Modified epidermal lipid composition in air-exposed culture of non-bullous congenital ichthyotic erythroderma (NBCIE) keratinocytes

Stratum corneum hydration and flexibility are useful parameters to indicate clinical severity of congenital ichthyosis

To determine any correlation between the stratum corneum barrier function and the phenotypic severity of congenital ichthyosis, we studied stratum corneum hydration, flexibility, thickness and transepidermal water loss (TEWL) in patients with congenital ichthyosis. Seven patients with congenital ichthyosis aged 2-46 years and age-matched controls were included in the present study. We divided seven patients into two groups; patients with non-bullous type (non-bullous congenital ichthyosiform erythroderma patients) and patients with the bullous type of congenital ichthyosis (bullous congenital ichthyosiform erythroderma and ichthyosis bullosa of Siemens). Stratum corneum hydration, thickness and flexibility were measured using a Corneometer ASA-M2. The stratum corneum thickness was also examined using a skin biopsy technique. TEWL was measured using Evaporimeter AS-TW1. The clinical severity of ichthyosis phenotype was evaluated using a visual analogue scale (VAS). Stratum corneum hydration and flexibility were significantly reduced in both congenital ichthyosis patient groups. Stratum corneum thickness was significantly increased in both groups. In the patient group with non-bullous congenital ichthyosis, significant negative correlations were confirmed between the VAS score and stratum corneum hydration and between the VAS score and flexibility. A significant, positive correlation was also observed between the VAS score and stratum corneum thickness. There was a positive correlation between the VAS score and TEWL on both the extensor and flexor sides of the forearm and back. We conclude that stratum corneum hydration, flexibility and thickness measured by the corneometer, and TEWL on the arm may be a useful indicator of the severity of ichthyosis phenotype.

Analyse biochimique des lipides épidermiques

According to the knowledge acquired some 15 years ago, the cutaneous lipids may be classified into 2 families: the "neutral" lipids, represented by cholesterol, cholesterol esters, cholesterol sulphate, triglycerides, free fatty acids, squalen and alcanes, and the "polar" lipids including phospholipids (phosphatidylcholine, phosphatidylserine, phosphatidylethanolamine, sphingomyeline) and sphingolipids (ceramides I-VII, monohexosylceramides). From the functional point of view, free fatty acids, cholesterol, and ceramides organised in layers are the most important components of intercellular spaces of the stratum corneum. Analytic methods have been recently developed to help understand the structural organisation of these various molecules within the horny layer and their influence on the epidermal barrier function. Raman microspectroscopy or X-ray diffraction are most frequently used. Differential calorimetry and fluorescence or infrared spectroscopy provide complementary information. The principal findings are: lamellar structure depends on the presence of ceramides supplemented by adequate quantities of free fatty acids and cholesterol; ceramide chains interact to provide the ordered structure and ceramide-1 is necessary for stabilisation of lipid layers; cholesterol may regulate the molecular mobility of hydrocarbon chains within the bi-layers. Knowledge of the molecular structure of the barrier lipids finds several applications, e.g.: in pharmacology--conception of new formulations adapted for percutaneous and topical application of drugs; in dermatology--comprehension of physiopathologic mechanisms of various dermatoses; in biotechnology--development of skin substitutes with valid stratum corneum barrier; in cosmetics--choice of best formulations suited for reconstruction of the intercellular lipid substance.

Données structurales et ultrastructurales sur les lipides cutanés humains

The principal function of intercellular lipids of the epidermal horny layer is the constitution of an occlusive barrier and regulation of transepidermal water fluxes. Self-assembly of lipid bilayers and formation of multilayered structures can be observed in the intercellular spaces of the stratum corneum. Progressive organisation of lipids provokes the lateral displacements of hydrophilic compartments, squeezed aside along the lipid layers towards intercellular junctions (corneodesmosomes). Proteolytic enzymes contained in the hydrophilic material are thus delivered to the extracellular portions of cohesive junctional proteins. Consequently, modifications of the composition and structure of the stratum corneum lipids may influence epidermal desquamation through the regulation of corneodesmosome accessibility to extracellular enzymes.