Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 137, Issue 4, Pages 1091-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2015.08.013
Keywords
Petrolatum; moisturizer; occlusion; patch tests; antimicrobial peptides; innate immunity; atopic dermatitis; barrier; skin surgeries
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Funding
- Center for Basic and Translational Research on Disorders of the Digestive System through the generosity of the Leona M. and Harry B. Helmsley Charitable Trust
- American Dermatological Association's Medical Student Fellowship
- National Center for Research Resources (NCRR), National Institutes of Health (NIH) [5UL1RR024143-02]
- NIH Roadmap for Medical Research
- Dermatology Foundation Physician Scientist Career Development Award
- CTSA grant from the Rockefeller University
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Background: Petrolatum is a common moisturizer often used in the prevention of skin infections after ambulatory surgeries and as a maintenance therapy of atopic dermatitis (AD). However, the molecular responses induced by petrolatum in the skin have never been assessed. Objective: We sought to define the cutaneous molecular and structural effects induced by petrolatum. Methods: Thirty-six healthy subjects and 13 patients with moderate AD (mean SCORAD score, 39) were studied by using RT-PCR, gene arrays, immunohistochemistry, and immunofluorescence performed on control skin, petrolatum-occluded skin, and skin occluded with a Finn chamber only. Results: Significant upregulations of antimicrobial peptides (S100A8/fold change [FCH], 13.04; S100A9/FCH, 11.28; CCL20/FCH, 8.36; PI3 [elafin]/FCH, 15.40; lipocalin 2/FCH, 6.94, human beta-defensin 2 [DEFB4A]/FCH, 4.96; P < .001 for all) and innate immune genes (IL6, IL8, and IL1B; P < .01) were observed in petrolatum-occluded skin compared with expression in both control and occluded-only skin. Application of petrolatum also induced expression of key barrier differentiation markers (filaggrin and loricrin), increased stratum corneum thickness, and significantly reduced T-cell infiltrates in the setting of normal-appearing or nonlesional AD skin, which is known to harbor barrier and immune defects. Conclusions: Petrolatum robustly modulates antimicrobials and epidermal differentiation barrier measures. These data shed light on the beneficial molecular responses of petrolatum in barrier-defective states, such as AD and postoperative wound care.
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