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Elias and Williams: The Inside-Out of Skin by dermatologists and skin researchers Peter M. Elias, M.D. and Mary L. Williams, M.D.

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You are here: Home / Archives for Research: From The Elias Lab

Research from the Elias Lab

For nearly forty years, this University of California San Francisco-based research laboratory has focused on elucidating the structural and metabolic basis for the barrier function of the skin, including work aimed at understanding the cause and treatment of skin diseases.

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our picks for the top 5 discoveries about skin of the past decade.  Some of these arose from work in our laboratory, and some from research by other investigators.

  • 1. Common inflammatory skin diseases, like the eczemas and even psoriasis, begin with an inherited weakness in the skin’s barrier. 

This revelation came pretty much as a surprise to everyone in the dermatologic research community – although not to us. Our work on the skin barrier had long before led us to this conclusion.  But heretofore most other research into these common disorders had focused on the role of the immune system.  The question was – which is the chicken and which the egg?  Both the barrier and inflammation were clearly involved in the disease process – but which came first? 

It was the work of the new generation of geneticists – who, in their search for the genes that underlay atopic dermatitis, (which have a strong familial bent), discovered that genes of the skin’s barrier system are commonly altered in people who suffer from these disorders. 

The pendulum of opinion in regard their causation has not completely swung from the immunological to the barrier, but it certainly is gravitating in that direction.  Work in progress includes studies to see whether preventing the development of a defective barrier through the use of barrier repair therapies can also prevent the development of atopic dermatitis and other allergic disorders. Stay tuned here.

  • 2. Skin plays host to an amazing diversity of microbes – both good and bad. 

In the past, when our knowledge of the skin’s microbial flora depended upon our ability to grow these organisms in the laboratory, we assumed there were only  limited numbers of ‘normal’ and ‘disease-causing’ microbes that lived on skin.  Now with the advent of RNA-sequencing technology, we have learned that the skin – like the gastrointestinal tract – hosts a large number of micro-organisms. 

The role of the skin’s microbiome in health and disease is beginning to be unraveled.  Stay tuned for more insights on that front.

  • 3. Air pollution provokes skin diseases and accelerates skin aging.

Air pollution has been with us for a long time, and we have long been aware that it is a problem for people with chronic lung conditions, like asthma.  But in recent years we have learned that it can also be harmful to pregnant women and their babies, to people with heart disease, and even for those with kidney and psychiatric conditions.  The close ties between air pollution and climate change are also now receiving attention.

Just in the past decade we have learned that pollution also is bad for the skin – producing flares of eczemas and acne, and accelerating skin aging. That skin is also affected by air pollution should come as no surprise.  Skin after all is bathed in the polluted air that surrounds us.  And although skin evolved robust defenses against assault by foreign chemicals, its capabilities are finite and can be overwhelmed.  Our knowledge about the effects of air pollution on skin is in its infancy.  We predict you will need to stay tuned for more here, too.

  • 4. Age-related abnormalities in the skin’s permeability barrier provoke systemic inflammation.

We learned some years ago that the skin’s barrier becomes weaker as we age – a defect that begins by age 50 in most people.  It has also been known for some time that many of the common diseases associated with aging – for example, heart disease, Alzheimer’s disease, and osteoarthritis – are associated with markers of chronic inflammation carried in the blood.  Recently, we discovered that the age-related barrier defect in the skin results in the release of inflammatory markers into the blood stream.  And conversely, correction of the skin’s barrier defect, (through the use a topical barrier-repair formulation), can reduce the load of  chronic inflammation markers in the blood. 

These results suggest that the chronic inflammation in the blood that is provoking many common age-related diseases could be arising from the skin.  If so, then correction of the age-related barrier defect might prevent some of these age-related  disorders of heart, brain and joints.  This concept will require further experimental proof, so stay tuned, once again.

  • 5. Many products that claim to moisturize the skin are actually harmful, particularly for people with ‘sensitive skin’.

This is another chapter in the age old story of ‘caveat emptor’ – buyer beware!  Unfortunately, there is little requirement for scientific truth in the claims on the packages of cosmetics and other products sold over the counter. 

In this research, we learned that many products which claim to be beneficial for moisturizing dry skin, are actually harmful.  Improvements are only temporary, and overtime  they can worsen the skin barrier and provoke more symptoms of dryness and itch – especially in those of us who have sensitive skin to begin with.   

The How and Why of Sensitive Skin

November 1, 2018 By Peter M. Elias, M.D. 1 Comment

Babies have sensitive skin, but so do many adults
Detail of angels from a fresco in Verona Italy
Babies, angels and many adults have sensitive skin. Photo by Mary L. Williams

An alarming percentage (about 60%) of normal adults, mostly women, self-report that they regularly experience ‘sensitive skin’. Most perceive ‘sensitive skin’ as various amounts of stinging, burning, irritation, and itch with the use of skin care products. In a large population based study in China, we found no increase in the proportion of females among those patients whose reactions were severe enough to seek the help of a dermatologist, but we did find the reactions to be more marked in older age groups.

The types of skin care products that produce these reactions vary greatly – and sometimes even include products like moisturizers and cortisone containing creams that are intended to help – not harm – the skin. This raises two obvious questions. 1) What is it about some people’s skin that makes it so ‘sensitive’ to skin care products? And 2) what is it about skin care products that is so hard on skin? [Read more…] about The How and Why of Sensitive Skin

2018 IID Meeting Update: Deciphering The Link Between Atopic Dermatitis and Autism

September 20, 2018 By Peter M. Elias, M.D. Leave a Comment

Peter M. Elias, M.D. speaking at the IID 2018 (International Investigative Dermatology) Conference on the Atopic Dermatitis-Autism Link

 

There seems to be little doubt that both autism and atopic dermatitis have become much more prevalent in recent years. In neither disorder is the cause nor the reason for the current epidemics entirely understood. We have addressed the hypotheses concerning the atopic dermatitis epidemic elsewhere on this site.  Recently, several population-based studies have demonstrated an increased incidence of autism spectrum disorders in children with atopic disorders, including atopic dermatitis.

Both autism spectrum disorders and atopic dermatitis have evidence for genetic underpinnings, and both are thought to be triggered by environmental factors. Both disorders also have in common a barrier defect (blood brain barrier vs. skin permeability barrier) and an immunologic component. [Read more…] about 2018 IID Meeting Update: Deciphering The Link Between Atopic Dermatitis and Autism

2018 IID Meeting Update: Systemic Inflammation of Aging Humans Comes from the Skin

May 29, 2018 By Peter M. Elias, M.D. Leave a Comment

inflammation from aged skin
Peter M. Elias, M.D. in front of his poster at the 2018 IID meeting.

Could inflammation arising from aged skin actually be responsible for a whole host of age-related systemic diseases, such as Alzheimer’s disease, type II diabetes, osteoarthritis, and atherosclerosis? Markers of inflammation are found in the blood in all these conditions, but their source has yet to be unidentified – could they be coming from the skin? [Read more…] about 2018 IID Meeting Update: Systemic Inflammation of Aging Humans Comes from the Skin

How is pigmented skin more acidic?

August 20, 2015 By Peter M. Elias, M.D. Leave a Comment

 How is Pigmented Skin More Acidic?

 

As we discussed in an earlier post, darkly pigmented skin is superior to lightly pigmented skin. It functions better in holding in body water. It does a better job of preventing skin infections. And it is better at resisting mechanical trauma.  We then discussed work from the Elias laboratory demonstrating that this superiority is due to the lower pH of the skin surface.  In other words, darkly pigmented skin is more acidic. Yet darkly pigmented skin has the same number of pigment-forming cells (‘melanocytes’) as does lightly colored skin.  So, what then is the difference in the melanocytes of darkly- vs. lightly-pigmented skin? Well, one big difference is in the the clusters of pigment (or ‘melanin granules’) made by melanocytes in darkly pigmented skin. They are larger and more numerous than the sparser and smaller melanin granules made by pale skin. Melanocytes transfer these granules to the cytoplasm of neighboring epidermal cells (‘keratinocytes’) using their long arms (or ‘dendrites’).  This transfer process happens in both light and dark skin, but here’s where things proceed differently.

Slide1
Comparison of melanin granules in darkly pigmented (left side) vs. lightly pigmented (right side) epidermis. Both skin types have the same endowment of pigment cells or melanocytes. But, the pigment granules produced by melanocytes in dark skin are larger and more numerous than those in light skin. When transferred to cells of the epidermis (keratinocytes), pigment granules in dark skin (left side) persist as the cells move towards the skin surface and some of the granules “escape” into the spaces outside the cells. In contrast in lighter skin (right side) the small granules tend to cluster over the top of the nucleus (‘nuclear cap’) where they can protect the DNA from sun damage. Very few make it into the outer skin cell layers and few of those are found outside the cells there. Drawing by Jessica Kraft.

The small, crumbly (read ‘crummy’, if you wish) pigment granules of very lightly pigmented skin are degraded within the keratinocytes well before they can reach the outermost layers of the epidermis. In contrast, the larger, more robust melanin granules of darkly-pigmented skin persist within cells as they mature and move outward towards the skin surface. [Read more…] about How is pigmented skin more acidic?

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INSIDE THE SKIN BARRIER

The Skin Microbiome: Good Bugs And The Bugs That Bug Us

January 7, 2020 By Peter M. Elias, M.D.

We hear a lot about the multitude and diversity the micro-organisms – especially the bacteria - that … Read More...

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SKIN DISORDERS

Dry Skin: Who Is At Risk and What Can Be Done About It?

December 1, 2019 By Peter M. Elias, M.D. Leave a Comment

Who is at risk? Many people are prone to develop dry skin. Examples include those who have or … Read More...

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REPAIRING THE SKIN BARRIER

The How and Why of Sensitive Skin

November 1, 2018 By Peter M. Elias, M.D. 1 Comment

An alarming percentage (about 60%) of normal adults, mostly women, self-report that they regularly … Read More...

MORE FROM REPAIRING THE SKIN BARRIER >>

CLIMATE AND THE SKIN

The Skin’s Many Barriers and Climate Change

October 9, 2020 By Mary L Williams, M.D.

Skin's Many Barriers And How Climate Change May Affect Them Skin has many barriers: it keeps us … Read More...

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Q & A

Q& A: Preventing Dry Skin From COVID-19 Hand Washing And Toxic Hand Sanitizers

December 1, 2020 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

Q: I have developed dry skin from COVID-19 because I have to wash my hands so often. Hand sanitizers … Read More...

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Research: From The Elias Lab

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our … Read More...

MORE FROM THE ELIAS LAB >>

Research: From Labs Around the World

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our … Read More...

MORE FROM RESEARCH AROUND THE WORLD >>

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