Ceramides and EczemaEczema and Ceramides
Because of their beneficial effect on dermal barriers, emollients and humectants are regarded as one of the major therapies of AE. New, soothing and moisturising face lotions and a moisturising face lotion with L-Isoleucine, Ceramides, Niacinamid and Rhamnosoft have recently been formulated (Pro-AMP Face and Body Lotions). This cream formulation could affect various facets of dermal barriers disorders that improve dermal barriers in the AE.
Objective: We conducted a prospective, evaluative, assessor-blinded trial to evaluate the impact of pro-AMP face and limb cream on development, itching and S. aurue colonisation in pediatric patients with light to moderately severe AE. The treatment was administered twice a day for a 2-month treatment to the affected area (face, throat, top limb, lower limb and body).
The EASI (Eczema Area Sovereignty Index) scores (face, throat, and body) for erythema, thick scratches, and lightenification were rated with a 4-point scores (from 0: absence to 3: severe) and a rated Baseline, months 1 and 2. Swabs for the evidence of S. aureus were obtained from lesion membrane at study initiation and in monthly 2:
Initially, the EASI face and bodily values were mean (SD) 1. The Itch VAS mark at the start of the study was 6.4 (2.8). At the beginning of the study, nine (20%) volunteers were positively affected by S. aureus. The EASI results were significantly reduced by 50% (facial) and 52% (body) in 1. In 2 EASI face and 79% (body) results were reduced by 75% and 79%, respectively.
Itching VAS was decreased by 42% in weeks 4 and 66% in weeks 8. Except for one volunteer with S. aureus at the beginning of the study, all had 2 adverse dermal smears per metre. Conclusion: Formulated with icoleucine, ceramides, nicacinamide and diamondosoft, these new Pro-AMP face and neck lotions have been shown to be potent in relieving manifestations and symptom levels in light to moderately severe cases of autoimmune disease.
The treatment was also associated with an amelioration of the lesionsodysbiosis. Atrotic eczema (AE) is a very frequent type of chronically inflammable childhood dermatitis. Haut-Xerose and itching are the hallmarks of the disease and indicate that the change of the dermal barriers is the reason for the AE.
Changes in the dermal barriers such as xerosis, elevated pH of the dermis, changes in congenital immune response with a decrease in the secretion of antimicrobial peptides, could favor the collonization of S. ureus, which in turn could be a progression associated with AE flares. The S. ureus virus is indeed the most frequent type of autoimmune E disorder aggravation[ 8].
Because of their benefits on dermal barriers, softeners and humectants are regarded as one of the main therapies of AE. Plasticization treatment could also have an indirectly favourable effect on the healthy microbial condition of the skin. Novel soothing and moisturising face care and moisturising face care products containing 2% ilanucine, 0.01% ceramides, 1% nicacinamide, 1-dimethicon.
7 percent and Rhamnosoft 0.2 percent were recently formulated (Pro-AMP face cream). However, the formulation of these crèmes could affect various facets of dermal barriers disorders that improve dermal barriers in the AE. Moreover, S. aureus' liability on the dermis could be adversely affected by Rhamnosoft. Thus, the special formulation of these soothing emollients may be particularly beneficial in pediatric patients with AE, who not only improve the dermal barriers, but also strengthen some internal dermal pathways such as AMP induction.
Our collaborative research project evaluates the impact of Pro-AMP face and neck cream on human itching, development, and coloration in pediatric patients with mildly moderated AE in a perspective assessor-blind assessment cohort assessment report. A nonprofit, bipartite, perspective, investigator-blind child aged 6 month to 14 years with face and limb AE was registered.
Face creams containing 2% icoleucine, 0.2% gumnosoft (Gum2) and 0.01% ceramides (ceramide 3 and NP ) were used for face lesion (Nutratopic pro-AMP Face creams, Isdin SA, Barcelona Spain). Creams for lesion in the lower and higher extremities contain 2% icoleucine, 0.2% ammnosoft (Gum 2), 0.01% ceramides, 1% nicacinamide and 1-dimethicon.
The treatment was administered twice a day, once in the mornings and once in the evenings, for a duration of 8 weeks to the affected areas (face, throat, top extremities, bodies and lower extremities). The EASI Severity Index (Eczema Area Severity Index) (for face, throat, and body: top extremities and bottom extremities), which evaluates erythema, thick scratches, and lichen? ration, was scored with a 4-point mark (from 0: absence to 3: severe) and scored at the beginning, 1st and 2nd months. The EASI Severity Index was scored blindfolded.
Specimens for the S. aureus test were collected at at least three lesion site locations at the start of the trial and on the second day of the trial. The protocol-specific results of the trial were the development of EASI and VAS itch values. Secundary results of the trial were the development of the percent of volunteers with S. aureus positives.
Specimens were taken with a modificated peeling method using a q-tip. The Wilcoxon pair test was used to evaluate the ESI and VAS results. Fisherman's Accurate Test was used to compare the percentages of S. aureus positives during the trial.
Chart 1 shows the demo and clinic features of the 45 volunteers registered at first. Initially, ESI face and bodily values (upper and lower limbs), mean value (SD), 4. The Itch VAS mark at the start of the study was 6.4 (2.8). At the beginning of the study, nine (20%) volunteers were positively affected by S. aureus.
The EASI mark was significantly higher (+37%) than the EASI mark in the group with S. aureus negatively (p=0.03) in those cases with S. aureus positives at initiation, which confirms that the existence of these bacterial strains is associated with a poorer outcome. EASI values in all volunteers dropped significantly by 50% (face) and 52% (body) in the first months and by 75% and 79%, respectively, in the second months (Figure 1).
Itching VAS was decreased by 42% in the first and 66% in the second half of the year ( Fig. 2). Except for one subject with S. aureus at the beginning of the study, all had adverse dermal smears in 2 weeks (p=0. 002; Fischer exact test). Chart 1: Development of the eczema severity index (ESI) of face (a) and b ) at the start of the study and after 1 and 2 montotherapy.
Base line vs. months 1: p=0. 0002; base line vs. months 2: p=0. 0001; Wilcoxon test. Fig. 2: Development of the Itch VAS Scores from base line to months 1 and 2. Base line vs. months 1: p=0. 0003; base line vs. months 2: p=0. 0001; Wilcoxon test. Chart 1: Features of the volunteers at the beginning of the study.
Hautbarriere has an important part to play for the human system by inhibiting the introduction of pathogens into the human system, thermoregulating and hydrating the skin. A change in dermal barriers has been reported in eczema, both in the affected areas and in normally looking skin.
Especially Xerose is a trademark of the AE and affects both the injured and the non-affected areas of the skin. Furthermore, a significant role of the dermal wall is associated with congenital immune mechanisms. A keratinocyte produces antimicrobial peptide (AMP) and the pH of dermal acids provides extra protective action against pathogens.
Patients with patients with atopic eczema were found to have faulty TMP production. Eczema dermatitis is characterised by a condition of disbiosis in which the existence of regular "protective" bacteria such as S. épidermidis could be substituted by an unusual proliferation of S. aureus. In AE patients, the colonisation of the ureus is associated with the aggravation of the condition and AE excerbation is associated with a reduction in lesion lesions' virulence (dysbiosis).
The S. ureus is capable of secreting superantigenic exotoxins. However, the scattered use of antibiotics could ease the proliferation of methicillin-resistant Sureus ( "MRSA") strain, which in turn could be a therapeutical challenge: A recent meta-analysis shows that there is a clear link between antibiotic exposures and MRSA isolation.
Furthermore, a recent meta-analysis assessing various anti-Stilokokken intervention has shown that none of the trials showed evidence of efficacy. Plasticizing and hydrating treatments aimed at improving the dermal barriers of AE patients are now regarded as a basic strategy for the management of this disease.
Improving the functioning of the dermal barriers (water level, normalisation of the dermal pH value) can per se also enhance the dermal congenital immunity. Recently, Page et al. [ 9] have shown that the use of an enzyme is associated with an enhancement of dermal microbial activity in AE patients. However, there are no recent topically derived emollients or moisturizers with special ingredients that could directly enhance the skin's congenital defense mechanism and especially the secretion of AMP.
The present trial evaluates the effect of two topically derived compounds containing glamnosoft, isolin, niacinamide and ceramides. Ceramides of topically occurring ceramides could re-establish the changed dermal wall in AE[28,29]. Furthermore, S. aureus may affect Rhamnosoft's adherence to the epidermis. topical isolin has been shown to stimulates the secretion of AMP at dermal levels.
The use of topically anti-inflammatory, soothing and moisturising agents that also contain substances that could enhance the natural immunological system of the human dermis, such as solucine, could therefore be a further stage in the rationale of topically treating AE. We have shown in this trial that the use of shamnosoft, ceramides, nicacinamide and icoleucine face and bodycreams significantly improves sign and symptom in infants with light to moderately severe AE.
A multi-center, peer group, conducted in 105 patients with facial eczema, the results were confirmed by these results. Furthermore, we found that after two month of cream use, the improved dybiosis was about 1/3 of this time.
To enhance the in-house validation of our study, we have chosen a clinically validated assessment method blindfolded by the investigator with regard to the ESI scores. Symptogenetic roles of SAE colonisation appear to be more related to the severity of AE than to light to medium cases. However, in the subgroup of volunteers with affirmative eczema, we found that the ESI base value was significantly higher than the ESI value of volunteers with affirmative eczema, indicating that even in light to medium cases, the existence of eczema could be associated with a more serious disease onset.
Use of the trial lotions was associated with an improved dybiosis state in this subgroup of volunteers. Evidence suggests that even with light to medium AE, normalisation of dermal microbial activity may have a beneficial effect on CL outcomes. Formulated with isolin, nicacinamide, ceramides and ammnosoft, these new Pro-AMP face and neck lotions have been shown to be potent in relieving pain and reduce symptom (itching) in light to moderately severe cases of autoimmune disease.
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