Atopic Dermatitis

Ceramides as a possible treatment for atopic dermatitis


Ceramide and cholesterol composition of the skin of patients with atopic dermatitis.

Di Nardo A, Wertz P, Giannetti A, Seidenari S. Acta Derm Venereol. 1998 Jan;78(1):27-30.
Department of Dermatology, University of Modena, Italy.

Atopic dermatitis skin tends to be easily irritated and appears dry. These clinical peculiarities correspond to impaired barrier function and to increased transepidermal water loss (TEWL) values. A few studies suggest that a reduced amount of total ceramides (especially of ceramide 1) is responsible for functional abnormalities of the skin of atopic dermatitis patients. The aim of this study was to analyze the relationship between epidermal lipids and barrier impairment in the skin of patients with atopic dermatitis. The quantity of ceramides, cholesterol sulphate and free cholesterol of 47 patients with atopic dermatitis and 20 age- and sex-matched healthy subjects was assessed by cyanoacrylate stripping and thin layer chromatography.

Capacitance and TEWL were recorded at the same site of the lipid sample. In patients with atopic dermatitis, the levels of ceramide 1 and 3 were significantly lower and values of cholesterol significantly higher with respect to healthy subjects. Moreover, the CER/CH ratio was significantly lower with respect to normal skin. Patients with active signs of eczema also had higher TEWL values and lower capacitance values. By contrast, patients with no active signs of atopic dermatitis had a normal barrier function and intermediate values of ceramides and cholesterols, when compared to patients with atopic dermatitis with active lesions and normal subjects. The quantity of ceramide 3 was significantly correlated with TEWL impairment. These findings suggest that a decrease in ceramides in the stratum corneum is involved in barrier impairment in atopic dermatitis skin. Our data confirm those of other authors and support the view that impaired metabolism of ceramides may be the cause of dry skin and impaired barrier function in atopic dermatitis.

Shark liver oil as a supporting therapy in atopic dermatitis

Nowicki R, Barańska-Rybak W. Pol Merkur Lekarski. 2007 Apr;22(130):312-3.
Akademia Medyczna w Gdańsku, Klinika Dermatologii, Wenerologii i Alergologii. mowicki@amg.gda.pl

Shark liver oils are the source of alkylglycerols and squalene but contain relatively low amounts of polyunsaturated fatty acids (EFA). They are modulators of immunity to infections and cancers. Their protective action from bacterial and fungal infections indicates that they should be recommended in the patients suffering from atopic dermatitis. Those patients because of xerosis and disturbances of skin barrier are susceptible for that kind of infections.

Immunochemical characterization of the distinct monocyte cyclic AMP-phosphodiesterase from patients with atopic dermatitis.

Chan SC, Reifsnyder D, Beavo JA, Hanifin JM. J Allergy Clin Immunol. 1993 Jun;91(6):1179-88. Department of Dermatology, Oregon Health Sciences University,

atopic dermatitisBACKGROUND: Previous findings have suggested that the immunopathology of patients with atopic dermatitis (AD) results from altered cellular responses caused by cyclic nucleotide regulatory abnormalities. One such defect is the increased degradation of the second messenger, cyclic adenosine monophosphate (cAMP), by elevated cAMP-phosphodiesterase (PDE) activity in patients with AD.

METHODS: We used two monoclonal antibodies to identify the major PDE isoform in AD blood monocytes. We have also characterized the abnormal PDE activity by means of chromatofocusing and sucrose gradient centrifugation.

RESULTS: The chromatofocusing technique allowed the separation of a PDE-containing fraction (isoelectric point = 6.1) from AD monocytes but not from normal cells. This monocyte fraction accounted for most of the elevated leukocyte-PDE activity and was a cytosolic, cAMP-specific, low Michaelis constant, calcium-calmodulin-dependent enzyme, inhibited by the cAMP-PDE inhibitor, Ro 20-1724. The majority of the PDE activity in this chromatofocused fraction was immunoadsorbed by the solid-phase immobilized antibodies against calcium-calmodulin-dependent PDE.

CONCLUSIONS: The increased degradation of cAMP by a unique form of PDE may cause defective regulation of intracellular functions of AD monocytes, leading to the characteristic hyperreactive immune and inflammatory events. Characterization of PDE isoenzymes from different leukocyte subpopulations may allow further expansion of cell-directed therapy for inflammatory disease.

A trial of oolong tea in the management of recalcitrant atopic dermatitis.

Uehara M, Sugiura H, Sakurai K. Arch Dermatol. 2001 Jan;137(1):42-3.
Department of Dermatology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu 520-2193, Japan.

BACKGROUND: Mild cases of atopic dermatitis (AD) generally improve with standard treatment. However, standard treatment fails many patients with recalcitrant AD skin lesions. Study results in animal models have demonstrated that the administration of tea (ie, green, black, or oolong) has suppressed type I and type IV allergic reactions.

OBJECTIVE: To test the effectiveness of oolong tea in the treatment of recalcitrant AD.

PATIENTS: Although 121 patients with recalcitrant AD were enrolled in the study, 118 patients completed the open study.

METHODS: Patients were asked to maintain their dermatological treatment. However, they were also instructed to drink oolong tea made from a 10-g teabag placed in 1000 mL of boiling water and steeped for 5 minutes. This amount was then divided into 3 equal servings and 1 serving was drunk daily after 3 regular meals. Photographs of 2 or 3 representative lesion sites were taken at baseline and at 1 and 6 months and the severity of pruritus was assessed on a 6-point Lickert-like scale ranging from markedly improved (>50% improvement) to worsened.

RESULTS: After 1 month of treatment 74 (63%) of the 118 patients showed marked to moderate improvement of their condition. The beneficial effect was first noticed after 1 or 2 weeks of treatment. A good response to treatment was still observed in 64 patients (54%) at 6 months.

CONCLUSION: The therapeutic efficacy of oolong tea in recalcitrant AD may well be the result of the antiallergic properties of tea polyphenols.