Article

Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin

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Abstract

Magnesium salts, the prevalent minerals in Dead Sea water, are known to exhibit favorable effects in inflammatory diseases. We examined the efficacy of bathing atopic subjects in a salt rich in magnesium chloride from deep layers of the Dead Sea (Mavena(R) Dermaline Mg(46) Dead Sea salt, Mavena AG, Belp, Switzerland). Volunteers with atopic dry skin submerged one forearm for 15 min in a bath solution containing 5% Dead Sea salt. The second arm was submerged in tap water as control. Before the study and at weeks 1-6, transepidermal water loss (TEWL), skin hydration, skin roughness, and skin redness were determined. We found one subgroup with a normal and one subgroup with an elevated TEWL before the study. Bathing in the Dead Sea salt solution significantly improved skin barrier function compared with the tap water-treated control forearm in the subgroup with elevated basal TEWL. Skin hydration was enhanced on the forearm treated with the Dead Sea salt in each group, which means the treatment moisturized the skin. Skin roughness and redness of the skin as a marker for inflammation were significantly reduced after bathing in the salt solution. This demonstrates that bathing in the salt solution was well tolerated, improved skin barrier function, enhanced stratum corneum hydration, and reduced skin roughness and inflammation. We suggest that the favorable effects of bathing in the Dead Sea salt solution are most likely related to the high magnesium content. Magnesium salts are known to bind water, influence epidermal proliferation and differentiation, and enhance permeability barrier repair.

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... Penelitian lain yang mempelajari tentang efektivitas mineral pada perbaikan sawar kulit, termasuk pada penyakit kulit kronis telah banyak dilakukan di beberapa negara di Eropa dengan memanfaatkan mineral yang bersumber dari air laut mati. 24,25 Penelitian yang dilakukan oleh Paravina, dkk. di Serbia pada tahun 1914 menjelaskan secara luas mengenai efek balneoterapi pada pasien psoriasis. ...
... Beberapa perusahaan kosmetik di dunia telah membuat sebuah produk yang mengandung garam mineral, di mana produk tersebut tidak hanya bersifat sebagai pelembap tetapi juga dapat mengurangi kemerahan dan gatal. 25 Produk yang mengandung garam mineral tersebut antara lain berupa garam mandi, masker, dan air mineral yang telah dikemas dalam tabung spray sehingga lebih mudah digunakan. 37 Bahan-bahan yang digunakan untuk produk tersebut diambil langsung dari sumbernya dengan menggunakan kemasan khusus disertai proses sterilisasi, sehingga tidak mengurangi kandungan mineral yang terkandung. ...
... Beberapa produk yang berbentuk krim maupun gel dengan kandungan mineral terkadang diberikan tambahan zat aktif lainnya. 25 Produk yang telah banyak beredar di Indonesia antara lain Avene ® , Evian ® , La Roche-Posay ® . ...
Article
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Psoriasis merupakan penyakit inflamasi kronis residif dengan beberapa faktor risiko yang memengaruhi antara lain genetik, sistem imunitas, lingkungan serta hormonal. Lesi kulit psoriasis berupa plak eritematosa berbatas tegas dengan skuama tebal berlapis yang berwarna keputihan. Tata laksana psoriasis bervariasi tergantung dari derajat keparahan penyakit dan dapat berupa penggunaan obat topikal, sistemik, terapi sinar maupun terapi dengan menggunakan bahan-bahan alami seperti mineral dan balneoterapi. Balneoterapi dapat digunakan sebagai terapi tambahan pada psoriasis karena efektivitasnya terhadap perbaikan lesi psoriasis terutama tipe plak. Balneoterapi adalah teknik pengobatan tradisional dengan cara mandi, minum atau inhalasi menggunakan air yang mengandung mineral dan dapat menggunakan sumber mineral seperti air mineral, lumpur yang mengandung mineral (peloid) dan gas alam yang berasal dari mata air alami. Balneoterapi dapat mengurangi ketebalan stratum korneum dan lusidum, menurunkan jumlah limfosit, histiosit, granulosit dan eosinofil, meningkatkan permeabilitas kulit, mengurangi inflamasi, memperbaiki mikrosirkulasi serta sistem imun kulit serta dapat menurunkan cytokine proinflamasi pada penyakit psoriasis. Artikel ini bertujuan untuk membahas efektivitas modalitas balneoterapi sebagai terapi tambahan pada psoriasis sehingga dapat mempercepat terjadinya perbaikan klinis dan mengurangi terjadinya kekambuhan penyakit.
... 1,3,5 In this study, the MN patch was composed of magnesium metal, which is well known to play a beneficial role in the skin. [14][15][16] The magnesium ion plays a role in increasing skin hydration, ...
... 17,18 There also have been several reports of topical agents including magnesium ion regarding favorable effects on different types of dermatitis including diaper dermatitis, contact dermatitis, and atopic dermatitis. 15,19,20 On the basis of previous studies, [14][15][16][17][18][19][20] ...
... 17,18 There also have been several reports of topical agents including magnesium ion regarding favorable effects on different types of dermatitis including diaper dermatitis, contact dermatitis, and atopic dermatitis. 15,19,20 On the basis of previous studies, [14][15][16][17][18][19][20] ...
Article
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Microneedling is a common cosmetic procedure for improvement of wrinkles, acne, scars, and other conditions. Various microneedle (MN) patches have been developed as home care therapy for wrinkles and skin texture. Most of them are made of soluble and absorbable needles. To evaluate the efficacy and safety of non‐absorbable magnesium (Mg) MN patches on under‐eye wrinkles. A total of 20 subjects aged 27 to 58 years was enrolled in the study. The subjects applied Mg MN patches on the under‐eye wrinkle area for one to two hours every other night for 12 weeks. The evaluation comprised grading by clinicians, measuring the wrinkle index with a facial analyzer, and measuring the dermal thickness of the under‐eye area with ultrasonography. Any adverse events and discomfort were addressed during the study. The application of Mg MN patches on under‐eye areas showed improvements in under‐eye grading scale, wrinkle index, and dermal thickness after 12 weeks. The mean grading scale significantly improved after eight weeks of application (p < 0.01). The wrinkle index showed significant improvement after 12 weeks on the right under‐eye area (p < 0.05). The dermal thickness of the under‐eye area tended to increase, but no statistically significant changes were observed. Non‐absorbable Mg MN patches can be used for under‐eye wrinkles with minimal discomfort. This article is protected by copyright. All rights reserved.
... When hypersaline solutions are applied on skin, MIOS affects the modulation of cell-cycle dynamics. This is evident in reduced expression levels of inflammatory cytokines and in altered cell proliferation and differentiation rates [13] [15]. Specific external ion levels, mainly magnesium, calcium, potassium, and bromide, have been shown to affect cell proliferation and differentiation [13] [15] [16] [17] [18]. ...
... This is evident in reduced expression levels of inflammatory cytokines and in altered cell proliferation and differentiation rates [13] [15]. Specific external ion levels, mainly magnesium, calcium, potassium, and bromide, have been shown to affect cell proliferation and differentiation [13] [15] [16] [17] [18]. ...
... A particular case of MIOS's beneficial effect on human skin, is the topical exposure to Dead Sea minerals. The Dead Sea contains high levels of magnesium, calcium, and bromide ions and is clinically proven for its beneficial effects on several skin diseases [15] [21] [22]. Although these effects have been thoroughly studied on patients with skin diseases, the mechanism of MIOS involved as a key generating step for clinical efficacy, is not fully understood. ...
... Researchers have tried to find alternative treatments including bathing in Dead Seawater and spring water. ese have been proven to be effective in ameliorating symptoms in patients with AD and other skin diseases [7,8]. According Proksch et al. [8], patients who took baths in Dead Seawater for 15 minutes showed higher water contents in the epidermis, better epidermal barrier function, and decreased skin inflammation compared with the group who took baths in regular tap water. ...
... ese have been proven to be effective in ameliorating symptoms in patients with AD and other skin diseases [7,8]. According Proksch et al. [8], patients who took baths in Dead Seawater for 15 minutes showed higher water contents in the epidermis, better epidermal barrier function, and decreased skin inflammation compared with the group who took baths in regular tap water. Portales et al. also reported that bathing in spring water from Avene decreased serum inflammatory cytokines [9]. ...
... alassotherapy, a therapy using seawater, has been developed since the mid-19 th century [19]. Dead Seawater was shown to be effective in alleviating symptoms of psoriasis and AD, with or without solar irradiation [8,20]. It improves skin barrier function through high concentrations of magnesium and calcium ions, influencing epidermal proliferation and differentiation [21,22]. ...
Article
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Background: Saline groundwater, collected from the east coast of Korea, has been shown to have protective effects against 2,4-dinitrochlorobenzene- (DNCB-) induced atopic dermatitis-like skin lesions in the murine model. Objectives: To determine the effects of saline groundwater solution baths as a treatment of mild-to-moderate atopic dermatitis. Methods: Twenty-four subjects with mild-to-moderate atopic dermatitis were instructed to take a bath in saline groundwater solution for 20 minutes per day for two weeks. Evaluations were performed at baseline and week 2, including SCORing Atopic Dermatitis (SCORAD) index, corneometry, transepidermal water loss, visual analogue scale for pruritus, and collection of adverse events. Results: Subjects showed significant improvement with respect to the SCORAD index, skin hydration, transepidermal water loss, and pruritus at week 2 when compared with the baseline. Conclusion: Baths in saline groundwater solution may be an alternative therapeutic strategy for treating atopic dermatitis.
... Eitan et al. compared the indexes before the study and at weeks 1-6, then they observed the elevation of basal TEWL and enhanced skin hydration. Meanwhile, the common skin inflammation markers, such as roughness and redness, were also significantly reduced after treatment [39]. By evaluating skin roughness using computer-aided laser profilometry, Ma'Or et al. investigated the cutaneous smoothing effects of three different liquid gels, one of which contained Dead Sea minerals. ...
... Clinically, the DSW also demonstrated an anti-inflammation effect on chronic inflammatory skin diseases, such as psoriasis or atopic dermatitis. As reported by Proksch [39], a magnesium-rich Dead Sea salt solution was applied to patients with atopic dry skin. A 15 min treatment in bath solution containing 5% Dead Sea salt for 6 weeks could greatly improve skin hydration, roughness, and reduce skin redness. ...
Article
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Applying natural mineral water to skin care is a popular tendency and many cosmetics products based on thermal spring water have been developed. The special location and environmental conditions provide Dead Sea water (DSW) with unique ion composition and concentrations, which bring comprehensive positive effects on skin health. This article reviews two potential action modes of DSW, and the biological function of DSW and its related complex in dermatology and skin care. Previous studies have proved the functions of skin moisturization, anti-inflammation, skin barrier repair, and anti-pollution. Especially, the anti-aging effect of DSW and related complexes can act in three different ways: keratinocyte rejuvenation, photo-protection, and cellular energy elevation. Additionally, the issues that need further investigation are also discussed. We hope that this review will help to improve the understanding of DSW and its related complex, and further contribute to product development in the skincare industry.
... Bathing in the Dead Sea waters (with an average concentration of 280 g/K) has been extensively studied: magnesium salts are known to bind water, influence epidermal proliferation and differentiation, and enhance permeability barrier repair [130]. In a study by Proksch et al. [131], immersion in magnesium-rich salt solutions from the Dead Sea was investigated (Mavena ® Dermaline Mg Dead Sea). The experiment consisted of 15 min bathing in a solution containing 5% Dead Sea salt daily for 6 weeks; transepidermal water loss (TEWL), stratum corneum hydration, and skin redness in atopic dry skin (xerosis) were measured, concluding that bathing with Mavena ® Dermaline Mg Dead Sea salt solution, owing to its high content of magnesium ions, enhanced stratum corneum hydration, improved skin barrier function and reduced skin roughness and inflammation [131]. ...
... In a study by Proksch et al. [131], immersion in magnesium-rich salt solutions from the Dead Sea was investigated (Mavena ® Dermaline Mg Dead Sea). The experiment consisted of 15 min bathing in a solution containing 5% Dead Sea salt daily for 6 weeks; transepidermal water loss (TEWL), stratum corneum hydration, and skin redness in atopic dry skin (xerosis) were measured, concluding that bathing with Mavena ® Dermaline Mg Dead Sea salt solution, owing to its high content of magnesium ions, enhanced stratum corneum hydration, improved skin barrier function and reduced skin roughness and inflammation [131]. ...
Article
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Cancer treatments have undergone significant advances in recent years, although they are not exempt from side effects, including skin toxicity. Different studies show that skin care for cancer patients can be effective in reducing sequelae such as inflammation, xerosis, skin rash, and radiodermatitis, among others. This is the reason why research is being carried out on the ingredients of cosmeceuticals for those indicated for oncological skin care. On the other hand, it is necessary to implement measures that improve the patient’s well-being and, therefore, thalassotherapy techniques and the marine environment could be an effective resource to achieve this goal. This article reviews the publications related to skin care after cancer treatment, including thalassotherapy techniques that can also contribute to well-being.
... Magnesium salts, the prevalent minerals in Dead Sea water, exhibit favorable effects on in lammatory diseases. Proksch, et al. examined the ef icacy of bathing atopic subjects in salt rich in magnesium chloride from deep layers of the Dead Sea [15]. Volunteers with atopic dry skin submerged one forearm for 15 min in a bath solution containing 5% Dead Sea salt. ...
... The authors reported that bathing in the salt solution was well tolerated, improved skin barrier function, the enhanced stratum corneum hydration, and reduced skin roughness and in lammation. Magnesium salts are known to bind water, in luence epidermal proliferation, and differentiation, and enhance permeability barrier repair [15]. ...
Article
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Introduction: Dead Sea Salt, rich in minerals and ionic compositions and low in Sodium Chloride (NaCl) has many reported unique properties that set it apart from other salts. Objectives: To evaluate the composition of Dead Sea Salt and assess its in vitro cytotoxicity, and efficacy against oral bacterial leukotoxins, oral endotoxins and oral glucan sucrase. Methods: The cytotoxicity was evaluated in an established cell line (solution at 5000 µg/mL of culture medium) using positive and negative control groups. The effect on oral bacterial leukotoxin (LtxA) and different concentrations of lipopolysaccharide and glucan sucrase was established at 24, 36, 48, 60, 72, 84, and 96 hours using the HPLC method (high-performance liquid chromatography). Results: The most predominant elements detected were the water of crystallization (H2O, water that is found in the crystalline framework of salt and which is not directly bonded ), magnesium chloride (MgCl2), potassium chloride (KCl), sodium chloride (NaCl), calcium chloride (CaCl2), bromide (Br -) and sulfates (SO4). In vitro, Dead Sea Salt presented no cytotoxicity and was highly effective against leukotoxin, endotoxin, and glucan sucrase enzyme. Conclusion and clinical significance: We believe that rinsing with Dead Sea Salt has the potential to contribute to the prevention of periodontal, peri-implant and dental disease and merits clinical research.
... The epidermal calcium gradient is attenuated or highly disturbed in aged or inflamed skin. Modification of the Ca 2+ /Mg 2+ ratio in favor of the latter mineral proves beneficial for recovery of the epidermal homeostasis, resulting in an optimal reparation of skin barrier, and may have impact on inflammatory skin diseases [72][73][74]. Acute abrogation of the extracellular calcium gradient by removal of the overlying SC barrier results in an instantaneous mobilization and excretion of the intracellular pool of lipids, aimed at the rapid restoration of tissue impermeability [75]. Many biochemical mechanisms, including those involved in keratinocyte differentiation, are regulated by calcium. ...
... Notably, inflammatory skin diseases such as psoriasis and atopic dermatitis were reported to benefit from such "cures" [135]. The mineral-rich solutes used contain principally magnesium and/or sulfur salts [74]. ...
Article
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As odd as it may seem at first glance, minerals, it is what we are all about…or nearly. Although life on Earth is carbon-based, several other elements present in the planet’s crust are involved in and often indispensable for functioning of living organisms. Many ions are essential, and others show supportive and accessory qualities. They are operative in the skin, supporting specific processes related to the particular situation of this organ at the interface with the environment. Skin bioenergetics, redox balance, epidermal barrier function, and dermal remodeling are amongst crucial activities guided by or taking advantage of mineral elements. Skin regenerative processes and skin ageing can be positively impacted by adequate accessibility, distribution, and balance of inorganic ions.
... Few studies have objectively assessed skin barrier function by measuring SC hydration, TEWL and skin surface pH. However, all these studies had been done in adults, neonates, and children, [16,17] None of the studies were done in infants, the group most commonly affected. Benefits were reported only in dead sea salt solution and acidic water bathing. ...
... Benefits were reported only in dead sea salt solution and acidic water bathing. [16,18] Adverse outcome to bathing in AD was reported in one randomized controlled trial (RCT) but had a small sample size (5 AD individuals and 5 healthy controls) and bathing was without an emollient. [19] No effect of bathing in AD was reported in a few RCTs. ...
Article
Introduction: The skin barrier function resides primarily in the stratum corneum (SC). Defect in SC hydration and skin surface pH leads to barrier impairment causing atopic dermatitis (AD). We have noticed a clinical improvement in infants with AD after a bath. We aimed to assess barrier functions in infants with AD before and after a single bath. There are no large controlled studies that clarify the optimal parameters of bathing. However, there are few studies recommending bath in AD. We proposed a “twenty minutes immersion bath.” Materials and Methods: We conducted an interventional analytic study without comparison group. The main instruments used were the corneometer and skin pH meter. Results: The measured values of SC hydration were significantly higher on the lesional skin immediately after a bath (P < 0.001). The mean SC hydration dropped dramatically within one hour and gradually reduced further over the next three hours. However, healthy looking skin had short climb and slow drop of SC hydration. The measured values of skin pH were lower on the lesional skin after bathing (P = 0.026). Discussion: An immersion bath improves SC hydration and helps to maintain skin pH and warrants further evaluation in the context of atopic dermatitis.
... Calcium, potassium and phosphate have synergic effects, repairing the stratum corneum lipidic content and improving the barrier function (Lee et al., 1992). Proksch et al. evaluated the efficacy of bathing in a Dead Sea salt solution (rich in magnesium chloride) in 30 volunteers with atopic dry skin (Proksch, Nissen, Bremgartner, & Urquhart, 2005). The authors reported that the salt-solution improved the stratum corneum hydration, smoothed the skin, enhanced the skin barrier function and decreased the skin roughness and inflammation (Proksch et al., 2005). ...
... Proksch et al. evaluated the efficacy of bathing in a Dead Sea salt solution (rich in magnesium chloride) in 30 volunteers with atopic dry skin (Proksch, Nissen, Bremgartner, & Urquhart, 2005). The authors reported that the salt-solution improved the stratum corneum hydration, smoothed the skin, enhanced the skin barrier function and decreased the skin roughness and inflammation (Proksch et al., 2005). ...
Article
Background Actinidia arguta is a climbing, fruit plant that recently generated a spread interest in many regions of the world, due to world globalization and knowledge expansion. During its production, different by-products are generated, such as fruits, leaves, stems, flowers and roots, being characterized by a rich bioactive composition that wise the scientific community for its health effects. Inboard of this panoply of valuable bioactive compounds, vitamin C, chlorogenic and neochlorogenic acids, caffeic acid, quercetin, catechin, kaempferol, p-coumaric acid, minerals and fatty acids play critical roles. As a result, the valorization and reuse of these by-products is a challenge, particularly for producers. Scope and approach This review aims to summarize the potential cosmetic and medical skincare applications of the different bioactive compounds from A. arguta by-products, describing and exploring their potential to contribute as active ingredients based on the biological activities reported. Simultaneously, a critical analysis of the patents available on the market regarding its use as cosmetic and medical skincare ingredient is provided. Key Findings and conclusions Cosmetic and medical skincare products could be a sustainable and green option for the use of A. arguta by-products bioactive compounds. Apart from contribute to skin appearance and health, the addition of these active compounds to the final cosmetic and pharmaceutical products may also provide skin beneficial effects such as photoprotection, anti-aging and anti-inflammatory effects, also acting as depigmenting and emollients, among other activities. Besides that, the impact on food by-product valorization and circular economy will be enormous.
... Beberapa penelitian telah dilakukan mengenai penggunaan material yang melepaskan ion bioaktif seperti Zn 2 + , Si 4 + dan Mg 2 + untuk regenerasi jaringan pada area yang mengalami kerusakan dalam tubuh manusia [13]- [15]. Ion Mg 2+ memiliki kelebihan tersendiri karena sangat penting dalam metabolisme pada tubuh manusia, seperti sintesis protein, fungsi otot, sistem saraf dan kekebalan [10]- [11]. ...
... Ion Mg 2+ memiliki kelebihan tersendiri karena sangat penting dalam metabolisme pada tubuh manusia, seperti sintesis protein, fungsi otot, sistem saraf dan kekebalan [10]- [11]. Beberapa riset menunjukkan bahwa ion Mg 2+ meningkatkan pembaruan jaringan kulit, meningkatkan fungsi pelindung kulit, meningkatkan hidrasi kulit, dan mengatur proliferasi dan diferensiasi epiderma [12]- [13]. Selain itu, ion Mg 2+ yang dilepaskan memberikan respons biologis yang sangat baik dan mendorong pembentukan kolagen pada luka kulit [14]. ...
Article
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Pada penelitian ini telah dilakukan pembuatan implan bioabsorbable dengan bahan polimer logam komposit (PLA/ABS/Mg) dengan menggunakan metode solvent casting dengan tiga komposisi yakni PLA:ABS 70:30, 60:40, 80:20 dengan komposisi Mg masing-masing 5%, 10% dan 15% kemudian dilarutkan dengan clorofoam sebanyak 17 mL sehingga mendapatkan sampel berbentuk film. Penelitian ini bertujuan untuk mengetahui variasi optimal PLA/ABS terhadapat karakterisitik sifat mekanik, morfologi, impedansi dengan adanya penambahan Mg. Hasil karakterisasi sifat mekanik menggunakan uji tarik dengan komposisi PLA:ABS 80:20 pada variasi Mg 10% dan 15% menunjukkan hasil yang optimal, sehingga Mg terbukti meningkatkan sifat mekanik dari PLA. Semakin banyak penambahan variasi Mg menunjukkan peningkatan nilai kekerasan vikers dan impedansi pada polimer logam komposit. Hasil pengamatan dengan menggunakan SEM pada kompoisi PLA:ABS 70:30 menunjukan bahwa homogenitas Mg didalam polimer telah tercapai dengan baik.
... Noteworty, among cations of interest, Mg 2+ and Ca 2+ have been recognized for their benefits in skin barrier recovery (Denda et a., l999). In normal skin, magnesium and calcium ions were localized with a high concentration in the upper epidermis (Proksch et al., 2005). After barrier disruption, the gradients of calcium, magnesium, and potassium in the epidermis disappeared while the pH was not altered (Denda et a., l999). ...
... Hence it is very useful in psoriatic patients who have a low magnesium level in the serum and scales (Rivaz et al., 2011). Calcium-and magnesium-rich thermal spring waters are known to improve skin barrier function and accelerate wound healing (Proksch et al., 2005). ...
... Low magnesium (Mg) levels are linked to increased inflammation [45]. For example, magnesium salts in Dead Sea water have a beneficial effect on inflammatory diseases [46]. Moreover, in 1966, the German chemist Bedouno Sanouni analyzed the sands near Siwa. ...
Article
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Background and Objectives: The most frequent cause of mortality in rheumatoid arthritis (RA) patients is cardiovascular disease (CVD). Inflammation, dyslipidemia, and decreased physical activity are some of the main risk factors for CVD. Siwan sand therapy is a type of traditional therapy used in Egypt to treat RA. The approach of this therapy depends on the experience of the healers. The aim of the current study was to compare the effects of three sessions of Siwan traditional therapy to five sessions on common CVD risk factors and physical function in rheumatoid arthritis patients. Materials and Methods: Thirty patients (9 male and 21 female) were assigned into two groups of equal size: group (A) received three sessions of Siwan traditional therapy in the form of a sand bath. Group (B) received the same form of therapy for five days. Erythrocyte sedimentation rate (ESR), lipid profile, atherogenic index of plasma (AIP), and a health assessment questionnaire (HAQ) were measured before and after treatment. Results: There was a significant increase above normal within group (A) for ESR (p = 0.001), triglycerides (TG; p = 0.015), total cholesterol (Tot-Chol; p = 0.0001), and low-density lipoprotein (LDL; p = 0.0001). However, there were no considerable differences in high-density lipoprotein (HDL; p = 0.106), very low-density lipoprotein (VLDL; p = 0.213), AIP (p = 0.648), and HAQ (p = 0.875). For the second group, there were significant changes within group B only in Tot-Chol (p = 0.0001), HDL (p = 0.0001), VLDL (p = 0.0001), AIP (p = 0.008), and HAQ (p = 0.014). There was a significant difference between both groups regarding HDL (p = 0.027), LDL (p = 0.005), AIP (p = 0.029), ESR (p = 0.016), and HAQ (p = 0.036). Conclusions: For RA patients, five days of Siwan traditional therapy caused significant changes regarding inflammation, Tot-Chol, LDL, HDL, AIP, and functional activity when compared to three days of Siwan hot sand therapy.
... WANG AND TANG -3 of 15 epidermal proliferation, differentiation, and skin barrier functions. 74,75 Sr ion has been reported to promote angiogenesis and suppress inflammation in skin wound treatments. [76][77][78] Cu ion is well-known for its significant role in angiogenesis by regulating the expression of proangiogenic factors such as vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β) as well as the hypoxia-inducible factor (HIF-1α) to stimulate skin wound healing. ...
Article
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Regeneration of both anatomic and functional integrity of the skin tissues after injury represents a huge challenge considering the sophisticated healing process and variability of specific wounds. In the past decades, numerous efforts have been made to construct bioceramic‐based wound dressing materials with ion‐mediated multifunctionality for facilitating the healing process. In this review, the state‐of‐the‐art progress on bioceramic materials with ion‐mediated bioactivity for wound healing is summarized. Followed by a brief discussion on the bioceramic materials with ion‐mediated biological activities, the emerging bioceramic‐based materials are highlighted for wound healing applications owing to their ion‐mediated bioactivities, including anti‐infection function, angiogenic activity, improved skin appendage regeneration, antitumor effect, and so on. Finally, concluding remarks and future perspectives of bioceramic‐based wound dressing materials for clinical practice are briefly discussed. In this review, we provide a brief summary of the state‐of‐the‐art progress on bioceramic materials with ion‐mediated bioactivity for wound healing applications. The emerging bioceramic‐based materials for wound healing are highlighted based on their ion‐mediated bioactivities, including enhanced angiogenesis, antibacterial activity, improved skin appendage regeneration, anti‐tumor effects, wound monitoring, and other multi‐functions.
... However, the binding between protein and ligands is generally affected by series of complex intermolecular interactions [33]. It has been reported that some salt ions play a significant role in decreasing skin inflammation [34], and salts component drugs can be used to treat several skin diseases, for example, salt water is useful to treat atopic dermatitis [35], therefore we study how salt ions affect the affinity of ligands to keratin at molecular scale, which is believed to be beneficial for both cosmetic and healthcare research. Nowadays, scientists are having an increasing interest in investigating the permeation efficiency of targeted small molecules [36][37][38]. ...
... However, the binding between protein and ligands is generally affected by series of complex intermolecular interactions [33]. It has been reported that some salt ions play a significant role in decreasing skin inflammation [34], and salts component drugs can be used to treat several skin diseases, for example, salt water is useful to treat atopic dermatitis [35], therefore we study how salt ions affect the affinity of ligands to keratin at molecular scale, which is believed to be beneficial for both cosmetic and healthcare research. Nowadays, scientists are having an increasing interest in investigating the permeation efficiency of targeted small molecules [36][37][38]. ...
... In the skin, Mg 2+ has functions such as acceleration of tissue repair [4] and suppression of inflammatory response [5]. Bathing in a Mg 2+ -rich Dead Sea salt solution induces several favorable effects, including the improvement of skin barrier function, enhancement of skin hydration, and reduction of inflammation in atopic dry skin [6]. These effects may be caused by the properties of Mg 2+ such as water binding capability. ...
Article
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Magnesium ions (Mg2+) have favorable effects such as the improvement of barrier function and the reduction of inflammation reaction in inflammatory skin diseases. However, its mechanisms have not been fully understood. Microarray analysis has shown that the gene expressions of polyamine synthases are upregulated by MgCl2 supplementation in human HaCaT keratinocytes. Here, we investigated the mechanism and function of polyamine production. The mRNA and protein levels of polyamine synthases were dose-dependently increased by MgCl2 supplementation, which were inhibited by U0126, a MEK inhibitor; CHIR-99021, a glycogen synthase kinase-3 (GSK3) inhibitor; and Naphthol AS-E, a cyclic AMP-response-element-binding protein (CREB) inhibitor. Similarly, reporter activities of polyamine synthases were suppressed by these inhibitors, suggesting that MEK, GSK3, and CREB are involved in the transcriptional regulation of polyamine synthases. Cell viability was reduced by ultraviolet B (UVB) exposure, which was rescued by MgCl2 supplementation. The UVB-induced elevation of reactive oxygen species was attenuated by MgCl2 supplementation, which was inhibited by cysteamine, a polyamine synthase inhibitor. Our data indicate that the expression levels of polyamine synthases are upregulated by MgCl2 supplementation mediated through the activation of the MEK/GSK3/CREB pathway. MgCl2 supplementation may be useful in reducing the UVB-induced oxidative stress in the skin.
... Long term exposure studies highlighted one potential beneficial effect of the seawater mineral extract on human keratinocyte cell biology in that it appreciably slowed the rate of keratinocyte cell proliferation up to concentrations of 0.8%, without inhibiting the process (especially at concentrations between 0.1% to 0.4%). skin hydration and reduced skin roughness, redness, and inflammation of the skin compared to tap water control (4). Both in vitro and in vivo studies reveal that magnesium ions significantly inhibit the antigen-presenting function of human epidermal Langerhans cells (5). ...
Research
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Nutrient poor diets implicated as major contributing factors to many inflammatory skin conditions have contributed to industries looking to the use of trace minerals, with limited success, due to the form, bioavailability and bio-functionality. This study utilises a unique free ion form of Deep Sea Magnesium and Trace Minerals harvested through organic, sustainable methods. These results challenge ideas fundamental to skin health and aging well. Utilising advanced in vitro dermal organotypic modelling of 3D human skin and employing integrative cell and molecular biology techniques we demonstrate Oriel Deep Sea Magnesium Mineral Complex to have potent cell health and functional benefits, including the regulation of genes involved in Dynamic Reciprocity and Tensegrity of the dermis, improving hydration and barrier function.
... Overall, 560 articles were found, but only 152 studies were published after 1980. Research items matching the PICOS criteria were 14 [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Results of studies eligible for inclusion were reported in Table 1. ...
Conference Paper
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The aim of this review was to summarize any evidence-based clinical uses of thalassotherapy. PubMed was searched up to the 15th July 2021 for relevant studies. Overall, 560 articles were found and 14 studies were included in this review. Clinical efficacy of thalassotherapy was mostly tested for skin problems (psoriasis, atopic dermatitis, vitiligo) and rheumatic disorders (fibromyalgia, ankylosing spondylitis). Disease severity and the patients’ quality of life significantly improved after intervention, with the majority of evidence for psoriasis and fibromyalgia. Thalassotherapy can be associated with symptomatic improvements in some health conditions. Further studies on the topic are recommended.
... Due to the lack of basic data such as the distribution of deep seawater resources and the water quality under the jurisdiction, many researches are blocked, which seriously restricts the development space of industrial utilization of deep seawater in China. Therefore, it is urgent to investigate the regional characteristics and water quality characteristics, evaluate the effective utilization of deep seawater resources, promote the development and utilization technology, and enhance the competitiveness of marine science and technology in China [28][29][30]. Deep seawater samples were taken from the central SCS in different depth among 12 stations. The overall objectives of this work were to: (1) analyze content of the temperature, salinity, dissolved oxygen, pH, nutrient salts, essential elements, trace elements, organic elements, chlorophyll and microorganisms; (2) investigate the vertical distribution pattern. ...
Article
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During the investigation in the South China Sea in the summer of 2018, the sea water samples were for temperature, salinity, dissolved oxygen, pH, nutrient salts (NO 3 -N, NO 2 -N, NH 4 -N, PO 4 -P, SiO 3 -Si), essential elements (Na, K, Mg, Ca, Sr, Cl, Br, B), trace elements (Cu, Zn, Fe Mn, Ni, Se, Mo, Co and V), heavy metal (Hg, Pb, As, Cd), organic elements (TOC, DOC, GOC), chlorophyll and microorganisms analyses from different layers of 12 stations according to the standard sampling specifications. The seawater samples of different depths were directly measured by inductively coupled plasma mass spectrometry. The distribution of several elements in the South China Sea water was investigated. It could be seen from the analytical results that the water temperature, salinity, pH, dissolved oxygen, the content of NO 3 -N, PO 4 -P, SiO 3 -Si, K ⁺ , Mg ²⁺ , Ca ²⁺ , Sr ²⁺ , Cl ⁻ , Br ⁻ , B ³⁺ , Zn, Mn, V, Cr, GOC and Chlorophyll was significantly correlated with depth of seawater.
... Atopic dermatitis patients are presented with declined levels of erythrocyte zinc and serum magnesium levels (Makiura et al. 2004). Magnesium supplements are effective by reducing inflammation, enhancing the proliferation and differentiation of epidermal cells, by enhancing skin hydration and dermal permeability (Proksch et al. 2005). Magnesium with ceramides has been beneficial in treating mild to moderate atopic dermatitis (Schwalfenberg and Genuis 2017). ...
Article
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Magnesium (Mg²⁺) is the 2nd most abundant intracellular cation, which participates in various enzymatic reactions; there by regulating vital biological functions. Magnesium (Mg²⁺) can regulate several cations, including sodium, potassium, and calcium; it consequently maintains physiological functions like impulse conduction, blood pressure, heart rhythm, and muscle contraction. But, it doesn’t get much attention in account with its functions, making it a “Forgotten cation”. Like other cations, maintenance of the normal physiological level of Mg²⁺ is important. Its deficiency is associated with various diseases, which point out to the importance of Mg²⁺ as a drug. The roles of Mg²⁺ such as natural calcium antagonist, glutamate NMDA receptor blocker, vasodilator, antioxidant and anti-inflammatory agent are responsible for its therapeutic benefits. Various salts of Mg²⁺ are currently in clinical use, but their application is limited. This review collates all the possible mechanisms behind the behavior of magnesium as a drug at different disease conditions with clinical shreds of evidence.
... Due to the rich nutrients and low temperature characteristics of DOW, it is widely used in various industries, including aquaculture, skin health products, fermented foods, health foods, and medical research applications. [7][8][9]. Especially in health and medical research, DOW is focused on cardiovascular disease and metabolic syndrome in the applied research of medical care. Because of its rich mineral composition, deep ocean water has been pointed out to help improve hyperlipidemia, atherosclerosis, diabetes, obesity, and hypertension [10][11][12][13][14][15][16]. ...
Article
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Accumulated lipid droplets in liver cause nonalcoholic fatty liver disease (NAFLD). Deep ocean water (DOW) containing high levels of magnesium, calcium, and potassium, etc. was proven to suppress hepatic lipid in obese rats fed high fat diet in the previous study. However, the effect of mineral compositions of DOW on the prevention of NAFLD is still unclear. This study removed calcium and potassium from DOW for modulating the mineral composition, and further compared the effects of DOW (D1(Mg + Ca + K)), DOW with low potassium (D2(Mg + Ca)), and DOW with low calcium and potassium (D3(Mg)) on the prevention of NAFLD in the mice model fed with high fat diet. In these results, DOW with high magnesium levels reduced serum and liver triglyceride and cholesterol levels and serum AST and ALT activities. However, when the calcium and/or potassium minerals were removed from DOW, the effects of reduction of triglyceride level, inhibition of acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), and peroxisome proliferator-activated receptor-alpha (PPAR-α) expressions, and activation of superoxide dismutase, catalase, and glutathione reductase activities would be weaker. In conclusion, DOW including magnesium, calcium and potassium minerals has the strongest preventive effect on NAFLD in a mouse model by increasing the antioxidant system and inhibiting fatty acid biosynthesis.
... In a study on AD patients conducted at the Dead Sea [23,24], clearance of skin lesions was observed on 89 and 97% of them following 4 and 6 weeks of balneotherapy, respectively. Moreover, another study [25] has showed that bathing in a Death Sea salt solution can improve skin barrier function and skin hydration as well as reduce inflammation in adult atopic dry skin. Balneotherapy was also reported to be effective for AD in studies conducted at La Roche-Posay Thermal Center [26] and Avène hydrotherapy center [27]. ...
Article
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Background: Several studies have investigated the efficacy of balneotherapy in atopic dermatitis (AD), including a pediatric open randomized clinical trial conducted at the Comano thermal spring water center, which showed a significant reduction in AD severity and an improvement of the quality of life. However, so far many studies on balneotherapy in pediatric AD have included relatively small populations without identifying patients' characteristics associated with their response. The aim of the present study was to identify any features associated with the clinical response to the Comano thermal spring water balneotherapy in a large cohort of pediatric AD patients. Methods: An observational study was conducted on 867 children aged ≤16 years (females 50.5%, mean patient's age 5.9 years, standard deviation ±3.6 years) with mild to severe AD who underwent balneotherapy at the Comano thermal spring water center (Comano, Trentino, Italy) from April to October 2014. Patients were stratified according to their disease severity, which was evaluated using five SCORing Atopic Dermatitis (SCORAD) categories before and immediately after a thermal spring water balneotherapy course. Potential characteristics associated with the patients' clinical response to Comano thermal spring water balneotherapy were investigated. Results: A statistically significant improvement in AD severity was observed after Comano thermal spring water balneotherapy (p < 0.0001). A significantly higher percentage of patients achieving improvement in AD severity was reported among children ≤4 years old (p < 0.0001) with early-onset AD (p < 0.0001), severe AD (p < 0.0001) or coexistent reported food allergies (p < 0.01). The therapy was well tolerated, and no relevant adverse effects were reported during the treatment course. Conclusions: Comano thermal spring water balneotherapy is a safe complementary treatment for pediatric patients with AD, as it was able to reduce the disease severity, especially in children ≤4 years old, with early onset AD, severe AD or concomitant food allergies.
... It has also been reported that salts play an important role in reducing skin inflammation. In treatment of several skin diseases, e.g., atopic dermatitis, application of salt water has been reported to be useful [36,37]. Still, there is limited information of the effects of various salts on the molecular dynamics and organization of stratum corneum components. ...
Article
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The ‘acid mantle’ of the human skin is considered crucial for several protective functions of the skin. It has been associated with numerous biological processes including enzymatic activities and barrier function for diffusional transport. The outer thin layer of the skin– the stratum corneum (SC) - is primarily responsible for the skin barrier function. In this paper, we investigate how the structure and dynamics of SC lipid and protein components are influenced by variations in pH, ionic strength and salt composition. We characterize molecular mobility and organization in pieces of SC exposed to buffer solutions with pH ranging from acidic to neutral to basic conditions. Using solid state NMR we obtain details on molecular dynamics in intact SC at close to atomistic resolution, providing detailed information on the molecular responses. The highest mobility in both lipid and protein components is observed at the lowest pH 4.0. We also study the effects of adding salt, either with monovalent Na⁺ or divalent Mg²⁺ ions at the different pH conditions. Our results provide new understanding how SC molecular properties respond to solution conditions that can be utilized in the development of topical drug delivery and cosmetic formulations.
... This may in part be because the magnesium ion concentration is higher still at 45,900 mg/L, that is a ratio of 0.38. 33 As ion-exchange water softeners remove both calcium and magnesium, along with other divalent cations such as iron, zinc and manganese, this may partly explain the lack of efficacy of water softeners in the treatment of AE. Softened water is different from naturally soft water in both its mineral content and pH, in that softened water retains the alkaline pH of the original hard water, whereas naturally soft water has a lower (more acidic) pH due to lower alkalinity. ...
Article
Background Hard domestic water has been reported to worsen atopic eczema (AE) and may contribute to its development in early life. Objective To review the literature on the relationship between the effect of water hardness (high calcium carbonate; CaCO3) on (a) the risk of developing AE, (b) the treatment of existing AE and (c) skin barrier function in human and animal studies. Design , data sources and eligibility criteria We systematically searched databases (MEDLINE, Embase, Cochrane CENTRAL, GREAT and Web of Science) from inception until 30/6/2020. Human and animal observational and experimental studies were included. The primary outcomes were risk of AE and skin barrier function. Studies were meta‐analysed using a random effects model. Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Sixteen studies were included. Pooled observational data from seven studies on 385,901 participants identified increased odds of AE in children exposed to harder versus softer water (odds ratio 1.28, 95% CI 1.09, 1.50; GRADE certainty: very low). Two mechanistic studies in humans reported higher deposition of the detergent sodium lauryl sulphate in those exposed to harder versus softer water. Two randomized controlled trials comparing water softeners with standard care did not show a significant difference in objective AE severity with softened water (standardized mean difference 0.06 standard deviations higher, 95% CI 0.16 lower to 0.27 higher; GRADE certainty: moderate). Conclusions & Clinical Relevance There was a positive association between living in a hard water (range: 76 to > 350 mg/L CaCO3) area and AE in children. There is no evidence that domestic water softeners improve objective disease severity in established AE. There may be a role of water hardness in the initiation of skin inflammation in early life, but there is a need for further longitudinal and interventional studies.
... Several studies proved such a combined treatment more efficient in psoriatic patients than phototherapy alone Gambichler et al., 2000;Schiener et al., 2007). Proksch et al. (2005) gave evidence that bathing in Dead sea waters led to enhancement of stratum corneum hydration, improvement of skin barrier function and reduction of skin roughness and inflammation in patients suffering from atopic dermatitis. Authors attributed these effects to the high content of magnesium. ...
Article
Skin constitutes a barrier protecting the organism against physical and chemical factors. Therefore, it is constantly exposed to the xenobiotics, including inorganic ions that are ubiquitous in the environment. Some of them play important roles in homeostasis and regulatory functions of the body, also in the skin, while others can be considered dangerous. Many authors have shown that inorganic ions could penetrate inside the skin and possibly induce local effects. In this review, we give an account of the current knowledge on the effects of skin exposure to inorganic ions. Beneficial effects on skin conditions related to the use of thermal spring waters are discussed together with the application of aluminium in underarm hygiene products and silver salts in treatment of difficult wounds. Finally, the potential consequences of dermal exposure to topical sensitizers and harmful heavy ions including radionuclides are discussed.
... Bathing or NS soaks improve skin barrier function, enhance stratum corneum hydration, and reduce dryness and inflammation. 27 In addition, NaCl solution has a weak antiseptic role 26,28 and reduces the load of Staphylococcus aureus in atopic skin 29,30 ; thus, two crucial pathogenetic features of atopic dermatitis are dealt with. ...
Article
Background Saline, with its different concentrations, is the most used crystalloid solution in medicine. In dermatology, no large studies investigated the benefits of saline. The aim of this article is to review the different possible uses of saline in dermatology, in order to give final recommendations based on the literature review and our experience. Methods We performed a literature search based on PubMed, EMBASE, WHO Global Health Library, Virtual Health Library, Web of Science, Scopus, Google Scholar, and Research gate. using the keywords: saline, physiological, hypertonic, isotonic, hypotonic, salt solution, sodium chloride, 0.9% NaCl, solvent, drug delivery, injection mixtures, diluent, sclerosant, intravenous, intralesional, injection, topical, soaks, fomentation, inhalation, alopecia, psoriasis, scars, atopic dermatitis, eczema, bromoderma, iododerma, lipodystrophy, in various combinations with the Boolean operators AND, OR and NOT. We also hand‐searched textbooks. Results Saline was used as a diluent with intralesional injection of steroids to minimize the risk of steroid‐induced atrophy, being safe and free from preservatives that may precipitate steroids at site of injection and maximize their side effects. Saline has also been used after surgery, when atrophic scars take place or anticipated, and through injection in leishmaniasis, granuloma annulare, atrophic acne scars before using other expensive and less tolerated treatment options. Conclusions The saline represents a helpful option as a diluent with intralesional injection of steroids in various dermatologic therapeutic indications. Moreover, the use of saline in this setting could help to minimize the risk of steroid‐induced atrophy. We encourage the use of saline after surgery, when atrophic scars take place or anticipated. Also, we encourage a trial of saline injection in leishmaniasis, granuloma annulare, atrophic acne scars before using other expensive and less tolerated treatment options.
... 200 This element is emerging as a key player in many physiological functions, for instance, promoting bone formation, protein, and nucleic acid synthesis, adenosine triphosphate (ATP) metabolism, contraction and relaxation of muscle, normal heart rhythm, and activation of vitamin D. 200,201 In the epidermis of the normal skin, a higher concentration of magnesium is located in the stratum corneum layer compared to lower layers of the epidermis, which is associated with the regulatory role of magnesium ions in epidermal proliferation, differentiation, and barrier functions of the skin. 202,203 It is reported that the release of Mg 2+ and Si 4+ ions from Mg-smectite clay mineral can promote healing by accelerating neovascularization, re-epithelialization, and also collagen maturation in full-thickness skin wound of rats. 204 6.8. ...
Article
The morbidity, mortality, and burden of burn victims and patients with severe diabetic wounds are still high, which leads to an extensively growing demand for novel treatments with high clinical efficacy. Biomaterial-based wound treatment approaches have progressed over time from simple cotton wool dressings to advanced skin substitutes containing cells and growth factors; however, no wound care approach is yet completely satisfying. Bioactive glasses are materials with potential in many areas that exhibit unique features in biomedical applications. Today, bioactive glasses are not only amorphous solid structures that can be used as a substitute in hard tissue but also are promising materials for soft tissue regeneration and wound healing applications. Biologically active elements such as Ag, B, Ca, Ce, Co, Cu, Ga, Mg, Se, Sr, and Zn can be incorporated in glass networks; hence, the superiority of these multifunctional materials over current materials results from their ability to release multiple therapeutic ions in the wound environment, which target different stages of the wound healing process. Bioactive glasses and their dissolution products have high potency for inducing angiogenesis and exerting several biological impacts on cell functions, which are involved in wound healing and some other features that are valuable in wound healing applications, namely hemostatic and antibacterial properties. In this review, we focus on skin structure, the dynamic process of wound healing in injured skin, and existing wound care approaches. The basic concepts of bioactive glasses are reviewed to better understand the relationship between glass structure and its properties. We illustrate the active role of bioactive glasses in wound repair and regeneration. Finally, research studies that have used bioactive glasses in wound healing applications are summarized and the future trends in this field are elaborated.
... To these mechanisms of action as described above, we must add a specific one: its of, shower-type effect, mechanically sweeping much of the cellular waste from the eye surface, and the hyperosmolarisation of electrolytes and pro-inflammatory molecules and cells (IL-1 beta, IL-6, IL-8 and MMP-3, especially MMP-9, TNF and macrophages and T lymphocytes). The efficacy of seawater has already been previously documented, in addition to DED (8), in other dry and inflammatory diseases of the human body (dermatitis, trophic ulcers of the skin, atopic rhinitis [14] [15] [16]. A previous study [8] showed that seawater reduces the presence of the pro-inflammatory molecules IL-1 beta and IL-6 to levels almost similar to those of the normal population without dry eye. ...
... There are reports of beneficial effects on skin barrier function with extracts prepared from bluelagoon silica mud [185] and Dead sea salts [186], indicating possible positive effects of climatotherapy. ...
... There is an interest in topical Mg ++ administration in dermatology as it reduces inflammation. Topical Mg ++ is known to bind water, influence epidermal proliferation and differentiation, and enhance permeability barrier repair [15,16]. Magnesium is used, e.g., in atopic dermatitis. ...
Article
Magnesium (Mg⁺⁺) contributes to several normal physiological functions. Some topical Mg++ products are marketed for Mg⁺⁺ deficiency, but the rate and extent of topical Mg⁺⁺ absorption are not known. Our aim was to compare the permeation of Mg⁺⁺ across porcine skin from 1 % (m/m) Mg⁺⁺ creams with and without levomenthol. Permeability studies were performed with the Franz cell model, and the Mg⁺⁺ concentrations were quantified with inductively coupled plasma-mass spectrometry. The flux of Mg⁺⁺ across porcine skin was higher with levomenthol-based cream, for a median value of 29.7 μg/ cm²/32 hr, than that from the cream without menthol, which was 6.2 μg/cm²/32 hr. The median apparent permeability (Papp) value was 2.6·10⁻⁸ cm/sec (range 0.44 - 8.1) from levomenthol-based cream and 0.9·10⁻⁸ cm/sec (range 0.1 - 3.8) from the cream without menthol. This study confirmed that Mg⁺⁺ can permeate through porcine skin and that coadministration with levomenthol substantially enhanced the permeability.
... Magnesium Magnesium assists in the activation of vitamin D, which in turn regulates serum calcium and phosphate levels and facilitates immune function; this element has thus been widely studied for its relationship with AD [227]. Magnesium itself also exhibits antiinflammatory activity on the skin and improves skin barrier function by participating in cell proliferation and differentiation [228,229]. In a small-scale children's study, AD patients had significantly lower serum magnesium level compared with the controls (p = 0.007). ...
Article
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Atopic dermatitis (AD) is the leading chronic skin inflammatory disease and the initial manifestation of atopic march. Available evidence supports the notion that primary prevention early in life leads to a decreased incidence of AD, thus possibly decreasing the subsequent occurrence of atopic march. Nutritional status is essential to a proper functioning immune system and is valued for its important role in AD. Essential nutrients, which include carbohydrates, proteins, lipids, vitamins, and minerals, are transferred from the mother to the fetus through the placenta during gestation. Various nutrients, such as polyunsaturated fatty acids (PUFAs) and vitamin D, were studied in relation to maternal status and offspring allergy. However, no strong evidence indicates that a single nutrient or food in mothers’ diet significantly affects the risk of childhood AD. In the light of current evidence, mothers should not either increase nor avoid consuming these nutrients to prevent or ameliorate allergic diseases in their offspring. Each essential nutrient has an important role in fetal development, and current government recommendations suggest specific intake amounts for pregnant women. This review discusses evidence on how various nutrients, including lipids (monounsaturated fatty acids, PUFAs, saturated fatty acids, and short-chain fatty acids), carbohydrates (oligosaccharides and polysaccharides), proteins, vitamins (A, B, C, D, and E), and trace minerals (magnesium, iron, zinc, copper, selenium, and strontium) in maternal status are associated with the development of AD and their possible mechanisms.
... Calcium-and magnesium-rich TSW are known to improve skin barrier function and accelerate wound healing [20,21]. Moreover, they have soothing and protective properties in sensitive skin (antioxidant or anti-ageing) that are enhanced by the presence of trace elements such as selenium, strontium and zinc [22][23][24]. ...
Article
Objective: Thermal spring waters (TSW) are commonly used as active ingredients in cosmetics. Their biological activities directly depend on the ionic composition of the spring. However, in order to exhibit beneficial properties, the minerals need to reach viable skin layers. The present study addresses the incorporation of marketed TSW in model cosmetic formulations and the impact of the formulation on skin absorption of magnesium and calcium ions that are known to improve skin barrier function. Methods: Marketed TSW was introduced into five formulations. Liposomes were prepared using saturated or unsaturated phospholipids mixed with cholesterol by the thin layer evaporation technique. Emulsions water-in-oil (W/O), oil-in-water (O/W) or double: water-in-oil-in-water (W/O/W) were prepared by high shear mixing. Skin absorption of Mg2+ and Ca2+ from those formulations was studied in vitro using static Franz diffusion cells under infinite dose condition and under occlusion of the apparatus. Results: Mg2+ and Ca2+ penetrate skin samples from TSW. Encapsulating TSW into double emulsion (TSW/O/W) increased skin absorption of both cations of interest and kept the Ca2+ /Mg2+ ratio equal to that of TSW in each skin layer. The dermal absorption of Mg2+ from the double emulsion departs from both single emulsions. Application of liposome suspension improved the skin absorption of Ca2+ while keeping constant that of Mg2+ , leading to unbalanced Ca2+ /Mg2+ ratio inside skin. Conclusion: The beneficial effects of TSW are not only due to their action on the skin surface. Their active components, especially Ca2+ and Mg2+ cations reach viable skin layers in a formulation-dependent manner. The distribution of ions inside skin depends on the type of formulation.
... 27,28 It has also been shown to reduce the inflammation of the atopic dry skin. 29,30 Moreover, it has been described the protective ultraviolet B (UVB) effects that the unique composition of minerals in the DSW can confer. 31 DSW minerals composition have also been found to stimulate cell proliferation and mitochondrial activity, decrease the expression of some aging markers, and limit apoptotic damage after UVB irradiation in keratinocytes and human skin. ...
Article
Millions of people suffer from different types of skin diseases worldwide. In the last decade, the development of nanocarriers has been the focus of the pharmaceutical and cosmetic industries to enhance the performance of their products, and to meet consumers’ demands. Several delivery systems have been developed to improve the efficiency and minimize possible side effects. In this study, retinyl palmitate and Dead Sea water loaded nanoemulsions were developed as carriers to treat skin conditions such as photoaging, psoriasis, or atopic dermatitis. Toxicity profiles were carried out by means of viability, cell membrane asymmetry study, evaluation of oxidative stress induction (reactive oxygen species), and inflammation via cytokines production with a human keratinocyte cell line (HaCaT) and a mouse embryo fibroblasts cell line (BALB/3T3). Results showed that loaded nanoemulsions were found to be non-cytotoxic under the conditions of the study. Furthermore, no oxidative stress induction was observed. Likewise, an efficacy test of these loaded nanoemulsions was also tested on human skin organ cultures, before and after ultraviolet B light treatment. Viability and caspase-3 production assessment, in response to the exposure of skin explants to the loaded nanoemulsions, indicated non-toxic effects on human skin in culture, both with and without ultraviolet B irradiation. Further the ability of loaded nanoemulsions to protect the skin against ultraviolet B damage was assessed on skin explants reducing significantly the apoptotic activation after ultraviolet B irradiation. Our promising results indicate that the developed loaded nanoemulsions may represent a topical drug delivery system to be used as an alternative treatment for recurrent skin diseases.
... In addition, we did not find a statistical difference in skin hydration between WM and DM, a finding that has previously been demonstrated. 51 Although the improvement in AD seen with WM does not seem to be related to increased SC hydration, we did not measure TEWL, which is considered a better biomarker of skin barrier function. 16,17 Thus, it is possible that Figure 2 and Table II). ...
Article
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Background: Studies evaluating bathing frequency in pediatric atopic dermatitis (AD) are limited. Parents of children with AD often receive conflicting information, leading to frustration and confusion. Objective: To evaluate efficacy of twice-daily, soaking baths, followed by immediate application of an occlusive moisturizer (i.e. soak-and-seal [SS]), versus twice-weekly SS baths, in the acute management of pediatric AD. Methods: We conducted a randomized, single-blind, crossover-controlled trial comparing frequent versus infrequent SS baths, in children 6 months to 11 years of age with moderate-to-severe AD. Children were randomized 1:1 into 2 groups: Group 1 underwent twice-weekly SS baths, for 10-minutes or less, over 2-weeks ("dry method" - DM) followed by twice-daily SS baths, for 15-20 minutes, over 2-weeks ("wet method" - WM). Group 2 did the inverse. Patients received the same moisturizer, cleanser, and low-potency topical corticosteroid (TCS). Primary outcome was AD severity evaluated using SCORing Atopic Dermatitis (SCORAD) index. Caregiver assessment of AD severity (Atopic Dermatitis Quickscore - ADQ), quality of life, Staphylococcal aureus colonization, skin hydration, moisturizer and TCS usage were assessed. Results: Of the 63 children screened, 42 fulfilled inclusion criteria and were randomized. Forty (95%) completed the study. WM decreased SCORAD by 21.2 compared with DM (95% CI, 14.9 to 27.6; P<0.0001). Secondary analysis showed a greater than 30% SCORAD improvement for WM versus DM (McNemar's χ2=8.83, df=1, p=0.0030). SCORAD correlated with ADQ (r=0.66), and ADQ also showed significant improvement with WM decreasing ADQ by 5.8 (95% CI, 1.8 to 9.7). No other secondary endpoints showed significance. Conclusions: As an acute treatment intervention, WM is superior to DM at improving disease severity in moderate-to-severe pediatric AD.
... Mg 2+ ions are of special interest because they are essential in the metabolism at a biochemical level, such as protein synthesis, muscle function, nervous and immune system [6,7]. Several authors have reported that Mg 2+ ions promote skin tissue renewal , improve skin barrier function, enhance skin hydration, and regulate epidermal proliferation and differentiation [8][9][10]. Additionally, the released Mg 2+ ions present an extraordinary biological response, promoting the formation of collagen in skin wounds [4]. ...
Article
During recent years, Mg reinforced polylactic acid (PLA) composites have emerged as potential biocompatible and bioabsorbable materials for biomedical applications. It has been shown that Mg particles added to a matrix based on a biodegradable polymer can address the lack of bioactivity and the low mechanical properties of the polymers and, furthermore, it can counteract the detrimental effects associated to the high degradation rate of Mg, as alcalinization and elevated H2 release. Additionally, the polymer can protect the Mg particles, by tailoring their degradation rate. Former processing of these composites performed by extrusion, compression and injection molding employed Mg contents up to 10 wt.%. Higher amounts of Mg resulted in heterogeneous materials and thermally degraded matrices, with the corresponding higher degradation rate. In the present work, Mg reinforced PLA films with Mg content as high as 50 wt.% were obtained without compromising the thermal stability of the polymer. Firstly, a successful dispersion of Mg microparticles was achieved by a breakthrough in processing introducing a colloidal step where organic additives were added to modify the Mg particle surface and promote a chemically stable suspension. The resulting colloidal suspension was then used as feedstock to obtain composite films by tape casting. The films show advantageous in vitro behaviour in terms of degradation, hydrogen release and oxygen permeability. In addition, the viability with fibroblastic cells (MEF) opens a window of opportunity for these composite films as bioabsorbable material for tissue engineering and wound dressing applications. STATEMENT OF SIGNIFICANCE: Magnesium materials have extraordinary biodegradable properties and bioactive behavior due to release of Mg2+ ions, which offer a promising opportunity for their applicability as biomaterials for tissue regeneration. However, Mg is one of the most reactive metals with a high degradation rate. In contact with water produces H2, associated with a risk of failure of the implant. One alternative to minimize this drawback is the use of Mg particles surrounded by a biodegradable biocompatible polymer such as polylactic acid (PLA) to obtain PLA/Mg composites. In this work we processed Mg reinforced PLA in the shape of films that would be suitable for tissue regeneration. In vitro behavior of PLA/Mg films demonstrated that Mg2+ ions increase the fibroblastic cells growth.
Chapter
Over the last decades, different compositions of bioactive glasses in various forms of nano/microparticles, fibers, and 3D scaffolds have been proposed as multifunctional therapeutic materials to induce biological responses in soft tissues, including skin wounds. The superiority of bioactive glasses over the other materials is the possibility of incorporating multiple biologically active elements such as cerium, cobalt, copper, gallium, selenium, silver, and zinc in their structure, which can target different stages of the wound healing process following the release of these therapeutic ions in the wound environment. Since no wound care approach is yet completely satisfying, diverse biomaterial‐based wound care approaches are already under development to address the unfulfilled clinical needs of patients with severe burn injuries and chronic wounds. In this regard, the use of bioactive glasses seems to be an effective approach in complementing the current role of polymeric biomaterials in wound healing applications. The purpose of this chapter is to focus on the application of bioactive glasses in the healing process and particularly their specific biological effects in the wound bed, which may facilitate the healing of hard‐to‐heal wounds.
Article
Reconstruction of the microenvironment at the site of injury plays an important role in tissue regeneration and functional recovery. With calcium magnesium phosphate (MCPC) as a model, the effects of MCPC on the vascularization and neurotization in the process of wound regeneration were investigated. Herein, a series of MCPC/hydrogels with different concentrations (0–4%) of MCPC were synthesized. The results showed that MCPC could stimulate the migration behavior of vascular endothelial cells (HUVECs) and up-regulate the expression of VEGF and HIF-1α genes. Further in vivo results revealed that MCPC/hydrogels significantly improved wound healing and blood vessel formation. In addition, we demonstrated that MCPC/hydrogels could also largely accelerate the regeneration of nerves, which would finally contribute to wound healing due to the proper release of magnesium and calcium ions. This research also provides an insight toward the positive role of MCPC in vascular and nerve reconstruction during wound healing.
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Photodermatology
Research
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Dietary macro and trace minerals like magnesium, calcium, copper, zinc, nickel and manganese are nutrients critical to human skin and general health, performance and welfare. Skin health and nutrition for immunity, cardiovascular, gastrointestinal and reproductive health, to name a few, depend on optimal macro and trace mineral nutrition. In recent years, magnesium is proving to be far and above the most important of these minerals, playing an important role in skin, hair and general health and wellbeing.
Chapter
Conventional treatments for atopic dermatitis include topical corticosteroids, emollients, and topical and/or systemic immunomodulators (e.g., dupilumab). However, there is an increasing interest and demand from patients for alternative therapies. In this chapter, we discuss CAM approaches with clinical evidence in atopic dermatitis. Topics discussed include topical and oral oils, topical and oral micronutrients, bathing additives, fabrics, and topical endocannabinoids. Evidence-based CAM therapies can be strategically integrated with conventional therapies to augment response in appropriate cases.
Article
Novel magnesium doped non-mulberry silk fibroin nanofibers with ability to enhance skin barrier function were successfully fabricated using electrospinning technique for wound healing applications. Magnesium nanoparticles incorporated in the electrospun nanofibers releases Mg ²⁺ ions at the site of implementation. The effect of Mg ²⁺ is of considerable concern in wound healing due to its skin barrier repair ability and its role in blood coagulation. The physicochemical characterization of the scaffold was investigated by determining the morphology and secondary structure confirmation. The effects of Mg ²⁺ ions in silk fibroin microenvironment have been evaluated using SEM, XRD, and FTIR to confirm the incorporation of magnesium in the film. The aim of this study is to see the effect of doped Mg on the structural, physical, and biological properties of non-mulberry silk fibroin (NSF) film. The magnesium doped nanofibrous film exhibited enhanced mechanical property, satisfactory blood clotting ability, and good in vitro degradability. This silk fibroin-based film mimicking extracellular matrix for skin regeneration were constructed using electrospinning technique. The wound healing efficiency of prepared nanofibers were evaluated in full-thickness wound models of rat. The Mg doped silk fibroin film exhibited faster wound healing activity (14 days) among all experimental group. The study indicates the potential of magnesium-doped silk /PVA film as skin substitute film.
Article
The development of an external gel containing purified bischofite will allow the scars treatment in the stage of prevention and formation due to the effect on various links of pathological wound healing. This study’s aim was the development of a gel with bischofite for the scars prevention and treatment. Bischofite brine from the purified Volgograd deposit was selected as the active pharmaceutical substance. Polymer gelling agents: methylcellulose-100, sodium carboxymethyl cellulose, hydroxymethyl cellulose, aerosil, Tizol®. The QTPP requirements for developed bischofite gel are aimed at effective wound healing and prevention of pathological scarring, which corresponds to the ointments used at the III stage of the wound process. Comprehensive technological studies of model samples of gels with bischofite were carried out: determination of external signs and the application to the skin, smearing, thermal stability and pH, study of osmotic activity and release of bischofite (in terms of magnesium ions). The maximum amount (8 points) was observed in the composition using the Tizol® gel-forming agent, the model sample based on it provided the maximum degree of release, minimal osmotic activity, and good smearing. In addition, Tizol® possesses anti-inflammatory activity. The optimal concentration of the aqueous phase is justified by the assessment of the consistency properties, the spreadability and rheological properties. Thus, as a result the composition of the bischofite gel was developed using Tizol® as a base, containing glycerin as a plasticizer and a moisture agent, the preservative sodium benzoate and purified water.
Chapter
Besides chemical composition, the water temperature at the emergence site is, as a rule, a requisite for traditional crenotherapy/balneotherapy practice officially recognized in many European countries as a clinically effective complementary approach in the treatment of low-grade inflammation and stress-related pathologies, the absorption of biologically active inorganic and organic substances through the skin playing an effective role, although the mechanisms of action still remain matter of scientific discussion. The history of balneotherapy and of thermalism, i.e. the economic activity addressed to the prevention, therapy, rehabilitation and wellness provided by the use of hot or warm natural mineral water in thermal resorts or health resort medicine spas. This chapter reports the natural requisites of natural mineral water and spring water to be used in health resort medicine, employing the traditional methods and practices of hydrotherapy, crenotherapy and climatotherapy at the balnearies or bathhouses of the so-called health resort spas.
Article
The introduction of salt as a therapeutic agent in dermatological disorders has been in use since ancient times. This ubiquitous agent is the most underrated substance after the advent of modern medicine. Though a commonly used agent in both traditional and modern medicine, it is important to understand its relationship to the skin to further enhance the comprehensive benefit. The complex history of the evolution of medicine and its skewed distribution among the countries of the world led to inclusion of locally available and economical agents into therapeutics as it becomes almost an inevitable need. Moreover, an inadequate knowledge about the harmful effects of chronic salt exposure led salt to have a unique role in occupational dermatoses. There is no adequate literature on both detrimental and therapeutic effects of salt and its relation to skin. Hence, a genuine attempt was made to summarize the known and the lesser known facts of this particular common seasoning agent.
Chapter
The treatment of and rehabilitation methods in contact dermatitis and the evidence supporting them are presented, following the “rule of the four Rs”: recognize (the causative allergic/irritant agent), remove (the irritant/allergen), reduce inflammation, and restore the skin barrier. Avoidance of the inducing allergen(s) and/or irritant(s) is the most important aspect in the management of contact dermatitis, and the different measures are reviewed. The principles of basic topical therapy and the treatment modalities – topical corticosteroids, topical calcineurin inhibitors, retinoids, phototherapy, X-ray therapy, and systemic corticosteroids and immunosuppressive agents – are described. Their effects on the skin barrier function, as well as those of moisturizers and other factors influencing barrier recovery, are examined separately.
Thesis
Human skin forms a unique interface between the body and the external environment. Its main role is to protect the internal organs from external factors. Its highly hydrophobic outermost layer, stratum corneum, has long been believed impermeable for highly hydrophilic compounds, including ions. Several studies proved this concept wrong, and recent research by Paweloszek et al. demonstrated the important contribution of facilitated transport in permeation of halide anions. Skin penetration of anions classified in Hofmeister series (of F-, Br-, I-, SCN, ClO4-) alone and in bi- and ternary mixtures in two experimental series was studied in vitro. All tested ions permeated viable skin within 24h. Among halides, the presence of F- reduced the penetration of Br- and I- in mixtures, and synergy between Br- and I- was observed. Within the second group (I-, SCN-, ClO4-) the inhibition of ClO4- penetration in the presence of other ions was observed. Finally, the impact of formulation of marketed thermal spring water (TSW) into emulsions (TSW/O, O/TSW, TSW/O/W) and liposomes on skin absorption of Ca2+ and Mg2+ was evaluated. Liposomes and emulsions promoted retention of Ca2+ and Mg2+ in skin layers as compared to TSW. Our results prove that the beneficial effects observed during treatment with TSW are associated with penetration of the minerals into and through the skin and are not only a surface action. In this thesis, we demonstrate the possibility of both anions and cations to penetrate viable skin in vitro, and we disclose the effects of mixing and formulating on skin penetration profiles
Article
Based on their chemical composition, salus per aquam (spa) mineral waters (or medical mineral waters) can be classified as sulphurous, sulphate, bicarbonate etc. Sulphate mineral waters where the predominant element is sulphate anion SO 4²⁻ , are frequently used in clinical therapy. In this review, we describe and analyze the current scientific knowledge concerning the therapeutic effect of sulphate mineral waters in the treatment of several disorders. Moreover, we underline how important is to integrate spa treatments with other therapeutic approaches to meet the various needs that can arise during a specific pathological state. © 2019 Center for Food and Biomolecules, National Taiwan University
Article
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Background/aims: Topometry is one of the most relevant methods for biophysical research on skin in dermatologic and cosmetic science, because it relates very closely to the perceived quality of skin. Taking silicon replicas of skin sites under investigation and measuring those imprints with mechanical or optical profilometers is still the most frequently used method. Direct measurement of the topography of human skin in vivo by active image triangulation avoids the need to make replicas and seems to be a promising alternative.
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Topical solvent treatment removes lipids from the stratum corneum leading to a marked increase in transepidermal water loss (TEWL). This disturbance stimulates a variety of metabolic changes in the epidermis leading to rapid repair of the barrier defect. Using an immersion system we explored the nature of the signal leading to barrier repair in intact mice. Initial experiments using hypotonic to hypertonic solutions showed that water transit per se was not the crucial signal. However, addition of calcium at concentrations as low as 0.01 mM inhibited barrier repair. Moreover, both verapamil and nifedipine, which block calcium transport into cells, prevented the calcium-induced inhibition of TEWL recovery. Additionally, trifluoroperazine or N-6-aminohexyl-5-chloro-1-naphthalenesulfonamide, which inhibit calmodulin, prevented the calcium-induced inhibition of TEWL recovery. Although these results suggest an important role for calcium in barrier homeostasis, calcium alone was only modestly effective in inhibiting TEWL recovery. Potassium alone (10 mM) and phosphate alone (5 mM) also produced a modest inhibition of barrier repair. Together, however, calcium and potassium produced a synergistic inhibition of barrier repair (control 50% recovery vs. calcium + potassium 0-11% recovery in 2.5 h). Furthermore, in addition to inhibiting TEWL recovery, calcium and potassium also prevented the characteristic increase in 3-hydroxy-3-glutaryl CoA reductase activity that occurs after barrier disruption. Finally, the return of lipids to the stratum corneum was also blocked by calcium and potassium. These results demonstrate that the repair of the epidermal permeability barrier after solvent disruption can be prevented by calcium, potassium, and phosphate. The repair process may be signalled by a decrease in the concentrations of these ions in the upper epidermis resulting from increased water flux leading to passive loss of these ions.
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The influence of tap-water (TW) and salt solutions on the minimal erythema dose (MED) was investigated for normal human skin and uninvolved skin of psoriasis patients. MED (UVB) determinations on the forearm revealed that: (1) the MED definitely decreases whenever the arm is immersed in TW or NaCl solutions with a low concentration (4%) prior to UVB exposure, whereas almost saturated NaCl solution (26%), as well as locum Dead Sea water (LDSW), do not produce a change in the MED, and (2) the decrease in MED obtained by wetting the skin with TW was no longer present when the skin was allowed to dry for 20 min. A decrease in water uptake by skin (in vivo) and by callus (in vitro) was found as the salt concentration of the external solution increased. It is proposed that water taken up by the skin plays an important role in the sensitivity of the skin to UVB exposure. Bathing in TW or 4% NaCl prior to UVB exposure offered a slight to moderate improvement in psoriasis over UVB irradiation alone. Finally, it was shown that there is no obvious difference in clearance of the psoriatic skin between a bath in TW, 4% NaCl, or LDSW prior to UVB exposure.
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To gain a better understanding of the interaction of the model detergent sodium lauryl sulfate (SLS) with the stratum corneum, we investigated systematically the ultrastructural changes of the epidermal barrier and the nucleated parts of the epidermis after the occluded application of different concentrations of SLS in human. Different application models were investigated. Two of the three irritation procedures (long duration exposure and the repetitive exposure for 3 d) provoked damage of the nucleated parts of the epidermis and alterations of the lower parts of the stratum corneum. Here, the extrusion and transformation of lamellar body derived lipids into lamellar lipid bilayers were disturbed; however, the upper portions of stratum corneum displayed intact intercellular lipid layers that contradict the long-standing belief that surfactants damage the skin by delipidization. Furthermore, we investigated ultrastructurally and by measurement of transepidermal water loss the influence and protective capacity of a lipophilic barrier cream on acute irritant contact dermatitis. The irritant contact dermatitis was induced by the standardized cumulative short application model with two SLS concentrations (0.5% and 0.75%). The cumulative type of exposure simulates daily living more realistically. Because most of the previous tests have been performed on the human forearm or back, we analyzed whether the pattern of response was similar on both sites. The back showed a higher level of irritant reaction, but the pattern of irritant response proved to be similar to the forearm. Application of the barrier cream before and during irritation showed a decrease of transepidermal water loss enhancement with 0.5% SLS by 58% (back) and 49% (arm) and after irritation with 0.75% SLS by 56% (back) and 43% (arm). Because the experimental result correlated with the clinical experience, the development of the cumulative short exposure model might help to predict and to discriminate the efficacy of barrier creams.
Article
Using the crotonoil test, anti-inflammatory effects of magnesium chloride-containing ointments were compared with those of steroid-containing ointments. Our results: Magnesium-chloride-containing ointments can significantly inhibit the croton-oil-induced inflammation (15% magnesium chloride: 58.2% inhibition, p < 0.001; 7% magnesium chloride: 49.9% inhibition, p < 0.01). These ointments inhibit like a 0.5% hydrocortisone-containing ointment.
Chapter
The epidermal permeability barrier resides in the stratum corneum (SC), a heterogeneous, two-compartment tissue. Whereas the cells (corneocytes) of the SC are lipid-depleted, they are embedded in a continuous, lipid-enriched extracellular matrix organized into characteristic, multilamellar membrane unit structures, which mediate barrier function (22). The formation of the permeability barrier is the goal of epidermal proliferation and differentiation, processes that begin in the basal layer. The quantitatively most important cell type of the epidermis, the keratinocyte, derives from stem cells, and en route to the SC it synthesizes specific basal (K5 and K14) and suprabasal (K1 and K10) keratins, as well as cornified envelope (CE)-associated proteins (20). The CE begins to form with the deposition and cross-linking of involucrin and envoplakin on the intracellular surface of the plasma membrane in the upper spinous and granular cell layers of the epidermis. The process begins at or near desmosomal sites, followed by the subjacent addition of elafin, small prolin-rich proteins, and loricrin. With cornification, the phospholipid-enriched plasma membrane disappears, followed by the formation of a ceramide-containing membrane bilayer (see below), which is covalently attached to involucrin, envoplakin, and periplakin moieties on the extracellular surface of the CE by ω-hydroxyester bonds (57).
Article
At the Dead Sea spas, which are 400 m below sea level, both the ultraviolet radiation from the sun and the mineral-rich waters of the lake have special features. The separate influence of these two factors was studied in 81 patients with psoriasis. The condition was assessed during 4 weeks of treatment using the psoriasis area and severity index (PASI). In subjects who only bathed in Dead Sea water the improvement was 28%, in those who only sunbathed it was 73%, and in those who did both it was 83%. The main therapeutic factor was thus shown to be sun exposure, possibly enhanced by bathing in Dead Sea water. Similar degrees of improvement in spring, summer and autumn led to speculation about the optimum dose of solar radiation needed.
Article
We have demonstrated recently that shifts in the concentrations of extracellular Mg++ and Ca++ occur during cutaneous injury in viva. These shifts correlate well with the timing of migration of various cell types involved in wound healing, including keratinocytes, In the present study, we examined the potential of such cation shifts to activate the keratinocyte migratory phenotype. In modified Boyden chamber migration assays, α2β1 integrin-mediated migration of human keratinocytes (HaCaT) on type I collagen was supported by Mg++ but not by Ca++ alone. Migration could be increased up to twofold, however, by using both cations in combination, as long as the Mg++ concentration was in the optimal range for migration in Mg++ only (1–3 mM) and Ca++ was present at concentrations of approximately 0.1–1 mM, Further examination of this divalent-cation-induced migratory keratinocyte phenotype demonstrated that, as Mg++ is elevated and Ca++ is reduced, mature E-cadherin and cell-cell contacts are reduced and the α2β1 integrin is redistributed from cell-cell contacts to the periphery. These in vitro observations corroborate what occurs in vivo at the keratinocyte migrating front during wound healing. Together these data suggest that changes in the concentrations of extracellular Mg++ and Ca++ can regulate the competitive interplay between Ca++-dependent E-cadherin-mediated and Mg++-dependent α2β1-integrin-mediated adhesion, promoting the development of an activated keratinocyte phenotype.
Article
In previous studies we have shown that experimental permeability barrier disruption leads to an increase in epidermal lipid and DNA synthesis. Here we investigate whether barrier disruption also influences keratins and cornified envelope proteins as major structural keratinocyte proteins. Cutaneous barrier disruption was achieved in hairless mouse skin by treatments with acetone occlusion, sodium dodecyl sulfate, or tape-stripping. As a chronic model for barrier disruption, we used essential fatty acid deficient mice. Epidermal keratins were determined by one- and two-dimensional gel electrophoresis, immunoblots, and anti-keratin antibodies in biopsy samples. In addition, the expression of the cornified envelope proteins loricrin and involucrin after barrier disruption was determined by specific antibodies in human skin. Acute as well as chronic barrier disruption resulted in the induction of the expression of keratins K6, K16, and K17. Occlusion after acute disruption led to a slight reduction of keratin K6 and K16 expression. Expression of basal keratins K5 and K14 was reduced after both methods of barrier disruption. Suprabasal keratin K10 expression was increased after acute barrier disruption and K1 as well as K10 expression was increased after chronic barrier disruption. Loricrin expression in mouse and in human skin was unchanged after barrier disruption. In contrast, involucrin expression, which was restricted to the granular and upper spinous layers in normal human skin, showed an extension to the lower spinous layers 24 h after acetone treatment. In summary, our results document that acute or chronic barrier disruption leads to expression of keratins K6, K16, and K17 and to a premature expression of involucrin. We suggest that the coordinated regulation of lipid, DNA, keratin, and involucrin synthesis is critical for epidermal permeability barrier function.Keywords: loricrin
Article
Rheinwald and Green's technique is currently the standard method for growing stratifying epidermal cell cultures. The serum free system developed in Ham's laboratory (MCDB 153) was designed to grow keratinocyte monolayers in clonogenic conditions. Our aim was to optimize conditions in serum-free MCDB 153 for culturing epidermal sheets from adult normal skin, and to assess the effect of extracellular calcium and temperature on proliferation and differentiation of cultured keratinocytes. Sixteen strains derived from plastic surgery specimens (mean age of donors 37 years; range 5–89) were used. Primary cultures were seeded at an optimal density of 8 × 104 cells/cm2 in primary cultures and 104 cells/cm2 in secondary cultures in complete medium including EGF, insulin, hydrocortisone and bovine pituitary extract, supplemented with isoleucine, tyrosine, methionine, phenylalanine, tryptophane and histidine.
The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and atopic dermatits were studied and compared. In healthy volunteers increased baseline TEWL and increased light reflection from the skin, interpreted as "fair" skin, was found to be associated with increased susceptibility to SLS. Hand eczema patients were found to have fairer and thinner skin than matched controls. Increased susceptibility to SLS was found only in patients with acute eczema. Patients with atopic dermatitis had increased baseline TEWL as well as increased skin susceptibility as compared to controls. Skin susceptibility is thus influenced by individual- as well as environment-related factors. Knowledge of determinants of skin susceptibility may be useful for the identification of high-risk subjects for development of irritant contact dermatitis, and may help to prevent the formation of the disease.
Article
The relationship between the in vivo irritation potential of sodium lauryl sulfate (SLS) and linear alkyl benzene sulfonate (LAS) and the ability of these two surfactants to remove lipid from the stratum corneum (SC) in vitro were investigated. Either surfactant removes detectable levels of lipids only above its critical micelle concentration (CMC). At high concentrations the surfactants removed only very small amounts of cholesterol, free fatty acid, the esters of those materials, and possibly squalene. SLS and LAS have been shown, below the CMC, to bind to and irritate the SC. Thus, clinical irritation provoked by SLS or LAS is unlikely to be directly linked with extraction of SC lipid. The milder forms of irritation--dryness, tightness, roughness--may involve both surfactant binding to and denaturation of keratin as well as disruption of lipid. Our findings challenge earlier assumptions that surfactants' degreasing of the SC is involved in the induction of erythema.
Article
Water containing high concentrations of magnesium ions (e.g. Dead Sea water) is effective in the treatment of inflammatory skin diseases. Therefore, we examined the influence of Mg2+ on inflammation in allergic contact dermatitis induced by 1-chloro-2,4-dinitrobenzene (DNCB) in BALB/c mice. Animals challenged with 0.125% DNCB in the presence of magnesium chloride (28% and 14%) demonstrated significantly less pronounced contact dermatitis (ear swelling) than did animals challenged with DNCB alone (p less than 0.001 and p less than 0.01). In mice challenged with DNCB in combination with sodium chloride (14%) there was no statistically significant difference in the degree of ear swelling. These results were borne out in 5 patients known to be allergic to nickel, in whom magnesium chloride but not sodium chloride, suppressed nickel sulphate-induced contact dermatitis.
Article
This report reviews individual-related variables, environment-related variables and instrument-related variables, with a focus on the Evaporimeter EP1 (ServoMed). Start-up and use is described, and guidelines for good laboratory practice given.
Article
To obtain data on the function of the epidermal barrier in patients with atopic dermatitis (AD) the transepidermal water loss (TEWL) was studied. Measurements were made on three body locations in two clinically well defined groups of patients with AD and in a control group. The TEWL was found to be increased both in dry non-eczematous skin and in clinically normal skin in patients with AD. The TEWL was highest in patients with dry skin. The result of the study may indicate a primary defect in the epidermal barrier: the stratum corneum.
Article
In order to further clarify the role of intercellular lipids in the water-retention properties of the stratum corneum, forearm skin of six healthy male volunteers was treated with 5% sodium dodecyl sulfate (SDS) for 1, 10, and 30 min. All treatment periods induced chapping and scaling of the stratum corneum without any inflammatory reaction, accompanied by a significant decrease in its water-retention function. Electron-microscopic analysis of SDS-treated stratum corneum revealed selective depletion of the lipids from the intercellular spaces, accompanied by marked disruption of multiple lamellae structures. Lipid analysis also showed a considerable and selective loss of intercellular lipids such as cholesterol, cholesterol ester, free fatty acid, and sphingolipids. To evaluate the recovery potential for intercellular lipids, lipids which were separated as sebaceous-rich lipids (SLs) and stratum corneum lipids (SCLs) were applied daily on SDS-treated forearm skin. Two daily applications of the SCLs which were emulsified at 10% concentration in W/O (water in oil) cream caused a significant increase in conductance, accompanied by a definite improvement in the level of scaling over no application or W/O emulsion base only, whereas SLs in the W/O emulsion base led to no significant recovery in either conductance value or scaling. When two daily topical applications of four chromatographically separated lipid fractions (cholesterol ester, free fatty acid, cholesterol, and sphingolipid) from the SCL were carried out at 1% concentration in the same system, the cholesterol ester and sphingolipid fractions were found to induce a significant increase in the conductance value over no application.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
Sodium dodecyl sulfate (SDS) has been used to induce a dry scaly skin condition in human subjects. Measurements of stratum (s.) corneum hydration, scaliness, and lipid composition reveal in vivo surfactant perturbations on desquamation. Subjects (n = 10) were briefly treated daily with a 4% aqueous solution of SDS on one lower leg over a period of 2 weeks. The other control leg received no treatments. At the end of the treatment period, both lower legs were evaluated for hydration using an electrical impedance technique and examined by an independent dermatologist using a visually based grading scale for surface roughness and scaliness. Shave biopsies were then excised from each lower leg for analysis of s. corneum lipids. Treatment resulted in decreased s. corneum hydration and increased surface scale/roughness. These physical changes were accompanied by significant changes in s. corneum lipid composition. While surfactant treatments did not alter the total quantity of lipids per gram s. corneum protein, significant changes in specific lipid classes were observed. The free cholesterol to cholesterol ester ratio increased while the quantity of total sterols remained constant. The distribution of certain ceramide species were altered while the quantity of total ceramides remained constant. Free fatty acids were resolved into 2 distinct bands, only one of which diminished upon treatment. These results are interpreted in terms of a model for surfactant-induced perturbation of keratinization which leads to abnormal s. corneum lipids and altered desquamation.
Article
Erythrocyte selenium-dependent glutathione peroxidase activity was measured in psoriatic Danes, before and after their four-week balneological therapy at the Ein-Bokek International Psoriasis Treatment Center, on the Dead-Sea shore in Israel. The drinking water in Ein-Bokek was found to be rich in selenium, a trace element with anticarcinogenic properties and of great importance in human nutrition and health. The most reliable biological parameter for increase in selenium bioavailability is the erythrocytes' glutathione-peroxidase activity. As psoriasis is a proliferative skin disease, the activity of this enzyme was assayed in 35 psoriatic Danes and in 25 long-term local hotel workers, as well as in 34 volunteers drinking low-selenium water. The glutathione peroxidase activity in the psoriatic patients increased significantly during their four-week stay in Ein-Bokek. Erythrocyte glutathione peroxidase activity in the hotel workers was 50% higher than that in the healthy volunteers consuming low-selenium water. A possible role of selenium in psoriasis is suggested.
Article
— Using an electrolytic hygrometer, the Transepidermal Water Loss (T.W.L.) from the skin was measured in normal individuals and in patients with dermatitis (eczema). It was found that there was a close correlation between T.W.L. and the state of activity of the dermatitis; and that there was a gradual reduction in abnormally raised T.W.L. in parallel with the return to normal of the skin response (dermatitis). Sweating did not contribute to the increased insensible water loss in dermatitis under the fixed limits of ambient temperature and humidity of this investigation.
Article
Accruing evidence indicates that the levels of extracellular Mg2+ and Ca2+ can have a distinct impact on the adhesive and migratory activities of many cell types. The physiological relevance of these observations, however, has remained largely unexplored. In the present study, wound fluids collected throughout the early stages of cutaneous wound repair were examined for possible Mg2+ and Ca2+ fluctuations. Early in the process, when cell migration into the wound site is initiated, Mg2+ is elevated and Ca2+ is reduced (Mg2+:Ca2+ = 1). As wound healing progresses, wound fluid concentrations of Mg2+ and Ca2+ begin to return to normal plasma levels (Mg2+:Ca2+ = 0.4). When macrophages, keratinocytes, fibroblasts, and endothelial cells were exposed to dialyzed wound fluid, the migration stimulated by undialyzed wound fluid was lost. Addition back to dialyzed wound fluid of 24 h, postinjury concentrations of Mg2+ and Ca2+ restored all migratory stimulus. This observed migration is approximately twofold greater than when normal plasma Mg2+ and Ca2+ concentrations are present. Changes in the levels of Mg2+ and Ca2+ in wound fluid occur during the same period that inflammatory cells, keratinocytes, fibroblasts, and neovasculature have been shown to migrate during wound healing in vivo. Together, these data suggest that the impact of these changes on integrins and E-cadherin may play a direct role in the activation and maintenance of the migratory phenotypes of the cells involved in the wound healing process.
Article
Two commercially available electrical instruments which evaluate the hydration state of the skin surface were compared in in vitro and in vivo experiments. The skin surface hygrometer (Skicon-200) employs high-frequency conductance, whereas the corneometer (CM 420, CM 820) uses electrical capacitance to determine the level of hydration. In a simulation model of in vivo stratum corneum (SC), the high frequency conductance device showed a much closer correlation with the hydration state of the surface SC (r = 0.99) than the capacitance device (r = 0.79), suggesting that the former can accurately assess the hydration dynamics of SC, particularly that due to the accumulation of easily releasable secondary bound water and free water. Both devices were insensitive to changes of hydration taking place in deeper viable skin tissues, e.g. the accumulated tissue fluids in suction blisters. Although the capacitance device correlated poorly with the hydration dynamics in normal SC, its sensitivity to changes occurring in extremely dry skin, such as scaly psoriatic lesions, suggests its measurements characteristics at an extremely low state of hydration, consisting of mostly bound water, such as noted in pathologic SC.
Article
In order to obtain objective data on skin functions in subjects with atopic dermatitis (AD), according to the different phases of the disease, we evaluated the skin of children with AD instrumentally and compared it to that of healthy subjects of the same age group. One hundred patients, aged 3 to 12, and 21 healthy children were studied by means of measurements of pH, capacitance and transepidermal water loss (TEWL) at 8 different skin sites. At the moment of the investigation 55 children out of 100 presented skin lesions on at least one of the assessed skin areas, whereas 45 had been free from eczema for at least 1 month. Considering all skin sites together, significant differences were found between mean values of pH, capacitance and TEWL of eczematous skin, both in respect to those referring to apparently healthy skin in the same patients and in respect to the skin of control subjects. Moreover, TEWL, pH and capacitance values referring to uninvolved skin of AD patients significantly differed from those of healthy subjects. Finally, when values referring to patients with skin lesions and to patients without lesions were separately considered, significant differences concerning the parameters of uninvolved skin were observed. These data show that, in subjects with AD, skin functions undergo fluctuations according to the phase of the disease and support the hypothesis that the presence of active eczema determines an impairment of the barrier of uninvolved skin, even at sites far from active lesions.
Article
The effect of five selected minerals abundant in the Dead-sea brine was studied on proliferation of fibroblasts grown from psoriatic and healthy skin biopsy specimens in cell culture. The reason for carrying out this study was looking for the mechanism of the antiproliferative effect of selective Dead-sea minerals in improving the psoriatic condition. Psoriatic skin shave biopsy specimens (both from involved and uninvolved areas of the body) as well as healthy skin (obtained from amputated limbs) were incubated in tissue culture, and their outgrowing fibroblasts were used for this study. The number of cells and their cyclic AMP content were used as parameters for cell division and for proving the selective involvement of magnesium salts in the antiproliferative effect. It is shown that the inhibitory effects of magnesium bromide and magnesium chloride on cell growth were significantly stronger than those of their corresponding potassium salts or of sodium chloride. These results were obtained with both psoriatic and healthy skin fibroblasts, indicating that the inhibitory effect of the selected Dead-sea minerals is present in healthy and psoriatic skin cells.
Article
This report reviews individual-related variables (age, sex, race, anatomical site, skin surface properties), intra- and interindividual variation (temporal, physical and mental activity, orthostatic effect, menstrual cycle/menopause), environment-related variables (light conditions, temperature) and various instrument-related variables that influence skin colour. CIE colorimetry (Minolta Chroma Meter) and spectrophotometric measurement (Derma Spectrometer) are considered. The guidelines give recommendations for measuring conditions and procedures.
Article
The hallmarks of dry skin (xerosis) are scaliness and loss of elasticity. Decreased hydration and a disturbed lipid content of the stratum corneum are also well-known features. The frequency of dry skin increases with ageing. The aim of this study was to examine if these known features of dry skin are related to changes in epidermal proliferation and differentiation. In addition, age-related changes in normal and in dry skin were examined: 62 volunteers were divided by clinical grading and biophysical measurements into groups with young/normal, young/dry, aged/normal and aged/dry skin. Biopsy samples from the lower legs (most severe dryness) were examined by two-dimensional gel electrophoresis and by immunohistochemistry for epidermal proliferation, epidermal keratins and cornified envelope proteins. There was a slight increase in proliferation in both groups with dry skin compared with normal skin of the corresponding age. In aged/normal compared with young/normal skin there was a significant decrease in proliferation. However, epidermal proliferation was the same in aged/dry skin as in young/normal skin. For epidermal differentiation, an age-independent decrease of keratins K1 and K10 and an associated increase in the basal keratins K5 and K14 was detected in dry skin. There was also an age-independent premature expression of the cornified envelope protein involucrin. In contrast, loricrin expression was not influenced by dry skin conditions. In summary, epidermal proliferation was significantly decreased in aged/normal compared with young/normal skin. Dry skin showed significant changes in the epidermal expression of basal and differentiation-related keratins, and a premature expression of involucrin irrespective of age.
Article
In irritancy studies, measurement of transepidermal water loss (TEWL) is a widely used technique to assess barrier function. Using inappropriate statistical methods, however, leads to loss of information and misinterpretation of results. In this paper, we discuss some problems and pitfalls when using a suitable statistical technique for most designs in bioengineering studies, analysis of variance (ANOVA): multiple comparisons, choice of sample size and violation of statistical assumptions. For clarification of these points, a practical example will be given. Using the proposed adequate statistical methods correctly will, although accompanied by increased complexity, increase the efficiency of bioengineering studies.
Article
The effects of four different magnesium salts on the cutaneous barrier recovery rate after barrier disruption were evaluated. We spread an aqueous solution of each salt on the flank skin of hairless mice, occluded the area with a plastic membrane for 20 min, and then left the skin surface to dry. All of the magnesium salts, except magnesium bis(dihydrogen phosphate), accelerated barrier repair. We next estimated the effects of magnesium chloride aqueous solutions which contained calcium chloride at different molar ratios. When the calcium to magnesium ratio was lower than 1, the mixture accelerated barrier repair. The application of an aqueous solution of 10 mM magnesium chloride and 10 mM calcium chloride was found to hasten the barrier recovery more effectively than a solution of 10 mM magnesium chloride. These results suggest that the effects of these metal ions are different depending on the counter ion and/or the method of application.
Article
Although it has been well established that the dry skin often seen in patients with atopic dermatitis shows a deranged barrier function, there is no unanimity of opinion as to whether the barrier in normal-appearing skin of patients with the disease is deranged or not. Hence, it remains unclear whether individuals with atopic dermatitis constitution have an intrinsic derangement of skin barrier function or not. To settle this problem, in the present study we examined transepidermal water loss and stratum corneum water content in normal appearing skin of the upper back of 16 patients with completely healed atopic dermatitis who had been free from skin symptoms for 5 years or more, 30 patients with active atopic dermatitis, and 39 healthy subjects. The transepidermal water loss values and the stratum corneum water content values in normal-appearing skin of the completely healed patients were not different from the values in normal controls. These findings indicate that skin barrier function is not disturbed in patients with completely healed atopic dermatitis.
Article
Irritant substances have been shown to induce elemental changes in human and animal epidermal cells in situ. However, skin biopsies are a complicated experimental system and artefacts can be introduced by the anaesthesia necessary to take the biopsy. We therefore attempted to set up an experimental system for X-ray microanalysis (XRMA) consisting of cultured human keratinocytes. A number of methodological aspects were studied: different cell types, washing methods and different culture periods for the keratinocytes. It was also investigated whether the keratinocytes responded to exposure to sodium lauryl sulphate (SLS) with changes in their elemental composition. The concentrations of biologically important elements such as Na, Mg, P and K were different in HaCaT cells (a spontaneously immortalized non-tumorigenic cell line derived from adult human keratinocytes) compared to natural human epidermal keratinocytes. The washing procedure and time of culture influenced the intracellular elemental content, and rinsing with distilled water was preferred for further experiments. Changes in the elemental content in the HaCaT cells compatible with a pattern of cell injury followed by repair by cell proliferation were seen after treatment with 3.33 microM and 33 microM SLS. We conclude that XRMA is a useful tool for the study of functional changes in cultured keratinocytes, even though the preparation methods have to be strictly controlled. The method can conceivably be used for predicting effects of different chemicals on human skin.
Article
The combination of seawater baths and solar radiation at the Dead Sea is known as an effective treatment for patients with psoriasis and atopic dermatitis. Dead Sea water is particularly rich in magnesium ions. In this study we wished to determine the effects of magnesium ions on the capacity of human epidermal Langerhans cells to stimulate the proliferation of alloreactive T cells. Twelve subjects were exposed on four subsequent days on the volar aspects of their forearms to 5% MgCl2, 5% NaCl, ultraviolet B (1 minimal erythemal dose), MgCl2 + ultraviolet B, and NaCl + ultraviolet B. Epidermal sheets were prepared from punch biopsies and were stained for ATPase and HLA-DR. Compared with untreated skin, the number of ATPase+/HLA-DR+ Langerhans cells was significantly reduced after treatment with MgCl2 (p = 0.0063) or ultraviolet B (p = 0.0005), but not after NaCl (p = 0.7744). We next questioned whether this reduced expression of ATPase and HLA-DR on Langerhans cells bears a functional relevance. Six subjects were treated on four subsequent days with 5% MgCl2, ultraviolet B (1 minimal erythemal dose), and MgCl2 + ultraviolet B. Epidermal cell suspensions from treated and untreated skin were assessed for their antigen-presenting capacity in a mixed epidermal lymphocyte reaction with allogeneic naive resting T cells as responder cells. Treatment with MgCl2, similarly to ultraviolet B, significantly reduced the capacity of epidermal cells to activate allogeneic T cells (p = 0.0356). Magnesium ions also suppressed Langerhans cells function when added to epidermal cell suspensions in vitro. The reduced antigen-presenting capacity of Langerhans cells after treatment with MgCl2 was associated with a reduced expression by Langerhans cells of HLA-DR and costimulatory B7 molecules, and with a suppression of the constitutive tumor necrosis factor-alpha production by epidermal cells in vitro. These findings demonstrate that magnesium ions specifically inhibit the antigen-presenting capacity of Langerhans cells and may thus contribute to the efficacy of Dead Sea water in the treatment of inflammatory skin diseases.