The Skin Responses to Dimethyl Sulfoxide in Normal Human Forearm Skin

BACKGROUND: Dimethyl sulfoxide (DMSO) is a strong urticariogenic agent and a primary irritant. A DMSO test which measures erythema and wheal responses in skin after exposure for 5 min could be a simple and easy method in evaluating cutaneous irritation. Several non-invasive bioengineering methods for the evaluation of skin irritancy have been developed in recent decades. OBJECTIVE: To evaluate whether the DMSO test using filter paper discs instead of the open well with measurements of transepidermal water loss (TEWL) and erythema index (E-index) could be useful to study skin irritancy. METHODS: Twenty healthy volunteers (19-29 years, 10 males and 10 females) with no history of atopic dermatitis were included. DMSO solutions (90%, 95%, and 100%) of 60l were applied to the left volar forearm for 5 min using filter paper discs (12mm) for large Finn chamber. Visual scores (whealing scores and erythema), TEWL and E-index were measured at 30 min after removal of the filter papers. RESULTS: The number of subjects showing erythema and wheals after DMSO exposure were: 6 (30%), 8 (40%) with 90% DMSO solution; 14 (70%), 15 (75%) with 95% DMSO solution; and 20 (100%), 20 (100%) with 100% DMSO solution, respectively. Whealing scores were 0.5±0.6 (90%), 1.4±1.1 (95%), 3.5±0.9 (100%), and erythema ones were 2.9±4.9 (90%), 7.7±7.2 (95%), 20.0±6.5 (100%). E-index results were 10.0±3.4 (90%), 10.9±3.1 (95%), 12.3±2.7 (100%), and TEWL values were 14.6±4.9 (90%), 21.0±8.8 (95%), 44.9±15.3 (100%). As the DMSO concentrations were increased, there were significant increases in whealing scores, and erythema and TEWL values. E-index results were not significant, but showed a rising score tendency. There were no significant differences between the males and the females. CONCLUSION: DMSO testing may be a quick and simple method to assess cutaneous irritation. Also, TEWL measurements may be more accurate and sensitive than those of E-index measurement in the assessment of erythema and wheals. DMSO testing using filter paper discs with TEWL measurement could be a useful method in the study of cutaneous irritation.

The Effect of Chamber Size and Vulume of Test Solution on Cutaneous Irritation / 대한피부과학회지

BACKGROUND: There are some variables including chamber size in irritant patch test responses. Several non-invasive bidengineering methods for quantifying and obtaining information have been developed in recent decades. OBJECTIVE: Our study was done to compare the effect of chamber size and the volume effect on the irritation potential of 1% SLS solution. METHODS: Patches with 1% sodium lauryl sulfate(SLS) solution were applied to the volar forearm of 14 healthy volunteers for 24 h. Finn chambers with 8mm(20ul), 12mm(60pl), 18mm(80ul, 200ul) inner diameters were used. Visual score and transepidermal water loss (TEWL) were measured at 30 min after removal of the patches, and every 24 h up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.18+0.32(8mm), 0.75+0.33(12mm) and 0.64+0.41(18mm) at 24 h after removal of 1% SLS and were 0.11+0.29, 0.50+0.34 and 0.25+0.26 on 4 days after removal. They were inereased 30 min and 24 h after removal and decreased towards normal 4 days after removal. By chamber size, the skin response with the large Finn chamber(12mm) increased more significantly than with the small Finn chamber(8mm). However, there were no significant differences in skin response between large and extralarge Finn chambers(18mm). 2. TEWL values were 11.86+4.09, 23.05+6.1l and 22.24+7.54g/m/h at 30 min after removal and were 9.37+2.30, 1..49+3.08 and 14.56+5.00g/m/h on 4 days after removal. They were increased 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as visual scores. 3. By visual score and TEWL, the skin response with 200pl of 1% SLS increased more significantly than 80pl in the extralarge Finn chamber. CONCLUSION: The small Finn chamber may be too small to elicit sufficient cutaneous irritation for evaluation. The large Finn chamber having larger test areas may be suitable to yield positive reactions to certain irritants. Also, the quantity of test solution per mm skin may be of importance for the skin response.

Cutaneous Irritation to Sodium Lauryl Sulfate and Sodium Lauroyl Glutamate / 대한피부과학회지

BACKGROUND: Sodium lauryl sulfate(SLS) is the most widely utilized model for studying acute and cumulative irritation. Sodium lauroyl glutamate(SLG) has exhibited a low irritation potential and an anti-irritating effect on other anionic surfactants. OBJECTIVE: Our study was done to compare the skin irritancy of SLS and SLG using non-in- vasive techniques. METHODS: Patches with 1% SLS and SLG solution were applied to the volar forearm of 20 healthy volunteers for 24 h. Finn chambers with 8mm(20pl) and 12mm(60pl) inner diameters were used. Visual scores, transepidermal water loss(TEWL) and an erythema(E)-index were measured at 30 min after removal of the patches, and every 24hours(h) up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.20+0.30(8mm) and 0.73+0.34(12mm) at 24 h after removal of 1% SLS and were 0.15+0.29(8mm) and 0.30+0.41(12mm) at 24 h after removal of 1% SLG. They were increased at 30 min and 24 h after removal and decreased towards normal at 4 days after removal. By chamber size, the skin response with large Firin chamber(12mm) increased more significantly than with the small Finn chamber(8mm). In the small Finn chamber, there were no significant differences in the skin response between 1% SLS and 1% SLG. In the large Finn chamber, the skin response with 1% SLS increased more significantly than with 1% SLG. 2. TEWL values were 11.14+4.77(8mm) and 20.48+10.61(12mm) at 24 h after removal of 1 % SLS and were 10.38+3.99 and 14.87+7.46 at 24 h after removal of 1% SLG. They were increased at 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as the visual scores. Also, on comparison between 1% SLS and 1% SLG, their results were the same as the visual scores. 3. E-index was 10.05+2.70(8mm) and 11.15+2.56(12mm) at 24 h after removal of 1% SLS and was 10.15+2.16 and 10.60+2.26 at 24 h after removal of 1% SLG. They were increased at 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as the visual scores. In the small and large Finn chamber, there were no significant differences in the skin response between 1% SLS and 1% SLG. CONCLUSION: SLS is more irritating than SLG. The large Finn chamber may be more suitable to yield positive irritant reactions than the small Finn chamber. Also, TEWL measurements may be a more accurate and sensitive method than the E-index.

The Effects of Cyclosporin A and FK-506 on the Cytokine Production of Lymphocytes in Atopic Dermatitis

BACKGROUND: It has been demonstrated that patients with atopic dermatitis(AD) show an impaired capacity of their T cells to release of interleukin-2(IL-2) in vitro and elevated serum levels of soluble IL-2 receptor(sIL-2R). Both immunosuppressive agents, cyclosporin A(CsA) and FK-506 can block early events in T lymphocyte activation and FK-506 is 10- to 100-fold more potent in the inhibition of IL-2 and other lymphokines production. OBJECTIVE: We compared the effects of CsA and FK-506 on PHA-induced lymphokine and sIL-2R production and compared the effects of CsA and FK-506 on PHA-induced IL-4 production in a high IgE group and a low IgE group in patients with AD. METHODS: A total of 32 peripheral blood samples from 17 patients with AD and 15 control groups were tested. Lymphocytes were isolated from blood samples and were cultured with PHA(positive control), PHA and CsA(10 ng/ml), PHA and FK-506 (1 ng/ml), and without stimulation (negative control). The amount of cytokines such as IL-2, IL-3, IL-4 and sIL-2R were measured using an enzyme-linked immunosorbent assay(ELISA). RESULTS: CsA and FK-506 inhibited significantly the production of IL-2, IL-3, IL-4 in PHA-stimulated lymphocytes of both the AD patients and the control groups. FK-506(1 ng/ml) inhibited cytokines production more significantly than CsA(10 ng/ml). However, CsA and FK-506 did not significantly inhibit the production of sIL-2R. There were no significant differences in the inhibitory effect of CsA and FK-506 on IL-4 production upon PHA-stimulation between AD patients with a high IgE level and with a low IgE level. CONCLUSION: Both FK-506 and CsA inhibit lymphokine production, but not the production of sIL-2R. FK-506 inhibited more significantly lymphokine production at a 10-fold lower concentration than CsA. Our data suggest that FK-506 could be more effective in the treatment of severe AD than CsA, and both these agents show their immunosuppressive activity through the suppression of lymphokine production, not via the suppression of sIL-2R production in AD.

Two Cases of Atopic Dermatitis Treated with Thymopentin / 대한피부과학회지

The pat,hogenesis of atopic dermititis(AD) is still undefined. The prominent immunologic abnormalities associated with AD are defective cell-mediated immunity and increased IgE production. Also, the predominant CD4 subset in the skin lesion of AD is a Th2-like. Thymopentin, the active pentapepide of a thymic hormone, promotes differentiation of thymocytes and exhibits immunomodulating function. We experienced 2 case. of severe AD patients who were treated with subcutaneous injection of thymopentin three times a week for 6 weeks or 8 weeks. We compared the effects of cyclosporine A(CsA), FK -506 and thymopentin on the production of IL-2, IL-3, IL-4 and sIL-2R in vitro. In patient 1, there was no clinical response with thymopentin therapy. There was no difference in the serum IgE levels between before and after treatment. The ratio of Th/Ts was increased after treatment. In vitro study, CsA and FK-506 inhibited the production of IL-2, IL-3, IL 4 and sIL-2R, and thymopentin inhibited the production of IL-2, IL-3, IL-4 and sIL-2R. In patient 2, the clinical score of the patient was improved from 15 to 10 after treatment with thymopentin. There was no difference in the serum IgE level. The ratio of Th/Ts was decreased after treatment. In vitro study, the production of IL-2, IL-3 and IL-4 were decreased in lymphocytes added with CsA and FK-506, but the production of sIL-2R was increased by CsA and FK-506. Also, the production of IL-3 and IL-4 were increased in lymphocytes added with thyrnopentin, but the proluction of IL-2 and sIL-2R were increased by thymopentin. Our data suggest that thymopentin could be effective in the treatment of severe AD through the upregulation of Thl-like subset, not via the downregulation of Th2-like subset.