Di Nardo A, Wertz P, Giannetti A, Seidenari S
Department of Dermatology, University of Modena, Italy.
Acta Derm Venereol. 1998 Jan;78(1):27-30. doi: 10.1080/00015559850135788.
Atopic dermatitis skin tends to be easily irritated and appears dry. These clinical peculiarities correspond to impaired barrier function and to increased transepidermal water loss (TEWL) values. A few studies suggest that a reduced amount of total ceramides (especially of ceramide 1) is responsible for functional abnormalities of the skin of atopic dermatitis patients. The aim of this study was to analyze the relationship between epidermal lipids and barrier impairment in the skin of patients with atopic dermatitis. The quantity of ceramides, cholesterol sulphate and free cholesterol of 47 patients with atopic dermatitis and 20 age- and sex-matched healthy subjects was assessed by cyanoacrylate stripping and thin layer chromatography. Capacitance and TEWL were recorded at the same site of the lipid sample. In patients with atopic dermatitis, the levels of ceramide 1 and 3 were significantly lower and values of cholesterol significantly higher with respect to healthy subjects. Moreover, the CER/CH ratio was significantly lower with respect to normal skin. Patients with active signs of eczema also had higher TEWL values and lower capacitance values. By contrast, patients with no active signs of atopic dermatitis had a normal barrier function and intermediate values of ceramides and cholesterols, when compared to patients with atopic dermatitis with active lesions and normal subjects. The quantity of ceramide 3 was significantly correlated with TEWL impairment. These findings suggest that a decrease in ceramides in the stratum corneum is involved in barrier impairment in atopic dermatitis skin. Our data confirm those of other authors and support the view that impaired metabolism of ceramides may be the cause of dry skin and impaired barrier function in atopic dermatitis.
特应性皮炎患者的皮肤往往容易受到刺激且显得干燥。这些临床特征与屏障功能受损以及经表皮水分流失（TEWL）值升高相对应。一些研究表明，总神经酰胺（尤其是神经酰胺1）含量的减少是特应性皮炎患者皮肤功能异常的原因。本研究的目的是分析特应性皮炎患者皮肤中表皮脂质与屏障功能受损之间的关系。通过氰基丙烯酸酯剥离法和薄层色谱法评估了47例特应性皮炎患者以及20名年龄和性别匹配的健康受试者的神经酰胺、硫酸胆固醇和游离胆固醇的含量。在脂质样本的同一部位记录电容和TEWL。与健康受试者相比，特应性皮炎患者的神经酰胺1和3水平显著降低，胆固醇值显著升高。此外，与正常皮肤相比，CER/CH比值显著降低。有湿疹活动迹象的患者TEWL值也更高，电容值更低。相比之下，与有活动性皮损的特应性皮炎患者和正常受试者相比，没有特应性皮炎活动迹象的患者屏障功能正常，神经酰胺和胆固醇值处于中间水平。神经酰胺3的含量与TEWL受损显著相关。这些发现表明，角质层中神经酰胺的减少与特应性皮炎皮肤的屏障功能受损有关。我们的数据证实了其他作者的数据，并支持以下观点：神经酰胺代谢受损可能是特应性皮炎皮肤干燥和屏障功能受损的原因。
