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Reevaluation of the non-lesional dry skin in atopic dermatitis by acute barrier disruption: an abnormal permeability barrier homeostasis with defective processing to generate ceramide

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Abstract

Atopic dermatitis is characterized by disruption of the cutaneous barrier due to reduced ceramide levels even in non-lesional dry skin. Following further acute barrier disruption by repeated tape strippings, we re-characterized the non-lesional dry skin of subjects with atopic dermatitis, which shows significantly reduced levels of barrier function and ceramide but not of beta-glucocerebrosidase activity. For the first time, we report an abnormal trans-epidermal water loss homeostasis in which delayed recovery kinetics of trans-epidermal water loss occurred on the first day during the 4 days after acute barrier disruption compared with healthy control skin. Interestingly, whereas the higher ceramide level in the stratum corneum of healthy control skin was further significantly up-regulated at 4 days post-tape stripping, the lower ceramide level in the stratum corneum of subjects with atopic dermatitis was not significantly changed. In a parallel study, whereas beta-glucocerebrosidase activity at 4 days post-tape stripping was significantly up-regulated in healthy control skin compared with before tape stripping, the level of that activity remained substantially unchanged in atopic dermatitis. These findings indicate that subjects with atopic dermatitis have a defect in sphingolipid-metabolic processing that generates ceramide in the interface between the stratum corneum and the epidermis. The results also support the notion that the continued disruption of barrier function in atopic dermatitis non-lesional skin is associated with the impaired homeostasis of a ceramide-generating process, which underscores an atopy-specific inflammation-triggered ceramide deficiency that is distinct from other types of dermatitis.

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Abbreviations

AD:

Atopic dermatitis

HC:

Healthy control

SC:

Stratum corneum

TEWL:

Trans-epidermal water loss

BGCase:

β-Glucocerebrosidase

aSMase:

Acid sphingomyelinase

aCDase:

Acid ceramidase

LG:

Lamellar granule

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Acknowledgments

We thank Ms Chiharu Honma, Yukari Takeno and Mari Kawauchi for their excellent technical assistance.

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The authors have no conflict of interest to declare.

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Correspondence to Genji Imokawa.

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Sugiura, A., Nomura, T., Mizuno, A. et al. Reevaluation of the non-lesional dry skin in atopic dermatitis by acute barrier disruption: an abnormal permeability barrier homeostasis with defective processing to generate ceramide. Arch Dermatol Res 306, 427–440 (2014). https://doi.org/10.1007/s00403-013-1430-x

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  • DOI: https://doi.org/10.1007/s00403-013-1430-x

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