| ObjectiveTo investigate the therapeutic effect of prinsepia utilis royle oil-based, purslane and hyaluronan-dominant topical emulsion on atopic dermatitis model of BALB/c mouse. To evaluate the therapeutic effect of topical application of hyaluronan-dominant emulsion on asteatotic eczema.MethodsAnimal experimentsThe induction of AD-like skin lesion was performed by topical application of DNCB and OX. After2weeks later of the first induction, the clinical features, scratching frequency, the ear thickness and total serum IgE was measured to assess the AD-like condition. Then, the ears were treated with vehicle cream, hyaluronan-containing emulsion and different hyaluronan-dominant, purslane or prinsepia utilis royle oil-based topical emulsion, twice a day for4weeks. The change of AD-like skin lesion, ear swelling, the value of trans-epidermal water loss (TEWL) and serum IgE level were measured before and after treatment in different experimental groups. Protein chip technology was used to detect the level of various cytokines. The number of lamellar bodies was observed by electron microscopy; immunohistochemical staining method was used to assess the expression of epidermal keratines.Clinical observation A multicenter, randomized, open study was carried on.82patients with asteatotic eczema, which was divided into experimental and control group. The patients in experimental group were topically treated with hyaluronan-dominant emulsion combining with Mometasone furoate cream, and the control group only was topically treated with Mometasone furoate cream twice a day for14days. Then, the patients in experimental group still topically applied with hyaluronan-dominant emulsion. The SCORAD. TEWL value and the water content of stratum corneum was measured; and the improvement and reoccurrence rate were evaluated after in1,2,4,6and8weeks after treatment.ResultsThe results presented here have shown that1%DNCB and1%OX was repeatedly applied on the ear of BALB/c mice to induce AD-like lesion, including erythema, edema, scaling and excoriation with increased scratching behavior. Significant ear swelling was observed and the total serum IgE was increased. AD-like histological features also was observed, which characterized in increased epidermal thickness, telangiectasis and infiltration of inflammatory cells in super-dermis. Up-regulated expression of IL-4. IL-5and IL-13, and down-regulated expression of IL-12and IFN-y was also observed in AD-like lesion. It suggested that repeated application of DNCB and OX was efficient for induction of BALB/c mice AD model. The histological appearance has shown that compared with vehicle-treated group, the epidermal thickness of mice ear become thinner, infiltration of inflammatory cells and telangiectasis alleviated in hyaluronan-treated mice and all HA-dominant, purslane or prinsepia utilis royle oil-based topical emulsion-treated mice (P<0.05), especially in HA-dominant, purslane and prinsepia utilis royle oil-based topical emulsion-treated group(P<0.01). Compared with vehicle-treated group and other experimental group, the level of serum IgE significantly decreased in HA-dominant, purslane and prinsepia utilis royle oil-based topical emulsion-treated mice (P<0.01). When the AD-like lesion was topically treated for14days, the levels of IL-4, IL-5and IL-13decreased (P<0.05), and the expression of IL-12and IFN-y increased, especially in HA-dominant, purslane and prinsepia utilis royle oil-based topical emulsion-treated group. Topical application of HA-dominant emulsion increased the density of lamellar body in epidermal keratinocytes and alleviated the swelling. When the mice were treated with HA-dominant, purslane and prinsepia utilis royle oil-based topical emulsion, the thickness of K6expression significantly decreased. It has been shown that K10expressed on the suprabasal layers of the epidermis in normal skin, AD-like lesion and treatment group. K.14expressed on the basal layer of epidermis in normal skin, but it was observed on entire epidermis in AD-like lesion. However, it was only distributed on the basal layer in HA-dominant emulsion-treated skin. Compare with normal skin, the TEWL value rose in AD-like lesion (P<0.05). The elevated TEWL value was significantly inhibited by topical application of HA-dominant emulsion (P<0.05).Compared with control group, The SCORAD of experimental group significantly decreased in6and8weeks after treatment (P<0.05). The improvement rate of experimental group was higher than that of control group in8weeks after treatment (P<0.05). There was no recurrent case in experimental group in4,6and8weeks after treatment. Compared with control group, The TEWL value significantly decreased and the water content of stratum corneum significantly increased in8weeks after treatment (P<0.05). The smooth, glossy and moisture of patient skin in experimental group also improved.ConclusionThe study presented here demonstrated that the prinsepia utilis royle oil-based, purslane and hyaluronan-dominant topical emulsion could inhibit the inflammatory response and restore the epidermal barrier function in AD model of BALB/c mouse, which was mediated by inhibition of IgE production, balanced expression of cytokines, balanced the proliferation and differentiation of keratinocytes, and recovery of lamellar body structure and density. This emulsion could be a new therapeutic approach for atopic dermatitis.Topical application of hyaluronan-dominant emulsion could reduce recurrence of asteatotic eczema and restore the epidermal barrier function, which could improve the effect of treatment of asteatotic eczema. |
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