scholarly journals Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology

2021 ◽  
pp. e2021091
Author(s):  
Rachel Graubard ◽  
Ariadna Perez-Sanchez ◽  
Rajani Katta
Keyword(s):  
Stress Response ◽  
Skin Disease ◽  
Skin Barrier ◽  
Psychosocial Outcomes ◽  
Skin Inflammation ◽  
The Body ◽  
Skin Barrier Function ◽  
Beneficial Effects ◽  
Potential Benefits ◽  
The Mind

Stress has multiple and wide-ranging physiologic and clinical impacts on skin disease. This has led to an interest in mind body therapies as potential adjunct treatments for skin disease. The stress response results in the activation of the endocrine, neurologic, and immune systems, with a resulting cascade of impacts, that are both systemic and cutaneous. The 2 main arms of the stress response are the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. The resultant release of cortisol, catecholamines, and neuropeptides has multiple effects. Clinically, these have been shown to increase skin inflammation, increase itching, impair skin barrier function, impair wound healing, and suppress immunity.Mind body therapies are those that focus on the interaction between the mind and the body, with the goal to influence physical function and impact health. These have been shown to ameliorate some of the harmful physiologic changes attributed to stress or to reduce harmful behaviors. In some cases, such as with biofeedback, they may also result in beneficial physiologic changes. Treatments such as meditation, biofeedback, hypnosis, guided imagery, and others have been evaluated in the treatment of skin disease and have shown some benefits. Although randomized controlled trials are limited, these interventions have shown beneficial effects on itching, psychosocial outcomes, and even skin severity. These interventions have been evaluated in diseases such as atopic dermatitis, psoriasis, trichotillomania, and others. Given the potential benefits, improvements in psychosocial outcomes, and a low risk profile, referral to qualified practitioners or multidisciplinary clinics should be considered for some patients.

The Role of Host Defense Peptide Human β-defensins in the Maintenance of Skin Barriers

2018 ◽  
Vol 24 (10) ◽  
pp. 1092-1099 ◽  
Author(s):  
Chanisa Kiatsurayanon ◽  
Hideoki Ogawa ◽  
Francois Niyonsaba
Keyword(s):  
Host Defense ◽  
Current Knowledge ◽  
Skin Barrier ◽  
Skin Inflammation ◽  
The Body ◽  
Skin Barrier Function ◽  
Host Defense Peptides ◽  
Host Defense Peptide ◽  
Novel Therapeutic Strategies

The epidermis functions as a first-line defense barrier that protects the body from the external environment. As a chemical hindrance, the epidermis possesses acidic pH, highly organized lipids and various host defense peptides, also known as antimicrobial peptides. Human β-defensins (hBDs), one of the most important host defense peptide families found in our skin, are well-known for their broad-spectrum microbicidal activities. However, there is a growing body of evidence indicating that hBDs also orchestrate several immunomodulatory functions and are the cornerstone that bridges the innate and adaptive immune responses during skin inflammation and infection. Moreover, recent work identified the potential role of hBDs in the regulation and maintenance of the skin barrier function. In this review, we describe the current knowledge concerning the role of hBDs in skin barriers and discuss the potential clinical implications of these peptides in cutaneous biology. Understanding the roles of hBDs in the regulation and maintenance of skin barriers may aid in the development of novel therapeutic strategies for skin conditions where the skin barrier is impaired, such as atopic dermatitis and psoriasis.

scholarly journals Ex-Vivo Skin Explant Culture Is a Model for TSLP-Mediated Skin Barrier Immunity

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1237
Author(s):  
Thomas Bauer ◽  
Daniela Gubi ◽  
Jörg Klufa ◽  
Philipp Novoszel ◽  
Martin Holcmann ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Ex Vivo ◽  
Skin Barrier ◽  
Skin Inflammation ◽  
The Body ◽  
Suitable Model ◽  
Ex Vivo Model ◽  
Egfr Inhibition ◽  
Explant Cultures ◽  
Barrier Immunity

The skin is the outermost barrier protecting the body from pathogenic invasion and environmental insults. Its breakdown initiates the start of skin inflammation. The epidermal growth factor (EGFR) on keratinocytes protects this barrier, and its dysfunction leads to atopic dermatitis-like skin disease. One of the initial cytokines expressed upon skin barrier breach and during atopic dermatitis is TSLP. Here, we describe the expression and secretion of TSLP during EGFR inhibition and present an ex-vivo model, which mimics the early events after barrier insult. Skin explants floated on culture medium at 32 °C released TSLP in parallel to the activation of the resident Langerhans cell network. We could further show the up-regulation and activation of the AP-1 family of transcription factors during atopic-like skin inflammation and its involvement in TSLP production from the skin explant cultures. Inhibition of the c-Jun N-terminal kinase pathway led to a dose-dependent blunting of TSLP release. These data indicate the involvement of AP-1 during the early stages of atopic-like skin inflammation and highlight a novel therapeutic approach by targeting it. Therefore, skin explant cultures mimic the early events during skin barrier immunity and provide a suitable model to test therapeutic intervention.

scholarly journals Regulation of Skin Barrier Function via Competition between AHR Axis versus IL-13/IL-4‒JAK‒STAT6/STAT3 Axis: Pathogenic and Therapeutic Implications in Atopic Dermatitis

2020 ◽  
Vol 9 (11) ◽  
pp. 3741
Author(s):  
Masutaka Furue
Keyword(s):  
Atopic Dermatitis ◽  
Barrier Function ◽  
Coal Tar ◽  
Calcineurin Inhibitors ◽  
Skin Barrier ◽  
Skin Inflammation ◽  
Interleukin 4 ◽  
Skin Barrier Function ◽  
Barrier Dysfunction ◽  
Therapeutic Implications

Atopic dermatitis (AD) is characterized by skin inflammation, barrier dysfunction, and chronic pruritus. As the anti-interleukin-4 (IL-4) receptor α antibody dupilumab improves all three cardinal features of AD, the type 2 cytokines IL-4 and especially IL-13 have been indicated to have pathogenic significance in AD. Accumulating evidence has shown that the skin barrier function is regulated via competition between the aryl hydrocarbon receptor (AHR) axis (up-regulation of barrier) and the IL-13/IL-4‒JAK‒STAT6/STAT3 axis (down-regulation of barrier). This latter axis also induces oxidative stress, which exacerbates inflammation. Conventional and recently developed agents for treating AD such as steroid, calcineurin inhibitors, cyclosporine, dupilumab, and JAK inhibitors inhibit the IL-13/IL-4‒JAK‒STAT6/STAT3 axis, while older remedies such as coal tar and glyteer are antioxidative AHR agonists. In this article, I summarize the pathogenic and therapeutic implications of the IL-13/IL-4‒JAK‒STAT6/STAT3 axis and the AHR axis in AD.

Randomised double-blind placebo-controlled study of the effect of Lactobacillus paracasei NCC 2461 on skin reactivity

2014 ◽  
Vol 5 (2) ◽  
pp. 137-145 ◽  
Author(s):  
A. Gueniche ◽  
D. Philippe ◽  
P. Bastien ◽  
G. Reuteler ◽  
S. Blum ◽  
...  
Keyword(s):  
Barrier Function ◽  
Skin Barrier ◽  
The Body ◽  
Lactobacillus Paracasei ◽  
Controlled Study ◽  
Skin Barrier Function ◽  
Skin Sensitivity ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Function Recovery

In recent decades, the prevalence of subjects with reactive skin has considerably increased in industrialised countries. 50% of women and 30% of men report cutaneous discomfort classified under reactive/sensitive skin. Several topical approaches have been proposed, in particular through improvement of galenic forms or protection of epidermal surface. We propose to act differently, deeply from inside the body via an innovative nutritional approach. To this purpose, Lactobacillus paracasei NCC 2461 (ST11) was selected because of its specific beneficial skin properties discovered in in vitro studies, i.e. diminution of neurogenic inflammation and promotion of the recovery of skin barrier function. We designed a randomised double-blind placebo-controlled clinical study with a two-month supplementation in two female treatment groups (n=32 per group). A capsaicin test was performed to monitor the time course of skin sensitivity. Moreover, transepidermal water loss was assessed to analyse the rate of skin barrier function recovery; dryness of the leg and roughness of the cheeks was investigated by a dermatologist as well as by self-assessment. The results of the present clinical trial show that oral supplementation with the probiotic decreases skin sensitivity and increases the rate of barrier function recovery. Thus, the data provide evidence that daily intake of ST11 could improve reactive skin condition.

Hypo-osmotic Shock-Induced Subclinical Inflammation of Skin in a Rat Model of Disrupted Skin Barrier Function

2014 ◽  
Vol 17 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Chihiro Kishi ◽  
Takeo Minematsu ◽  
Lijuan Huang ◽  
Yuko Mugita ◽  
Aya Kitamura ◽  
...  
Keyword(s):  
Barrier Function ◽  
Inflammatory Responses ◽  
Osmotic Shock ◽  
Skin Barrier ◽  
Skin Inflammation ◽  
The Elderly ◽  
Basic Mechanism ◽  
Skin Barrier Function ◽  
Inflammatory Reactions ◽  
C Fibers

Aging disrupts skin barrier function and induces xerosis accompanied by pruritus. In many cases, elderly patients complain of pruritus during skin hygiene care, a condition called aquagenic pruritus of the elderly (APE). To date, the pathophysiology and mechanism of action of APE have not been elucidated. We conducted the present study to test the hypothesis that hypo-osmotic shock of epidermal cells induces skin inflammation and elongation of C-fibers by nerve growth factor β (NGFβ) as a basic mechanism of APE. The dorsal skin of HWY rats, which are a model for disrupted skin barrier function, was treated with distilled water (hypotonic treatment [Hypo] group) or normal saline (isotonic treatment [Iso] group) by applying soaked gauze for 7 days. Untreated rats were used as a control (no-treatment [NT] group). Histochemical and immunohistochemical analyses revealed inflammatory responses in the epidermis and the dermal papillary layer in the Hypo group, while no alterations were observed in the Iso or NT groups. Induction of expression and secretion of NGFβ and elongation of C-fibers into the epidermis were found in the Hypo group. In contrast, secretion of NGFβ was significantly lower and elongation of C-fibers was not observed in the Iso group. These results suggest that hypo-osmotic shock–induced inflammatory reactions promote hypersensitivity to pruritus in skin with disrupted barrier function.

scholarly journals Commensal Microbiota Regulates Skin Barrier Function And Repair Via Signaling Through The Aryl Hydrocarbon Receptor

2020 ◽  
Author(s):  
Aayushi Uberoi ◽  
Casey Bartow-McKenney ◽  
Qi Zheng ◽  
Laurice Flowers ◽  
Amy Campbell ◽  
...  
Keyword(s):  
Aryl Hydrocarbon Receptor ◽  
Skin Barrier ◽  
The Body ◽  
Epidermal Differentiation ◽  
Skin Barrier Function ◽  
Dependent Manner ◽  
Skin Microbiome ◽  
Barrier Dysfunction ◽  
Epidermal Barrier ◽  
Aryl Hydrocarbon

SUMMARYThe epidermis forms a barrier that defends the body from desiccation and entry of harmful substances, while sensing and integrating environmental signals. The tightly orchestrated cellular changes required for the proper formation and maintenance of this epidermal barrier occur in the context of the skin microbiome. Using germ free mice, we demonstrate the microbiota is necessary for proper differentiation and repair of the epidermal barrier. These effects were mediated by the aryl hydrocarbon receptor (AHR) in keratinocytes, a xenobiotic receptor also implicated in epidermal differentiation. Murine skin lacking keratinocyte AHR was more susceptible to barrier damage and infection, during steady state and epicutaneous sensitization. Colonization with a defined consortium of human skin isolates restored barrier competence in an AHR-dependent manner. We reveal a fundamental mechanism whereby the microbiota regulates skin barrier formation and repair, with far-reaching implications for the numerous skin disorders characterized by epidermal barrier dysfunction.

scholarly journals Combined pathogenetic therapy of allergic dermatoses in children

2021 ◽  
pp. 28-38
Author(s):  
J. S. Kovaleva ◽  
N. K. Zyablitskaya ◽  
M. V. Orobei ◽  
N. K. Bishevskaya
Keyword(s):  
Side Effects ◽  
Skin Diseases ◽  
Local Therapy ◽  
Calcineurin Inhibitors ◽  
Skin Barrier ◽  
The Body ◽  
Skin Barrier Function ◽  
Severe Exacerbation ◽  
Omega 3 ◽  
Topical Calcineurin Inhibitors

Allergodermatoses make up the majority of allergic skin diseases in childhood, have a recurrent course and significantly disrupt the quality of life of patients and their families. The constant use of emollients, allowing to lengthen periods of remission and reduce the need for topical drugs, is associated with defects in the skin barrier function. Treatment with topical glucocorticosteroids (TCS) and topical calcineurin inhibitors (TCI), which are the basis of pharmacotherapy, should be carried out differentially, taking into account the localization, stage and activity of the inflammatory process, the area of the lesion, the age of the child and the multifactorial genesis of the disease. The basic principles of rational local therapy include the choice of the degree of activity of the drug, its concentration, dosage form, dosage frequency, duration of use to obtain a therapeutic effect and minimize side effects. In case of severe exacerbation and localization of inflammatory elements on the body and limbs in children, it is necessary to start treatment with class 2–3 THCS. When the process is localized on the face and other sensitive areas of the skin (neck and large folds), it is recommended to use class 7 TCS or give preference to TCI. The duration of a continuous course of TCS therapy in children depends on the severity of the exacerbation and should not exceed 2 weeks. The most effective way to reduce the course steroid load and avoid side effects is the early and correct use of TCS during an exacerbation. The advantages of TCI in comparison with TCS are the low incidence of side effects, the absence of contraindications for use on sensitive skin areas, and the possibility of longer use. The article contains Russian and foreign literature data on the use of THCS and TEC in the treatment of allegodermatosis in children and our own clinical observations of the effectiveness of the use of combination therapy: Comfoderm K cream (methylprednisolone aceponate with ceramides in the base), 0.03% tacrolimus ointment and emollient means - special cream Sensoderm with physiological lipids omega 3–6–9.

scholarly journals Approbation of the iimiquimod-induced psoriasislike skin inflammation in BALB/с mice

2019 ◽  
Vol 6 (4) ◽  
pp. 50-58
Author(s):  
A. A. Zueva ◽  
K. L. Kryshen ◽  
M. N. Makarova ◽  
V. G. Makarov
Keyword(s):  
Body Weight ◽  
Skin Disease ◽  
Histological Study ◽  
Skin Inflammation ◽  
The Body ◽  
Disease Area ◽  
Inflammatory Infiltration ◽  
Blood Profile ◽  
Hematological Analysis ◽  
Area Determination

Background. Antipsoriatic medicines that have been successfully tested by imiquimod-induced psoriasislike skin inflammation in BALB/c mice may be used for therapy of psoriasis induced by the immune response as inflammatory cascade into skin layers.Objective. Imiquimod-induced psoriasis-like skin inflammation approbation in BALB/c mice and search of more informative method of pathologic progress assessment for further extrapolating data to clinical cases.Design and methods. Psoriasis-like skin inflammation in mice was induced by topical applying of the Aldara® cream (5 % imiquimod) to back skin for 7 days. Psoriasis Area and Severity Index (PASI), histological study, calculation of relative spleen and thymus mass to the body weight, hematological analysis and skin disease area determination were used for registration of pathologic building.Results. During the study, was detected the increase of PASI score of animals with pathology to 18 with the formation of psoriasis-like plaques, significantly decrease body weight and relative thymus mass, significantly increase relative spleen mass, leukocytosis and leukocytic blood profile change, significant increase epidermal thickness, hyperkeratosis and inflammatory infiltration different degree.Conclusion. Results of approbation studied pathologic model with using of hematological analysis and skin disease area determination consistent with similar studies’ data and partly clinical sings in patient with psoriasis.

The Comparative Efficacy Between Shea Butter-Ceramide Cream and 1% Hydrocortisone Cream in Childhood Atopic Dermatitis

2021 ◽  
Vol 104 (7) ◽  
pp. 1172-1178
Keyword(s):  
Atopic Dermatitis ◽  
Adverse Events ◽  
Median Time ◽  
Skin Barrier ◽  
The Body ◽  
Shea Butter ◽  
Skin Barrier Function ◽  
Double Blind Study ◽  
Butyrospermum Parkii ◽  
Time To Relapse

Background: Atopic dermatitis (AD) is the most common chronic eczema in children due to skin barrier dysfunction. Topical non-steroidal antiinflammatory agents such as Butyrospermum parkii (shea butter) and ceramide are developed to target specific defects in skin barrier function in AD patients and to reduce the side effects of topical corticosteroids. Objective: To compare the efficacy of the emollient containing shea butter and ceramide to 1% hydrocortisone in childhood AD. Materials and Methods: The present study was a randomized, double-blind study in 26 children, aged 2 to 18 years, with mild to moderate AD. The patients were randomized to treat twice daily with shea butter and ceramide cream (SC) on one side of the body and 1% hydrocortisone on the other side. The treatment period was eight weeks, with follow-ups on the second, fourth, sixth, and eighth week. The shea butter and ceramide side were applied for eight weeks; while the 1% hydrocortisone side was applied for the first four weeks and changed to cream base for the latter four weeks. The clinical outcomes were evaluated by using SCORAD and POEM at baseline, and on every follow up week. Time to remission, time to relapse, and adverse events were evaluated. Results: The result showed a significant improvement of SCORAD and POEM in both groups after eight weeks of treatment. When comparing the two groups, it was found that SCORAD and POEM were not different. Regarding the median time to remission and the median time to relapse, there was no statistical difference between the two groups of treatments. There were no related adverse events. Conclusion: The emollient containing shea butter and ceramide is effective in the treatment and prevention of relapse in childhood mild to moderate atopic dermatitis. Keywords: Ceramide; Butyrospermum parkii; shea butter; atopic dermatitis

scholarly journals Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section IV: Treatment Options for the Management of Atopic Dermatitis

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 21S-29S ◽  
Author(s):  
Gurbir Dhadwal ◽  
Lorne Albrecht ◽  
Robert Gniadecki ◽  
Yves Poulin ◽  
Jensen Yeung ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Topical Therapy ◽  
Treatment Options ◽  
Skin Barrier ◽  
Skin Inflammation ◽  
Skin Barrier Function ◽  
Improve Quality ◽  
Consensus Document ◽  
Basic Care

The objectives of therapy for atopic dermatitis (AD) are to reduce skin inflammation and pruritus, restore skin barrier function, and improve quality of life (QoL). Treatments can be classified as moisturizing and basic care, topical therapy, phototherapy, and systemic therapy. In this review, we summarize the treatments for AD and recommendations for their use.

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