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Yadav JP, Verma A, Pathak P, Dwivedi AR, Singh AK, Kumar P, Khalilullah H, Jaremko M, Emwas AH, Patel DK. Phytoconstituents as modulators of NF-κB signalling: Investigating therapeutic potential for diabetic wound healing. Biomed Pharmacother 2024; 177:117058. [PMID: 38968797 DOI: 10.1016/j.biopha.2024.117058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/14/2024] [Accepted: 06/26/2024] [Indexed: 07/07/2024] Open
Abstract
The NF-κB pathway plays a pivotal role in impeding the diabetic wound healing process, contributing to prolonged inflammation, diminished angiogenesis, and reduced proliferation. In contrast to modern synthetic therapies, naturally occurring phytoconstituents are well-studied inhibitors of the NF-κB pathway that are now attracting increased attention in the context of diabetic wound healing because of lower toxicity, better safety and efficacy, and cost-effectiveness. This study explores recent research on phytoconstituent-based therapies and delve into their action mechanisms targeting the NF-κB pathway and potential for assisting effective healing of diabetic wounds. For this purpose, we have carried out surveys of recent literature and analyzed studies from prominent databases such as Science Direct, Scopus, PubMed, Google Scholar, EMBASE, and Web of Science. The classification of phytoconstituents into various categorie such as: alkaloids, triterpenoids, phenolics, polyphenols, flavonoids, monoterpene glycosides, naphthoquinones and tocopherols. Noteworthy phytoconstituents, including Neferine, Plumbagin, Boswellic acid, Genistein, Luteolin, Kirenol, Rutin, Vicenin-2, Gamma-tocopherol, Icariin, Resveratrol, Mangiferin, Betulinic acid, Berberine, Syringic acid, Gallocatechin, Curcumin, Loureirin-A, Loureirin-B, Lupeol, Paeoniflorin, and Puerarin emerge from these studies as promising agents for diabetic wound healing through the inhibition of the NF-κB pathway. Extensive research on various phytoconstituents has revealed how they modulate signalling pathways, including NF-κB, studies that demonstrate the potential for development of therapeutic phytoconstituents to assist healing of chronic diabetic wounds.
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Affiliation(s)
- Jagat Pal Yadav
- Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India; Pharmacology Research Laboratory, Faculty of Pharmaceutical Sciences, Rama University, Kanpur 209217, India; Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India.
| | - Amita Verma
- Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Prateek Pathak
- Department of Pharmaceutical Analysis, Quality Assurance and Pharmaceutical Chemistry, GITAM School of Pharmacy, GITAM (Deemed to be University), Hyderabad Campus, 502329, India
| | - Ashish R Dwivedi
- Department of Pharmaceutical Analysis, Quality Assurance and Pharmaceutical Chemistry, GITAM School of Pharmacy, GITAM (Deemed to be University), Hyderabad Campus, 502329, India
| | - Ankit Kumar Singh
- Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India; Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| | - Pradeep Kumar
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| | - Habibullah Khalilullah
- Department of Pharmaceutical Chemistry and Pharmacognosy, Unaizah College of Pharmacy, Qassim University, Unayzah 51911, Saudi Arabia
| | - Mariusz Jaremko
- Smart-Health Initiative (SHI) and Red Sea Research Center (RSRC), Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
| | - Abdul-Hamid Emwas
- Core Labs, King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
| | - Dinesh Kumar Patel
- Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India.
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Choudhury S, Dhoke NR, Chawla S, Das A. Bioengineered MSC Cxcr2 transdifferentiated keratinocyte-like cell-derived organoid potentiates skin regeneration through ERK1/2 and STAT3 signaling in diabetic wound. Cell Mol Life Sci 2024; 81:172. [PMID: 38597972 PMCID: PMC11006766 DOI: 10.1007/s00018-023-05057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 04/11/2024]
Abstract
Skin regeneration is severely compromised in diabetic foot ulcers. Allogeneic mesenchymal stem cell (MSC) transplantation is limited due to the poor engraftment, mitogenic, and differentiation potential in the harsh wound microenvironment. Thus, to improve the efficacy of cell therapy, the chemokine receptor Cxcr2 was overexpressed in MSCs (MSCCxcr2). CXCL2/CXCR2 axis induction led to the enhanced proliferation of MSCs through the activation of STAT3 and ERK1/2 signaling. Transcriptional upregulation of FGFR2IIIb (KGF Receptor) promoter by the activated STAT3 and ERK1/2 suggested trans-differentiation of MSCs into keratinocytes. These stable MSCCxcr2 in 2D and 3D (spheroid) cell cultures efficiently transdifferentiated into keratinocyte-like cells (KLCs). An in vivo therapeutic potential of MSCCxcr2 transplantation and its keratinocyte-specific cell fate was observed by accelerated skin tissue regeneration in an excisional splinting wound healing murine model of streptozotocin-induced type 1 diabetes. Finally, 3D skin organoids generated using MSCCxcr2-derived KLCs upon grafting in a relatively avascular and non-healing wounds of type 2 diabetic db/db transgenic old mice resulted in a significant enhancement in the rate of wound closure by increased epithelialization (epidermal layer) and endothelialization (dermal layer). Our findings emphasize the therapeutic role of the CXCL2/CXCR2 axis in inducing trans-differentiation of the MSCs toward KLCs through the activation of ERK1/2 and STAT3 signaling and enhanced skin regeneration potential of 3D organoids grafting in chronic diabetic wounds.
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Affiliation(s)
- Subholakshmi Choudhury
- Department of Applied Biology, Council of Scientific & Industrial Research-Indian Institute of Chemical Technology (CSIR-IICT), Uppal Road, Tarnaka, Hyderabad, 500007, TS, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Neha R Dhoke
- Department of Applied Biology, Council of Scientific & Industrial Research-Indian Institute of Chemical Technology (CSIR-IICT), Uppal Road, Tarnaka, Hyderabad, 500007, TS, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Shilpa Chawla
- Department of Applied Biology, Council of Scientific & Industrial Research-Indian Institute of Chemical Technology (CSIR-IICT), Uppal Road, Tarnaka, Hyderabad, 500007, TS, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Amitava Das
- Department of Applied Biology, Council of Scientific & Industrial Research-Indian Institute of Chemical Technology (CSIR-IICT), Uppal Road, Tarnaka, Hyderabad, 500007, TS, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Shin KO, Kim B, Choi Y, Bae YJ, Park JH, Park SH, Hwang JT, Choi EH, Uchida Y, Park K. Barrier Abnormalities in Type 1 Diabetes Mellitus: The Roles of Inflammation and Ceramide Metabolism. J Invest Dermatol 2024; 144:802-810.e5. [PMID: 37952608 DOI: 10.1016/j.jid.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023]
Abstract
Xerosis is a common sign of both type 1 and type 2 diabetes mellitus (DM), and patients with DM and mouse models for DM show a compromised epidermal permeability barrier. Barrier defects then allow the entry of foreign substances into the skin, triggering inflammation, infection, and worsening skin symptoms. Characterizing how barrier abnormalities develop in DM could suggest treatments for xerosis and other skin disease traits. Because the proper ratio, as well as proper bulk amounts, of heterogeneous ceramide species are keys to forming a competent barrier, we investigated how ceramide metabolism is affected in type 1 DM using a mouse model (induced by streptozotocin). Chronic inflammation, evident in the skin of mice with DM, leads to (i) decreased de novo ceramide production through serine racemase activation-mediated attenuation of serine palmitoyl transferase activity by D-serine; (ii) changes in ceramide synthase activities and expression that modify the ratio of ceramide molecular species; and (iii) increased ceramide-1-phosphate, a proinflammatory lipid mediator, that stimulates inflammatory cytokine expression (TNFα and IFN-γ). Together, chronic inflammation affects ceramide metabolism, which attenuates epidermal permeability barrier formation, and ceramide-1-phosphate could amplify this inflammation. Alleviation of chronic inflammation is a credible approach for normalizing barrier function and ameliorating diverse skin abnormalities in DM.
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Affiliation(s)
- Kyong-Oh Shin
- Department of Food Science & Nutrition, and Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon, Republic of Korea; The Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea; LaSS Lipid Institute, LaSS Inc, Chuncheon, Republic of Korea
| | - Bokyung Kim
- Department of Food Science & Nutrition, and Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon, Republic of Korea; The Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea; LaSS Lipid Institute, LaSS Inc, Chuncheon, Republic of Korea
| | - Yerim Choi
- Department of Food Science & Nutrition, and Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon, Republic of Korea; The Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Yoo-Jin Bae
- Department of Food Science & Nutrition, and Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon, Republic of Korea; The Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Jae-Ho Park
- Personalized Diet Research Group, Korea Food Research Institute, Jeonju, Republic of Korea
| | - Soo-Hyun Park
- Personalized Diet Research Group, Korea Food Research Institute, Jeonju, Republic of Korea
| | - Jin-Taek Hwang
- Personalized Diet Research Group, Korea Food Research Institute, Jeonju, Republic of Korea; Department of Food Biotechnology, University of Science and Technology, Daejeon, Republic of Korea
| | - Eung Ho Choi
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Yoshikazu Uchida
- Department of Food Science & Nutrition, and Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon, Republic of Korea; The Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea.
| | - Kyungho Park
- Department of Food Science & Nutrition, and Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon, Republic of Korea; The Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea.
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Fang WC, Lan CCE. The Epidermal Keratinocyte as a Therapeutic Target for Management of Diabetic Wounds. Int J Mol Sci 2023; 24:4290. [PMID: 36901720 PMCID: PMC10002069 DOI: 10.3390/ijms24054290] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Diabetes mellitus (DM) is an important cause of chronic wounds and non-traumatic amputation. The prevalence and number of cases of diabetic mellitus are increasing worldwide. Keratinocytes, the outermost layer of the epidermis, play an important role in wound healing. A high glucose environment may disrupt the physiologic functions of keratinocytes, resulting in prolonged inflammation, impaired proliferation, and the migration of keratinocytes and impaired angiogenesis. This review provides an overview of keratinocyte dysfunctions in a high glucose environment. Effective and safe therapeutic approaches for promoting diabetic wound healing can be developed if molecular mechanisms responsible for keratinocyte dysfunction in high glucose environments are elucidated.
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Affiliation(s)
- Wei-Cheng Fang
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Che E. Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Evaluation of Morphological and Structural Skin Alterations on Diabetic Subjects by Biophysical and Imaging Techniques. Life (Basel) 2023; 13:life13020579. [PMID: 36836936 PMCID: PMC9962953 DOI: 10.3390/life13020579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/19/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Diabetes causes increased production of advanced glycation end products (AGEs), which may lead to irreversible damage to collagen fibers, and early and more accentuated signs of skin aging. Thus, the objective of this study was to evaluate diabetic skin's mechanical and morphological characteristics and compare these to healthy skin. Twenty-eight female participants aged between 39 and 55 years were enrolled: half had type 2 diabetes, and the others were healthy. Wrinkles, transepidermal water loss (TEWL), stratum corneum water content, skin color, elasticity, morphological and structural characteristics of epidermis and dermis echogenicity were evaluated using biophysical and skin imaging techniques. Higher TEWL values were observed in participants with diabetes, who also showed lower skin elasticity and wrinkles with greater volume, area, and depth. In addition, the Reflectance Confocal Microscopy (RCM) imaging analysis showed that all participants with diabetes presented polycyclic papillae and deformed and amorphous collagen fibers. The obtained data showed significant differences between healthy and diabetic skin and could help develop more specific topical treatments to improve the treatment of skin conditions in people with diabetes. Finally, RCM is an advanced imaging technique that allows for a more profound analysis of diabetic skin, which could assist in the evaluation of dermocosmetic treatments to improve the skin alterations caused by this disease.
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Li M, Yuan J, Hou Q, Zhao Y, Zhong L, Dai X, Chen H, Fu X. Characterization of the Skin Bacteriome and Histology Changes in Diabetic Pigs. INT J LOW EXTR WOUND 2022:15347346221100887. [PMID: 35548944 DOI: 10.1177/15347346221100887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic wound is one of the most common complications that are associated with diabetes. The cutaneous microbiome is known to play essential roles in the regulation of barrier function and protecting against potential assault. Thus, it is necessary to gain a better understanding of the relationship between microbial community and skin structures in unwounded diabetic skin to explore possible preventive strategies. To achieve the same, a pig diabetic model was built in the present study. Further,16S rDNA sequencing was used to characterize the skin bacteriome. It was observed that the pigs showed skin bacteriome similar to humans in the non-diabetes group, while it varied in the case of diabetes. Further, the β-diversity analysis showed that the bacterial community was significantly different under the diabetes group. More species differences were identified between the two groups at genus level. The predictive function analysis also showed the involvement of significantly different pathways of microbial gene function in diabetes. In agreement with this, skin histology analysis also showed signs of reduced epidermal thickness and rete ridges in diabetic skin. Less proliferation of keratinocytes and impaired TJ barrier was also detected. This evidence suggested that pigs might serve as the best surrogate for cutaneous microbiome studies. Altogether, the present study reported that the skin bacteriome and histology changed significantly in unwounded diabetic skin, which provided a theoretical basis for the regulation of disordered skin bacteriome. The findings of the study would assist in the improvement of the skin environment and prevention of skin infection and chronic wounds.
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Affiliation(s)
- Meirong Li
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Division and 4th Medical Center, PLA General Hospital and PLA Medical College, Beijing, China
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, Beijing, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences 2019RU051, Beijing, China
- Central Laboratory, Trauma Treatment Center, Central Laboratory, 104607Chinese PLA General Hospital, Hainan Hospital, Sanya, China
| | - Jifang Yuan
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Division and 4th Medical Center, PLA General Hospital and PLA Medical College, Beijing, China
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, Beijing, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences 2019RU051, Beijing, China
- Central Laboratory, Trauma Treatment Center, Central Laboratory, 104607Chinese PLA General Hospital, Hainan Hospital, Sanya, China
- Laboratory Animal Center, Medical Innovation Research Division of 104607Chinese PLA General Hospital, Beijing, P. R. China
| | - Qian Hou
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Division and 4th Medical Center, PLA General Hospital and PLA Medical College, Beijing, China
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, Beijing, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences 2019RU051, Beijing, China
| | - Yali Zhao
- Central Laboratory, Trauma Treatment Center, Central Laboratory, 104607Chinese PLA General Hospital, Hainan Hospital, Sanya, China
| | - Lingzhi Zhong
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Division and 4th Medical Center, PLA General Hospital and PLA Medical College, Beijing, China
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, Beijing, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences 2019RU051, Beijing, China
| | - Xin Dai
- Laboratory Animal Center, Medical Innovation Research Division of 104607Chinese PLA General Hospital, Beijing, P. R. China
| | - Hua Chen
- Laboratory Animal Center, Medical Innovation Research Division of 104607Chinese PLA General Hospital, Beijing, P. R. China
| | - Xiaobing Fu
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Division and 4th Medical Center, PLA General Hospital and PLA Medical College, Beijing, China
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, Beijing, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences 2019RU051, Beijing, China
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Takayanagi T, Hirai H, Asada Y, Yamada T, Hasegawa S, Tomatsu E, Maeda Y, Yoshino Y, Hiratsuka I, Sekiguchi-Ueda S, Shibata M, Seino Y, Sugimura Y, Akamatsu H, Itoh M, Suzuki A. Terminal differentiation of keratinocytes was damaged in type 2 diabetic mice. Mol Biol Rep 2022; 49:5875-5882. [PMID: 35347543 DOI: 10.1007/s11033-022-07367-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 03/11/2022] [Indexed: 11/25/2022]
Abstract
AIMS Although skin manifestations are common in diabetic patients, its characteristics are poorly identified. This study explored the differentiation process of keratinocytes in type 2 diabetes mellitus (T2DM) in vivo. METHODS Back skin of T2DM model KKAy/TaJcl mice (KKAy) and C57BL/6JJcl mice (control) aged 8 and 12 weeks was used. The mRNA expression of differentiation markers of keratinocytes was measured by quantitative real-time polymerase chain reaction (qRT-PCR). The expression of each marker in situ was examined immunohistochemically. RESULTS KKAy mice showed hyperglycemia versus control mice. The histological findings showed increased thickness and structural impairment of epidermal tissue in KKAy mice. The qRT-PCR revealed that the expression of integrin beta 1 and keratin 14 in KKAy and control mice was identical. However, the expression of involucrin at 8 weeks, keratin 10 at 12 weeks, and filaggrin and loricrin at 8 and 12 weeks was decreased in KKAy mice. Immunohistochemical findings showed that filaggrin was markedly decreased in KKAy mice, though Ki-67 remained unchanged. CONCLUSION The terminal differentiation process was impaired in the diabetic skin, while keratinocyte proliferation was preserved. Damaged terminal differentiation of keratinocytes may contribute to impairment of the skin barrier function in diabetic dermatoses.
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Affiliation(s)
- Takeshi Takayanagi
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Hiroyuki Hirai
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yohei Asada
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Takaaki Yamada
- Research Laboratories, Nippon Menard Cosmetic Co., Ltd, Nagoya, Aichi, Japan
| | - Seiji Hasegawa
- Research Laboratories, Nippon Menard Cosmetic Co., Ltd, Nagoya, Aichi, Japan
| | - Eisuke Tomatsu
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshiteru Maeda
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yasumasa Yoshino
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Izumi Hiratsuka
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Sahoko Sekiguchi-Ueda
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Megumi Shibata
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yusuke Seino
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshihisa Sugimura
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Hirohiko Akamatsu
- Department of Applied Cell and Regenerative Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Mitsuyasu Itoh
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Atsushi Suzuki
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
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Wang M, Yao S, He D, Qahar M, He J, Yin M, Wu J, Yang G. Type 2 Diabetic Mellitus Inhibits Skin Renewal through Inhibiting WNT-Dependent Lgr5+ Hair Follicle Stem Cell Activation in C57BL/6 Mice. J Diabetes Res 2022; 2022:8938276. [PMID: 35469170 PMCID: PMC9034921 DOI: 10.1155/2022/8938276] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Hair follicles are important accessory organs of the skin, and it is important for skin renewal and performs variety of important functions. Diabetes can cause several dermatoses; however, its effect on hair follicles is unclear. The purpose of this study was to investigate the effect of type II diabetes (T2DM) on the hair follicles of mice. METHODS Seven-week-old male C57BL/6 littermate mice were divided into two groups. The treatment group was injected with streptozotocin (STZ) to induce T2DM, and the control group was parallelly injected with the same dose of buffer. Seven days after injection, the back is depilated to observe the hair follicle regeneration. Hair follicle regeneration was observed by naked eyes and HE staining. The proliferation of the skin cells was observed by PCNA and K14 staining. The altered genes were screened by RNA sequencing and verified by qRT-PCR. In addition, Lgr5 + GFP/mTmG transgenic mice were used to observe the effect of T2DM on Lgr5 hair follicle stem cells (HFSC). And the expression of WNT4 and WNT8A were measured by Western Blot. RESULTS T2DM inhibited hair follicle regeneration. Compared to control mice, T2DM mice had smaller hair follicles, reduced skin thickness, and less expression of PCNA and K14. RNA sequencing showed that the two groups had significant differences in cell cycle and proliferation-related pathways. Compared with the control mice, the mRNA expression of Lgr4, Lgr5, Wnt4, and Wnt8a was decreased in the T2DM group. Moreover, T2DM inhibited the activation of Lgr5 HFSC and the expression of WNT4 and WNT8A. CONCLUSIONS T2DM inhibited hair follicle regeneration and skin cells proliferation by inhibiting WNT-dependent Lgr5 HFSC activation. This may be an important reason for the reduction of skin renewal ability and the formation of chronic wounds caused by diabetes. It is important for the treatment of chronic diabetic wounds and the development of tissue engineering.
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Affiliation(s)
- Minghui Wang
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
| | - Shangsheng Yao
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
| | - Dehua He
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
| | - Mulan Qahar
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
| | - Jinqing He
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
| | - Meifang Yin
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
| | - Jun Wu
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
- Human Histology & Embryology Section, Department of Surgery, Dentistry, Pediatrics & Gynecology, University of Verona Medical School, Verona 37134, Italy
| | - Guang Yang
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
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9
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Stefaniak AA, Krajewski PK, Bednarska-Chabowska D, Bolanowski M, Mazur G, Szepietowski JC. Itch in Adult Population with Type 2 Diabetes Mellitus: Clinical Profile, Pathogenesis and Disease-Related Burden in a Cross-Sectional Study. BIOLOGY 2021; 10:1332. [PMID: 34943248 PMCID: PMC8698455 DOI: 10.3390/biology10121332] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Despite growing interest in itch, data regarding itch in type 2 diabetes mellitus (DM2) are still limited, and mostly based on outdated studies. This study aimed to evaluate the clinical characteristics of itch in the adult population with DM2 and explore potential underlying causes. METHODS The study group consisted of 109 adult patients with DM2. Standardized questionnaires were completed in order to assess the itch intensity [Numerical Rating Scale (three days, 24hours) (NRS)] and the Four-item Itch Questionnaire (4IIQ) and to assess the psychological impact of itch [ItchyQoL, Six-Item Stigmatization Scale (6-ISS), Hospital Anxiety and Depression Scale (HADS)]. Skin dryness was evaluated clinically and by non-invasive assessment of epidermis moisturizing. Neuropathy was assessed using the clinical Katzenwadel neuropathy scale. RESULTS Itch occurred in 35.8% of adult patients with DM2, with NRSmax three days 6.31 ± 2.16 and 8.1 ± 3.5 points in 4IIQ. Itchy patients have had significantly higher FPG levels compared with the non-itchy population (p = 0.01). Patients with itch had a significantly higher possibility of neuropathy compared with non-itchy subjects (p < 0.01). Skin xerosis was significantly more advanced in patients with itch compared to those without (p < 0.01). The mean ItchyQol score was assessed as 41.2 ± 13.4 points, indicating mild life quality impairment and correlated positively with itch intensity. Itchy subjects had significantly higher scores in both anxiety and depression dimensions of HADS (in each p < 0.01). CONCLUSIONS We suggest that the primary cause of itch is prolonged poor diabetes control with altered glucose and insulin levels, subsequently causing skin dryness and neuropathy in long-lasting DM2.
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Affiliation(s)
- Aleksandra A. Stefaniak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (A.A.S.); (P.K.K.)
| | - Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (A.A.S.); (P.K.K.)
| | - Dorota Bednarska-Chabowska
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Marek Bolanowski
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Grzegorz Mazur
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (A.A.S.); (P.K.K.)
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10
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Wang H, Zhou Q, Wan L, Guo M, Chen C, Xue J, Yang L, Xie L. Lipidomic analysis of meibomian glands from type-1 diabetes mouse model and preliminary studies of potential mechanism. Exp Eye Res 2021; 210:108710. [PMID: 34339682 DOI: 10.1016/j.exer.2021.108710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/13/2021] [Accepted: 07/26/2021] [Indexed: 12/25/2022]
Abstract
Diabetes is a significant risk factor for meibomian gland dysfunction (MGD), but its mechanism is poorly understood. The main function of the meibomian glands (MGs) is to synthesize, store, and secrete lipids. In this study, we found that the amount of lipids in the meibomian acini in STZ-induced type 1 diabetic mice decreased, and the lipid droplets became larger and irregular. In all, 31 lipid subclasses were identified in the mouse MGs, which contained 1378 lipid species in total through lipidomics analysis based on LC-MS/MS. Diabetes caused a significant increase in the content of ceramides (Cer) in the MGs but a significant decrease in the ration of sphingomyelin to ceramides (SM/Cer). The quantity of meibocytes in diabetic mice was dramatically decreased, and the proliferation activity was alleviated, which may be associated with cell cycle arrest caused by diabetes-induced abnormal Cer metabolism in MGs. We found an increase in macrophage and neutrophils infiltration in the diabetic MGs, which may be related to the significant reduction of AcCa in diabetic MGs. Taken together, the results of the present study demonstrated that diabetes induced disruption of lipid homeostasis in MGs, which may mediate the decreased cell proliferation and increased inflammation caused by diabetes in MGs.
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Affiliation(s)
- Huifeng Wang
- Department of Medicine, Qingdao University, Qingdao, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Qingjun Zhou
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Luqin Wan
- Department of Medicine, Qingdao University, Qingdao, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Menglong Guo
- Shanghai Applied Protein Technology Co., Ltd., Shanghai, China
| | - Chen Chen
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Junfa Xue
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Lingling Yang
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.
| | - Lixin Xie
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.
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11
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PDL1 triggered by binding eIF3I contributes to the amelioration of diabetes-associated wound healing defects by regulating IRS4. J Invest Dermatol 2021; 142:220-231.e8. [PMID: 34293353 DOI: 10.1016/j.jid.2021.06.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/10/2021] [Accepted: 06/18/2021] [Indexed: 11/21/2022]
Abstract
Persistent chronic inflammation and delayed epithelialization lead to stalled healing in diabetic ulcers (DUs). PDL1 shows anti-inflammatory and proliferative activities in healing defects, while its function in DU pathogenesis remains unknown. Lower levels of PDL1 were found in DU tissues, and exogenous PDL1 has therapeutic effects in healing process by accelerating re-epithelialization and attenuating prolonged inflammation, which contributed to the delayed wound closure. We detected the downstream effectors of PDL1 using transcriptional profiles, and screened the interacting proteins by IP-MS and Co-IP assays. The biological functions of eIF3I-PDL1-IRS4 axis were tested both in vivo and in vitro. Finally, we validated the expression levels of eIF3I, PDL1, and IRS4 in DU tissues from human clinical samples by immunohistochemistry staining. Mechanistically, PDL1 binds to eIF3I and promotes cutaneous diabetic wound healing by downregulating IRS4. These findings identify the eIF3I-PDL1-IRS4 axis contributes to wound healing defects, which can serve as a potential therapeutic target in DUs.
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12
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Lai CCK, Md Nor N, Kamaruddin NA, Jamil A, Safian N. Comparison of transepidermal water loss and skin hydration in diabetics and nondiabetics. Clin Exp Dermatol 2020; 46:58-64. [PMID: 32619023 DOI: 10.1111/ced.14363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pruritus is common in patients with diabetes mellitus (DM), and may lead to complex dermatological conditions if left untreated. Pruritus can be caused by increased transepidermal water loss (TEWL) and reduced skin hydration. AIMS To compare TEWL and skin hydration in patients with DM and controls, and to investigate associations between TEWL and skin hydration with glycated haemoglobin (HbA1c), fasting blood sugar (FBS), treatment, peripheral neuropathy (PN) and age in patients with diabetes. METHODS This was a prospective, case-control study carried out at a tertiary medical centre in Kuala Lumpur, Malaysia. TEWL and skin hydration measurements were taken at six different body sites in both groups. RESULTS In total, 146 patients (73 cases, 73 controls) were included (24 men and 49 women in each group). No significant difference in TEWL or skin hydration was seen between patients with DM and controls, but there were significant reductions in skin hydration in patients with DM who had FBS > 7 mmol/L (P < 0.01) or PN (P < 0.01). There was a reduction in TEWL over the anterior shin in patients with HbA1c levels > 6.5% (P < 0.02) and an increase in TEWL on the flank in patients on insulin injections at doses of > 1 U/kg/day (P < 0.01). In participants > 45 years old, there was a significant reduction in TEWL (P = 0.04) and hydration (P < 0.04) in the DM and control groups, respectively. CONCLUSION There was no difference in TEWL and skin hydration in patients with DM compared with controls. In the DM group, reduction in skin hydration was associated with uncontrolled FBS and PN but not with HbA1c or DM treatment, whereas TEWL was lower in patients with FBS > 8 mmol/L and increased in patients with higher insulin requirement.
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Affiliation(s)
- C C K Lai
- Departments of, Department of, Medicine, Faculty of Medicine University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N Md Nor
- Departments of, Department of, Medicine, Faculty of Medicine University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N A Kamaruddin
- Departments of, Department of, Medicine, Faculty of Medicine University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A Jamil
- Departments of, Department of, Medicine, Faculty of Medicine University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N Safian
- Department of, Public Health, Faculty of Medicine University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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13
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Stefaniak AA, Zubkiewicz-Kucharska A, Matusiak Ł, Noczyńska A, Szepietowski JC. Itch in Children with Type 1 Diabetes: A Cross-Sectional Study. Dermatol Ther (Heidelb) 2020; 10:745-756. [PMID: 32514836 PMCID: PMC7367954 DOI: 10.1007/s13555-020-00403-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Type 1 diabetes (T1D) is reported to be one of the most common medical conditions in school-age youth and is ranked third in the prevalence of pediatric conditions. Only a few studies have investigated the occurrence of itch in diabetes mellitus, reporting conflicting data. The purpose of this study was to investigate the prevalence of itch in T1D to provide itch characteristics and to explore the potential underlying causes. METHODS This prospective study evaluated itch among 100 children with T1D. Itch intensity was assessed with the Numerical Rating Scale (NRS) and the 4-Item Itch Questionnaire (4IIQ). The Children's Dermatology Life Quality Index (CDLQI) was implemented to assess the quality of life issues. Various clinical features and factors influencing itch were also examined. Skin dryness was evaluated clinically by non-invasive assessment of epidermis moisturizing. RESULTS Itch occurred in 22% of children with T1D with the mean maximal intensity of 5.9 ± 3.0 points in NRS and 6.7 ± 3.5 points in 4IIQ (median, 5.5 points). In the majority of patients, the itch was limited to a few regions of the body; usually, the upper limbs (68.2%) were affected, followed by the lower limbs (50%) and the trunk (31.8%). Clinically examined skin xerosis was significantly more advanced in children with itch compared with those without itch (p < 0.01). The mean CDLQI score in the itchy group was 4.0 ± 4.7 points (median, 2.5 points), indicating a small impairment of quality of life. The intensity of itch (both NRS last 3 days and NRS last 24 h) correlated positively with life quality impairment (R = 0.7; p = 0.015 and R = 0.8, p = 0.002, respectively). CONCLUSIONS Our study found itch as a moderately frequent symptom in children with T1D; however, itch presence and intensity may relevantly debilitate quality of life among subjects. We suggest that dryness of the skin may play a role in the pathogenesis of itch in this population.
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Affiliation(s)
- Aleksandra A Stefaniak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, ul. Chałubińskiego 1, 50-368, Wrocław, Poland
| | - Agnieszka Zubkiewicz-Kucharska
- Department of Endocrinology and Diabetology for Children and Adolescents, Wroclaw Medical University, ul. Chałubińskiego 2a, 50-368, Wrocław, Poland
| | - Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, ul. Chałubińskiego 1, 50-368, Wrocław, Poland
| | - Anna Noczyńska
- Department of Endocrinology and Diabetology for Children and Adolescents, Wroclaw Medical University, ul. Chałubińskiego 2a, 50-368, Wrocław, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, ul. Chałubińskiego 1, 50-368, Wrocław, Poland.
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14
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Ali N, Rezvani HR, Motei D, Suleman S, Mahfouf W, Marty I, Ronkainen VP, Vainio SJ. Trisk 95 as a novel skin mirror for normal and diabetic systemic glucose level. Sci Rep 2020; 10:12246. [PMID: 32699238 PMCID: PMC7376074 DOI: 10.1038/s41598-020-68972-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 07/03/2020] [Indexed: 11/21/2022] Open
Abstract
Developing trustworthy, cost effective, minimally or non-invasive glucose sensing strategies is of great need for diabetic patients. In this study, we used an experimental type I diabetic mouse model to examine whether the skin would provide novel means for identifying biomarkers associated with blood glucose level. We first showed that skin glucose levels are rapidly influenced by blood glucose concentrations. We then conducted a proteomic screen of murine skin using an experimental in vivo model of type I diabetes and wild-type controls. Among the proteins that increased expression in response to high blood glucose, Trisk 95 expression was significantly induced independently of insulin signalling. A luciferase reporter assay demonstrated that the induction of Trisk 95 expression occurs at a transcriptional level and is associated with a marked elevation in the Fluo-4AM signal, suggesting a role for intracellular calcium changes in the signalling cascade. Strikingly, these changes lead concurrently to fragmentation of the mitochondria. Moreover, Trisk 95 knockout abolishes both the calcium flux and the mitochondrial phenotype changes indicating dependency of glucose flux in the skin on Trisk 95 function. The data demonstrate that the skin reacts robustly to systemic blood changes, and that Trisk 95 is a promising biomarker for a glucose monitoring assembly.
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Affiliation(s)
- Nsrein Ali
- Laboratory of Developmental Biology, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, University of Oulu, Aapistie 5A, 90220, Oulu, Finland. .,Infotech Oulu, University of Oulu, 90220, Oulu, Finland.
| | - Hamid Reza Rezvani
- Inserm, BMGIC, UMR 1035, University of Bordeaux, Bordeaux, France.,Centre de Référence pour les Maladies Rares de la Peau, CHU de Bordeaux, Bordeaux, France
| | - Diana Motei
- Laboratory of Developmental Biology, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, University of Oulu, Aapistie 5A, 90220, Oulu, Finland
| | - Sufyan Suleman
- Laboratory of Developmental Biology, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, University of Oulu, Aapistie 5A, 90220, Oulu, Finland
| | - Walid Mahfouf
- Inserm, BMGIC, UMR 1035, University of Bordeaux, Bordeaux, France
| | - Isabelle Marty
- Inserm U1216, Grenoble Institut des Neurosciences, University Grenoble, La Tronche, France
| | | | - Seppo J Vainio
- Laboratory of Developmental Biology, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, University of Oulu, Aapistie 5A, 90220, Oulu, Finland.,Infotech Oulu, University of Oulu, 90220, Oulu, Finland.,Borealis Biobank of Northern Finland, Oulu University Hospital, Oulu, Finland
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15
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Tsuruoka K, Oe M, Minematsu T, Tomida S, Ohashi Y, Shimojima Y, Mori Y, Nitta S, Qin Q, Abe M, Yamauchi T, Sanada H. Skin characteristics associated with foot callus in people with diabetes: A cross-sectional study focused on desmocollin1 in corneocytes. J Tissue Viability 2020; 29:291-296. [PMID: 32653294 DOI: 10.1016/j.jtv.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/16/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this study was to investigate the degradation of desmocollin-1 (DSC1), a member of the desmosomal cadherin family in patients with diabetes, as well as the factors associated with the suppression of DSC1 degradation. METHODS This cross-sectional study included 60 cases of foot callus involving 30 patients with diabetes (DM) and 30 matched volunteers without diabetes (non-DM). DSC1 degradation in samples from debrided calluses was analysed using western blotting. Skin hydration, a factor reported to suppress DSC1 degradation, was measured using a mobile moisture device. RESULTS Full-length DSC1 (approximately 100 kDa) was detected in six participants only in the DM group, and no relationship was found between the suppression of DSC1 degradation and decreased skin hydration in the DM group. There was no significant difference in skin hydration values between the DM and non-DM groups. CONCLUSION DSC1 degradation was suppressed in the DM group. There was no relationship between the suppression of DSC1 degradation and decreased skin hydration in the DM group. Current external force callus care would not be sufficient. This study highlights the need to develop novel callus care to enhance the degradation of DSC1.
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Affiliation(s)
- Kahori Tsuruoka
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Makoto Oe
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Minematsu
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sanai Tomida
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yumiko Ohashi
- Nursing Department, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuko Shimojima
- Nursing Department, The University of Tokyo Hospital, Tokyo, Japan
| | - Yukie Mori
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shiori Nitta
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Qi Qin
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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16
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Wilkinson HN, Hardman MJ. Wound senescence: A functional link between diabetes and ageing? Exp Dermatol 2020; 30:68-73. [PMID: 32009254 DOI: 10.1111/exd.14082] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 12/11/2022]
Abstract
Arguably, the two most important causes of pathological healing in the skin are diabetes and ageing. While these factors have historically been considered independent modifiers of the healing process, recent studies suggest that they may be mechanistically linked. The primary contributor to diabetic pathology is hyperglycaemia, which accelerates the production of advanced glycation end products, a characteristic of ageing tissue. Indeed, advanced age also leads to mild hyperglycaemia. Here, we discuss emerging literature that reveals a hitherto unappreciated link between cellular senescence, diabetes and wound repair. Senescent cells cause widespread destruction of normal tissue architecture in ageing and have been shown to be increased in chronic wounds. However, the role of senescence remains controversial, with several studies reporting beneficial effects for transiently induced senescence in wound healing. We recently highlighted a direct role for senescence in diabetic healing pathology, mediated by the senescence receptor, CXCR2. These findings suggest that targeting local tissue senescence may provide a therapeutic strategy applicable to a broad range of chronic wound types.
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Affiliation(s)
- Holly N Wilkinson
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, The University of Hull, Hull, UK
| | - Matthew J Hardman
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, The University of Hull, Hull, UK
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17
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Contribution of Palmitic Acid to Epidermal Morphogenesis and Lipid Barrier Formation in Human Skin Equivalents. Int J Mol Sci 2019; 20:ijms20236069. [PMID: 31810180 PMCID: PMC6928966 DOI: 10.3390/ijms20236069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 11/28/2019] [Accepted: 11/30/2019] [Indexed: 12/15/2022] Open
Abstract
The outermost barrier layer of the skin is the stratum corneum (SC), which consists of corneocytes embedded in a lipid matrix. Biosynthesis of barrier lipids occurs de novo in the epidermis or is performed with externally derived lipids. Hence, in vitro developed human skin equivalents (HSEs) are developed with culture medium that is supplemented with free fatty acids (FFAs). Nevertheless, the lipid barrier formation in HSEs remains altered compared to native human skin (NHS). The aim of this study is to decipher the role of medium supplemented saturated FFA palmitic acid (PA) on morphogenesis and lipid barrier formation in HSEs. Therefore, HSEs were developed with 100% (25 μM), 10%, or 1% PA. In HSEs supplemented with reduced PA level, the early differentiation was delayed and epidermal activation was increased. Nevertheless, a similar SC lipid composition in all HSEs was detected. Additionally, the lipid organization was comparable for lamellar and lateral organization, irrespective of PA concentration. As compared to NHS, the level of monounsaturated lipids was increased and the FFA to ceramide ratio was drastically reduced in HSEs. This study describes the crucial role of PA in epidermal morphogenesis and elucidates the role of PA in lipid barrier formation of HSEs.
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18
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Aoki M, Murase T. Obesity-associated insulin resistance adversely affects skin function. PLoS One 2019; 14:e0223528. [PMID: 31581253 PMCID: PMC6776356 DOI: 10.1371/journal.pone.0223528] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/23/2019] [Indexed: 01/12/2023] Open
Abstract
The aim of this study was to identify changes in skin function associated with obesity and the mechanisms underlying these changes. Functional changes and gene expression in skin were investigated in C57BL/6J mice fed either a control or high-fat diet (HFD). The insulin responsiveness of the skin and skeletal muscle was also evaluated. The effects of inhibiting insulin signaling and altered glucose concentration on skin function-associated molecules and barrier function were analyzed in keratinocytes. HFD-fed mice were not only severely obese, but also exhibited impaired skin barrier function and diminished levels of glycerol transporter aquaporin-3, keratins, and desmosomal proteins involved in maintaining skin structure. Moreover, the expression of cell cycle regulatory molecules was altered. Insulin signaling was attenuated in the skin and skeletal muscle of HFD-fed mice. In keratinocytes, inhibition of insulin signaling leads to decreased keratin expression and diminished barrier function, and higher glucose concentrations increased the expression of CDK inhibitor 1A and 1C, which are associated with cell-cycle arrest. Obesity-associated impairment of skin function can be attributed to structural fragility, abnormal glycerol transport, and dysregulated proliferation of epidermal cells. These alterations are at least partly due to cutaneous insulin resistance and hyperglycemia.
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Affiliation(s)
- Masafumi Aoki
- Biological Science Laboratories, Kao Corporation, Ichikai-machi, Haga-gun, Tochigi, Japan
| | - Takatoshi Murase
- Biological Science Laboratories, Kao Corporation, Ichikai-machi, Haga-gun, Tochigi, Japan
- * E-mail:
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19
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Lechner A, Akdeniz M, Tomova-Simitchieva T, Bobbert T, Moga A, Lachmann N, Blume-Peytavi U, Kottner J. Comparing skin characteristics and molecular markers of xerotic foot skin between diabetic and non-diabetic subjects: An exploratory study. J Tissue Viability 2019; 28:200-209. [PMID: 31575473 DOI: 10.1016/j.jtv.2019.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/06/2019] [Accepted: 09/23/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Xerosis cutis of the feet is one of the most common skin conditions among type 2 diabetics. Whether skin dryness among diabetic patients is different from 'general' skin dryness is unclear. The overall aim was to compare the structure, function and molecular markers of dry and cracked foot skin between diabetics and non-diabetics. METHODS The foot skin of 40 diabetics and 20 non-diabetics was evaluated. A clinical assessment of skin dryness was performed and transepidermal water loss, stratum corneum hydration, skin surface pH, epidermal thickness, skin roughness, elasticity and structural stiffness were measured. Ceramides, natural moisturizing factors, histamines, proteins and molecular markers of oxidative stress were analyzed based on a non-invasive sampling method for collection of surface biomarkers. RESULTS The mean number of superficial fissures in the diabetic group was nearly three times higher than in the non-diabetic group (11.0 (SD 6.2) vs. 3.9 (SD 4.2)). The skin stiffness was higher in the diabetic group and the values of almost all molecular markers showed considerably higher values compared to non-diabetics. Malondialdehyde and glutathione were lower in the diabetic sample. CONCLUSIONS The high number of superficial fissures may be based on an increased stiffness of dry diabetic foot skin combined with different concentrations of molecular markers in the stratum corneum compared to dry foot skin of non-diabetics.
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Affiliation(s)
- Anna Lechner
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Berlin, Germany.
| | - Merve Akdeniz
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Berlin, Germany.
| | - Tsenka Tomova-Simitchieva
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Berlin, Germany.
| | - Thomas Bobbert
- Charité-Universitätsmedizin Berlin, Department of Diabetology and Endocrinology, Berlin, Germany.
| | | | | | - Ulrike Blume-Peytavi
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Berlin, Germany.
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Berlin, Germany.
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Ikarashi N, Mizukami N, Kon R, Kaneko M, Uchino R, Fujisawa I, Fukuda N, Sakai H, Kamei J. Study of the Mechanism Underlying the Onset of Diabetic Xeroderma Focusing on an Aquaporin-3 in a Streptozotocin-Induced Diabetic Mouse Model. Int J Mol Sci 2019; 20:ijms20153782. [PMID: 31382467 PMCID: PMC6696158 DOI: 10.3390/ijms20153782] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 12/16/2022] Open
Abstract
Xeroderma is a frequent complication in diabetic patients. In this study, we investigated the mechanism underlying the onset of diabetic xeroderma, focusing on aquaporin-3 (AQP3), which plays an important role in water transport in the skin. Dermal water content in diabetic mice was significantly lower than that in control mice. The expression level of AQP3 in the skin was significantly lower in diabetic mice than in control mice. One week after streptozotocin (STZ) treatment, despite their increased blood glucose levels, mice showed no changes in the expression levels of AQP3, Bmal1, Clock, and D site-binding protein (Dbp) in the skin and 8-hydroxydeoxyguanosine (8-OHdG) in the urine. In contrast, two weeks after STZ treatment, mice showed increases in the blood glucose level, decreases in AQP3, Bmal1, Clock, and Dbp levels, and increases in the urinary levels of 8-OHdG. The results of this study suggest that skin AQP3 expression decreases in diabetes, which may limit water transport from the vessel side to the corneum side, causing dry skin. In addition, in diabetic mice, increased oxidative stress triggered decreases in the expression levels of Bmal1 and Clock in the skin, thereby inhibiting the transcription of Aqp3 by Dbp, which resulted in decreased AQP3 expression.
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Affiliation(s)
- Nobutomo Ikarashi
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan.
| | - Nanaho Mizukami
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Risako Kon
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan.
| | - Miho Kaneko
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Ryogo Uchino
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Izumi Fujisawa
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Natsuko Fukuda
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Hiroyasu Sakai
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Junzo Kamei
- Department of Biomolecular Pharmacology, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
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Unravelling effects of relative humidity on lipid barrier formation in human skin equivalents. Arch Dermatol Res 2019; 311:679-689. [PMID: 31321505 PMCID: PMC6787114 DOI: 10.1007/s00403-019-01948-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/19/2019] [Accepted: 07/02/2019] [Indexed: 12/15/2022]
Abstract
Relative humidity (RH) levels vary continuously in vivo, although during in vitro generation of three-dimensional human skin equivalents (HSEs) these remain high (90-95%) to prevent evaporation of the cell-culture medium. However, skin functionality is directly influenced by environmental RH. As the barrier formation in HSEs is different, there is a need to better understand the role of cell-culture conditions during the generation of HSEs. In this study, we aim to investigate the effects of RH on epidermal morphogenesis and lipid barrier formation in HSEs. Therefore, two types of HSEs were developed at 90% or at 60% RH. Assessments were performed to determine epidermal morphogenesis by immunohistochemical analyses, ceramide composition by lipidomic analysis, and lipid organization by Fourier transform infrared spectroscopy and small-angle X-ray diffraction. We show that reduction of RH mainly affected the uppermost viable epidermal layers in the HSEs, including an enlargement of the granular cells and induction of epidermal cell activation. Neither the composition nor the organization of the lipids in the intercorneocyte space were substantially altered at reduced RH. In addition, lipid processing from glucosylceramides to ceramides was not affected by reduced RH in HSEs as shown by enzyme expression, enzyme activity, and substrate-to-product ratio. Our results demonstrate that RH directly influences epidermal morphogenesis, albeit the in vitro lipid barrier formation is comparable at 90% and 60% RH.
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22
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Mieremet A, van Dijk R, Gooris G, Bouwstra JA, El Ghalbzouri A. Shedding light on the effects of 1,25-dihydroxyvitamin D 3 on epidermal lipid barrier formation in three-dimensional human skin equivalents. J Steroid Biochem Mol Biol 2019; 189:19-27. [PMID: 30711472 DOI: 10.1016/j.jsbmb.2019.01.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/17/2019] [Accepted: 01/30/2019] [Indexed: 11/25/2022]
Abstract
Human skin equivalents (HSEs) are three dimensional models resembling native human skin (NHS) in many aspects. Despite the manifold similarities to NHS, a restriction in its applications is the altered in vitro lipid barrier formation, which compromises the barrier functionality. This could be induced by suboptimal cell culturing conditions, which amongst others is the diminished activation of the vitamin D receptor (VDR) signalling pathway. The active metabolite of this signalling pathway is 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). An interacting role in the formation of the skin barrier has been ascribed to this pathway, although it remains unresolved to which extent this pathway contributes to the (mal-)formation of the epidermal barrier in HSEs. Our aim is to study whether cell culture medium enriched with 1,25(OH)2D3 affects epidermal morphogenesis and lipid barrier formation in HSEs. Addition of 20 nM 1,25(OH)2D3 resulted in activation of the VDR signalling pathway by inducing transcription of VDR target genes (CYP24A and LL37) in keratinocyte monocultures and in HSEs. Characterization of HSEs supplemented with 1,25(OH)2D3 using immunohistochemical analyses revealed a high similarity in epidermal morphogenesis and in expression of lipid processing enzymes. The barrier formation was assessed using state-of-the art techniques analysing lipid composition and organization. Addition of 1,25(OH)2D3 did not alter the composition of ceramides. Additionally, the lateral and lamellar organization of the lipids was similar, irrespective of supplementation. In conclusion, epidermal morphogenesis and barrier formation in HSEs generated in presence or absence of 1,25(OH)2D3 leads to a similar morphogenesis and comparable barrier formation in vitro.
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Affiliation(s)
- Arnout Mieremet
- Department of Dermatology, Leiden University Medical Centre, the Netherlands; Division of BioTherapeutics, Leiden Academic Centre for Drug Research, the Netherlands
| | - Rianne van Dijk
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, the Netherlands
| | - Gert Gooris
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, the Netherlands
| | - Joke A Bouwstra
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, the Netherlands
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Skin Hydration Level as a Predictor for Diabetic Wound Healing: A Retrospective Study. Plast Reconstr Surg 2019; 143:848e-856e. [PMID: 30676507 DOI: 10.1097/prs.0000000000005474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND In the diabetic foot, the skin may crack and develop fissures, potentially increasing vulnerability to ulceration and infection. Therefore, maintaining adequate skin hydration may be crucial for diabetic wound healing. However, no clinical study has addressed this issue. This study aimed to determine and compare the effect of the skin hydration level on diabetic wound healing with that of the tissue oxygenation level, which is recognized as the most reliable parameter in predicting diabetic wound healing. METHODS This retrospective study included 263 diabetic patients with forefoot ulcers. Skin hydration and transcutaneous oxygen pressure data collected before and after percutaneous transluminal angioplasty were analyzed. Skin hydration and tissue oxygenation were graded as poor, moderate, or acceptable. Wound healing outcomes were graded as healed without amputation, minor amputation, or major amputation. Wound healing outcomes were compared using four parameters: skin hydration at baseline, transcutaneous oxygen pressure at baseline, post-percutaneous transluminal angioplasty skin hydration, and post-percutaneous transluminal angioplasty transcutaneous oxygen pressure. RESULTS Each of the four parameters exhibited statistically significant correlations with wound healing outcomes. In the concurrent analysis of both skin hydration and transcutaneous oxygen pressure, skin hydration was a dominant parameter (p = 0.0018) at baseline, whereas transcutaneous oxygen pressure was a dominant parameter (p < 0.0001) following percutaneous transluminal angioplasty. CONCLUSIONS Skin hydration level might be a useful predictor for diabetic wound healing. In particular, the skin hydration level before recanalization was found to be superior to transcutaneous oxygen pressure in predicting wound healing. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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24
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The Dynamics of the Skin's Immune System. Int J Mol Sci 2019; 20:ijms20081811. [PMID: 31013709 PMCID: PMC6515324 DOI: 10.3390/ijms20081811] [Citation(s) in RCA: 310] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022] Open
Abstract
The skin is a complex organ that has devised numerous strategies, such as physical, chemical, and microbiological barriers, to protect the host from external insults. In addition, the skin contains an intricate network of immune cells resident to the tissue, crucial for host defense as well as tissue homeostasis. In the event of an insult, the skin-resident immune cells are crucial not only for prevention of infection but also for tissue reconstruction. Deregulation of immune responses often leads to impaired healing and poor tissue restoration and function. In this review, we will discuss the defensive components of the skin and focus on the function of skin-resident immune cells in homeostasis and their role in wound healing.
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25
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Kim M, Jeong H, Lee B, Cho Y, Yoon WK, Cho A, Kwon G, Nam KT, Ha H, Lim KM. Enrichment of Short-Chain Ceramides and Free Fatty Acids in the Skin Epidermis, Liver, and Kidneys of db/db Mice, a Type 2 Diabetes Mellitus Model. Biomol Ther (Seoul) 2019; 27:457-465. [PMID: 30739427 PMCID: PMC6720538 DOI: 10.4062/biomolther.2018.214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 01/10/2023] Open
Abstract
Patients with diabetes mellitus (DM) often suffer from diverse skin disorders, which might be attributable to skin barrier dysfunction. To explore the role of lipid alterations in the epidermis in DM skin disorders, we quantitated 49 lipids (34 ceramides, 14 free fatty acids (FFAs), and cholesterol) in the skin epidermis, liver, and kidneys of db/db mice, a Type 2 DM model, using UPLC-MS/MS. The expression of genes involved in lipid synthesis was also evaluated. With the full establishment of hyperglycemia at the age of 20 weeks, remarkable lipid enrichment was noted in the skin of the db/db mice, especially at the epidermis and subcutaneous fat bed. Prominent increases in the ceramides and FFAs (>3 fold) with short or medium chains (<C26) occurred in the skin epidermis (16NS, 18NS, 24NS, 16NDS, 18NDS, 20NDS, 22NDS, 24NDS, C16:1FA, C18:2FA, and C18:1FA) and the liver (16NS, 18NS, 20NS, 24:1NS, 18NDS, 20NDS, 22NDS, C16:1FA, C18:2FA, C18:1FA), whereas those with very long chains were not affected. In the kidney, only slight increases (<3 fold) were observed for 16NS, 18NS, 20NS, 26NDS, C26FA, and C22:1FA. Consistently, LXRα/β and PPARγ, nuclear receptors promoting lipid synthesis, lipid synthesis enzymes such as elongases 1, 4, and 6, and fatty acid synthase and stearoyl-CoA desaturase were highly expressed in the skin and livers of the db/db mice. Collectively, our study demonstrates an extensive alteration in the skin and systemic lipid profiles of db/db mice, which could contribute to the development of skin disorders in DM.
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Affiliation(s)
- Minjeong Kim
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Haengdueng Jeong
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Buhyun Lee
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Yejin Cho
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Won Kee Yoon
- Laboratory Animal Resource Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Cheongju 28116, Republic of Korea
| | - Ahreum Cho
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Guideock Kwon
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Ki Taek Nam
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hunjoo Ha
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Kyung-Min Lim
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea
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26
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Sekijima H, Goto K, Hiramoto K, Komori R, Ooi K. Characterization of dry skin associating with type 2 diabetes mellitus using a KK-Ay/TaJcl mouse model. Cutan Ocul Toxicol 2018; 37:391-395. [DOI: 10.1080/15569527.2018.1490746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Hidehisa Sekijima
- Faculty of Pharmaceutical Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Kenji Goto
- Faculty of Pharmaceutical Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Keiichi Hiramoto
- Faculty of Pharmaceutical Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Rio Komori
- Faculty of Pharmaceutical Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Kazuya Ooi
- Faculty of Pharmaceutical Science, Suzuka University of Medical Science, Suzuka, Japan
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27
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Soltanipoor M, Stilla T, Riethmüller C, Thyssen JP, Sluiter JK, Rustemeyer T, Fischer TW, Kezic S, Angelova-Fischer I. Specific barrier response profiles after experimentally induced skin irritation in vivo. Contact Dermatitis 2018; 79:59-66. [PMID: 29607504 PMCID: PMC6099430 DOI: 10.1111/cod.12981] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 12/25/2022]
Abstract
Background Recently, natural moisturizing factors (NMFs) and corneocyte surface topography were suggested as biomarkers for irritant dermatitis. Objectives To investigate how exposure to different irritants influences corneocyte surface topography, NMF levels and the barrier function of human skin in vivo. Methods Eight healthy adult volunteers were exposed to aqueous solutions of 60% n‐propanol, 0.5% sodium lauryl sulfate (SLS), 0.15% sodium hydroxide, and 2.0% acetic acid, and distilled water, in a repeated irritation test over a period of 96 hours. Erythema, transepidermal water loss (TEWL), skin hydration, the dermal texture index (DTI) and NMF levels were measured at baseline, and after 24 and 96 hours. Results SLS and sodium hydroxide had the most pronounced effects on erythema and TEWL. Although n‐propanol caused only slight changes in TEWL and erythema, it showed pronounced effects on skin hydration, NMF levels, and the DTI. NMF was the only parameter that was significantly altered by all investigated irritants. The changes in the DTI were inversely associated with NMF levels and skin hydration. Conclusion Skin barrier impairment and the inflammatory response are irritant‐specific, emphasizing the need for a multiparametric approach to the study of skin irritation. NMF levels seem to be the most sensitive parameter in detecting irritant‐induced skin barrier alterations.
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Affiliation(s)
- Maryam Soltanipoor
- Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.,Department of Dermatology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Tasja Stilla
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Christoph Riethmüller
- Centre for Nanotechnology, Serend-ip GmbH, Centre for Nanotechnology, Münster, Germany
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, University of Copenhagen, Hellerup, Denmark
| | - Judith K Sluiter
- Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Tobias W Fischer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Sanja Kezic
- Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
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28
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Kim JH, Yoon NY, Kim DH, Jung M, Jun M, Park HY, Chung CH, Lee K, Kim S, Park CS, Liu KH, Choi EH. Impaired permeability and antimicrobial barriers in type 2 diabetes skin are linked to increased serum levels of advanced glycation end-product. Exp Dermatol 2018; 27:815-823. [PMID: 29151267 DOI: 10.1111/exd.13466] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 12/17/2022]
Abstract
The incidence of type 2 diabetes mellitus (DM) has been increasing rapidly, and the disease has become a serious sociomedical problem. Many skin problems, such as xerosis, pruritus, skin infections and delayed wound healing, that might be related to chronic impairment of skin barrier function decrease the quality of life in patients with DM. However, the status of the permeability and antimicrobial barrier of the skin in DM remains unknown. This study aimed to elucidate skin barrier impairment in patients with type 2 DM and its pathomechanisms using classic animal models of type 2 DM. Functional studies of the skin barrier and an analysis of stratum corneum (SC) lipids were compared between patients with type 2 DM and age- and sex-matched non-diabetes controls. Also, functional studies on the skin barrier, epidermal lipid analyses, and electron microscopy and biomolecular studies were performed using type 2 DM animal models, db/db and ob/ob mice. Patients with type 2 DM presented with epidermal barrier impairments, including SC hydration, which was influenced by blood glucose control (HbA1c level). In the lipid analysis of SC, ceramides, fatty acids and cholesterol were significantly decreased in patients with type 2 DM compared with controls. Type 2 DM murine models presented with severe hyperglycaemia, impairment of skin barrier homeostasis, decreases in epidermal proliferation and epidermal lipid synthesis, decreases in lamellar body (LB) and epidermal antimicrobial peptides (AMPs), an increase in receptors for advanced glycation end-product (AGE) in the epidermis and an increase in serum AGE. Impairment of the skin barrier was observed in type 2 DM, which results in part from a decrease in epidermal proliferation. Serum AGE and its epidermal receptors were increased in type 2 diabetic mice which display impaired skin barrier parameters such as epidermal lipid synthesis, LB production, epidermal AMP and SC lipids.
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Affiliation(s)
- Jae-Hong Kim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Na Young Yoon
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong Hye Kim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Minyoung Jung
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Myungsoo Jun
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hwa-Young Park
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Choon Hee Chung
- Department of Internal medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyohoon Lee
- Department of Chemical and Biochemical Engineering, Dongguk University, Seoul, Korea
| | - Sunki Kim
- Department of Chemical and Biochemical Engineering, Dongguk University, Seoul, Korea
| | - Chang Seo Park
- Department of Chemical and Biochemical Engineering, Dongguk University, Seoul, Korea
| | - Kwang-Hyeon Liu
- College of Pharmacy and Research, Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea
| | - Eung Ho Choi
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
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29
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Tončić RJ, Kezić S, Hadžavdić SL, Marinović B. Skin barrier and dry skin in the mature patient. Clin Dermatol 2017; 36:109-115. [PMID: 29566915 DOI: 10.1016/j.clindermatol.2017.10.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Dry skin is the most common clinical manifestation of dermatologic diseases, and it presents with itching, redness, and desquamation-signs and clinical manifestations that are not only physically uncomfortable but also affect patients psychologically. The water content in the stratum corneum is largely dependent on the composition and amount of the intercellular lipids, which regulate the loss of water from the skin, and on the levels of hygroscopic substances of the natural moisturizing factors, which are responsible for retention of water in the stratum corneum. Prevention of water loss and penetration of potentially toxic substances and microorganisms into the body are the most important functions of the skin, which acts as a natural frontier between the inner organism and the environment. Skin barrier defects occur in several skin diseases, but the influence of aging on the skin barrier function is largely unknown and conflicting results have been reported. In this review, the structure and function of the barrier in relation to the aging process are discussed.
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Affiliation(s)
- Ružica Jurakić Tončić
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
| | - Sanja Kezić
- Academic Medical Center Amsterdam, Coronel Institute of Occupational Health, Amsterdam, The Netherlands
| | - Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
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30
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Shetage SS, Traynor MJ, Brown MB, Galliford TM, Chilcott RP. Application of sebomics for the analysis of residual skin surface components to detect potential biomarkers of type-1 diabetes mellitus. Sci Rep 2017; 7:8999. [PMID: 28827705 PMCID: PMC5566448 DOI: 10.1038/s41598-017-09014-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/20/2017] [Indexed: 02/04/2023] Open
Abstract
Metabolic imbalance in chronic diseases such as type-1 diabetes may lead to detectable perturbations in the molecular composition of residual skin surface components (RSSC). This study compared the accumulation rate and the composition of RSSC in type-1 diabetic patients with those in matched controls in order to identify potential biomarkers of the disease. Samples of RSSC were collected from the foreheads of type-1 diabetic (n = 55) and non-diabetic (n = 58) volunteers. Samples were subsequently analysed to identify individual components (sebomic analysis). There was no significant difference in the rate of accumulation of RSSC between type-1 diabetics and controls. In terms of molecular composition, 171 RSSC components were common to both groups, 27 were more common in non-diabetics and 18 were more common in type-1 diabetic patients. Statistically significant (P < 0.05) differences between diabetic and non-diabetic volunteers were observed in the recovered amounts of one diacylglyceride (m/z 594), six triacylglycerides (m/z 726-860) and six free fatty acids (m/z 271-345). These findings indicate that sebomic analysis can identify differences in the molecular composition of RSSC components between type-1 diabetic and non-diabetic individuals. Further work is required to determine the practical utility and identity of these potential biomarkers.
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Affiliation(s)
- Satyajit S Shetage
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK
| | - Matthew J Traynor
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK
| | - Marc B Brown
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK
- MedPharm Ltd, 50 Occam Road, Surrey Research Park, Guildford, Surrey, GU2 7AB, UK
| | - Thomas M Galliford
- West Hertfordshire Hospitals NHS Trust, Watford General Hospital, Watford, WD18 0HP, UK
| | - Robert P Chilcott
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK.
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31
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Okano J, Kojima H, Katagi M, Nakagawa T, Nakae Y, Terashima T, Kurakane T, Kubota M, Maegawa H, Udagawa J. Hyperglycemia Induces Skin Barrier Dysfunctions with Impairment of Epidermal Integrity in Non-Wounded Skin of Type 1 Diabetic Mice. PLoS One 2016; 11:e0166215. [PMID: 27846299 PMCID: PMC5113047 DOI: 10.1371/journal.pone.0166215] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/25/2016] [Indexed: 11/18/2022] Open
Abstract
Diabetes causes skin complications, including xerosis and foot ulcers. Ulcers complicated by infections exacerbate skin conditions, and in severe cases, limb/toe amputations are required to prevent the development of sepsis. Here, we hypothesize that hyperglycemia induces skin barrier dysfunction with alterations of epidermal integrity. The effects of hyperglycemia on the epidermis were examined in streptozotocin-induced diabetic mice with/without insulin therapy. The results showed that dye leakages were prominent, and transepidermal water loss after tape stripping was exacerbated in diabetic mice. These data indicate that hyperglycemia impaired skin barrier functions. Additionally, the distribution of the protein associated with the tight junction structure, tight junction protein-1 (ZO-1), was characterized by diffuse and significantly wider expression in the diabetic mice compared to that in the control mice. In turn, epidermal cell number was significantly reduced and basal cells were irregularly aligned with ultrastructural alterations in diabetic mice. In contrast, the number of corneocytes, namely, denucleated and terminally differentiated keratinocytes significantly increased, while their sensitivity to mechanical stress was enhanced in the diabetic mice. We found that cell proliferation was significantly decreased, while apoptotic cells were comparable in the skin of diabetic mice, compared to those in the control mice. In the epidermis, Keratin 5 and keratin 14 expressions were reduced, while keratin 10 and loricrin were ectopically induced in diabetic mice. These data suggest that hyperglycemia altered keratinocyte proliferation/differentiation. Finally, these phenotypes observed in diabetic mice were mitigated by insulin treatment. Reduction in basal cell number and perturbation of the proliferation/differentiation process could be the underlying mechanisms for impaired skin barrier functions in diabetic mice.
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Affiliation(s)
- Junko Okano
- Department of Anatomy and Cell Biology, Shiga University of Medical Science, Shiga, Japan
- * E-mail:
| | - Hideto Kojima
- Departments of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Miwako Katagi
- Departments of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Takahiko Nakagawa
- Industry-Academia-Government Collaboration Center of Nara Medical University, Nara, Japan
| | - Yuki Nakae
- Departments of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Tomoya Terashima
- Departments of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Takeshi Kurakane
- Department of Anatomy and Cell Biology, Shiga University of Medical Science, Shiga, Japan
| | - Mamoru Kubota
- Department of Anatomy and Cell Biology, Shiga University of Medical Science, Shiga, Japan
| | - Hiroshi Maegawa
- Internal Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Jun Udagawa
- Department of Anatomy and Cell Biology, Shiga University of Medical Science, Shiga, Japan
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Hu SCS, Lan CCE. High-glucose environment disturbs the physiologic functions of keratinocytes: Focusing on diabetic wound healing. J Dermatol Sci 2016; 84:121-127. [PMID: 27461757 DOI: 10.1016/j.jdermsci.2016.07.008] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 07/15/2016] [Indexed: 12/15/2022]
Abstract
Impaired wound healing is a common and potentially serious complication in patients with diabetes. In recent years, disturbed physiologic functions of epidermal keratinocytes have been found to play a central role in the poor healing ability of diabetic wounds. Factors involving keratinocytes that may contribute to the dysfunctional wound healing process in diabetes include impaired keratinocyte migration and proliferation, gap junction abnormalities, chronic inflammation, chronic infections associated with defective innate immunity, impaired angiogenesis, increased oxidative stress, and abnormal expression of matrix metalloproteinases (MMPs). In this review article, we provide evidence from the scientific literature for the molecular mechanisms of delayed wound healing in diabetes, with particular emphasis on keratinocytes. Elucidating the spectrum of molecular and functional abnormalities in keratinocytes induced by high-glucose environment may lead to more effective and individualized therapeutic strategies for the prevention and management of chronic diabetic wounds.
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Affiliation(s)
- Stephen Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Che E Lan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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de Macedo GMC, Nunes S, Barreto T. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review. Diabetol Metab Syndr 2016; 8:63. [PMID: 27583022 PMCID: PMC5006568 DOI: 10.1186/s13098-016-0176-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 08/09/2016] [Indexed: 01/19/2023] Open
Abstract
Skin disorders, usually neglected and frequently underdiagnosed among diabetic patients, are common complications and encounter a broad spectrum of disorders in both type 1 and type 2 diabetes mellitus (DM)-e.g. cutaneous infection, dry skin, pruritus. Skin disorders are highly associated with increased risk of important outcomes, such as skin lesions, ulcerations and diabetic foot, which can lead to major complications and revolve around multifactorial factors besides hyperglycemia and advanced glycation end products. Although diabetic's skin disorders are consistent in the literature, there is limited data regarding early-stage skin disorders in DM patients. Disease control, early-stage treatment (e.g. skin hydration, orthotic devices) and awareness can reduce morbidity of DM patients. Thus, better understanding of the burden of skin disorders in DM patients may raise awareness on prevention and management. Therefore, the aim of this study is to perform a literature review to evaluate the main clinical characteristics and complications of skin disorders in diabetic's patients. Additionally, physiopathology early-stage skin disorders and dermocosmetic management were also reviewed.
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Affiliation(s)
- Geisa Maria Campos de Macedo
- Endocrine and Diabetes Department, Agamenon Magalhães Hospital, Estrada do Arraial, 2723, Casa Amarela, Recife, PE 52070-230 Brazil
| | - Samanta Nunes
- Brazilian Society of Dermatology São Paulo, São Paulo, 05423 010 Brazil
| | - Tania Barreto
- Diabetes Division, Sanofi, São Paulo, São Paulo 05693-000 Brazil
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Lehman PA, Franz TJ. Effect of Induced Acute Diabetes and Insulin Therapy on Stratum Corneum Barrier Function in Rat Skin. Skin Pharmacol Physiol 2014; 27:249-53. [DOI: 10.1159/000357478] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 11/20/2013] [Indexed: 11/19/2022]
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Zoumpliou V, Stamatiadi M, Vassiliadis C, Rallis M, Papaioannou GT, Liakos S, Angelou A, Daskalaki S, Kyriazi M, Roussis V, Vagias C. Effect of Cigarette Smoke on Diabetic Skin and Protection with Topical Administration of Pinus halepensis Extract. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ajps.2014.526415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Quondamatteo F. Skin and diabetes mellitus: what do we know? Cell Tissue Res 2013; 355:1-21. [PMID: 24318789 DOI: 10.1007/s00441-013-1751-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 10/29/2013] [Indexed: 12/20/2022]
Abstract
Diabetes mellitus (DM) is becoming increasingly prevalent worldwide. Although major complications of this condition involve kidney, retina and peripheral nerves, the skin of diabetic patients is also frequently injured. Hence, interest is mounting in the definition of the structural and molecular profile of non-complicated diabetic skin, i.e., before injuries occur. Most of the available knowledge in this area has been obtained relatively recently and, in part, derives from various diabetic animal models. These include both insulin-dependent and insulin-resistant models. Structural work in human diabetic skin has also been carried out by means of tissue samples or of non-invasive methods. Indications have indeed been found for molecular/structural changes in diabetic skin. However, the overall picture that emerges is heterogeneous, incomplete and often contradictory and many questions remain unanswered. This review aims to detail, as much as possible, the various pieces of current knowledge in a systematic and synoptic manner. This should aid the identification of areas in which key questions are still open and more research is needed. A comprehensive understanding of this field could help in determining molecular targets for the prevention and treatment of skin injuries in DM and markers for the monitoring of cutaneous and systemic aspects of the disease. Additionally, with the increasing development of non-invasive optics-based deep-tissue-imaging diagnostic technologies, precise knowledge of cutaneous texture and molecular structure becomes an important pre-requisite for the use of such methods in diabetic patients.
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Affiliation(s)
- Fabio Quondamatteo
- Skin and ECM Research Group-Anatomy, NUI Galway, Anatomy Building, University Road, Galway, Ireland,
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Li SS, Song ZH, Xiong LQ, Zhang Q, Liu Q, Li GF. The percutaneous permeability and absorption of dexamethasone esters in diabetic rats: a preliminary study. Drug Deliv 2013; 21:17-25. [PMID: 24102159 DOI: 10.3109/10717544.2013.838809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To evaluate the influence of diabetes on the permeation of dexamethasone acetate (DA) and dexamethansone sodium phosphate (DSP), the two major dexamethansone esters in clinical practice, when applied percutaneously, histochemical staining was used to determine the skin morphology; improved Franz diffusion cells and microdialysis were used to assess the percutaneous permeation of DA and DSP in normal and diabetic rats. Histopathological examination showed that the epidermal tissue of diabetic rat was much thinner, the epidermal cell layer was less clear and the stratified arrangement of epidemic cell had almost disappeared and progressive atrophy were developed on the subcutaneous fat. In vitro studies showed that the cumulative and the penetrated DSP amount in Group DM were higher. The mean flux value and the mean depositional amount of Group DM were increased significantly compared to those of Group CTL, whereas the amount of DA penetrating was of no difference. Microdialysis indicated that there was no significant difference between Group CTL and Group DM for all the pharmacokinetic parameters of DA. In contrast, the subcutaneous AUCall values and the C(max) of DSP were significantly increased compared to the control. In conclusion, diabetic rat skin significantly increased the percutaneous permeation of DSP but had no effect on that of DA. It suggests that patients with diabetes should consider the dose of administration when using DA, DSP or other glucocorticoids topically, as different liposolubilities may play some role in the permeability of these compounds via diabetic skin.
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Affiliation(s)
- Sha-Sha Li
- Nanfang Hospital, Southern Medical University , Guangzhou , PR China
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Shetage SS, Traynor MJ, Brown MB, Raji M, Graham-Kalio D, Chilcott RP. Effect of ethnicity, gender and age on the amount and composition of residual skin surface components derived from sebum, sweat and epidermal lipids. Skin Res Technol 2013; 20:97-107. [PMID: 23865719 PMCID: PMC4285158 DOI: 10.1111/srt.12091] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND/PURPOSE The superficial layer on the skin surface, known as the acid mantle, comprises a mixture of sebum, sweat, corneocyte debris and constituents of natural moisturizing factor. Thus, the phrase 'residual skin surface components' (RSSC) is an appropriate term for the mixture of substances recovered from the skin surface. There is no general agreement about the effects of ethnicity, gender and age on RSSC. The aim of this human volunteer study was to evaluate RSSC in relation to ethnicity, gender and age. A suitable acquisition medium for RSSC collection was identified and samples of RSSC were subsequently analysed using gas chromatography-mass spectrometry (GC-MS) and gravimetry. METHODS A total of 315 volunteers participated in the study from a range of self-declared ethnic backgrounds. Six acquisition media were compared to determine the most suitable media for RSSC collection. The effect of age, gender and ethnicity on RSSC collection was evaluated by gravimetric analysis while GC-MS was used to determine the composition of RSSC. RESULTS Of the six candidate materials assessed, cigarette paper provided the most practical and reproducible sample acquisition medium. There was no significant difference in the amount of RSSC collected when based on gender and ethnicity and no significant correlation between RSSC recovery and age. Up to 49 compounds were detected from human RSSC when analysed by GC-MS. CONCLUSIONS The results of the present study suggest that RSSC can be effectively collected using cigarette paper and analysed by GC-MS. Ethnicity, gender and age had no significant impact on the quantity of RSSC recovered from the skin surface.
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Affiliation(s)
- Satyajit S Shetage
- Department of Pharmacy, Centre for Topical Drug Delivery and Toxicology Research, University of Hertfordshire, Hatfield, UK
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Sugawara T, Iwamoto N, Akashi M, Kojima T, Hisatsune J, Sugai M, Furuse M. Tight junction dysfunction in the stratum granulosum leads to aberrant stratum corneum barrier function in claudin-1-deficient mice. J Dermatol Sci 2013; 70:12-8. [DOI: 10.1016/j.jdermsci.2013.01.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 12/21/2012] [Accepted: 01/15/2013] [Indexed: 01/19/2023]
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Abstract
Diabetes mellitus is the most common endocrine disorder with continuously increasing prevalence. Blood vessels, nerves, eyes, kidneys and skin are affected, which causes both an enormous financial burden and a reduced quality of life of the affected patients. Long-standing diabetes may impair skin homeostasis resulting in skin manifestations in at least one third of all diabetics. The skin involvement may be the first presenting sign of diabetes, thus the respective skin signs should lead to diabetes focused diagnostic. Besides, the skin signs may be considered as a marker for the course of the disease or for the success of therapeutic interventions.
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Affiliation(s)
- B Behm
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
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41
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Ikarashi N, Ogiue N, Toyoda E, Kon R, Ishii M, Toda T, Aburada T, Ochiai W, Sugiyama K. Gypsum fibrosum and its major component CaSO4 increase cutaneous aquaporin-3 expression levels. JOURNAL OF ETHNOPHARMACOLOGY 2012; 139:409-413. [PMID: 22138657 DOI: 10.1016/j.jep.2011.11.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/15/2011] [Accepted: 11/15/2011] [Indexed: 05/31/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE We have previously reported that Byakkokaninjinto improves cutaneous pruritus by increasing the expression level of aquaporin-3 (AQP3). In this study, we examined the effect of Gypsum fibrosum (main component: CaSO(4)), which is the main component of Byakkokaninjinto, on the cutaneous AQP3 expression level. MATERIALS AND METHODS KKAy mice were given a diet containing 0.3% Gypsum fibrosum extract, or a diet containing 0.3% CaSO(4) for 4 weeks. The urine volume, plasma glucose levels, cutaneous AQP3 protein expression, and the Ca(2+) content were measured. RESULTS The 24-h urine volumes and the plasma glucose levels in the Gypsum fibrosum extract group were not significantly different from those in the control group. In the Gypsum fibrosum extract group, the cutaneous AQP3 protein levels increased significantly, by approximately 3.2-fold, compared to the control group. The cutaneous Ca(2+) content in the control group was approximately 35μg/g. In the Gypsum fibrosum extract group, the Ca(2+) content increased to approximately 51μg/g, which was significant compared to the control group. In the CaSO(4) group, an increase in the AQP3 protein expression levels and Ca(2+) content were observed; the extent of these increases were similar to those in the Gypsum fibrosum extract group. CONCLUSIONS The results of this study suggest that Gypsum fibrosum plays an important role in the increased levels of cutaneous AQP3 expression enhanced by Byakkokaninjinto. The results also indicate that the increase in AQP3 caused by Gypsum fibrosum is attributable to an increase in the cutaneous Ca(2+) content from its main component, CaSO(4).
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Affiliation(s)
- Nobutomo Ikarashi
- Department of Clinical Pharmacokinetics, Hoshi University, Shinagawa-ku, Tokyo, Japan
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42
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Park HY, Kim JH, Jung M, Chung CH, Hasham R, Park CS, Choi EH. A long-standing hyperglycaemic condition impairs skin barrier by accelerating skin ageing process. Exp Dermatol 2011; 20:969-74. [DOI: 10.1111/j.1600-0625.2011.01364.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thyssen JP, Linneberg A, Carlsen BC, Johansen JD, Engkilde K, Hansen T, Pociot F, Pedersen O, Meldgaard M, Szecsi PB, Stender S, Menné T. A possible association between a dysfunctional skin barrier (filaggrin null-mutation status) and diabetes: a cross-sectional study. BMJ Open 2011; 1:e000062. [PMID: 22021744 PMCID: PMC3191408 DOI: 10.1136/bmjopen-2011-000062] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background Filaggrin proteins are located in the skin and prevent epidermal water loss and impede the entry of micro-organisms, allergens and chemicals. Filaggrin null mutations are strongly associated with ichthyosis vulgaris and atopic dermatitis. Objective The authors aimed to investigate the association between filaggrin null mutations, atopic dermatitis and diabetes. Design A random sample of 3335 adults from the general population in Denmark was filaggrin-genotyped for R501X and 2282del4 null-mutations and questioned about atopic dermatitis and diabetes. Furthermore, two independent study populations of patients with type 1 (n=104) or 2 (n=774) diabetes were genotyped. Results In a crude data analysis, a positive association was detected between the filaggrin null genotype and, respectively, subjects from the general population who reported diabetes (p=0.04) and patients with established type 2 diabetes (p=0.073). Adjustment for age and gender resulted in significant associations for patients with type 2 diabetes (p=0.048) and subjects with self-reported diabetes (p=0.032). Conclusions Adult Danes with a filaggrin null genotype had a significantly increased prevalence of self-reported diabetes. This finding was replicated when an independent sample of Danish patients with established type 2 diabetes was compared with control subjects from the general population.
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Affiliation(s)
- Jacob P Thyssen
- National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
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Takehara K, Oe M, Tsunemi Y, Nagase T, Ohashi Y, Iizaka S, Ueki K, Tsukamoto K, Kadowaki T, Sanada H. Factors associated with presence and severity of toenail onychomycosis in patients with diabetes: a cross-sectional study. Int J Nurs Stud 2011; 48:1101-8. [PMID: 21367414 DOI: 10.1016/j.ijnurstu.2011.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 02/02/2011] [Accepted: 02/05/2011] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To identify the factors associated with toenail onychomycosis in patients with diabetes. METHODS In this cross-sectional, observational study, the presence and severity (area of nail involvement and nail thickness) of toenail onychomycosis and related factors were examined. One hundred and thirteen patients with diabetes were surveyed at the Diabetic Foot Outpatient Clinic at the University hospital. Toenails of all patients enrolled in the survey were examined whether onychomycosis was present or absent by mycological examination. The severity of onychomycosis was assessed by clinical evaluation, using the area of nail involvement and the nail thickness. RESULTS Fifty eight (51.3%) patients had toenail onychomycosis. The presence of onychomycosis was significantly associated with not washing of feet every day (the unadjusted model, OR: 3.45, 95% CI: 1.24-9.65, P=0.018). The median area of nail involvement was 50.0% (range 5.0-100.0%). A larger area of involvement was significantly related to a lower toe brachial index (β=-67.46, P=0.040). The median nail thickness with onychomycosis was 1.14 mm (range 0.68-9.86 mm). Increasing thickness was significantly correlated with higher hemoglobin A(1)c levels (β=0.98, P=0.003). CONCLUSIONS This study suggested that daily washing of feet may reduce the risk of onychomycosis in patients with diabetes. This suggested that education regarding the importance of the washing of feet every day and support for continuous self-care might be effective in the prevention of onychomycosis in patients with diabetes. Furthermore, good control of blood glucose might prevent increasing nail thickness. This study may highlight importance of early nursing educational intervention to improve patients' daily life style for prevention of onychomycosis induced diabetic foot ulcers.
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Affiliation(s)
- Kimie Takehara
- Department of Gerontological Nursing/Wound Care Management, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Japan
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Aburada T, Ikarashi N, Kagami M, Ichikawa Y, Sugitani M, Maniwa A, Ueda H, Toda T, Ito K, Ochiai W, Matsushita R, Miyamoto KI, Sugiyama K. Byakkokaninjinto prevents body water loss by increasing the expression of kidney aquaporin-2 and skin aquaporin-3 in KKAy mice. Phytother Res 2010; 25:897-903. [DOI: 10.1002/ptr.3358] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 10/18/2010] [Accepted: 10/19/2010] [Indexed: 01/17/2023]
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Rissmann R, Oudshoorn MHM, Hennink WE, Ponec M, Bouwstra JA. Skin barrier disruption by acetone: observations in a hairless mouse skin model. Arch Dermatol Res 2009; 301:609-13. [PMID: 19350255 PMCID: PMC2728065 DOI: 10.1007/s00403-009-0946-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 03/06/2009] [Accepted: 03/12/2009] [Indexed: 11/26/2022]
Abstract
To disrupt the barrier function of the skin, different in vivo methods have been established, e.g., by acetone wiping or tape-stripping. In this study, the acetone-induced barrier disruption of hairless mice was investigated in order to establish a reliable model to study beneficial, long-term effects on barrier recovery after topical application. For both treatments (i.e., acetone treatment and tape-stripping) the transepidermal water loss directly after disruption and the subsequent barrier recovery profile were similar. Histological assessment showed significant lower number of corneocyte layers in acetone-treated and tape-stripped skin compared to untreated skin, while there was no statistical difference between the two treatments. Lipid analysis of acetone-treated skin revealed that only small fraction of lipids were extracted consisting of predominantly nonpolar lipids. Importantly, the ratio of the barrier lipids, i.e., cholesterol, free fatty acids and ceramides, remained similar between control and acetone-treated skin. This reflects the undisrupted lipid organization, as determined by small-angle X-ray diffraction measurements: the long-periodicity lamellar phase was still present after acetone treatment. Our results contradict earlier studies which reported no mechanical stratum corneum removal, a substantial extraction of lipids and disruption in lipid organization. In conclusion, our studies demonstrate that barrier disruption due to acetone treatment is mainly due to removal of corneocytes.
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Affiliation(s)
- Robert Rissmann
- Department of Drug Delivery Technology, Leiden/Amsterdam Center for Drug Research (LACDR), Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - Marion H. M. Oudshoorn
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Wim E. Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Maria Ponec
- Department of Drug Delivery Technology, Leiden/Amsterdam Center for Drug Research (LACDR), Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - Joke A. Bouwstra
- Department of Drug Delivery Technology, Leiden/Amsterdam Center for Drug Research (LACDR), Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
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Oudshoorn MHM, Rissmann R, van der Coelen D, Hennink WE, Ponec M, Bouwstra JA. Effect of synthetic vernix biofilms on barrier recovery of damaged mouse skin. Exp Dermatol 2009; 18:695-703. [DOI: 10.1111/j.1600-0625.2009.00858.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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48
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Seirafi H, Farsinejad K, Firooz A, Davoudi SM, Robati RM, Hoseini MS, Ehsani AH, Sadr B. Biophysical characteristics of skin in diabetes: a controlled study. J Eur Acad Dermatol Venereol 2009; 23:146-9. [DOI: 10.1111/j.1468-3083.2008.02950.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
PURPOSE Statins are widely used drugs for reducing cholesterol levels. The aim of this study was to observe the effects of statin therapy on skin histopathology in both normal and diabetic mice. METHODS 45 Swiss albino mice were studied in 4 sub-groups: control, statin-treated control, diabetic, and statin-treated diabetic. The first group was diabetic-induced with 250 mg/kg of streptozosin administered intravenously. The second group served as the control. Four weeks after streptozosin injection, both diabetic and control groups were divided into 2 sub-groups and 1 mg/kg/d simvastatin was injected for 14 d intraperitoneally to form the statin-treated control and statin-treated diabetic groups. The remaining 2 groups formed the untreated control and untreated diabetic groups. Histopathological examination of the skin was made with haematoxylin eosin staining under a light microscope. RESULTS There was no apparent difference between the groups in epidermal thickness, proliferative activity, dermal thickness and composition. Cystic dilatations in the infundibulum of hair follicles with distorted and smaller sebaceous glands were seen in the statin-treated control, diabetic, and statin-treated diabetic groups. CONCLUSION We conclude that there is altered lipid synthesis in the sebaceous glands in both diabetic and statin-treated groups.
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50
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Wakamatsu K, Ogita H, Okabe N, Irie K, Tanaka-Okamoto M, Ishizaki H, Ishida-Yamamoto A, Iizuka H, Miyoshi J, Takai Y. Up-regulation of loricrin expression by cell adhesion molecule nectin-1 through Rap1-ERK signaling in keratinocytes. J Biol Chem 2007; 282:18173-18181. [PMID: 17472964 DOI: 10.1074/jbc.m611159200] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Nectin is an immunoglobulin-like cell-cell adhesion molecule, which plays essential roles in the initial step of formation of adherens junctions and tight junctions. We demonstrate here the role of nectin-1 in the epidermis using nectin-1-/- mice. Newborn nectin-1-/- pups showed shiny and slightly reddish skin; the amount of loricrin, one of the differentiation markers and also a major component of cornified cell envelopes, was markedly reduced in the epidermis of nectin-1-/- mice. The amounts of repetin and SPRRP, other components of cornified cell envelopes, were markedly elevated probably due to a compensatory mechanism to overcome the impaired expression of loricrin. However, cornified cells from nectin-1-/- mice were sensitive to mechanical stress. Moreover, Ca2+-induced activation of ERK through Rap1 and expression of loricrin were reduced in primary cultured nectin-1-/- keratinocytes; in turn, the inhibition of ERK activation reduced the amount of loricrin in wild-type keratinocytes. These results indicate that nectin-1 plays a key role in the expression of loricrin in the epidermis.
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Affiliation(s)
- Kotaro Wakamatsu
- Department of Molecular Biology and Biochemistry, Osaka University Graduate School of Medicine/Faculty of Medicine, Suita, Osaka 565-0871, Japan
| | - Hisakazu Ogita
- Department of Molecular Biology and Biochemistry, Osaka University Graduate School of Medicine/Faculty of Medicine, Suita, Osaka 565-0871, Japan
| | - Noriko Okabe
- Department of Molecular Biology and Biochemistry, Osaka University Graduate School of Medicine/Faculty of Medicine, Suita, Osaka 565-0871, Japan
| | - Kenji Irie
- Department of Molecular Biology and Biochemistry, Osaka University Graduate School of Medicine/Faculty of Medicine, Suita, Osaka 565-0871, Japan
| | - Miki Tanaka-Okamoto
- Department of Molecular Biology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan
| | - Hiroyuki Ishizaki
- Department of Molecular Biology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan
| | - Akemi Ishida-Yamamoto
- Department of Dermatology, Asahikawa Medical College, Asahikawa, Hokkaido 078-8510, Japan
| | - Hajime Iizuka
- Department of Dermatology, Asahikawa Medical College, Asahikawa, Hokkaido 078-8510, Japan
| | - Jun Miyoshi
- Department of Molecular Biology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan
| | - Yoshimi Takai
- Department of Molecular Biology and Biochemistry, Osaka University Graduate School of Medicine/Faculty of Medicine, Suita, Osaka 565-0871, Japan.
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