The skin is our natural barrier and lipids are a key part of this barrier. In the outer skin layer, the stratum corneum (SC), lipids form a densely organized structure dependent on the composition... Show moreThe skin is our natural barrier and lipids are a key part of this barrier. In the outer skin layer, the stratum corneum (SC), lipids form a densely organized structure dependent on the composition of these lipids. Multiple skin diseases are characterized by alterations in SC lipid composition. These alterations are related to pathological barrier defects. This thesis describes the next steps towards a treatment modifying the lipid composition and thereby restoring this barrier. We developed a novel method to quantify a key SC lipid group called ceramides. This method was applied to compare SC regeneration of skin models to healthy volunteers. Regeneration in such an ex vivo skin model proved to be a potent model for formulation development. Ensuing, a clinical study was performed to determine the mechanistic effects of a formulation on barrier repair in healthy skin. The results warranted follow up analysis of the formulation in atopic dermatitis patients. This thesis also describes a detailed analysis of the ceramide fraction that is covalently attached to the cells in the SC. It was shown that a selected group of ceramides becomes bound. Further analysis showed that this group of ceramides was also affected in atopic dermatitis patients SC. Show less
The stratum corneum is the outermost skin layer and consists of dead cells embedded in a lipid matrix. The lipid matrix, consisting of ceramides, fatty acids, and cholesterol, is crucial for a... Show moreThe stratum corneum is the outermost skin layer and consists of dead cells embedded in a lipid matrix. The lipid matrix, consisting of ceramides, fatty acids, and cholesterol, is crucial for a proper skin barrier function. In inflammatory skin diseases the lipid composition and ordering is altered contributing to the impaired skin barrier. Vernix caseosa (VC) is the cheesy, white cream that covers the skin of the human fetus. Application of an in house developed synthetic VC enhanced skin barrier repair in mice. Currently, there are no suitable skin models available to study human skin barrier repair after application of a topical formulation. This thesis describes the development of a human skin barrier repair model and evaluates VC based formulations using this model. The results demonstrate that the barrier of this repair model mimics several aspects of inflammatory skin diseases. Additionally, it was shown that the lipid properties in this model were improved when a synthetic VC-based formulation was applied. Based on the outcome, clinical studies were performed. These studies showed that application on a disrupted human skin barrier in vivo enhanced the barrier repair. However, the effects of the formulation are limited when applied on atopic dermatitis skin Show less
Vernix caseosa (VC) is the cheesy, white cream that covers the skin of the human fetus and the newborn. VC is a protective cream, which consists of water containing dead cells that are embedded in... Show moreVernix caseosa (VC) is the cheesy, white cream that covers the skin of the human fetus and the newborn. VC is a protective cream, which consists of water containing dead cells that are embedded in lipids. This natural cream is suggested to feature multiple biological functions such as facilitating the skin formation during pregnancy and hydrating the skin of the newborn. The aim of this thesis was the rational design of synthetic creams which mimic VC__s structure and its unique properties. Synthetic creams were made of highly hydrated synthetic particles embedded in wool wax and skin lipids. These creams were shown to mimic excellently the structure and composition of natural VC, while the water content and release properties could be controlled. The developed creams showed their great potential for disrupted and underdeveloped skin concerning several aspects: the skin barrier recovery rate was drastically reduced, crust formation was prevented and thickening of the epidermis was less frequently observed. These promising results give rise to future clinical studies in order to prove the benefits of the newly developed creams to treat healthy, dry and diseased human skin. Show less
