The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis

Danby, Simon; Chittock, John; Brown, Kirsty; Albenali, Lujain; Cork, Michael J.

doi:10.1111/bjd.12778

Cited by 70 publications

(62 citation statements)

References 37 publications

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“…Moreover, semi‐quantitative analysis by transmission electron microscopy revealed a significant increase in intercellular lipid lamellae after application of topical tacrolimus compared with that of topical mometasone . Similar results were reported in a half‐side comparative study between topical tacrolimus and topical betamethasone valerate . Notably, topical tacrolimus significantly improved the skin barrier function of patients with AD, whereas it was shown to be adversely disrupted by topical betamethasone, likely because betamethasone downregulated the levels of natural moisturizing factors …”

Section: Effects Of Tacrolimus On Skin Barrier Functionsupporting

confidence: 75%

Mechanistic insights into topical tacrolimus for the treatment of atopic dermatitis

Nakahara

Morimoto

Murakami

et al. 2018

Pediatric Allergy Immunology

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More than 15 years have passed since the clinical launch of topical tacrolimus for the treatment of atopic dermatitis. Its efficacy and safety have been clearly demonstrated in many global and domestic short-term and long-term clinical trials. Although the prolonged external application of steroids causes many adverse reactions including cutaneous atrophy, no such reactions occur with the use of topical tacrolimus. Therefore, the therapeutic guidelines recommend a combined topical treatment with tacrolimus and steroids. Tacrolimus is a potent immunosuppressant. However, recent studies have revealed its diverse action on the cardinal pathomechanisms of atopic dermatitis. In this review, we summarize the mechanistic role of tacrolimus in various aspects of allergic inflammation including mast cell activation, innate allergic response, pruritus, sensory nerve activation, and skin barrier dysfunction.

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Section: Effects Of Tacrolimus On Skin Barrier Functionsupporting

confidence: 75%

Mechanistic insights into topical tacrolimus for the treatment of atopic dermatitis

Nakahara

Morimoto

Murakami

et al. 2018

Pediatric Allergy Immunology

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“…All test sites were acclimatized to room conditions for 20 min before assessment. Tape-stripping, to experimentally disrupt the SC, was performed as previously described [21]. Prior to tape-stripping the test sites were cleaned with cotton wool and water, and allowed to reacclimatize for 20 min.…”

Section: Methodsmentioning

confidence: 99%

The Effect of an Emollient Containing Urea, Ceramide NP, and Lactate on Skin Barrier Structure and Function in Older People with Dry Skin

Danby

Brown

Higgs-Bayliss

et al. 2016

Skin Pharmacol Physiol

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Xerosis affects up to 75% of older people and develops as a result of a skin barrier defect. Emollients are widely used to treat xerosis; however, there is limited understanding of the differences between them and their effects on the skin barrier in older people. This study aimed to compare the effect of a commercially available emollient containing 5% urea, ceramide NP and lactate (test emollient) to an alternative emollient without these additives (control emollient) on the properties of the skin barrier in older people. Two cohorts of 21 volunteers aged >60 years with dry skin were recruited. The first applied the test emollient to one forearm and no treatment to the other for 28 days. The second compared the test emollient to the control emollient observing the same parameters. Effects on the skin barrier were determined by measuring skin barrier function, hydration, skin surface pH and by analysing Fourier transform infrared spectra before and after treatment. A third cohort of 6 young adults was recruited to investigate the effect of a single treatment with the test emollient on the molecular structure of the skin barrier at greater depths by employing the tape-stripping technique. The test emollient hydrated the skin to a significantly greater extent and for a longer period of time compared to the control emollient, an effect associated with a significant elevation of carboxylate groups (a marker of natural moisturizing factor content) within the stratum corneum. Furthermore, the test emollient imparted additional benefits to the structure and function of the skin barrier not exhibited by the control emollient. In conclusion, the test emollient addressed the pathological features of xerotic aged skin, supporting its use as first-line therapy for xerotic skin conditions in this population.

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“…Then, 0.5 g FK506-NIC complex solution, FK506-NIC-CS-NPs [containing an equal amount of NIC of 20% (w/v) with the FK506-NIC complex solution], FK506 suspension, and commercial preparation of FK506 (Protopic) containing the same content of FK506 (0.1%, w/v) were placed into the donor compartment, respectively (n=6 for each group). At predetermined time intervals (12,14,16,20, and 24 h), 1 mL sample was collected from the receiver compartment and equal amounts of fresh receiving medium was supplemented immediately. At the end of the in vitro permeation study, the skin demounted from the Franz cell was cleaned, cut into small pieces, and placed in a centrifuge tube.…”

Section: Preparation Of Fk506-nic-cs-npsmentioning

confidence: 99%

“…Thereafter, the sensitized skin was challenged with 100 μL of 1.0% (w/v) DNCB solution on the back and 10 μL on the right ear on days 4,7,11,14,17,20,23,26, and 28, respectively.…”

mentioning

confidence: 99%

Tacrolimus nanoparticles based on chitosan combined with nicotinamide: enhancing percutaneous delivery and treatment efficacy for atopic dermatitis and reducing dose

Yu¹,

Wang²,

Wan³

et al. 2017

IJN

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Background Topical application of tacrolimus (FK506) was effective in the treatment of atopic dermatitis (AD); however, adverse effects frequently occurred with the increase of FK506 dose during long–term treatment. Objective The objective of this project was to develop a hybrid skin targeting system encapsulating FK506 based on nicotinamide (NIC) and chitosan nanoparticles (CS–NPs), ie, FK506–NIC–CS–NPs, which took advantages of both of NIC and CS–NPs to obtain the synergetic effects of percutaneous delivery and treatment efficacy enhancement along with dose reduction. Methods The formulation of FK506–NIC–CS–NPs was optimized and characterized. In vitro and in vivo skin permeation studies were performed. AD–like skin lesions were constructed with BALB/c mice by 1–chloro–2, 4–dinitrobenzene (DNCB)–induced, and FK506–NIC–CS–NPs containing different dose of FK506 were topically administered to treat AD–like skin lesions in comparison with Protopic. Results NIC was found to significantly increase the FK506 EE to 92.2% by CS–NPs. In comparison with commercial FK506 ointment (Protopic), in vitro and in vivo skin permeation studies demonstrated that NIC–CS–NPs system significantly enhanced FK506 permeation through and into the skin, and deposited more FK506 into the skin. The treatment efficacy on clinical symptoms, histological analysis, and molecular biology of the AD–mice demonstrated that NIC–CS–NPs with ~1/3 dose of FK506 of Protopic was superior to that of Protopic, and NIC–CS–NPs vehicle exhibited the adjuvant therapy and moderate anti–AD effects. Conclusion The system of NIC–CS–NPs enhances the permeability of FK506, plays an adjuvant role in anti-AD, reduces the dose of FK506 in treating AD, and is therefore a promising nanoscale system of FK506 for the effective treatment of AD.

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The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis

Abstract: In quiescent AD, 4 weeks of BMVc treatment adversely affected the biophysical properties of the skin and reduced the levels of natural moisturizing factor, whereas TACo improved the condition of the skin barrier.

Cited by 70 publications

References 37 publications

Mechanistic insights into topical tacrolimus for the treatment of atopic dermatitis

Mechanistic insights into topical tacrolimus for the treatment of atopic dermatitis

The Effect of an Emollient Containing Urea, Ceramide NP, and Lactate on Skin Barrier Structure and Function in Older People with Dry Skin

Tacrolimus nanoparticles based on chitosan combined with nicotinamide: enhancing percutaneous delivery and treatment efficacy for atopic dermatitis and reducing dose

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