, they were significantly lower in the α-tocopheryl-acetate-treated groups than both control and thermally injured groups from the 15th min to the 6th day. SOD activity of the skin and RBC and vitamin E levels in the plasma were significantly decreased between the 15th min and 6th day and then both parameters, i.e. SOD and vitamin E, were significantly increased by α-tocopheryl acetate administration. GSH-Px activity in the skin was also significantly decreased in groups from the 15th min to the 6th day, whereas it remained unchanged by the α-tocopheryl acetate administration. On the other hand, GSH-Px activity and GSH levels in the RBC remained the same during both thermal injury and α-tocopheryl acetate administration. In conclusion, we observed that the intraperitoneal administration of α-tocopheryl acetate protects the skin against thermal injury, which suggests that it may be due to the upregulation of enzymatic antioxidants.
We evaluated and characterized the mouse scratching behavior using a new apparatus, MicroAct. Scratching behavior was evoked in ICR and BALB/c mice by compound 48/80, passive cutaneous anaphylaxis or repeated hapten application. Under the present experimental condition, MicroAct detected consecutive scratching behavior (events) consisting of 3 or more beats. Although the detecting standard of MicroAct was not identical to that of an observer, the number of events detected by MicroAct and by an observer were almost comparable with each other. Frequency of events, total scratching time and total number of beats detected by MicroAct increased depending on the intensity of the causing stimuli for scratching. In contrast, the duration of each event and the number of beats in each event increased only slightly, but the scratching speed was almost constant. The present results demonstrate that MicroAct is a useful tool for evaluating mouse scratching behavior. Mouse scratching behavior seems to have a relatively fixed pattern and the causing stimulus increases mainly in the frequency of event without affecting the scratching speed.
We have studied the effect of squalene monohydroperoxides (Sq-OOH), initial products of UV-peroxidated squalene, on the skin of hairless mice. Repeated topical application of 10 mM Sq-OOH to hairless mice for 15 weeks induced definite skin wrinkling. When image analysis was used to compare wrinkle formation induced by ultraviolet B (UVB) irradiation and Sq-OOH treatment, the degree of wrinkling in exposed skin was seen to be similar. However, the characteristics of wrinkles induced by either method differed markedly with regard to direction and distribution. Biochemical analysis revealed a significant decrease in collagen content per unit area and mass in Sq-OOH-treated skin, whereas no changes per unit area and decrease in collagen per unit mass were observed in UVB-irradiated skin. As for glycosaminoglycan (GAG) content per unit area, significant increases were observed in both Sq-OOH-treated skin and UVB-irradiated skin. These changes were not induced by organic hydroperoxides such as tert-butylhydroperoxide or cumene hydroperoxide treatment. Histological observation revealed epidermal hyperplasia and dermal alterations such as collagen degradation and GAG increases in Sq-OOH-treated skin. Histological changes induced by Sq-OOH were not as pronounced as those induced by UVB irradiation. These results clearly suggest that the wrinkling and changes in dermal collagen content induced by Sq-OOH are qualitatively different to those induced by UVB exposure. This may provide a useful model for the study of skin aging, particularly with regard to collagen content.
According to the patients, improvement of efficacy, long-term safety and improvement of compliance are needed. The topical treatment has been innovated during the last decade. Most important are the introduction of two new classes of treatments: topical vitamin D(3) analogues and the retinoid tazarotene. To what extent, however, have we achieved developments which are in line with the needs as expressed by the patients? Improved efficacy has been realized by successful combinations of topical treatments. In particular, the combinations of dithranol, vitamin D(3) and tazarotene with a topical corticosteroid proved to be very effective with a reduced profile of side-effects. The efficacy of vitamin D(3) analogues and tazarotene is such that the efficacy of a potent corticosteroid (betamethasone-17-valerate) is approached; calcipotriol even showed an efficacy which is at least as good as this corticosteroid. The long-term safety of new compounds has been evaluated for at least 12 months in large studies. Remarkably for corticosteroids such information is available for only 12 weeks. However, intermittent applications of a topical corticosteroid in combination with another topical treatment provide an effective and safe long-term control of psoriasis. Compliance is a conditio sine qua non for an effective topical treatment. Important progress has been made to increase compliance. Short-contact dithranol has been popularized as an ambulatory treatment which is a highly effective approach as a care instruction programme. Formulations which are better from a cosmetical point of view have been developed for various topical treatments. Reduction of the frequency of applications proved to be possible for most treatments. Once daily applications for corticosteroids, vitamin D(3) analogues and retinoids have been developed, and intermittent applications, a few times per week, are possible for corticosteroids, which proved to be very effective with a reduced profile of side-effects, and are also developed for dithranol.
It has been suggested that platelet-activating factor (PAF) plays a role in the pathomechanisms of various inflammatory diseases. In an experimental animal model we demonstrated earlier that a selective PAF receptor antagonist gel inhibits ultraviolet-B (UVB) light-induced edema in mouse ears. The goal of our present investigation was to determine whether locally applied WEB 2086, a selective PAF receptor antagonist, alters the dermatitis-causing effect of UVB light on human skin. We induced dermatitis in healthy volunteers by irradiating their skin with UVB light in increasing doses. The irradiated area was treated with WEB 2086 gel (3%) or with a placebo. Erythema was measured spectrophotometrically after 24 and 48 h. After both 24 and 48 h, the WEB 2086 gel significantly inhibited the UVB light-induced erythema at each radiation dose in comparison with the placebo. The PAF antagonist gel therefore proved to be effective against UVB-induced dermatitis. Our results may help to understand the relative importance of mediators in UVB-induced dermatitis and might perhaps pave the way to better therapeutic modalities in this condition.
Sodium lauryl sulphate (SLS) is an anionic tenside widely utilized in commercial topical preparations that may cause skin irritation. It has been shown that the barrier damage caused by SLS in vivo is lower when SLS is used in combination with other tensides which are able to reduce the critical micelle concentration (CMC). The aim of our study was to evaluate if the cytotoxic effect of SLS is reduced by the association with different tensides also at concentrations well below the CMC. Normal human keratinocytes from plastic surgery were grown in serum-free medium. At subconfluency, the cells were treated with SLS at a dose of 0.0025% in combination with cocamidopropyl betaine, Tween 20 and Tween 80 at the minimum toxic dose. Following tenside treatment, the culture medium was changed, and after 24 h the cells were collected for (3)H-thymidine incorporation, the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay and neutral red (NR) uptake. The cytotoxic effect on normal human keratinocytes, as evaluated by (3)H-thymidine incorporation, MTT assay and NR uptake, was significantly decreased by the combination with all the tested tensides. The correlation between cytotoxicity and physical properties was also studied by a conductimetric assay to investigate the mechanism involved in this toxicity reduction.
As compared to standard glucocorticoids (GC), prednicarbate (PC) is favorable in the treatment of eczema due to its high benefit/risk ratio. The remarkable anti-inflammatory effects of PC are in strong contrast to its reported low glucocorticoid receptor (GR) binding affinity. In transfected COS-7 cells we related the transcriptional potencies of PC, its metabolites and conventional GC to their receptor binding properties. Moreover, the expression pattern of the human GR isoform hGRalpha and its mutual dominant negative inhibitor hGRbeta in skin cells have been investigated as well as the influence of hGRbeta on receptor binding and transactivation. hGRalpha mRNA and protein was largely overexpressed in skin cells. hGRbeta showed no influence on hGRalpha binding and transactivation. Concentration response curves indicated the greater transactivation potency of betamethasone 17-valerate followed by dexamethasone and prednisolone 17-ethylcarbonate. Native PC appeared almost as potent as dexamethasone. With both a strong correlation was observed between transactivation and GR binding.
The ever-growing resistance of pathogens to antibiotics and the lack of potent antibacterial drugs constitute major problems in the treatment of infectious diseases. Thus, the better understanding of the mode of action of antibiotics at the molecular level is of essential importance. Accumulating evidence points towards RNA as being a crucial target of antibacterial and antiviral drugs. Interestingly, aminoglycosides, one of the most important families of antibiotics, apart from their inhibitory effect on ribosome function, reportedly interfere with various RNA molecules and in vitro suppress the proliferation of human keratinocytes. In this study we investigated the effect of the aminoglycosides neomycin B, paromomycin, tobramycin and gentamycin on ribonuclease P activity from normal human epidermal keratinocytes. All aminoglycosides tested revealed a dose-dependent inhibition of tRNA maturation, which was reduced by increasing Mg2+ ion concentrations, indicating competition of the cationic aminoglycosides with magnesium ions required for catalysis. Our in vitro findings suggest that the inhibitory effects of aminoglycosides on tRNA processing may be implicated in the mechanisms of their antiproliferative action on human epidermal keratinocytes.
Since the limited knowledge of cutaneous drug metabolism can impair the development of specifically acting topical dermatics and transdermal application systems, the cell-type-specific androgen metabolism in human skin and its inhibition by drugs were investigated. Cultured human foreskin and scalp skin keratinocytes and fibroblasts as well as occipital scalp dermal papilla cells (DPC) were incubated with testosterone 10–6 and 10–8M alone and in the presence of 17α-estradiol, 17β-estradiol or dutasteride for 24 h. Androgens extracted from culture supernatants were subjected to thin-layer chromatography and quantified by β-counting. In keratinocytes and DPC, dihydrotestosterone (DHT) was only formed to a low extent while androstenedione was the main metabolite. In fibroblasts, DHT formation was pronounced following 10–8M testosterone. Dutasteride 10–8M completely suppressed 5α-dihydro metabolite formation. 17α-Estradiol and 17β-estradiol at nontoxic concentrations decreased 17-ketometabolites. Human skin regulates testosterone action by cell-type-specific activation or deactivation. Effects of 17α-estradiol in androgenetic alopecia are not due to 5α-reductase inhibition. Dutasteride may be useful in acne and androgenetic alopecia.
The influence of isopropyl myristate (IPM), isopropyl alcohol (IPA) and a combination of both was studied in view of hydrocortisone (HC) permeation across the human stratum corneum (SC). IPM, IPA and their combination were incorporated into water-containing hydrophilic ointment (WHS), and the resulting effects on HC permeation and on HC accumulation in human SC were investigated as well as the influence of these substances on the microstructure of the SC. Differential scanning calorimetry as well as wide- and small-angle X-ray diffraction show that IPM incorporation into SC results in densely packed bilayer lipids and a loss of order of the corneocyte-bonded lipids. Both effects result in a decreased diffusion coefficient of HC in SC and thus in a decreased permeation rate compared to that of HC from WHS. On the other hand, IPA fluidizes and disrupts the bilayer structure of the intercellular lipids. These effects, concomitant with an increased amount of dissolved HC within the ointment, increase the permeation rate of HC across SC. The combination of both ingredients effects a stronger fluidization and disruption of intercellular lipids than with IPA alone. Therefore, the permeation rate of HC across SC is higher than with IPA alone. Consequently, the IPM and IPA combination acts synergistically on the microstructure of SC.
Objective: To compare the keratolytic activities of a drug-free hydrophilic microemulsion (ME) and a drug-free lipophilic ME with water, and with regard to the hydrophilic ME also with a 5% salicylic acid gel on the sole of the foot. Methods: Twenty healthy volunteers had their plantar forefoot, midfoot, and rearfoot stratum corneum blackened with silver nitrate and a photographic developer, and a chromameter was used to determine the extent of removal of this black dye by a* value and L value measurement at 24 and 48 h. Results: Both drug-free MEs produced significantly greater increases in a* value and L value than water, and the hydrophilic ME was also more effective than 5% salicylic acid gel. Conclusion: The irritating effect of MEs is rather negligible on the sole of the foot because of the thick plantar stratum corneum. Both MEs therefore appear suitable for the elimination or prevention of plantar desquamative and hyperkeratotic skin changes.
The pH of the skin follows a sharp gradient across the stratum corneum (SC), which is suspected to play an important role in controlling the enzymatic activities involved in cellular metabolism and renewal. This gradient is maintained by several systems, such as sweat and sebum secretion and degradation as well as cellular metabolism. At the surface of the skin, what is measured is in fact an apparent skin pH due to extracted material from the SC diffusing into water applied at the surface. pH values recorded at the surface of a semi hydrophobic milieu such as the SC should be interpreted with great caution because it is obvious that hydrogen ions are not in a pure solution at the surface of the skin. For a correct measurement of skin surface pH, it is recommended to follow all practical operating conditions. Care must be taken in identifying the skin site, healthy controls (age, gender, skin type), the time of day of the measurement and the environmental conditions. Also, subjects should receive precise instructions before the test, mainly in terms of hygiene procedure or use of topical products. The interpretation of data should not overlook the fact that even small differences in pH may reflect significant modifications at the molecular level. Although it is usually agreed that the pH of the skin surface may influence the cutaneous microflora, much remains to be learnt about the role of the acid mantle of the skin with regard to defensins and other protective mechanisms.
