The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis
Summary Background Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects. Topical corticosteroids are safe and effective treatments for AD, when used in short courses. Prolonged use is associated with skin barrier damage. Topical calcine...
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| Veröffentlicht in: | British journal of dermatology (1951) 2014-04, Vol.170 (4), p.914-921 |
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| container_title | British journal of dermatology (1951) |
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| creator | Danby, S.G. Chittock, J. Brown, K. Albenali, L.H. Cork, M.J. |
| description | Summary
Background
Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects. Topical corticosteroids are safe and effective treatments for AD, when used in short courses. Prolonged use is associated with skin barrier damage. Topical calcineurin inhibitors are alternative immune‐modulating treatments for AD purported to have no negative effects on the skin barrier.
Objectives
To compare the effects of betamethasone valerate 0·1% cream (BMVc) and tacrolimus 0·1% ointment (TACo) on the skin barrier.
Methods
Twenty volunteers with quiescent AD (no active signs for 6 months) participated in a randomized observer‐blind study, wherein BMVc was applied to one forearm and TACo to the other, twice daily for 4 weeks. The biophysical/biological properties of the stratum corneum were assessed before and after treatment. Nine volunteers with active disease and 10 with healthy skin were assessed at untreated sites.
Results
BMVc significantly reduced skin barrier function, integrity and cohesion, and the levels of pyrrolidone carboxylic acid (PCA) and urocanic acid (UCA) towards the subclinical barrier defect observed in patients with AD (nonlesional sites). TACo preserved skin barrier function, integrity, cohesion and PCA and UCA levels, while significantly increasing skin hydration to levels comparable with healthy skin. Both treatments reduced skin surface pH and trypsin‐like protease activity, with TACo doing so to a significantly greater degree.
Conclusion
In quiescent AD, 4 weeks of BMVc treatment adversely affected the biophysical properties of the skin and reduced the levels of natural moisturizing factor, whereas TACo improved the condition of the skin barrier.
What's already known about this topic?
Skin barrier breakdown is a key event in the development of atopic dermatitis (AD).
Prolonged use of potent or moderately potent topical corticosteroids (TCS) disrupts the structure of the skin barrier, thins the stratum corneum (SC) and as a result reduces permeability barrier function.
The effect of topical calcineurin inhibitors (TCI) on the skin barrier is still unclear.
What does this study add?
In subjects with quiescent AD, application of betamethasone valerate reduced skin barrier function, SC integrity and natural moisturizing factor (NMF) levels towards the level of the subclinical barrier defect observed in active disease at nonlesional sites.
By comparison, a topical formulation containing tacroli |
| doi_str_mv | 10.1111/bjd.12778 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1517399926</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1517399926</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4548-7df67647a0b6288dee560cfe2be7d3efcf0808ef3935267e23b1fc802e6f17b73</originalsourceid><addsrcrecordid>eNp1kM1u1DAUhS1ERactC14AeYMEi7T-SexkSQsUqmoKYhBLy3GuNW6TeGo7_dnx6LhkWla9G9_Fd861PoTeUHJI8xy1l90hZVLWL9CCclEVjHL-Ei0IIbIgjeC7aC_GS0IoJxV5hXZZyVndELlAf1ZrwGAtmIS9xUmb4Hs3TBEbP2x0gA7furTGLSQ9QFrr6EfAN7qHoBNgP-KUC-KVG3GrQ3AQcF5vfD-NCSDEOX09OYgGxoR18htncAdh0MklFw_QjtV9hNfbdx_9-vJ5dfK1OL84_Xby8bwwZVXWheyskKKUmrSC1XUHUAliLLAWZMfBGktqUoPlDa-YkMB4S62pCQNhqWwl30fv595N8NcTxKQGl7_U93oEP0VFKyp50zRMZPTDjGYXMQawahPcoMO9okQ9CFdZuPonPLNvt7VTO0D3RD4azsC7LaCj0b0NejQu_ufqsiRN9cAdzdyt6-H--Yvq-OzT4-liTriY4O4pocOVEpLLSv1enqrvP34u5Wp5pgT_CyVfqQc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1517399926</pqid></control><display><type>article</type><title>The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis</title><source>MEDLINE</source><source>Wiley Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Danby, S.G. ; Chittock, J. ; Brown, K. ; Albenali, L.H. ; Cork, M.J.</creator><creatorcontrib>Danby, S.G. ; Chittock, J. ; Brown, K. ; Albenali, L.H. ; Cork, M.J.</creatorcontrib><description>Summary
Background
Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects. Topical corticosteroids are safe and effective treatments for AD, when used in short courses. Prolonged use is associated with skin barrier damage. Topical calcineurin inhibitors are alternative immune‐modulating treatments for AD purported to have no negative effects on the skin barrier.
Objectives
To compare the effects of betamethasone valerate 0·1% cream (BMVc) and tacrolimus 0·1% ointment (TACo) on the skin barrier.
Methods
Twenty volunteers with quiescent AD (no active signs for 6 months) participated in a randomized observer‐blind study, wherein BMVc was applied to one forearm and TACo to the other, twice daily for 4 weeks. The biophysical/biological properties of the stratum corneum were assessed before and after treatment. Nine volunteers with active disease and 10 with healthy skin were assessed at untreated sites.
Results
BMVc significantly reduced skin barrier function, integrity and cohesion, and the levels of pyrrolidone carboxylic acid (PCA) and urocanic acid (UCA) towards the subclinical barrier defect observed in patients with AD (nonlesional sites). TACo preserved skin barrier function, integrity, cohesion and PCA and UCA levels, while significantly increasing skin hydration to levels comparable with healthy skin. Both treatments reduced skin surface pH and trypsin‐like protease activity, with TACo doing so to a significantly greater degree.
Conclusion
In quiescent AD, 4 weeks of BMVc treatment adversely affected the biophysical properties of the skin and reduced the levels of natural moisturizing factor, whereas TACo improved the condition of the skin barrier.
What's already known about this topic?
Skin barrier breakdown is a key event in the development of atopic dermatitis (AD).
Prolonged use of potent or moderately potent topical corticosteroids (TCS) disrupts the structure of the skin barrier, thins the stratum corneum (SC) and as a result reduces permeability barrier function.
The effect of topical calcineurin inhibitors (TCI) on the skin barrier is still unclear.
What does this study add?
In subjects with quiescent AD, application of betamethasone valerate reduced skin barrier function, SC integrity and natural moisturizing factor (NMF) levels towards the level of the subclinical barrier defect observed in active disease at nonlesional sites.
By comparison, a topical formulation containing tacrolimus preserved barrier function, SC integrity and NMF levels.
This raises the importance of better understanding how to combine TCS and TCI to optimize effects on the skin barrier.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/bjd.12778</identifier><identifier>PMID: 24328907</identifier><identifier>CODEN: BJDEAZ</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Administration, Cutaneous ; Allergic diseases ; Betamethasone Valerate - administration & dosage ; Biological and medical sciences ; Calcineurin Inhibitors - administration & dosage ; Dermatitis, Atopic - drug therapy ; Dermatitis, Atopic - enzymology ; Dermatology ; Glucocorticoids - administration & dosage ; Humans ; Hydrogen-Ion Concentration ; Immunopathology ; Medical sciences ; Middle Aged ; Ointments ; Peptide Hydrolases - metabolism ; Skin - drug effects ; Skin - enzymology ; Skin allergic diseases. Stinging insect allergies ; Tacrolimus - administration & dosage ; Water Loss, Insensible - drug effects</subject><ispartof>British journal of dermatology (1951), 2014-04, Vol.170 (4), p.914-921</ispartof><rights>2013 British Association of Dermatologists</rights><rights>2015 INIST-CNRS</rights><rights>2013 British Association of Dermatologists.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4548-7df67647a0b6288dee560cfe2be7d3efcf0808ef3935267e23b1fc802e6f17b73</citedby><cites>FETCH-LOGICAL-c4548-7df67647a0b6288dee560cfe2be7d3efcf0808ef3935267e23b1fc802e6f17b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjd.12778$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjd.12778$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28440957$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24328907$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Danby, S.G.</creatorcontrib><creatorcontrib>Chittock, J.</creatorcontrib><creatorcontrib>Brown, K.</creatorcontrib><creatorcontrib>Albenali, L.H.</creatorcontrib><creatorcontrib>Cork, M.J.</creatorcontrib><title>The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary
Background
Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects. Topical corticosteroids are safe and effective treatments for AD, when used in short courses. Prolonged use is associated with skin barrier damage. Topical calcineurin inhibitors are alternative immune‐modulating treatments for AD purported to have no negative effects on the skin barrier.
Objectives
To compare the effects of betamethasone valerate 0·1% cream (BMVc) and tacrolimus 0·1% ointment (TACo) on the skin barrier.
Methods
Twenty volunteers with quiescent AD (no active signs for 6 months) participated in a randomized observer‐blind study, wherein BMVc was applied to one forearm and TACo to the other, twice daily for 4 weeks. The biophysical/biological properties of the stratum corneum were assessed before and after treatment. Nine volunteers with active disease and 10 with healthy skin were assessed at untreated sites.
Results
BMVc significantly reduced skin barrier function, integrity and cohesion, and the levels of pyrrolidone carboxylic acid (PCA) and urocanic acid (UCA) towards the subclinical barrier defect observed in patients with AD (nonlesional sites). TACo preserved skin barrier function, integrity, cohesion and PCA and UCA levels, while significantly increasing skin hydration to levels comparable with healthy skin. Both treatments reduced skin surface pH and trypsin‐like protease activity, with TACo doing so to a significantly greater degree.
Conclusion
In quiescent AD, 4 weeks of BMVc treatment adversely affected the biophysical properties of the skin and reduced the levels of natural moisturizing factor, whereas TACo improved the condition of the skin barrier.
What's already known about this topic?
Skin barrier breakdown is a key event in the development of atopic dermatitis (AD).
Prolonged use of potent or moderately potent topical corticosteroids (TCS) disrupts the structure of the skin barrier, thins the stratum corneum (SC) and as a result reduces permeability barrier function.
The effect of topical calcineurin inhibitors (TCI) on the skin barrier is still unclear.
What does this study add?
In subjects with quiescent AD, application of betamethasone valerate reduced skin barrier function, SC integrity and natural moisturizing factor (NMF) levels towards the level of the subclinical barrier defect observed in active disease at nonlesional sites.
By comparison, a topical formulation containing tacrolimus preserved barrier function, SC integrity and NMF levels.
This raises the importance of better understanding how to combine TCS and TCI to optimize effects on the skin barrier.</description><subject>Administration, Cutaneous</subject><subject>Allergic diseases</subject><subject>Betamethasone Valerate - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Calcineurin Inhibitors - administration & dosage</subject><subject>Dermatitis, Atopic - drug therapy</subject><subject>Dermatitis, Atopic - enzymology</subject><subject>Dermatology</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Immunopathology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Ointments</subject><subject>Peptide Hydrolases - metabolism</subject><subject>Skin - drug effects</subject><subject>Skin - enzymology</subject><subject>Skin allergic diseases. Stinging insect allergies</subject><subject>Tacrolimus - administration & dosage</subject><subject>Water Loss, Insensible - drug effects</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1u1DAUhS1ERactC14AeYMEi7T-SexkSQsUqmoKYhBLy3GuNW6TeGo7_dnx6LhkWla9G9_Fd861PoTeUHJI8xy1l90hZVLWL9CCclEVjHL-Ei0IIbIgjeC7aC_GS0IoJxV5hXZZyVndELlAf1ZrwGAtmIS9xUmb4Hs3TBEbP2x0gA7furTGLSQ9QFrr6EfAN7qHoBNgP-KUC-KVG3GrQ3AQcF5vfD-NCSDEOX09OYgGxoR18htncAdh0MklFw_QjtV9hNfbdx_9-vJ5dfK1OL84_Xby8bwwZVXWheyskKKUmrSC1XUHUAliLLAWZMfBGktqUoPlDa-YkMB4S62pCQNhqWwl30fv595N8NcTxKQGl7_U93oEP0VFKyp50zRMZPTDjGYXMQawahPcoMO9okQ9CFdZuPonPLNvt7VTO0D3RD4azsC7LaCj0b0NejQu_ufqsiRN9cAdzdyt6-H--Yvq-OzT4-liTriY4O4pocOVEpLLSv1enqrvP34u5Wp5pgT_CyVfqQc</recordid><startdate>201404</startdate><enddate>201404</enddate><creator>Danby, S.G.</creator><creator>Chittock, J.</creator><creator>Brown, K.</creator><creator>Albenali, L.H.</creator><creator>Cork, M.J.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201404</creationdate><title>The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis</title><author>Danby, S.G. ; Chittock, J. ; Brown, K. ; Albenali, L.H. ; Cork, M.J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4548-7df67647a0b6288dee560cfe2be7d3efcf0808ef3935267e23b1fc802e6f17b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Administration, Cutaneous</topic><topic>Allergic diseases</topic><topic>Betamethasone Valerate - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Calcineurin Inhibitors - administration & dosage</topic><topic>Dermatitis, Atopic - drug therapy</topic><topic>Dermatitis, Atopic - enzymology</topic><topic>Dermatology</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Immunopathology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Ointments</topic><topic>Peptide Hydrolases - metabolism</topic><topic>Skin - drug effects</topic><topic>Skin - enzymology</topic><topic>Skin allergic diseases. Stinging insect allergies</topic><topic>Tacrolimus - administration & dosage</topic><topic>Water Loss, Insensible - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Danby, S.G.</creatorcontrib><creatorcontrib>Chittock, J.</creatorcontrib><creatorcontrib>Brown, K.</creatorcontrib><creatorcontrib>Albenali, L.H.</creatorcontrib><creatorcontrib>Cork, M.J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Danby, S.G.</au><au>Chittock, J.</au><au>Brown, K.</au><au>Albenali, L.H.</au><au>Cork, M.J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2014-04</date><risdate>2014</risdate><volume>170</volume><issue>4</issue><spage>914</spage><epage>921</epage><pages>914-921</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><coden>BJDEAZ</coden><abstract>Summary
Background
Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects. Topical corticosteroids are safe and effective treatments for AD, when used in short courses. Prolonged use is associated with skin barrier damage. Topical calcineurin inhibitors are alternative immune‐modulating treatments for AD purported to have no negative effects on the skin barrier.
Objectives
To compare the effects of betamethasone valerate 0·1% cream (BMVc) and tacrolimus 0·1% ointment (TACo) on the skin barrier.
Methods
Twenty volunteers with quiescent AD (no active signs for 6 months) participated in a randomized observer‐blind study, wherein BMVc was applied to one forearm and TACo to the other, twice daily for 4 weeks. The biophysical/biological properties of the stratum corneum were assessed before and after treatment. Nine volunteers with active disease and 10 with healthy skin were assessed at untreated sites.
Results
BMVc significantly reduced skin barrier function, integrity and cohesion, and the levels of pyrrolidone carboxylic acid (PCA) and urocanic acid (UCA) towards the subclinical barrier defect observed in patients with AD (nonlesional sites). TACo preserved skin barrier function, integrity, cohesion and PCA and UCA levels, while significantly increasing skin hydration to levels comparable with healthy skin. Both treatments reduced skin surface pH and trypsin‐like protease activity, with TACo doing so to a significantly greater degree.
Conclusion
In quiescent AD, 4 weeks of BMVc treatment adversely affected the biophysical properties of the skin and reduced the levels of natural moisturizing factor, whereas TACo improved the condition of the skin barrier.
What's already known about this topic?
Skin barrier breakdown is a key event in the development of atopic dermatitis (AD).
Prolonged use of potent or moderately potent topical corticosteroids (TCS) disrupts the structure of the skin barrier, thins the stratum corneum (SC) and as a result reduces permeability barrier function.
The effect of topical calcineurin inhibitors (TCI) on the skin barrier is still unclear.
What does this study add?
In subjects with quiescent AD, application of betamethasone valerate reduced skin barrier function, SC integrity and natural moisturizing factor (NMF) levels towards the level of the subclinical barrier defect observed in active disease at nonlesional sites.
By comparison, a topical formulation containing tacrolimus preserved barrier function, SC integrity and NMF levels.
This raises the importance of better understanding how to combine TCS and TCI to optimize effects on the skin barrier.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>24328907</pmid><doi>10.1111/bjd.12778</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-0963 |
| ispartof | British journal of dermatology (1951), 2014-04, Vol.170 (4), p.914-921 |
| issn | 0007-0963 1365-2133 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1517399926 |
| source | MEDLINE; Wiley Journals; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Administration, Cutaneous Allergic diseases Betamethasone Valerate - administration & dosage Biological and medical sciences Calcineurin Inhibitors - administration & dosage Dermatitis, Atopic - drug therapy Dermatitis, Atopic - enzymology Dermatology Glucocorticoids - administration & dosage Humans Hydrogen-Ion Concentration Immunopathology Medical sciences Middle Aged Ointments Peptide Hydrolases - metabolism Skin - drug effects Skin - enzymology Skin allergic diseases. Stinging insect allergies Tacrolimus - administration & dosage Water Loss, Insensible - drug effects |
| title | The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis |
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