Reduction of <i>Staphylococcus aureus</i> in atopic skin lesions with acid electrolytic water ‐ a new therapeutic strategy for atopic dermatitis

Sasai-Takedatsu, Misa; Kojima, Takahiro; Yamamoto, Akemi; Hattori, Kousuke; S, Yoshijima; Taniuchi, Shoichiro; Namura, Shoko; Akamatsu, Hirohiko; Horio, Takeshi; Kobayashi, Yohnosuke

doi:10.1111/j.1398-9995.1997.tb02423.x

Cited by 28 publications

(6 citation statements)

References 17 publications

(9 reference statements)

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“…69 Reduction of S. aureus, Clostridium difficile and Bacillus subtilis in atopic skin lesions was achieved by application of acid electrolytic water or peracetic acid, respectively. 70,71 An increased pH in atopic dermatitis leads to enhanced adhesion and multiplication of S. aureus. Consequently, acidification by topical application of 0.75% lactic acid reduced the growth of S. aureus.…”

Section: Ph and Antimicrobial Effectsmentioning

confidence: 99%

pH in nature, humans and skin

Proksch

2018

The Journal of Dermatology

416

273

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The pH plays an important physiological role in nature and humans. pH varies from 1 to 8 in human organs with tight regulation in blood and epithelia of barrier organs. The physiological pH of the stratum corneum is 4.1-5.8 and several mechanisms contribute to its formation: filaggrin degradation, fatty acid content, sodium-hydrogen exchanger (NHE1) activation and melanosome release. First, the acidic pH of the stratum corneum was considered to present an antimicrobial barrier preventing colonization (e.g. by Staphylococcus aureus and Malassezia). Later on, it was found that the pH influences skin barrier function, lipid synthesis and aggregation, epidermal differentiation and desquamation. Enzymes of ceramide metabolism (e.g. β-glucocerebrosidase or acid sphingomyelinase) as well as proteases (e.g. chymotryptic enzyme or cathepsin D linked to epidermal differentiation and desquamation) are regulated by the pH. Experimental disruption of the physical barrier leads to an increase of pH, returning to normal levels only after many hours. Inflammatory skin diseases and diseases with an involvement of the epidermis exhibit a disturbed skin barrier and an increased pH. This is known for atopic dermatitis, irritant contact dermatitis, ichthyosis, rosacea and acne, but also for aged and dry skin. Normalizing the pH by acidification through topical treatment helps to establish a physiological microbiota, to repair skin barrier, to induce epidermal differentiation and to reduce inflammation.

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Section: Ph and Antimicrobial Effectsmentioning

confidence: 99%

pH in nature, humans and skin

Proksch

2018

The Journal of Dermatology

416

273

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“…Everyday bathing in an acidic hot spring can be challenging. Another research group in Japan has developed a new therapeutic strategy for AD 44 . They sprayed acid electrolytic water twice a day for a week.…”

Section: Barrier Function Disrupted In Eczema Lesions Could Be Restor...mentioning

confidence: 99%

Importance of Stratum Corneum Acidification to Restore Skin Barrier Function in Eczematous Diseases

Choi,

Kang

2024

Ann Dermatol

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Skin barrier function relies on three essential components: stratum corneum (SC) lipids, natural moisturizing factors (NMFs), and the acidic pH of the SC surface. Three endogenous pathways contribute to acidity: free fatty acids from phospholipids, trans-urocanic acid from filaggrin (FLG), and the sodium-proton antiporter (NHE1) activity. An acidic SC environment boosts the activity of enzymes to produce ceramides, which are vital for skin health. Conversely, an elevated pH can lead to increased skin infections, reduced lipid-processing enzyme activity, impaired permeability barrier recovery, and compromised integrity and cohesion of the SC due to increased serine protease (SP) activity. Elevated SC pH is observed in neonatal, aged, and inflamed skin. In atopic dermatitis (AD), it results from decreased NMF due to reduced FLG degradation, decreased fatty acids from reduced lamellar body secretion, and reduced lactic acid due to decreased sweating. Moreover, the imbalance between SP and SP inhibitors disrupts barrier homeostasis. However, acidifying the SC can help restore balance and reduce SP activity. Acidic water bathing has been found to be safe and effective for AD. In three different AD murine models, SC acidification prevented the progression of AD to respiratory allergies. In aging skin, a decrease in NHE1 leads to an increased skin pH. Mild acidic skin care products or moisturizers containing NHE1 activators can normalize skin pH and improve barrier function. In conclusion, maintaining the acidity of the SC is crucial for healthy skin barrier function, leading to significant benefits for various skin conditions, such as AD and aging-related skin issues.

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“…More recently, it has also demonstrated efficacy in blocking the progression of the atopic march from AD to food allergies . These attributes include its low pH (=5), which in itself is anti‐inflammatory by several mechanisms (Figure ), including (i) inactivation of potentially damaging KLKs that both compromise SC structural integrity and block activation of the plasminogen activator receptor 2 (PAR2); (ii) inhibition of pathogen colonization and attendant, superantigen‐initiated inflammation; and (iii) activation of two key lipid‐processing enzymes, β‐glucocerebrosidase and acidic sphingomyelinase, which generate the ceramides required to form the lamellar membranes that mediate the permeability barrier and contribute to antimicrobial defense …”

Section: How Barrier Repair Therapy Can Be Anti‐inflammatory In Admentioning

confidence: 99%

Primary role of barrier dysfunction in the pathogenesis of atopic dermatitis

Elias

2018

Experimental Dermatology

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Based upon the efficacy of recently developed biologics, the pathogenesis of atopic dermatitis (AD) is being attributed once again to the prominent inflammation that occurs in this disorder. Yet, molecular genetics has clearly shown that the aetiology of AD can be attributed to mutations in stratum corneum structural proteins that impact epidermal barrier function, while inflammation instead emerges as a downstream consequence of a sustained, barrier-driven cytokine cascade. Although several different mutations that compromise barrier function are associated with AD, all of these mutations compromise either the contents or secretion of epidermal lamellar bodies. Therapies directed at specific immune participants, though effective temporarily, inevitably are followed by "rebound flares," just as occur following glucocorticoid therapy. While occlusive moisturizers dampen inflammation, they do not address the underlying lipid biochemical abnormality in AD, which can be corrected more specifically with topical, physiologic lipid-based forms of barrier repair therapy (BRT). Accordingly, BRT has been shown to be as effective as topical, mid-potency steroids for the treatment of moderate-to-severe paediatric AD.

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Reduction of Staphylococcus aureus in atopic skin lesions with acid electrolytic water ‐ a new therapeutic strategy for atopic dermatitis

Cited by 28 publications

References 17 publications

pH in nature, humans and skin

pH in nature, humans and skin

Importance of Stratum Corneum Acidification to Restore Skin Barrier Function in Eczematous Diseases

Primary role of barrier dysfunction in the pathogenesis of atopic dermatitis

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