State of the Art in Stratum Corneum Research. Part II: Hypothetical Stratum Corneum Lipid Matrix Models.

This review is the second part of a series which presents the state of the art in stratum corneum (SC) lipid matrix (LM) research in depth. In this part, the various hypothetical models which were developed to describe the structure and function of the SC LM as the skin's barrier will be discussed. New as well as a cumulative assortment of older results which change the view on the different models are considered to conclude how well the different models are holding up today. As a final conclusion, a model, factoring in as much of the known data as possible, is concluded, unifying the varying different models into one which can be developed further, as new results are found in the future. So far, the model is described with a single crystalline or gel-like phase with a certain amount of nanocrystallites of concentrated ceramides (CERs) and free fatty acids and more fluid nanodomains caused by a fluidizing effect of the cholesterol. These domains are dynamically resolved and reformed and do not impair the barrier function. The chain conformation is not completely clear yet; however, an equilibrium of fully extended and hairpin-folded CERs with ratios depending on the properties of each individual CER species is proposed as most likely. An overlapping middle layer as described for the tri-layer model in part I of this series would be present for both conformations. The macroscopic broad-narrow-broad layering, observed in electron micrographs, is explained by an external templating by the lipid envelope, and an internal templating by short and long lipid chains each preferentially show a homophilic association, forming thicker and thinner bilayers, respectively. The degree of influence of the very long ω-hydroxy-CERs is discussed as well.