RESUMEN
Specific partially hydrolysed whey-based infant formulas (pHF-W) have been shown to decrease the risk of atopic dermatitis (AD) in infants. Historically, AD has been associated primarily with milk allergy; however, defective skin barrier function can be a primary cause of AD. We aimed to ascertain whether oral supplementation with pHF-W can improve skin barrier function. The effect of pHF-W was assessed on transepidermal water loss (TEWL) and antibody productions in mice epicutaneously exposed to Aspergillus fumigatus. Human primary keratinocytes were stimulated in vitro, and the expression of genes related to skin barrier function was measured. Supplementation with pHF-W in neonatal mice led to a significant decrease in TEWL and total IgE, but not in allergen-specific antibody levels. The whey hydrolysate was sufficient to decrease both TEWL and total IgE. Aquaporin-3 gene expression, linked with skin hydration, was modulated in the skin of mice and human primary keratinocytes following protein hydrolysate exposure. Skin barrier improvement may be an additional mechanism by which pHF-W may potentially reduce the risk of AD development in infants. Further human studies are warranted to confirm the clinical efficacy of these observations.
Asunto(s)
Dermatitis Atópica/prevención & control , Suplementos Dietéticos , Piel/efectos de los fármacos , Proteína de Suero de Leche/farmacología , Suero Lácteo/administración & dosificación , Animales , Animales Recién Nacidos , Acuaporina 3/metabolismo , Humanos , Hidrólisis , Inmunoglobulina E/efectos de los fármacos , Lactante , Fórmulas Infantiles , Recién Nacido , Queratinocitos/efectos de los fármacos , Ratones , Piel/metabolismo , Pérdida Insensible de Agua/efectos de los fármacosRESUMEN
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.
Asunto(s)
Trastornos de la Nutrición del Lactante/fisiopatología , Estado Nutricional/fisiología , Piel/fisiopatología , Preescolar , Estudios Transversales , Ácidos Grasos/metabolismo , Femenino , Humanos , Lactante , Recién Nacido , MasculinoRESUMEN
BACKGROUND/AIMS: Atopic dermatitis (AD) is a common disease in infancy, for which topical steroids are the first-line therapy but have side effects. Innovative approaches are needed to reduce the burden of AD and corticosteroid usage in infants. METHODS: The once-daily consumption of heat-treated probiotic Lactobacillus paracasei GM-080 or placebo for 16 weeks as supplementary approach to topical treatment with fluticasone propionate cream was compared in AD infants aged 4-30 months. Outcomes were SCORAD and its subscores, TEWL, Infants' Dermatitis Quality of Life Index (IDQOL), corticoid "sparing effect," CCL17/TARC, and IgE status. RESULTS: SCORAD, objective SCORAD, itching, and IDQOL decreased significantly (p < 0.001) over the treatment period in both treatment groups. Slight decreases (ns) were noted in TEWL in lesional and unaffected skin and CCL17 levels. There were no differences between the treatment groups. Total IgE increased over the treatment period in both groups, with significantly higher increase in the heat-treated probiotic group (p = 0.038). There was no evidence of a corticoid "sparing effect" by the probiotic. CONCLUSIONS: In this design, the probiotic L. paracasei was not beneficial as a complementary approach to topical corticosteroids in infants with AD. However, slight beneficial effects may have been masked by the moderate potency corticoid.
Asunto(s)
Dermatitis Atópica/terapia , Fármacos Dermatológicos/uso terapéutico , Fluticasona/uso terapéutico , Lacticaseibacillus paracasei , Probióticos/uso terapéutico , Preescolar , Terapia Combinada , Fármacos Dermatológicos/administración & dosificación , Método Doble Ciego , Femenino , Fluticasona/administración & dosificación , Calor , Humanos , Lactante , Masculino , Calidad de VidaRESUMEN
There is a need for a simple and reliable tool to evaluate hair loss and treatment effects in patients suffering from alopecia. In 2001 TrichoScan was introduced as a fully-automated method for the measurement of biological parameters of hair growth such as density, diameter and growth rate. However, the conventional phototrichogram method with manual marking of hairs on images is still performed and, although no real independent side-by-side comparison is available, the manual method is sometimes defined as the most precise method of measurement. The aim of this study was validation of the Trichoscan method by comparative assessment of TrichoScan analysis and manual marking of hairs. Digital images were taken from 10 patients with androgenetic alopecia (AGA) and validity and reliability of both methods were assessed. This study showed an excellent correlation of TrichoScan and manual marking of hairs. Considerable variability was noted in the results from manually evaluated images (range 2.71%-12.95%), compared to none in TrichoScan analyzed images. Results with TrichoScan were obtained more quickly and were more reproducible with a smaller margin of operator error. The consistency in the Trichoscan data allows statistically significant results to be obtained with a smaller sample size.