Cosmetic benefits of a novel biomimetic lamellar formulation containing niacinamide in healthy females with oily, blemish-prone skin in a randomized proof-of-concept study.

OBJECTIVE: A randomized study was designed to evaluate the potential cosmetic benefit of a biomimetic, niacinamide-containing moisturizing cream in oily, blemish-prone skin. METHODS: Healthy adult women with oily, blemish-prone skin were randomized to one of three treatment groups: test, control, or positive control. In the test group, subjects used the test product (containing 4% niacinamide), plus the standard cleanser (Simple® Kind to Skin Moisturizing Facial Wash). In the control group, subjects received no moisturizer but used the standard cleanser. In the positive control group, subjects used Vivatinell Acnecinamide® Gel Cream (containing 4% niacinamide) as a moisturizer and Neutrogena Visibly Clear® Spot Clearing Facial Wash (containing 2% salicylic acid) as a cleanser. The positive control regimen was included to provide a comparison for estimates of effect size. The primary objective was to evaluate skin moisturization as a change from baseline in corneometer values at 8 h for the test regimen vs. the control regimen. Analysis of covariance was applied for the primary efficacy analysis. RESULTS: A total of 132 subjects were randomized with 44 included in each treatment group. A significant difference was observed in the primary endpoint for the test regimen compared with the control regimen (least-squares mean difference [95% CI]: 3.12 [0.68, 5.56], P = 0.0128). A trend was observed in favour of the positive control regimen compared with the control regimen. Secondary measurements of moisturization supported the primary efficacy outcome. Assessment of blemishes showed a significant difference between the test regimen vs. the control regimen for change from baseline in mean total blemish count at Week 8 (least-squares mean difference [95% CI]: -1.80 [-3.41, -0.19], P = 0.0290). No statistical comparisons between the positive control group and the test group were performed. CONCLUSION: This study provides proof-of-concept evidence that a novel lamellar lipid moisturizer containing niacinamide, in combination with a standard cleanser, can help moisturize the skin and provide an overall improvement in the complexion appearance of people with blemish-prone skin. STUDY REGISTRATION: NCT03093181.

OBJECTIF: Une étude randomisée a été conçue pour évaluer le bénéfice cosmétique potentiel d'une crème hydratante biomimétique contenant du niacinamide sur une peau grasse sujette aux imperfections. MÉTHODES: Des femmes adultes en bonne santé, à peau grasse sujette aux imperfections, ont été randomisées dans l'un des trois groupes de traitement : test, témoin ou témoin positif. Dans le groupe test, les sujets ont utilisé le produit testé (contenant 4 % de niacinamide), plus le nettoyant standard (Nettoyant visage Simple® doux pour la peau). Dans le groupe témoin, les sujets n'ont reçu aucune crème hydratante mais ont utilisé le nettoyant standard. Dans le groupe témoin positif, les sujets ont utilisé le gel crème Vivatinell Acnecinamide® (contenant 4 % de niacinamide) comme crème hydratante et le nettoyant visage pour réduire les imperfections Neutrogena Visibly Clear® (contenant 2 % d'acide salicylique) comme nettoyant. Le schéma de traitement du groupe témoin positif était inclus pour fournir une comparaison des estimations de la taille de l'effet. L'objectif principal était d'évaluer l'hydratation de la peau par le changement par rapport à la référence des valeurs du cornéomètre à 8 h pour le schéma de traitement testé par rapport au schéma de traitement témoin. Une analyse de covariance a été appliquée pour l'analyse de l'efficacité primaire. RÉSULTATS: Un total de 132 sujets ont été randomisés, dont 44 inclus dans chaque groupe de traitement. Une différence significative a été observée dans le critère d'évaluation principal en faveur du schéma de traitement testé par rapport au schéma de traitement témoin (différence moyenne des moindres carrés [IC à 95 %] : 3,12 [0,68, 5,56], P = 0,0128). Une tendance a été observée en faveur du schéma de traitement témoin positif par rapport au schéma de traitement témoin. Les mesures secondaires de l'hydratation ont appuyé le résultat principal d'efficacité. L'évaluation des imperfections a montré une différence significative entre le schéma de traitement testé par rapport au schéma de traitement témoin en ce qui concerne le changement par rapport à la référence dans le nombre moyen total d'imperfections à la semaine 8 (différence moyenne des moindres carrés [IC à 95 %] : _1,80 [_3,41, _0,19], P = 0,0290). Aucune comparaison statistique entre le groupe témoin positif et le groupe test n'a été réalisée. CONCLUSION: Cette étude fournit des éléments de preuve de concept qu'une nouvelle crème hydratante lipidique lamellaire à base de niacinamide, en association avec un nettoyant standard, peut permettre d'hydrater la peau et fournir une amélioration globale de l'aspect du teint chez des personnes dont la peau est sujette aux imperfections. Numéro d'enregistrement de l'étude : NCT03093181.

Cosmetic benefit of a biomimetic lamellar cream formulation on barrier function or the appearance of fine lines and wrinkles in randomized proof-of-concept clinical studies.

OBJECTIVE: Two studies were designed to evaluate the potential cosmetic benefit of a biomimetic, niacinamide-containing moisturizing cream for the first time in humans. METHODS: In both studies, healthy women were randomized to use two treatments, one for the left side of the body and one for the right, from three options: the test cream, a positive control or no treatment (use of standard cleanser only). Treatments were applied twice daily for 4 weeks to the face and forearms (Study 1) or the face only (Study 2). Instrumental and clinical skin assessments were performed by trained technicians. Study 1 involved tape stripping and a 5-day no-treatment ('regression') period at the end of the 4 weeks. Independent lay graders were asked to grade the skin texture of subjects in Study 2 from high-resolution photographs. RESULTS: In Study 1 (n = 66), the test cream significantly decreased the transepidermal water loss (TEWL) values on the forearm, and in the cheek area of the face, relative to baseline and compared to no treatment, and increased skin Corneometer values. The improvements were partially retained during a subsequent 5-day period of no treatment. Increases in TEWL values on skin subjected to tape stripping were significantly lower after 4 weeks of using the test cream compared to no treatment. In Study 2 (n = 72 subjects with visible signs of ageing), there was a favourable trend in the change from baseline of a skin roughness parameter, Ra , for the test cream compared to no treatment. There were statistically significant improvements in the Fitzpatrick wrinkle score compared to no treatment, decreases in TEWL and increased Corneometer values and Cutometer values (R5 elasticity parameter). Grading of high-resolution images failed to detect the improvements in skin texture (defined as pores, smoothness and unevenness) for the test cream vs. no treatment. No treatment-related serious or severe adverse events were reported. CONCLUSION: Twice daily application of the test cream over 4 weeks had beneficial effects on skin barrier function, moisturization, wrinkle dimensions and elasticity compared to no treatment. These studies provide proof-of-concept evidence and highlight the cosmetic benefit of the biomimetic lamellar cream formulation. STUDY REGISTRATION: NCT03216265, NCT03180645.

OBJECTIF: Deux études ont été conçues pour évaluer pour la première fois chez l'être humain l'éventuel bénéfice cosmétique d'une crème hydratante biomimétique contenant de la niacinamide. MÉTHODES: Dans les deux études, des femmes en bonne santé ont été randomisées pour utiliser deux traitements, un pour le côté gauche du corps et un pour le côté droit, choisis entre trois options : la crème testée, un contrôle positif ou aucun traitement (utilisation d'un nettoyant standard uniquement). Les traitements ont été appliqués deux fois par jour pendant 4 semaines sur le visage et les avant-bras (Étude 1) ou seulement sur le visage (Étude 2). Des évaluations instrumentales et cliniques de la peau ont été effectuées par des techniciens qualifiés. L'étude 1 impliquait un stripping et une période de 5 jours sans traitement (« régression ¼) à la fin des 4 semaines. Il a été demandé à des évaluateurs profanes indépendants d'évaluer la texture de la peau des participantes dans l'Étude 2 à partir de photographies à haute résolution. RÉSULTATS: Dans l'Étude 1 (n = 66), la crème testée a diminué de manière significative les valeurs de la perte en eau transépidermique (transepidermal water loss, TEWL) au niveau de l'avant-bras, et au niveau de la joue, par rapport à la valeur de base, et par rapport au groupe sans aucun traitement, et a augmenté les valeurs des paramètres cutanés mesurés avec un cornéomètre. Les améliorations ont été partiellement conservées pendant une période ultérieure de 5 jours sans aucun traitement. Des augmentations des valeurs TEWL sur la peau exposée à un décollement d'un ruban adhésif étaient significativement plus faibles après 4 semaines d'utilisation de la crème testée par rapport à l'absence de traitement. Dans l'Étude 2 (n = 72 participantes avec des signes visibles de vieillissement), il y avait une tendance favorable au niveau de la variation par rapport à la valeur de base du paramètre relatif à la rugosité de la peau, Ra, pour la crème testée par rapport à l'absence de traitement. Il y a eu des améliorations statistiquement significatives du score de Fitzpatrick pour les rides par rapport à l'absence de traitement, des diminutions des valeurs TEWL et une augmentation des valeurs des paramètres mesurés avec un cornéomètre et des valeurs des paramètres mesurés avec un cutomètre (paramètre élasticité R5). L'évaluation des images à haute résolution n'a pas permis de détecter les améliorations de la texture de la peau (définie par les pores, la finesse et les irrégularités) pour la crème testée par rapport à l'absence de traitement. Aucun événement indésirable grave ou sévère lié au traitement n'a été rapporté. CONCLUSION: Une application deux fois par jour de la crème testée pendant 4 semaines a eu des effets bénéfiques sur la fonction barrière de la peau, l'hydratation, l'aspect des rides et l'élasticité par rapport à l'absence de traitement. Ces études fournissent des éléments de preuve de concept et soulignent les bienfaits cosmétiques de la formule lamellaire biomimétique de la crème. Numéro d'enregistrement de l'étude : NCT03216265, NCT03180645.

A susceptibility locus for asthma-related traits on chromosome 7 revealed by genome-wide scan in a founder population.

The genetics of asthma and atopy have been difficult to determine because these diseases are genetically heterogeneous and modified by environment. The pedigrees in our study (n=86) originate in eastern central Finland (Kainuu province). According to census records, this region had only 200 households (2,000 inhabitants) in the mid sixteenth to mid seventeenth centuries. The current population of 100,000 represents the expansion of these founders within the past 400 years. Because this population is relatively homogeneous, we hypothesized that the molecular genetic mechanisms underlying asthma might also have reduced heterogeneity and therefore be easier to dissect than in mixed populations. A recent twin family study supported a strong genetic component for asthma in Finland. We carried out a genome-wide scan for susceptibility loci in asthma in the Kainuu subpopulation. We identified two regions of suggestive linkage and studied them further with higher-density mapping. We obtained evidence for linkage in a 20-cM region of chromosome 7p14-p15 for three phenotypes: asthma, a high level of immunoglobulin E (IgE; atopy) and the combination of the phenotypes. The strongest linkage was seen for high serum IgE (non-parametric linkage (NPL) score 3.9, P=0.0001), exceeding the threshold for genome-wide significance based on simulations. We also observed linkage between this locus and asthma or atopy in two independent data sets.

Characterization of single-nucleotide polymorphisms in coding regions of human genes.

A major goal in human genetics is to understand the role of common genetic variants in susceptibility to common diseases. This will require characterizing the nature of gene variation in human populations, assembling an extensive catalogue of single-nucleotide polymorphisms (SNPs) in candidate genes and performing association studies for particular diseases. At present, our knowledge of human gene variation remains rudimentary. Here we describe a systematic survey of SNPs in the coding regions of human genes. We identified SNPs in 106 genes relevant to cardiovascular disease, endocrinology and neuropsychiatry by screening an average of 114 independent alleles using 2 independent screening methods. To ensure high accuracy, all reported SNPs were confirmed by DNA sequencing. We identified 560 SNPs, including 392 coding-region SNPs (cSNPs) divided roughly equally between those causing synonymous and non-synonymous changes. We observed different rates of polymorphism among classes of sites within genes (non-coding, degenerate and non-degenerate) as well as between genes. The cSNPs most likely to influence disease, those that alter the amino acid sequence of the encoded protein, are found at a lower rate and with lower allele frequencies than silent substitutions. This likely reflects selection acting against deleterious alleles during human evolution. The lower allele frequency of missense cSNPs has implications for the compilation of a comprehensive catalogue, as well as for the subsequent application to disease association.

Variants in the 5q31 cytokine gene cluster are associated with psoriasis.

A multitiered genetic association study of 25 215 single-nucleotide polymorphisms (SNPs) in three case-control sample sets (1446 patients and 1432 controls) identified three IL13-linked SNPs (rs1800925, rs20541 and rs848) associated with psoriasis. Although the susceptibility effects at these SNPs were modest (joint allelic odds ratios (ORs): 0.76 to 0.78; P(comb): 1.3E-03 to 2.50E-04), the association patterns were consistent across the sample sets, with the minor alleles being protective. Haplotype analyses identified one common, susceptible haplotype CCG (joint allelic OR=1.27; P(comb)=1.88E-04) and a less common, protective haplotype TTT (joint allelic OR=0.74; P(comb)=7.05E-04). In combination with the other known genetic risk factors, HLA-C, IL12B and IL23R, the variants reported here generate an 11-fold psoriasis-risk differential. Residing in the 5q31 cytokine gene cluster, IL13 encodes an important T-cell-derived cytokine that regulates cell-mediated immunity. These results provide the foundation for additional studies required to fully dissect the associations within this cytokine-rich genomic region, as polymorphisms in closely linked candidate genes, such as IRF1, IL5 or IL4, may be driving these results through linkage disequilibrium.

The heart SNPs a beat: polymorphisms in candidate genes for cardiovascular disease.

Several environmental risk factors of cardiovascular disease are well established, but genetic risk alleles contributing to the disease in the general population are hotly debated. New strategies focusing on polymorphism discovery in candidate disease genes followed by tests of association to genes across the genome offer a pioneering approach to identifying risk alleles. Several hundred candidate genes for cardiovascular disease have been screened for common polymorphisms and these variants may provide susceptibility alleles which largely contribute to risk of cardiovascular disease in the general population. However, the impact of common susceptibility alleles for disease management will depend on many years of future investigation.

Mining for SNPs: putting the common variants--common disease hypothesis to the test.

Classical molecular genetic strategies have succeeded in identifying mutations responsible for numerous rare diseases with Mendelian patterns of inheritance, but have been largely unsuccessful in unravelling the (genetic basis of complex medical conditions like cardiovascular disease' diabetes and mental illness. These common disorders are shaped by multiple genes that exert weak allelic effects in the setting of confounding environmental variables. Association study designs provide statistical povwer to reveal the modest contributions of weak alleles, and evidence is mounting that common genetic polymorphisms play a role in complex diseases. Cataloguing genetic variation in human populations is a prerequisite for further validation of the 'common variants-common disease' hypothesis, and polymorphism discovery has begun in earnest in the academic and private sector. We will review several strategies for high-throughput polymorphism discovery and discuss the implications of early results from polymorphism screens for future genetic studies.

Breastfeeding prevalence among six-week-old infants at University Hospital of the West Indies.

Eight-five (85) mothers attending postnatal and well baby clinics were interviewed at six weeks post-partum regarding breastfeeding. An overall prevalence of 98.8% at six weeks of age was seen, with an exclusive breastfeeding rate of 37.6%. Older maternal age and multiparity favoured exclusive breastfeeding. There was no significant association between pattern of breastfeeding (exclusive versus partial) and employment or union status. Breastfeeding was found to favour good weight gain in normal birthweight babies. Normal birthweight babies who were exclusively breastfed had a higher mean weight gain than the exclusively breastfed low birthweight infants, who in turn had better weight gain when partially breastfed.

PIP: 85 mothers attending postnatal and well baby clinics at the University Hospital of the West Indies were interviewed during August 1995 at 6 weeks postpartum regarding breast feeding. 98.8% of mothers breastfed their babies, although only 37.6% did so exclusively. Older maternal age and multiparity favored exclusive breast feeding. No significant association was found between pattern of breast feeding and employment or union status. Breast feeding was found to favor good weight gain in normal-birth-weight babies, with normal-birth-weight babies who were exclusively breastfed having a higher mean weight gain than the exclusively breastfed low-birth-weight babies. These latter babies had better weight gain when partially breastfed.

Familial eosinophilia maps to the cytokine gene cluster on human chromosomal region 5q31-q33.

Familial eosinophilia (FE) is an autosomal dominant disorder characterized by peripheral hypereosinophilia of unidentifiable cause with or without other organ involvement. To localize the gene for FE, we performed a genomewide search in a large U.S. kindred, using 312 different polymorphic markers. Seventeen affected subjects, 28 unaffected bloodline relatives, and 8 spouses were genotyped. The initial linkage results from the genome scan provided evidence for linkage on chromosome 5q31-q33. Additional genotyping of genetic markers located in this specific region demonstrated significant evidence that the FE locus is situated between the chromosome 5q markers D5S642 and D5S816 (multipoint LOD score of 6.49). Notably, this region contains the cytokine gene cluster, which includes three genes-namely, those for interleukin (IL)-3, IL-5, and granulocyte/macrophage colony-stimulating factor (GM-CSF)-whose products play important roles in the development and proliferation of eosinophils. These three cytokine genes were screened for potential disease-specific mutations by resequencing of a subgroup of individuals from the present kindred. No functional sequence polymorphisms were found within the promoter, the exons, or the introns of any of these genes or within the IL-3/GM-CSF enhancer, suggesting that the primary defect in FE is not caused by a mutation in any one of these genes but, rather, is caused by another gene in the area.

Linkage disequilibrium in the human genome.

With the availability of a dense genome-wide map of single nucleotide polymorphisms (SNPs), a central issue in human genetics is whether it is now possible to use linkage disequilibrium (LD) to map genes that cause disease. LD refers to correlations among neighbouring alleles, reflecting 'haplotypes' descended from single, ancestral chromosomes. The size of LD blocks has been the subject of considerable debate. Computer simulations and empirical data have suggested that LD extends only a few kilobases (kb) around common SNPs, whereas other data have suggested that it can extend much further, in some cases greater than 100 kb. It has been difficult to obtain a systematic picture of LD because past studies have been based on only a few (1-3) loci and different populations. Here, we report a large-scale experiment using a uniform protocol to examine 19 randomly selected genomic regions. LD in a United States population of north-European descent typically extends 60 kb from common alleles, implying that LD mapping is likely to be practical in this population. By contrast, LD in a Nigerian population extends markedly less far. The results illuminate human history, suggesting that LD in northern Europeans is shaped by a marked demographic event about 27,000-53,000 years ago.

Full-genome scan for linkage in 50 families segregating the bipolar affective disease phenotype.

A genome scan of approximately 12-cM initial resolution was done on 50 of a set of 51 carefully ascertained unilineal multiplex families segregating the bipolar affective disorder phenotype. In addition to standard multipoint linkage analysis methods, a simultaneous-search algorithm was applied in an attempt to surmount the problem of genetic heterogeneity. The results revealed no linkage across the genome. The results exclude monogenic models and make it unlikely that two genes account for the disease in this sample. These results support the conclusion that at least several hundred kindreds will be required in order to establish linkage of susceptibility loci to bipolar disorder in heterogeneous populations.

Two loci on chromosomes 2 and X for premature coronary heart disease identified in early- and late-settlement populations of Finland.

Coronary heart disease (CHD) is a complex disorder constituting a major health problem in Western societies. To assess the genetic background of CHD, we performed a genomewide linkage scan in two study samples from the genetically isolated population of Finland. An initial study sample consisted of family material from the northeastern part of Finland, settled by a small number of founders approximately 300 years ago. A second study sample originated from the southwestern region of Finland, settled approximately 2,000 years ago. Families were ascertained through probands exhibiting premature CHD, defined as >50% stenosis of at least two coronary arteries at a young age, as verified by coronary angiography. Both study samples and the pooled data set provided evidence for linkage in two chromosomal regions. A region on chromosome 2q21.1-22 yielded two-point LOD scores of 3.2, 1.9, and 3.7, in the affected sib-pair (ASP) analyses of the northeastern, southwestern, and pooled study samples. The corresponding multipoint maximum-likelihood scores (MLSs) for these three study samples were 2.4, 1.3, and 3.0. In addition, a region on chromosome Xq23-26 resulted in two-point LOD scores of 1.9, 3.5, and 2.9 and in multipoint MLSs of 3.4, 3.1, and 2.5, respectively. In conclusion, this study identifies two loci likely to contribute to premature CHD: one on chromosome 2q21.1-22 and another on chromosome Xq23-26.