Highlights of the 2013 IID. Part 6: Does barrier repair therapy improve skin defense against infection?

Prior work from our group has shown that the permeability and antimicrobial barriers in normal skin share many common features, and are co-regulated, such that perturbations in one function inevitably impact the other. We also showed that a variety of conditions that compromise the permeability barrier, including neonatal and aging skin, are also accompanied by a reduction in the production of the cathelicidin antimicrobial peptide, LL-37, a key defender against S. Aureus and Streptococcal infections.

In this study, we asked whether strategies that improve permeability barrier function also enhance production of LL-37. We first assessed the effects of a variety of ingredients, commonly included in cosmetic and prescription devices, such as urea, petrolatum, and activators of a family of lipid-sensing receptors in the same family as retinoids and vitamin D, that we had previously shown enhance skin barrier funciton.  We also tested a triple-lipid prescription device (EpiCeram® emulsion). Previously, we had demonstrated that only EpiCeram® among a large cohort of OTC and prescription ‘barrier-repair’ formulations, accelerated barrier repair both in normal and atopic dermatitis skin.  In all cases, agents that improved permeability barrier function stimulated the production of LL-37 in parallel, and the EpiCeram formulation also stimulated the secretion of LL-37.

Bottom Line: These results show that a variety of approaches that enhance permeability barrier function also likely improve the skin’s defense against invading pathogenic microorganisms.

Copyright © 2013 Elias and Williams

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