Ann Dermatol.  2013 Nov;25(4):462-470. 10.5021/ad.2013.25.4.462.

Therapeutic Effects and Immunomodulation of Suanbo Mineral Water Therapy in a Murine Model of Atopic Dermatitis

• Choi YJ
• Lee HJ
• Lee DH
• Woo SY
• Lee KH
• Yun ST
• Kim JM
• Kim HJ
• Kim JW

• KMID: 2265057
• DOI: http://doi.org/10.5021/ad.2013.25.4.462

Abstract

BACKGROUND
Balneotherapy is widely used as an alternative treatment modality for AD. Although the clinical benefit of some mineral waters has been established, their mechanisms of action in alleviating AD are only partly understood.
OBJECTIVE
The clinical modification and immunomodulatory or anti-inflammatory effects of mineral water from the Suanbo hot springs on the differentiation and cytokine production of Th1, Th2, and regulatory T cells (Treg) were investigated using spleen, skin tissue, and serum from NC/Nga mice.
METHODS
The therapeutic effects of bathing in mineral water in a Dermatophagoides farinae body extract ointment (Dfb ointment)-induced AD mouse model were assessed by measuring the modified Scoring atopic dermatitis (SCORAD) index scores, transepidermal water loss (TEWL), histological and immunohistochemical changes of the skin lesion, serum levels of interferon (IFN)-gamma, interleukin (IL)-4, IL-5 and immunoglobulin E, mRNA expression of IFN-gamma, IL-4 and IL-5 of dorsal skin, and helper T cell differentiation in the spleen.
RESULTS
Bathing in mineral water significantly reduced the modified SCORAD index scores, TEWL, epidermal hyperplasia, and inflammatory cell infiltration. IL-4 production and Th2 cell differentiation showed a decreasing tendency with mineral water bathing, but the Th1 cells did not. On the contrary, differentiation to Treg cells was promoted with mineral water bathing.
CONCLUSION
Balneotherapy not only has anti-inflammatory activity, but also shows positive effects on cutaneous barrier homeostasis. These results suggest that the favorable effects of balneotherapy may be mediated by modifying the Th2 response, and possibly in part by inducing Treg cell differentiation.

Keyword

Atopic dermatitis; Balneotherapy; Mineral waters; NC/Nga mice

MeSH Terms

Animals
Balneology
Baths
Cell Differentiation
Dermatitis, Atopic*
Dermatophagoides farinae
Homeostasis
Hot Springs
Hyperplasia
Immunoglobulin E
Immunoglobulins
Immunomodulation*
Interferons
Interleukin-4
Interleukin-5
Interleukins
Mice
Mineral Waters*
RNA, Messenger
Skin
Spleen
T-Lymphocytes, Regulatory
Th1 Cells
Th2 Cells
Mineral Waters
Immunoglobulin E
Immunoglobulins
Interferons
Interleukin-4
Interleukin-5
Interleukins
Mineral Waters
RNA, Messenger
Mineral Waterss

Figure

• 

  Fig. 1 Schematic diagram of experimental design. AD: atopic dermatitis, TEWL: transepidermal water loss, RT: reverse transcription, PCR: polymerase chain reaction, FACS: fluorescence-activated cell sorting.

• 

  Fig. 2 Bathing was performed daily for 5 minutes during 2 weeks with a regular water temperature.

• 

  Fig. 3 (A) Photographs of the clinical features of NC/Nga mice (a) in the untreated negative control (CONT), (b, c, d) Dermatophagoides farinae body (Dfb) ointment applied experimental groups on day 14 following the first challenge, (e) Dfb ointment positive control (AD), (f) Dfb ointment+distilled water bathing (AD+DW), and (g) Dfb ointment+mineral water bathing (AD+MW), on day 14 following first bathing. (B) Clinical skin severity scores. (C) Transepidermal water loss (TEWL). Data are presented as the mean±standard deviation. SCORAD: Scoring atopic dermatitis. *p<0.05 vs. AD+DW.

• 

  Fig. 4 (A) Histological features of dorsal skin (H&E, ×200). Effects of bathing in mineral water on Dermatophagoides farinae body (Dfb) ointment-induced infiltration of CD1+, CD4+, and CD8+ cells in the dorsal skin of NC/Nga mice (B: anti-CD1, C: anti-CD4 and D: anti-CD8; ×100). (a) The untreated negative control, (b) Dfb ointment positive control (AD), (c) Dfb ointment+distilled water bathing (AD+DW), and (d) Dfb ointment+mineral water bathing (AD+MW) on day 14 following the first bathing.

• 

  Fig. 5 Serum levels of (A) immunoglobulin E (IgE), (B) interleukin (IL)-4, (C) interferon (IFN)-γ, and (D) IL-5 on experimental day 14. Data are presented as the mean±standard deviation. CONT: the untreated negative control, AD: Dfb ointment positive control, AD+DW: Dfb ointment+distilled water bathing, AD+MW: Dfb ointment+mineral water bathing. *p<0.05 vs. CONT.

• 

  Fig. 6 Effects of bathing in mineral water on Dermatophagoides farinae body (Dfb) ointment-induced mRNA expression of (A) interferon (IFN)-γ, (B) interleukin (IL)-4 and (C) IL-5 of dorsal skin. Data are presented as the mean±standard deviation. CONT: the untreated negative control, AD: Dfb ointment positive control, AD+DW: Dfb ointment+distilled water bathing, AD+MW: Dfb ointment+mineral water bathing. *p<0.05.

• 

  Fig. 7 Effects of bathing in the mineral water on the Dermatophagoides farinae body (Dfb) ointment-induced T cell profile of spleen cells. Data are presented as the mean±standard deviation. CONT: the untreated negative control, AD: Dfb ointment positive control, AD+DW: Dfb ointment+distilled water bathing, AD+MW: Dfb ointment+mineral water bathing. *p<0.05.

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