In this article, I review the multiple endogenous mechanisms that contribute to the highly acidic pH of normal stratum corneum (SC). Then, I describe how each mechanism potentially impacts specific defensive functions of the SC. Finally, I review the rapidly expanding, clinical implications and potential therapeutic applications of SC acidification.
K E Y W O R D Sacidification, barrier function, pH, stratum corneum 1000 | ELIAS review the four established, endogenous mechanisms and then present evidence in support of a likely fifth mechanism.
| Mechanism 1During terminal differentiation, phospholipids are fully hydrolysed to their constituent FFA by secretory phospholipases (sPLA2). Studies with pharmacologic inhibitors [8] and in transgenic mice with deletions in the pla2g2f isoform of sPLA2 [9] show that phospholipid-derived FFA account for ≈one unit of SC bulk pH, but also that these FFA simultaneously become necessary components of the lamellar bilayers that mediate the permeability barrier. [8] Yet, whether the sPLA2 mechanism selectively acidifies only extracellular domains and/or whether it also impacts the pH within the corneocyte cytosol is not known.
| Mechanism 2In transgenic mice with a selective knockout of the sodium-hydrogen antiporter type 1 (NHE1), the bulk pH of the SC increases by only ≈1/4 pH unit.[4] Yet, this mechanism selectively acidifies extracellular domains in the lower SC, the key site where both barrier function and SC cohesion initially become established, and where the earliest events leading to desquamation also are initiated.[10] Pertinently, the enzymes that regulate these functions all are lamellar bodyderived products that are delivered to extracellular domains as the contents of these organelles are secreted. Of these enzymes, two are ceramide-generating hydrolases, β-glucocerebrosidase and acidic sphingomyelinase, which both require an acidic pH for optimal activity. Conversely, the extracellular kallikreins (KLKs) that initiate desquamation remain inactive at a reduced pH. [11] Together, the colocalization of a low pH along with secreted hydrolytic enzymes explains the impact of this acidifying mechanism on barrier function, SC cohesion and desquamation.
| Mechanism 3The catabolism of filaggrin (FLG) into its constituent amino acids, followed by the further, downstream deimination of these amino acids into polycarboxylic acids, [6] including trans-urocanic acid, accounts for about ½ unit of the bulk pH of the SC. The best evidence for this link is the pH changes that accompany loss-of-function mutations in FLG in ichthyosis vulgaris (IV), where single-allele mutations result in a ¼ unit increase in pH, while double-allele loss of function results in a ½ unit increase in surface pH. [12] If the protons generated via this mechanism remain largely localized to the corneocyte cytosol, they likely would suppress one or more KLKs, which exhibit neutral to alkaline pH optima. These KLKs in turn activate IL-1α and IL-1β as the pH of the SC increases following external insu...