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Divergent Mechanisms for Correction of Permeability Barrier Dysfunction

Man Mao-Qiang, MD; Barbara E. Brown; Suzanna Wu-Pong, PhD; Kenneth R. Feingold, MD; Peter M. Elias, MD

Arch Dermatol. 1995;131(7):809-816.

Abstract
Background and Design
Although barrier function requires cholesterol, free fatty acids, and ceramides, applications of one or two of these lipids to damaged skin impedes barrier recovery, while equimolar mixtures allow normal recovery. Both incomplete and complete mixtures appear to be internalized within the epidermal nucleated layers, followed by the secretion of abnormal vs normal lamellar body contents, respectively. We compared the ability of complete physiologic lipid mixtures vs a nonmetabolized hydrophobic lipid, petrolatum, to repair the barrier and the requirement for intracellular processing of these lipids within the epidermis.

Results
Neat petrolatum, which remains restricted to the stratum corneum, produces more rapid improvement in barrier function than the solvent-dispersed physiologic lipids, and its effects are not altered by coapplication of either monensin or brefeldin A (both from Sigma Chemi- cal Co, St Louis, Mo), known inhibitors of exocytosis and organellogenesis, respectively. In contrast, the physiologic lipids enter the nucleated layers in substantial amounts and require longer to produce barrier recovery. Whereas monensin blocks their ability to facilitate barrier recovery, the physiologic lipids overcome brefeldin A—induced delays in barrier recovery, bypassing the subcellular site of brefeldin A blockade, normalizing both lamellar body contents and intercellular bilayers.

Conclusions
While petrolatum remains restricted to the stratum corneum, physiologic lipid mixtures influence barrier recovery after transport to subjacent, nucleated layers, followed by internalization, apparent transport to the distal Golgi apparatus, and incorporation into nascent lamellar bodies.

(Arch Dermatol. 1995;131:809-816)

Author Affiliations
From the Dermatology Service (Drs Mao-Qiang, Wu-Pong, Feingold, and Elias and Ms Brown) and Metabolism Section (Drs Wu-Pong and Feingold), Veterans Affairs Medical Center; and Departments of Dermatology (Drs Mao-Qiang, Wu-Pong, Feingold, Elias, and Ms Brown) and Medicine (Drs Wu-Pong and Feingold), University of California-San Francisco.

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