J Korean Med Sci.  2010 May;25(5):766-771. 10.3346/jkms.2010.25.5.766.

Changes of Antimicrobial Peptides and Transepidermal Water Loss After Topical Application of Tacrolimus and Ceramide-dominant Emollient in Patients with Atopic Dermatitis

• Park KY
• Kim DH
• Jeong MS
• Li K
• Seo SJ

• KMID: 1713963
• DOI: http://doi.org/10.3346/jkms.2010.25.5.766

Abstract

Increased transepidermal water loss (TEWL) and downregulated antimicrobial peptides (AMPs) are observed in patients with atopic dermatitis (AD). Tacrolimus and ceramide-dominant emollients are effective in the treatment of AD by preventing the production of inflammatory cytokines and by correcting skin barrier dysfunctions, respectively. Present study was designed to investigate the relationship between antimicrobial and barrier factors by measuring the changes of AMPs and TEWL after topical application of tacrolimus and ceramide-dominant emollient in the patients with AD. A total of three patients with AD were treated with tacrolimus in one lesion and ceramide-dominant emollient in another lesion for 4 weeks. RT-PCR and western blotting revealed that the mRNA and protein expression levels of hBD-2 and LL-37 were increased on the both study sites. Immunohistochemical analysis showed significant increase of AMPs and IL-1alpha, while, IL-4 was decreased on the both study sites. The mean changes of TEWL and AMPs showed no statistical difference between both sites. Tacrolimus and ceramide-dominant emollient influence on both TEWL and AMPs expression in patients with AD, namely they have similar effects on both of the two. This study shows that restoration of permeability barrier function is accompanied by the concomitant improvement of antimicrobial defense in patients with AD.

Keyword

Antimicrobial peptide; Dermatitis, Atopic; Ceramides; Permeability Barrier; Tacrolimus

MeSH Terms

Administration, Topical
Adolescent
Antimicrobial Cationic Peptides/*metabolism
Ceramides/*administration & dosage
Dermatitis, Atopic/*drug therapy/*metabolism
Emollients/administration & dosage
Female
Humans
Immunosuppressive Agents/administration & dosage
Male
Skin Absorption/*drug effects
Tacrolimus/*administration & dosage
Treatment Outcome
Water Loss, Insensible/*drug effects
Young Adult
Antimicrobial Cationic Peptides
Ceramides
Emollients
Immunosuppressive Agents
Tacrolimus

Figure

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  Fig. 1 RT-PCR for expression of hBD-2 and LL-37 before and after application of tacrolimus and ceramide-dominant emollient. (A) Increased expression of hBD after application of tacrolimus and ceramide-dominant emollient. (B) Increased expression of LL-37 after application of tacrolimus and ceramide-dominant emollient (*P<0.05). (C) No statistical difference of hBD-2 between tacrolimus-applied and emollient-applied skin. (D) No statistical difference of LL-37 between tacrolimus-applied and emollient-applied skin. Pt., patient.

• 

  Fig. 2 Western blotting for expression of hBD-2 and LL-37 before and after application of tacrolimus and ceramide-dominant emollient. (A) Increased expression of hBD after application of tacrolimus and ceramide-dominant emollient. (B) Increased expression of LL-37 after application of tacrolimus and ceramide-dominant emollient.

• 

  Fig. 3 Immunohistochemical staining for hBD-2 and LL-37 in section from patients with atopic dermatitis. Expression of hBD-2, LL-37, IL-1α and IL-4 receptors before and after tacrolimus and ceramide treatments as assessed by immunohistochemistry. Y axis: numbers of stained cells in microscopic fields (×400).

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