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JUERGEN LADEMANN

Centre of Experimental and Applied Cutaneous Physiology (CCP) at the Dermatological Clinic Charité, Charitéplatz 1, DE-10117, Berlin Germany.
juergen.lademann@charite.de
Curriculum Vitae


Prof. Dr. Dr.-Ing. Juergen Lademann
born August 5th, 1955
in Fuerstenwalde, Germany

Charité - Universitaetsmedizin Berlin, Germany
Department of Dermatology
Center of Experimental and Applied Cutaneous Physiology (CCP)
Charitéplatz 1
10117 Berlin
Tel. +49-30-450 518 100
Fax +49-30-450 518 918
e-mail: juergen.lademann@charite.de



Education and Occupation

1974 - 1980 Course of Study in Biophysics at the Moscow Lomonosov University, Russia

1980 - 1991 Institute of Optics and Spectroscopy of the Academy of Science
in Berlin, Germany

1984 Attainment of Dr. rer. nat. from the Faculty of Physics at the Moscow Lomonosov University, Russia

1991 Attainment of Dr. sc. nat. from the Faculty of Physics at the Friedrich-Schiller-University Jena, Germany

1992 - 1995 Head of the Department „Biosensors” at the University of Munich, Germany

1995 Attainment of the Dr.-Ing. habil. at the University of Munich, Germany

since 1996 Director of the Centre of Experimental and Applied Cutaneous
Physiology (CCP) at the Charité, Germany

2000 Professor of Dermatology


Memberships

2003 - 2008President of the International Society of Skin Pharmacology and Physiology
since 2001 Editor of the International Journal “Skin Pharmacology and Applied Skin Physiology”
since 2003 - Board member of the journal Cosmetic Dermatology
- Board member of the journal Biomedical Optics
- Board member of the journal Laser Physic Letters
- Board member of the journal Case Reports in Dermatology
- Board member of the journal The Open Imaging Journal
- Member of Program Committees of international conferences
since 2008 Board member of the German Federal Institute of Risk Assessment, Berlin, Germany



Research Topics

• Penetration of topically applied substances into and through the skin barrier (penetration outside-in),
• Penetration of systemically applied substances onto the skin (penetration inside-out)
• Sun protection and skin aging
• In vivo and in vitro Investigations on human skin and on tissue models,
• Penetration and storage of nanoparticles in the skin,
• Safety assessment of nanoparticles
• Development and application of non-invasive online optical methods in skin physiology
• Determination of the antioxidative potential of the human skin,
• Interaction of antioxidant substances and free radicals in tissue

Journal articles

2010
M E Darvin, S Haag, M Meinke, L Zastrow, W Sterry, J Lademann (2010)  Radical production by infrared A irradiation in human tissue.   Skin Pharmacol Physiol 23: 1. 40-46 01  
Abstract: The influence of the ultraviolet (UV) irradiation of the sun on the formation of free radicals in human skin is well investigated. Up to now, only small amounts of data are available stating that infrared (IR) irradiation can produce free radicals in the skin. In the present study, the formation of free radicals in human skin, subsequent to IRA irradiation (600-1,500 nm), has been demonstrated by means of two different methods. Firstly, the radical formation was detected indirectly by the degradation of the cutaneous carotenoid antioxidants beta-carotene and lycopene, which was investigated in vivo by resonance Raman spectroscopic measurements. Secondly, the direct observation of produced radicals subsequent to IRA irradiation of the skin was performed in vitro by electron paramagnetic resonance spectroscopy. Taking into account the results of the present study and previous UV light studies, it can be expected that also solar irradiation in the visible spectral range will produce free radicals in the human skin. Therefore, the current sun protection strategies should be reconsidered. Furthermore, it was shown in the present study that the side effect in the form of radical formation could be significantly reduced by increasing the protection system of the human organism in form of the antioxidant network.
Notes:
J Lademann, H Richter, M Meinke, W Sterry, A Patzelt (2010)  Which skin model is the most appropriate for the investigation of topically applied substances into the hair follicles?   Skin Pharmacol Physiol 23: 1. 47-52 01  
Abstract: It has recently been demonstrated by the utilization of different techniques, such as differential stripping and laser scanning microscopy, that the hair follicles represent an efficient long-term reservoir for topically applied substances. In the present paper, the different in vivo techniques are compared to those of in vitro analysis. It was found that in vitro measurements on pig ear skin are highly superior for the analysis of follicular penetration, as compared to in vitro investigations on excised human skin, mainly due to the fact that the human skin contracts after removal. Restretching of the skin to its original size mainly stretches the interfollicular fibres, whereas the fibres around the hair follicles remain contracted. In contrast to excised human skin, pig ear tissue does not contract when the cartilage is not removed. Moreover, it has an intact barrier on both sides of the ear. Regardless of the fact that the hair follicles on pig ear skin are larger than those of humans, the porcine ear skin represents a more suitable in vitro model for the analysis of the penetration and storage of topically applied substances in the hair follicles than excised human skin.
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Maxim E Darvin, Wolfram Sterry, Jürgen Lademann (2010)  Resonance Raman spectroscopy as an effective tool for the determination of antioxidative stability of cosmetic formulations.   J Biophotonics 3: 1-2. 82-88 Jan  
Abstract: Carotenoids beta-carotene, lutein, lycopene and others are well-known powerful antioxidants acting as an effective neutralizer of free radicals produced in the human organism as a result of the influence of stress factors, such as UV irradiation. The protective effect of antioxidants is used in cosmetic products to increase the skin protection against the destructive action of free radicals and for the stabilization of formulations against oxidation. In the skin, the different antioxidant substances form protection chains to avoid their destruction by the interaction with the free radicals. Similar effects have to be expected also in topically applied formulations. In the present study the influence of different mixtures of antioxidants (beta-carotene, vitamins C and E) on the stability of antioxidants in formulations used for skin treatment was investigated. The measurements were carried out by using non-invasive resonance Raman spectroscopy for the detection of the carotenoid concentration in the cosmetic formulations.
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Lene N Axelsen, Jacob B Lademann, Jørgen S Petersen, Niels-Henrik Holstein-Rathlou, Thorkil Ploug, Clara Prats, Henrik D Pedersen, Anne Louise Kjølbye (2010)  Cardiac and metabolic changes in long-term high fructose-fat fed rats with severe obesity and extensive intramyocardial lipid accumulation.   Am J Physiol Regul Integr Comp Physiol 298: 6. R1560-R1570 Jun  
Abstract: Metabolic syndrome and obesity-related diseases are affecting more and more people in the Western world. The basis for an effective treatment of these patients is a better understanding of the underlying pathophysiology. Here, we characterize fructose- and fat-fed rats (FFFRs) as a new animal model of metabolic syndrome. Sprague-Dawley rats were fed a 60 kcal/100 kcal fat diet with 10% fructose in the drinking water. After 6, 12, 18, 24, 36, and 48 wk of feeding, blood pressure, glucose tolerance, plasma insulin, glucose, and lipid levels were measured. Cardiac function was examined by in vivo pressure volume measurements, and intramyocardial lipid accumulation was analyzed by confocal microscopy. Cardiac AMP-activated kinase (AMPK) and hepatic phosphoenolpyruvate carboxykinase (PEPCK) levels were measured by Western blotting. Finally, an ischemia-reperfusion study was performed after 56 wk of feeding. FFFRs developed severe obesity, decreased glucose tolerance, increased serum insulin and triglyceride levels, and an initial increased fasting glucose, which returned to control levels after 24 wk of feeding. The diet had no effect on blood pressure but decreased hepatic PEPCK levels. FFFRs showed significant intramyocardial lipid accumulation, and cardiac hypertrophy became pronounced between 24 and 36 wk of feeding. FFFRs showed no signs of cardiac dysfunction during unstressed conditions, but their hearts were much more vulnerable to ischemia-reperfusion and had a decreased level of phosphorylated AMPK at 6 wk of feeding. This study characterizes a new animal model of the metabolic syndrome that could be beneficial in future studies of metabolic syndrome and cardiac complications.
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Cornelia Kohlhardt-Floehr, Fritz Boehm, Stefan Troppens, Jürgen Lademann, T George Truscott (2010)  Prooxidant and antioxidant behaviour of usnic acid from lichens under UVB-light irradiation--studies on human cells.   J Photochem Photobiol B 101: 1. 97-102 Oct  
Abstract: Natural compounds which can behave as antioxidants and protect against UV-radiation may well have medical and cosmetic value. Usnic acid, which can be obtained from lichens offer such a potential. The latter is one of the best known and reviewed compounds present in lichens and exhibits many properties of value such as antibiotic, antitumor and UV-filter-effects. We report studies of the potential antioxidant and prooxidant activity of usnic acid extracted from Xanthoparmelia farinosa (Vainio) using a human lymphocyte cell line (Jurkat-cells) under UV-B-irradiation. Cell survival and cell metabolism were determined using different conditions such as usnic acid concentration and UVB dose. Compared to the controls the cells incubated with usnic acid in concentrations of 1 x 10(-8) and 1 x 10(-6) M showed a higher cell survival and a normal metabolism under low doses of UVB-light up to 0.1 J/cm(2). When both higher UVB doses (up to 14 J/cm(2)) and higher concentrations of usnic acid (1 x 10(-4) M) where used, the opposite effect was observed. It is concluded that these effects are due to bifunctional (a switch of) anti-oxidative-pro-oxidative behaviour of usnic acid under UV-B-irradiation.
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Maxim E Darvin, Stefan F Haag, Martina C Meinke, Wolfram Sterry, Jürgen Lademann (2010)  Determination of the influence of IR radiation on the antioxidative network of the human skin.   J Biophotonics Feb  
Abstract: Production of free radicals in the human skin subsequent to IR irradiation has been demonstrated by means of two different methods. The first technique, based on resonance Raman spectroscopy, enables the non-invasive measurements of the kinetics of cutaneous carotenoid antioxidants beta-carotene and lycopene, subsequent to IR irradiation. Obtained degradation of the cutaneous carotenoids was a hint but not evidence that IR irradiation can produce free radicals in the skin. Therefore, the direct observation sustaining the production of free radicals subsequent to IR irradiation in the skin was performed in-vitro by electron paramagnetic resonance spectroscopy. Enzymatic processes as well as heat shock-induced radicals in the human skin are presumably involved in the energy transfer from IR irradiation into the molecules of the skin. Protection strategy for human skin against IR-induced free radicals based on the increase in the concentration of antioxidants by means of antioxidant-rich supplementation is discussed. ((c) 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).
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Hicham Benkhai, Sandra Lemanski, Harald Below, Jens Uwe Heiden, Elke Below, Jürgen Lademann, Manfred Bornewasser, Theo Balz, Christine Chudaske, Axel Kramer (2010)  Can physical stress be measured in urine using the parameter antioxidative potential?   GMS Krankenhhyg Interdiszip 5: 2. 09  
Abstract: Although regular exercise is known to promote health, it is also well known that competetive sports can lead to an increase of free radical production, and thus to a drop in antioxidative potential. Thus, the present study examined the effect of competetive sports on the antioxidative potential (AOP). Using chemoluminescence, the AOP was measured in the spontaneous urine of leisure and semi-professional athletes during a training camp. Further, the parameters creatinin and uric acid were measured. It was shown that physical stress led to a drop in the antioxidant potential of up to approximately 50%. To compensate for this decline, special antioxidant food is recommended.
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S Trauer, J Lademann, F Knorr, H Richter, M Liebsch, C Rozycki, G Balizs, R Büttemeyer, M Linscheid, A Patzelt (2010)  Development of an in vitro modified skin absorption test for the investigation of the follicular penetration pathway of caffeine.   Skin Pharmacol Physiol 23: 6. 320-327 06  
Abstract: The Organization for Economic Cooperation and Development (OECD) recommends caffeine as a reference substance for in vitro skin absorption tests using Franz diffusion cells (FDC). However, it has not been possible to investigate the follicular penetration pathway using this method until now. The aim of this study was to develop a technique to allow the examination of the follicular penetration pathway of a substance penetrating into the skin. The OECD standard method was therefore combined with the follicle closing technique (FCT), an established in vivo method. By using test skin of varying follicular densities, different penetration values were obtained for the test substance caffeine. The follicular penetration rate was determined by an indirect calculation after modifying the in vivo FCT for use in the in vitro FDC. This method is the first to allow the differentiation of penetration pathways by combining the OECD standard method (using the FDC) and the FCT. Caffeine showed a surprisingly high rate of penetration through the follicular shunts in vitro.
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Ulrike Blume-Peytavi, Lida Massoudy, Alexa Patzelt, Jürgen Lademann, Ekkehart Dietz, Utkur Rasulev, Natalie Garcia Bartels (2010)  Follicular and percutaneous penetration pathways of topically applied minoxidil foam.   Eur J Pharm Biopharm Jun  
Abstract: In the past, it was assumed that the intercellular route was the only relevant penetration pathway for topically applied substances. Recent results on follicular penetration emphasize that the hair follicles represent a highly relevant and efficient penetration pathway and reservoir for topically applied substances. This study investigates a selective closure technique of hair follicle orifices in vivo assessing interfollicular and follicular absorption rates of topical minoxidil foam in humans. In delimited skin area, single hair orifices or interfollicular skin were blocked with a microdrop of special varnish-wax-mixture in vivo. Minoxidil foam (5%) was topically applied, and transcutaneous absorption was measured by a new surface ionization mass spectrometry technique in serum. Different settings (open, closed or none of both) enabled to clearly distinguish between interfollicular and follicular penetration of the topically applied minoxidil foam. Five minutes after topical application, minoxidil was detected in blood samples when follicles remained open, whereas with closed follicles 30min were needed. Highest levels were found first when both pathways were open, followed by open follicles and subsequently by closed follicles. These results demonstrate the high importance of the follicular penetration pathway. Hair follicles are surrounded by a dense network of blood capillaries and dendritic cells and have stem cells in their immediate vicinity, making them ideal targets for drug delivery.
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A Hammann, N - O Huebner, C Bender, A Ekkernkamp, B Hartmann, P Hinz, E Kindel, I Koban, S Koch, T Kohlmann, J Lademann, R Matthes, G Müller, R Titze, K - D Weltmann, A Kramer (2010)  Antiseptic efficacy and tolerance of tissue-tolerable plasma compared with two wound antiseptics on artificially bacterially contaminated eyes from commercially slaughtered pigs.   Skin Pharmacol Physiol 23: 6. 328-332 06  
Abstract: AIM: To compare the tissue tolerance and efficacy of two wound antiseptics with tissue-tolerable plasma (TTP) on enucleated contaminated eyes from slaughtered pigs in order to draw consequences for the use of TTP on wounds. METHOD: The corneas of extracted eyes were contaminated with Staphylococcus aureus or Pseudomonas aeruginosa. One and 10 min after application of 10% povidone (PVP)-iodine and 0.04% polyhexanide, respectively, the eyes were rinsed with inactivating solution. To test TTP, the plasma pen meandered over the eyes at a speed of 30 mm/s and a distance of 5 mm; the eyes were then rinsed with balanced salt solution. The reduction factor was calculated by the difference between the logarithm of colony-forming units in the rinse before and after antisepsis or TTP application. RESULTS: The efficacy of TTP (reduction factor 2.4-2.9) was significantly higher (p < 0.001) than that of PVP-iodine and polyhexanide (reduction factor 1.7-2.1). CONCLUSION: TTP is more effective than the tested wound antiseptics. The lack of histological damage to the eyes of slaughtered pigs would seem to make its use as a wound antiseptic a viable alternative. In contrast to antiseptics, it supplies additional energy in the form of heat, electric fields and radicals by TTP.
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Martina C Meinke, Maxim E Darvin, Henning Vollert, Jürgen Lademann (2010)  Bioavailability of natural carotenoids in human skin compared to blood.   Eur J Pharm Biopharm 76: 2. 269-274 Oct  
Abstract: Skin functions and structure are significantly influenced by nutrients. Antioxidants protect the supportive layer of the skin against any damaging irradiation effects and the action of free radicals. A lack of suitable methods means that the pharmacokinetic properties of systemically applied carotenoids transferred into the skin remain poorly understood. In this study, a natural kale extract or placebo oil were given orally to 22 healthy volunteers for 4 weeks. Carotenoid bioaccessibility was evaluated using non-invasive resonance Raman spectroscopy on the palm and forehead skin. For the analysis of the blood serum, the standard HPLC method was used. The blood and skin levels of the carotenoids increased significantly during the study but compared to the blood serum values, increases in skin were delayed and depended on the dermal area as well as on the carotenoid. Lycopene, measured as being low in the extract, increases more in the skin compared to the blood indicating that the natural mixture of the extract stabilizes the antioxidative network in the skin. After supplementation had ended, the carotenoids decreased much faster in the blood than in the skin. The delayed decrease in the skin may indicate a peripheral buffer function of the skin for carotenoids.
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M Rohr, E Klette, S Ruppert, R Bimzcok, B Klebon, U Heinrich, H Tronnier, W Johncock, S Peters, F Pflücker, T Rudolph, H Flösser-Müller, K Jenni, D Kockott, J Lademann, B Herzog, S Bielfeldt, C Mendrok-Edinger, C Hanay, L Zastrow (2010)  In vitro sun protection factor: still a challenge with no final answer.   Skin Pharmacol Physiol 23: 4. 201-212 03  
Abstract: In the past, several attempts have been made to develop in vitro methods for determining protection against UV radiation. To date however, there is no broadly accepted method. Various known and unknown parameters influence the transmission measurements of scattering films, such as the multifaceted compositions of sunscreens, the technical limitations of measurement devices as well as the difficulty to apply very thin films of sunscreen in a reproducible manner throughout different laboratories. In vitro data were measured in this multicenter study to compare possible methodologies and strategies for an in vitro approach to the sun protection factor (SPF). This publication will not present a final in vitro SPF test method, but it will point out which technical side effects may influence such a method. Influential factors such as the quality of spectrophotometer used, the amount of product applied, pretreatment of samples, time and temperature of equilibration, size of the measured surface, the application process or the calculation on the basis of standardized data are presented and discussed. Finally, a reduction of the standard deviations within single laboratories could be realized for in vitro SPF testing, but no improvement of the interlaboratory comparison was obtained. The development of a valid and reliable SPF in vitro test still remains a challenge, and further work is necessary to develop a satisfactory method.
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S F Haag, A Bechtel, M E Darvin, F Klein, N Groth, M Schäfer-Korting, R Bittl, J Lademann, W Sterry, M C Meinke (2010)  Comparative study of carotenoids, catalase and radical formation in human and animal skin.   Skin Pharmacol Physiol 23: 6. 306-312 06  
Abstract: Animal skin is widely used in dermatological free radical research. Porcine ear skin is a well-studied substitute for human skin. The use of bovine udder skin is rare but its high carotenoid content makes it particularly appropriate for studying the redox state of the skin. Yet, information on the suitability of animal skin for the study of external hazard effects on the redox state of human skin has been lacking. In this study, we investigated the activity of the antioxidant enzyme catalase and the carotenoid content defining the redox status as well as UV-induced radical formation of human, porcine ear and bovine udder skin ex vivo. In human skin only low levels of radical formation were detected following UV irradiation, whereas bovine skin contains the highest amount of carotenoids but the lowest amount of catalase. Porcine ear skin does not exhibit a carotenoid signal but its catalase activity is close to human skin. Therefore, radical formation can neither be correlated to the amount of catalase nor to the amount of carotenoids in the skin. All skin types can be used for electron paramagnetic resonance-based detection of radicals, but porcine skin was found to be the most suitable type.
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Axel Kramer, Ojan Assadian, Jürgen Lademann (2010)  Prevention of postoperative wound infections by covering the surgical field with iodine-impregnated incision drape (Ioban 2).   GMS Krankenhhyg Interdiszip 5: 2. 09  
Abstract: The literature is used to analyse the significance of the use of iodine-impregnated incision drape (Ioban(®) 2) for the prevention of postoperative wound infections (SSI). The drape has a microbiocidal effect in vitro. Consequently an antiseptic effect also occurs under the incision drape when it is applied to the skin; at the same time, bacterial wound contamination is reduced. Overall, based on the efficacy strength of the antiseptic incision drape, a reduction of the SSI rate can, however, be confirmed only with a large sample size. A meta analysis which evaluated four prospective studies and one retrospective study was able to provide significant confirmation of a reduction in the SSI rate. There are no limitations in terms of the biocompatibility of the iodine-impregnated incision drape.
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Suzanne M Bal, Annelieke C Kruithof, Raphaël Zwier, Ekkehart Dietz, Joke A Bouwstra, Jürgen Lademann, Martina C Meinke (2010)  Influence of microneedle shape on the transport of a fluorescent dye into human skin in vivo.   J Control Release 147: 2. 218-224 Oct  
Abstract: Microneedles can enhance the penetration of vaccines into the skin for transcutaneous vaccination. In this study for the first time the influence of microneedle geometry on the transport through the formed conduits was visualised in human volunteers by confocal laser scanning microscopy. Three differently shaped 300 μm long microneedle arrays were selected and fluorescein was applied either before or after piercing. Based on the intensity a distinction was made between regions with high and low intensity fluorescence (HIF and LIF). The areas of both intensities were quantified over time. In most cases HIF areas were only present in the stratum corneum, while LIF areas were also present in the viable epidermis. The areas were larger if fluorescein was applied after piercing compared to before piercing. After 15 min almost no HIF was present anymore at the skin surface. The microneedle geometry, but not the manner of application affected the shape and depth of the conduits. In conclusion we showed that the different microneedle arrays are able to form conduits in the skin, but the geometry of the microneedles influences the penetration of the fluorescent dye. This is the first step towards a more rational design of microneedle arrays for transcutaneous vaccination.
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2009
Martina Meinke, Mandana Abdollahnia, Frank Gähr, Thomas Platzek, Wolfram Sterry, Jürgen Lademann (2009)  Migration and penetration of a fluorescent textile dye into the skin--in vivo versus in vitro methods.   Exp Dermatol 18: 9. 789-792 Sep  
Abstract: The amount of textile dye migration from the textile and penetration into the skin is relevant when assessing the risk of textile dyes. In this paper, in vivo methods were developed using a harmless textile dye with a strong fluorescence and were then compared with in vitro methods. For the in vivo method, the textile was applied to the lower back of six volunteers wearing the textile 12 h and to the lower back of 12 volunteers during 30 min active sport. The maximum skin absorption of 55 +/- 17 ng/cm(2) was obtained in the group engaged in sports. The in vitro methods, which involved the application of the textile to the pig ear skin, was shown to yield similar results to the 12 h in vivo group (31.2 +/- 9.6 ng/cm(2) vs 27 +/- 14 ng/cm(2)). The migration of the textiles into artificial sweat resulted in approximately 20 microg/cm(2). The disadvantage of such textile extract applications on pig ear skin is discussed. It could be demonstrated that the absorption of the dye is strongly correlated to the amount of sweat, whereas the contact time was less important.
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J Lademann, M Meinke, W Sterry, A Patzelt (2009)  How safe are nanoparticles?   Hautarzt 60: 4. 305-309 Apr  
Abstract: Nanoparticles are experiencing an increasing application in dermatology and cosmetics. In both application areas, the requirements of nanoparticles are in most cases widely different. As a component of sunscreens, the nanoparticles are supposed to remain on the skin surface or in the upper most layers of the stratum corneum to protect the skin against UV-radiation of the sun. Whereas, on the other hand, when particulate substances are used as carrier systems for drugs, they have to cross the skin barrier to reach the target sites within the living tissue. We discuss the perspectives and risks of the topical application of nanoparticles.
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L Zastrow, N Groth, F Klein, D Kockott, J Lademann, L Ferrero (2009)  UV, visible and infrared light. Which wavelengths produce oxidative stress in human skin?   Hautarzt 60: 4. 310-317 Apr  
Abstract: Experimental evidence suggests that the creation of free radicals--mainly reactive oxygen species (ROS)--is the common photobiological answer to the skin-sunlight interaction. The free radical action spectrum (wavelength dependency) for ultraviolet and visible light (280-700 nm) has been determined by quantitative ESR spectroscopy. Visible light produces around 50% of the total oxidative stress caused by sunlight. Reactive species like *O(-)(2), *OH and *CHR are generated by visible light. The amount of ROS correlates with the visible light intensity (illuminance). We demonstrated the creation of excess free radicals by near-infrared light (NIR, 700-1600 nm). Free radical generation does not depend exclusively on the NIR irradiance, but also on the NIR initiated skin temperature increase. The temperature dependence follows the physiological fever curve. Our results indicate that the complex biological system skin creates the same type of free radicals over the entire active solar spectrum. This general response will make it possible to define the beneficial or deleterious action of sunlight on human skin by introduction of a free radical threshold value.
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Iren Bischofberger, Julia Lademann, Andrea Radvanszky (2009)  "work & care" - Combining employment and care: a literature analysis on challenges for family caregivers, companies, and nursing   Pflege 22: 4. 277-286 Aug  
Abstract: In German speaking Europe, concepts on combining family care and employment are widely lacking. However, due to increased participation of women in the labour market, women have less time to engage in traditional family care giving. For nurses, working caregivers are challenging because they are even more in need of integrated care models than non-caregivers. In the literature analysis, the current situation on "work & care" and its relevance for nursing in German-speaking countries is discussed. After presenting the relevance and the chosen research method, identified prevalence data are listed. Focusing on risks and resources resulting from combining employment and care, strategies and services used by companies are analysed. Based on this analysis, concepts will be presented which enable nurses to become involved in solutions for family caregivers and the development of innovative nursing services.
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Fanny Knorr, Jürgen Lademann, Alexa Patzelt, Wolfram Sterry, Ulrike Blume-Peytavi, Annika Vogt (2009)  Follicular transport route--research progress and future perspectives.   Eur J Pharm Biopharm 71: 2. 173-180 Feb  
Abstract: The important role of hair follicles as penetration pathways and reservoir structures for topically applied compounds has been validated in numerous animal models as well as in humans. Follicular penetration rates are modulated by regional variations in size and proportions and the functional status. Advances have especially been made in the targeting of hair follicle-associated cell populations including antigen-presenting cells and stem cells. Improved investigative methods based on differential stripping, spectrophotometry and confocal laser scanning microscopy have led to the determination of the penetration profiles and kinetics for a multiplicity of drugs and drug delivery systems. The observation that particulate delivery systems aggregate and remain in hair follicle openings and their penetration along the follicular duct occurs in a size-dependent manner, which has led to advanced concepts of targeted drug delivery of bioactive compounds in the field of solid particles, as well as semi-solid particles, such as liposomes. This review summarizes the recent progress in this field, and underlines the necessity for pilot studies in human volunteers to further the development of clinical applications for follicular targeting.
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L Zastrow, N Groth, F Klein, D Kockott, J Lademann, R Renneberg, L Ferrero (2009)  The missing link--light-induced (280-1,600 nm) free radical formation in human skin.   Skin Pharmacol Physiol 22: 1. 31-44 12  
Abstract: The recent European recommendation on the efficacy of sunscreen products requests now a minimum ratio of UVA/UVB protection. However, the visible and the infrared (IR) parts of the sun spectrum have received little attention concerning their possible contribution to skin damage. A common biophysical answer for the different wavelengths of the sun spectrum can be found in the creation of excess free radicals - mainly reactive oxygen species (ROS). Thanks to electron spin resonance spectroscopy applied to skin biopsies, we determined for the first time the free radical action spectrum covering UV and visible light (280-700 nm). Convolution of the action spectrum with sunlight spectral irradiance showed that 50% of the total skin oxidative burden was generated by visible light. Creation of ROS by visible light was experimentally confirmed by varying the illuminance of a spotlight. We also evidenced the creation of excess free radicals by near-IR radiation. In that case, free radical generation does not depend exclusively on the dose, but also on the skin temperature increase initiated by near-IR light. Some phenomena which are still unclear, such as the question about the deleterious or beneficial role of sunlight, are reviewed, implying the research on new protection strategies for the prevention of skin cancer.
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Sascha Jung, Alexa Patzelt, Nina Otberg, Gisela Thiede, Wolfram Sterry, Juergen Lademann (2009)  Strategy of topical vaccination with nanoparticles.   J Biomed Opt 14: 2. Mar/Apr  
Abstract: Liposomes in the nanosize range have been recognized as a versatile drug delivery system of both hydrophilic and lipophilic molecules. In order to develop a liposome-based topical vaccination strategy, five different types of liposomes were tested as a putative vaccine delivery system on pig ear skin. The investigated liposomes mainly varied in size, lipid composition, and surface charge. Using hydrophilic and hydrophobic fluorescent dyes as model drugs, penetration behavior was studied by means of confocal laser scanning microscopy of intact skin and histological sections, respectively. Follicular penetration of the liposomes was measured in comparison to a standard, nonliposomal formulation at different time points. Dependent on time but independent of their different characters, the liposomes showed a significantly higher penetration depth into the hair follicles compared to the standard formulation. The standard formulation reached a relative penetration depth of 30% of the full hair follicle length after seven days, whereas amphoteric and cationic liposomes had reached approximately 70%. Penetration depth of negatively charged liposomes did not exceed 50% of the total follicle length. The fluorescence dyes were mainly detected in the hair follicle; only a small amount of dye was found in the upper parts of the epidermis.
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J Lademann, U Jacobi, C Surber, H - J Weigmann, J W Fluhr (2009)  The tape stripping procedure--evaluation of some critical parameters.   Eur J Pharm Biopharm 72: 2. 317-323 Jun  
Abstract: Tape stripping is a simple and efficient method for the assessment of quality and efficacy of cosmetical and dermatological formulations. After topical application and penetration of formulations, the cell layers of the stratum corneum are successively removed from the same skin area using adhesive films. The tape strips contain the amount of corneocytes and the corresponding amount of the penetrated formulation, which can be determined by classical analytical chemical methods. Different formulations can strongly influence the amount of stratum corneum removed with every tape strip. Therefore, it is essential for the comparison of the penetration of different formulations that the amount of formulation detected on the single tape strip is not related to the tape strip number as a relative measure of the penetration depths, but to their standardized real position in the stratum corneum. Therefore, different methods are reported for the determination of the amount of stratum corneum removed with every tape strip. The tape stripping method in its standardized form is well-suited to determine the dermatopharmacokinetics of topically applied substances. Additionally, the method can be used to obtain information about the homogeneity and the distribution of formulations on the skin and in the stratum corneum. This is used, e.g., for the determination of the homogeneity of the distribution and the ex vivo determination of a universal sun protection factor (USPF) characterizing the efficacy of sunscreens.
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Judith M Gottwein, Troels K H Scheel, Tanja B Jensen, Jacob B Lademann, Jannick C Prentoe, Maria L Knudsen, Anne M Hoegh, Jens Bukh (2009)  Development and characterization of hepatitis C virus genotype 1-7 cell culture systems: role of CD81 and scavenger receptor class B type I and effect of antiviral drugs.   Hepatology 49: 2. 364-377 Feb  
Abstract: Six major hepatitis C virus (HCV) genotypes and numerous subtypes have been described, and recently a seventh major genotype was discovered. Genotypes show significant molecular and clinical differences, such as differential response to combination therapy with interferon-alpha and ribavirin. Recently, HCV research has been accelerated by cell culture systems based on the unique growth capacity of strain JFH1 (genotype 2a). By development of JFH1-based intergenotypic recombinants containing Core, envelope protein 1 and 2 (E1, E2), p7, and nonstructural protein 2 (NS2) of genotype 6a and 7a strains, as well as subtype 1b and 2b strains, we have completed a panel of culture systems for all major HCV genotypes. Efficient growth in Huh7.5 cells depended on adaptive mutations for HK6a/JFH1 (6a/2a, in E1 and E2) and J4/JFH1 (1b/2a, in NS2 and NS3); viability of J8/JFH1 (2b/2a) and QC69/JFH1 (7a/2a) did not require adaptation. To facilitate comparative studies, we generated virus stocks of genotype 1-7 recombinants with infectivity titers of 10(3.7) to 10(5.2) 50% tissue culture infectious dose/mL and HCV RNA titers of 10(7.0) to 10(7.9) IU/mL. Huh7.5 cultures infected with genotype 1-6 viruses had similar spread kinetics, intracellular Core, NS5A, and lipid amounts, and colocalization of Core and NS5A with lipids. Treatment with interferon-alpha2b but not ribavirin or amantadine showed a significant antiviral effect. Infection with all genotypes could be blocked by specific antibodies against the putative coreceptors CD81 and scavenger receptor class B type I in a dose-dependent manner. Finally, neutralizing antibodies in selected chronic phase HCV sera had differential effects against genotype 1-7 viruses. Conclusion: We completed and characterized a panel of JFH1-based cell culture systems of all seven major HCV genotypes and important subtypes and used these viruses in comparative studies of antivirals, HCV receptor interaction, and neutralizing antibodies.
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Christina Antoniou, Juergen Lademann, Sabine Schanzer, Heike Richter, Wolfram Sterry, Leonhard Zastrow, Stefan Koch (2009)  Do different ethnic groups need different sun protection?   Skin Res Technol 15: 3. 323-329 Aug  
Abstract: BACKGROUND: In the present study, the transmission of sunlight trough the human skin barrier into the living tissue was investigated in the spectral region between 280 and 700 nm. METHODS: The experiments were performed with a fiber-based spectrometer on sliced skin obtained from volunteers with different skin types. One fiber was positioned directly on the skin surface and the second one underneath the skin samples. The distribution of the sunlight under the epidermis was determined. RESULTS: Significant differences were found in the absorption properties of the different skin types, which were mainly determined by the variations in melanin concentration and distribution. It was found that sunscreens for specific ethnic groups need different combinations of UV filters, if a balanced relation between ultraviolet B (UVB) and ultraviolet A (UVA) protection is to be obtained. On the other hand, it could be demonstrated that the human skin is also well protected against visible and near-infrared light by melanin. CONCLUSIONS: The higher the skin type category, the better the protection in the visible part of the spectrum of the sun. This stimulates the hot discussion at the present time, as to whether sunscreens should also contain protection compounds in the visible and near-infrared parts of the spectrum.
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Jürgen Lademann, Alexa Patzelt, Heike Richter, Sabine Schanzer, Wolfram Sterry, Andreas Filbry, Kerstin Bohnsack, Frank Rippke, Martina Meinke (2009)  Comparison of two In Vitro Models for the Analysis of Follicular Penetration and its Prevention by Barrier Emulsions.   Eur J Pharm Biopharm Feb  
Abstract: The penetration of topically applied substances in and through the human skin is of special interest for the development and optimization of topically applied drugs and cosmetic products. In the present study, the efficacy of barrier emulsions in the prevention of the penetration of pollen allergens into the hair follicles was investigated. Because of the sensitising potential of the used pollen allergens, the study was carried out under in vitro conditions. Therefore, excised human skin and porcine ear skin were used as tissue models. Applying laser scanning microscopy and fluorescent labeled grass pollen allergens, we found that the preventive efficacy of the barrier emulsions could be significantly better investigated on porcine ear skin than on excised human skin. This might be due to the contraction of the elastic fibres around the hair follicles in excised human skin after its removal. In contrast to the excised human skin, the porcine ear skin remains on the cartilage during the experiment. Therefore, contraction of the tissue can be avoided. The results give further indication that in vitro studies based on membranes of excised skin are not suitable for the investigation of the follicular penetration pathway of topically applied substances.
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Maxim E Darvin, Joachim W Fluhr, Peter Caspers, André van der Pool, Heike Richter, Alexa Patzelt, Wolfram Sterry, Jürgen Lademann (2009)  In vivo distribution of carotenoids in different anatomical locations of human skin: comparative assessment with two different Raman spectroscopy methods.   Exp Dermatol 18: 12. 1060-1063 Dec  
Abstract: BACKGROUND: The cutaneous antioxidants form an efficient protection system against the destructive potential of free radicals, produced by environmental factors, such as UV-sun irradiation, hazardous substances and lifestyle habits. Most of the antioxidants cannot be produced by the human organism. Thus, they have to be incorporated by food and beverages. MATERIAL AND METHODS: In the present manuscript, the distribution of carotenoids as a marker for antioxidative potential in human skin was investigated with two different in vivo Raman spectroscopy methods with an excitation wavelength of 785 nm (Skin Analyzer) and at 488 nm (resonance Raman spectroscopy). The carotenoid profile was assessed at three different anatomical locations (palm, forehead and volar forearm) in 12 healthy volunteers. RESULTS: In untreated skin, the major fraction of the carotenoids is located in the upper part of the stratum corneum (SC). The amount of carotenoid is lower in the upper part of the SC on the forearm compared to forehead and palm shown with both methods. Both methods detect similar distinction patterns of carotenoid levels for the three anatomical locations. CONCLUSION: The present study supports the hypothesis that antioxidative substances; here carotenoids, are secreted via eccrine sweat glands and/or sebaceous glands to the skin surface. Raman spectroscopic methods are an efficient tool to analyze the distribution of carotenoids in the human skin over time and with the Skin Analyzer over different layers of the epidermis. Resonance Raman spectroscopy is suited to analyze deeper parts of the skin.
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Alexey P Popov, Stefan Haag, Martina Meinke, Jürgen Lademann, Alexander V Priezzhev, Risto Myllylä (2009)  Effect of size of TiO(2) nanoparticles applied onto glass slide and porcine skin on generation of free radicals under ultraviolet irradiation.   J Biomed Opt 14: 2. Mar/Apr  
Abstract: Titanium dioxide (TiO(2)) nanoparticles are extensively used today in sunscreens and coatings as protective compounds for human skin and material surfaces from UV radiation. In this paper, such particles are investigated by electron paramagnetic resonance spectroscopy as sources of free radicals under UV irradiation. The surface density of a placebo with embedded particles corresponds to the recommendations of dermatologists (2 mg cm(-2)). It is revealed that if applied onto glass, small particles 25 nm in diameter produce an increased amount of free radicals compared to the larger ones of 400 nm diam and the placebo itself. However, if applied onto porcine skin in vitro, there is no statistically distinct difference in the amount of radicals generated by the two kinds of particles on skin and by the skin itself. This proves that although particles as part of sunscreens produce free radicals, the effect is negligible in comparison to the production of radicals by skin in vitro.
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Bernhard Lange-Asschenfeldt, Alena Alborova, Daniela Krüger-Corcoran, Alexa Patzelt, Heike Richter, Wolfram Sterry, Axel Kramer, Eggert Stockfleth, Jürgen Lademann (2009)  Effects of a topically applied wound ointment on epidermal wound healing studied by in vivo fluorescence laser scanning microscopy analysis.   J Biomed Opt 14: 5. Sep/Oct  
Abstract: Epidermal wound healing is a complex and dynamic regenerative process necessary to reestablish skin integrity. Fluorescence confocal laser scanning microscopy (FLSM) is a noninvasive imaging technique that has previously been used for evaluation of inflammatory and neoplastic skin disorders in vivo and at high resolution. We employed FLSM to investigate the evolution of epidermal wound healing noninvasively over time and in vivo. Two suction blisters were induced on the volar forearms of the study participants, followed by removal of the epidermis. To study the impact of wound ointment on the process of reepithelization, test sites were divided into two groups, of which one test site was left untreated as a negative control. FLSM was used for serial/consecutive evaluations up to 8 days. FLSM was able to visualize the development of thin keratinocyte layers developing near the wound edge and around hair follicles until the entire epidermis has been reestablished. Wounds treated with the wound ointment were found to heal significantly faster than untreated wounds. This technique allows monitoring of the kinetics of wound healing noninvasively and over time, while offering new insights into the potential effects of topically applied drugs on the process of tissue repair.
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Jürgen Lademann, Alexa Patzelt, Heike Richter, Sabine Schanzer, Wolfram Sterry, Alexander Filbry, Kerstin Bohnsack, Frank Rippke, Martina Meinke (2009)  Comparison of two in vitro models for the analysis of follicular penetration and its prevention by barrier emulsions.   Eur J Pharm Biopharm 72: 3. 600-604 Aug  
Abstract: The penetration of topically applied substances in and through the human skin is of special interest for the development and optimization of topically applied drugs and cosmetic products. In the present study, the efficacy of barrier emulsions in the prevention of the penetration of pollen allergens into the hair follicles was investigated. Because of the sensitising potential of the used pollen allergens, the study was carried out under in vitro conditions. Therefore, excised human skin and porcine ear skin were used as tissue models. Applying laser-scanning microscopy and fluorescent-labeled grass pollen allergens, we found that the preventive efficacy of the barrier emulsions could be significantly better investigated on porcine ear skin than on excised human skin. This might be due to the contraction of the elastic fibres around the hair follicles in excised human skin after its removal. In contrast to the excised human skin, the porcine ear skin remains on the cartilage during the experiment. Therefore, contraction of the tissue can be avoided. The results give further indication that in vitro studies based on membranes of excised skin are not suitable for the investigation of the follicular penetration pathway of topically applied substances.
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Sindy Trauer, Alexa Patzelt, Nina Otberg, Fanny Knorr, Christel Rozycki, Gabor Balizs, Rolf Büttemeyer, Michael Linscheid, Manfred Liebsch, Jürgen Lademann (2009)  Permeation of topically applied caffeine through human skin--a comparison of in vivo and in vitro data.   Br J Clin Pharmacol 68: 2. 181-186 Aug  
Abstract: AIMS: Due to ethical reasons, in vivo penetration studies are not applicable at all stages of development of new substances. Therefore, the development of appropriate in vitro methods is essential, as well as the comparison of the obtained in vivo and in vitro data, in order to identify their transferability. The aim of the present study was to investigate the follicular penetration of caffeine in vitro and to compare the data with the in vivo results determined previously under similar conditions. METHODS: The Follicular Closing Technique (FCT) represents a method to investigate the follicular penetration selectively. In the present study, FCT was combined with the Franz diffusion cell in order to differentiate between follicular and intercellular penetration of caffeine into the receptor medium in vitro. Subsequently, the results were compared with the data obtained in an earlier study investigating follicular and intercellular penetration of caffeine in vivo. RESULTS: The comparison of the data revealed that the in vitro experiments were valuable for the investigation of the follicular penetration pathway, which contributed in vivo as well as in vitro to approximately 50% of the total penetration, whereas the kinetics of caffeine penetration were shown to be significantly different. CONCLUSIONS: The combination of FCT with the Franz diffusion cell represents a valuable method to investigate follicular penetration in vitro. Nevertheless, in vivo experiments should not be abandoned as in vitro, structural changes of skin occur and blood flow and metabolism are absent, probably accounting for reduced penetration rates in vitro.
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A Martschick, J Sehouli, Alexa Patzelt, H Richter, U Jacobi, G Oskay-Ozcelik, W Sterry, J Lademann (2009)  The pathogenetic mechanism of anthracycline-induced palmar-plantar erythrodysesthesia.   Anticancer Res 29: 6. 2307-2313 Jun  
Abstract: BACKGROUND: Anthracyclines, such as pegylated liposomal doxorubicin (PLD) and epirubicin (EP), are effective for the treatment of malignant tumors. Unfortunately, their implementation in therapy is limited due to severe side-effects such as palmar-plantar erythrodysesthesia (PPE). PATIENTS AND METHODS: As the exact pathogenesis of PPE still remains unclear, laser scanning microscopy was utilized to detect PLD, EP and their metabolites in and on the skin surface of patients. RESULTS: It was shown that PLD was significantly more frequently detectable on the skin than was EP (p<0.05), whereas both substances were most frequently seen in the palms and soles. Additionally, it has been visualized that the substances reach the skin surface via sweat, where they distribute and then penetrate back into the skin. CONCLUSION: It was concluded that a high density of sweat glands and a thick stratum corneum might represent important predestined factors for the development of PPE. These findings will help to develop efficient prevention and therapy strategies for PPE.
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Juergen Lademann, Alexa Patzelt, Heike Richter, Christina Antoniou, Wolfram Sterry, Fanny Knorr (2009)  Determination of the cuticula thickness of human and porcine hairs and their potential influence on the penetration of nanoparticles into the hair follicles.   J Biomed Opt 14: 2. Mar/Apr  
Abstract: An efficient penetration and long-term storage of topically applied substances is important for drug delivery in medical treatment and cosmetics. It has recently become apparent that the hair follicles represent an efficient and long-term reservoir for topically applied substances. It was found that particles sized 300-600 nm penetrate more efficiently into the hair follicles than smaller or larger particles. In the present paper, the hair surface structure of human and porcine hairs was analyzed by electron microscopy. It could be observed that the thickness of the cuticula corresponds to the optimal size of the nanoparticles for penetration into the hair follicles. Additionally, it could be demonstrated that the cuticula of human vellus and terminal hairs were of similar thickness (approx. 530 nm), while the thickness of the cuticula obtained from porcine ear bristles were slightly thinner (approx. 320 nm).
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Ulrike Blume-Peytavi, Anne Rolland, Maxim E Darvin, Anne Constable, Isabelle Pineau, Christiane Voit, Kristina Zappel, Gregor Schäfer-Hesterberg, Martina Meinke, Roger L Clavez, Wolfram Sterry, Jürgen Lademann (2009)  Cutaneous lycopene and beta-carotene levels measured by resonance Raman spectroscopy: high reliability and sensitivity to oral lactolycopene deprivation and supplementation.   Eur J Pharm Biopharm 73: 1. 187-194 Sep  
Abstract: Carotenoids, naturally occurring lipophilic micronutrients, possess an antioxidant activity associated with protection from damage induced by free radicals. The present study investigated an innovative non-invasive method to measure cutaneous levels of lycopene and beta-carotene and to monitor the distribution of orally administered lactolycopene in human skin and plasma. A double-blind placebo-controlled randomized study was performed in 25 volunteers, who were under a lycopene-deprived diet (4 weeks prior to study until end of the study) and orally received either lactolycopene or placebo for 12 weeks. Skin and plasma levels of lycopene and beta-carotene were monitored monthly using Raman spectroscopy and HPLC, respectively. Cutaneous levels of lycopene and beta-carotene monitored by resonance Raman spectroscopy showed high reliability. Irrespective of the investigated area, cutaneous levels were sensitive to lycopene deprivation and to oral supplementation; the forehead showed the closest correlation to lycopene variation in plasma. Plasma and skin levels of lycopene were both sensitive to oral intake of lactolycopene and, interestingly, also skin levels of beta-carotene. Thus, oral supplementation with lycopene led to an enrichment of beta-carotene in human skin, possibly due to the fact that carotenoids act in the skin as protection chains, with a natural protection against free radicals.
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Karoline Hesterberg, Jürgen Lademann, Alexa Patzelt, Wolfram Sterry, Maxim E Darvin (2009)  Raman spectroscopic analysis of the increase of the carotenoid antioxidant concentration in human skin after a 1-week diet with ecological eggs.   J Biomed Opt 14: 2. Mar/Apr  
Abstract: Skin aging is mainly caused by the destructive action of free radicals, produced by the UV light of the sun. The human skin has developed a protection system against these highly reactive molecules in the form of the antioxidative potential. Carotenoids are one of the main components of the antioxidants of the human skin. From former studies, it is known that skin aging is reduced in individuals with high levels of carotenoids. Because most of the antioxidants cannot be produced by the human organism, they must be up taken by nutrition. Using noninvasive Raman spectroscopic measurements it is demonstrated that not only fruits and vegetables but also eggs contain high concentrations of antioxidants including carotenoids, which are even doubled in the case of ecological eggs. After a 1-week diet with ecological eggs performed by six volunteers, it is found that the concentration of the carotenoids in the skin of the volunteers increased by approx. 20%. Our study does not intend to recommend exorbitant egg consumption, as eggs also contain harmful cholesterol. But in the case of egg consumption, ecological eggs from hens kept on pasture should be preferred to also receive a benefit for the skin.
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Juergen Lademann, Heike Richter, Alena Alborova, Daniel Humme, Alexa Patzelt, Axel Kramer, Klaus-Dieter Weltmann, Bernd Hartmann, Christian Ottomann, Joachim W Fluhr, Peter Hinz, Georg Hübner, Olaf Lademann (2009)  Risk assessment of the application of a plasma jet in dermatology.   J Biomed Opt 14: 5. Sep/Oct  
Abstract: Regardless of the fact that several highly efficient antiseptics are commercially available, the antiseptic treatment of chronic wounds remains a problem. In the past, electrical plasma discharges have been frequently used in biometrical science for disinfection and sterilization of material surfaces. Plasma systems usually have a temperature of several hundred degrees. Recently, it was reported that "cold" plasma can be applied onto living tissue. In in vitro studies on cell culture, it could be demonstrated that this new plasma possesses excellent antiseptic properties. We perform a risk assessment concerning the in vivo application of a "cold" plasma jet on patients and volunteers. Two potential risk factors, UV radiation and temperature, are evaluated. We show that the UV radiation of the plasma in the used system is an order of magnitude lower than the minimal erythema dose, necessary to produce sunburn on the skin in vivo. Additionally, thermal damage of the tissue by the plasma can be excluded. The results of the risk assessment stimulate the in vivo application of the investigated plasma jet in the treatment of chronic wounds.
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Hans-Jürgen Weigmann, Sabine Schanzer, Alexa Patzelt, Virginie Bahaban, Fabienne Durat, Wolfram Sterry, Jürgen Lademann (2009)  Comparison of human and porcine skin for characterization of sunscreens.   J Biomed Opt 14: 2. Mar/Apr  
Abstract: The universal sun protection factor (USPF) characterizing sunscreen efficacy based on spectroscopically determined data, which were obtained using the tape stripping procedure. The USPF takes into account the complete ultraviolet (UV) spectral range in contrast to the classical sun protection factor (SPF). Until now, the USPF determination has been evaluated only in human skin. However, investigating new filters not yet licensed excludes in vivo investigation on human skin but requires the utilization of a suitable skin model. The penetration behavior and the protection efficacy of 10 commercial sunscreens characterized by USPF were investigated, comparing human and porcine skin. The penetration behavior found for typical UV filter substances is nearly identical for both skin types. The comparison of the USPF obtained for human and porcine skin results in a linear relation between both USPF values with a correlation factor R(2)=0.98. The results demonstrate the possibility for the use of porcine skin to determine the protection efficacy of sunscreens.
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Christina Graf, Martina Meinke, Qi Gao, Sabrina Hadam, Jörg Raabe, Wolfram Sterry, Ulrike Blume-Peytavi, Jürgen Lademann, Eckart Rühl, Annika Vogt (2009)  Qualitative detection of single submicron and nanoparticles in human skin by scanning transmission x-ray microscopy.   J Biomed Opt 14: 2. Mar/Apr  
Abstract: First results on single particle detection in human skin samples by x-ray microscopy are reported. 94+/-6 and 161+/-13 nm gold core particles with silica shells and 298+/-11 nm silica particles coated with a gold shell on ultramicrotome sections of human skin were determined. The particles were applied on fresh intact skin samples, which were sectioned prior to imaging. After screening the sections by conventional microscopy techniques, defined areas of interest were qualitatively investigated by scanning transmission x-ray microscopy at the Swiss Light Source. In studies on the percutaneous penetration of 161+/-13 nm particles on human skin samples, x-ray microscopy yielded high-resolution images of single particles spreading on the superficial layer of the stratum corneum and on the epithelium in superficial parts of hair follicles. No deeper penetration was observed. The present work using x-ray microscopy provides the unique opportunity to study qualitative penetration processes and membrane-particle interactions on the level of single particles. This goes beyond present approaches using optical microscopy. Further improvement of this approach will allow one to study particles with different physicochemical properties and surface modifications, including responses of the exposed tissue.
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2008
Martina Meinke, Gehard Müller, Hansjörg Albrecht, Christina Antoniou, Heike Richter, Juergen Lademann (2008)  Two-wavelength carbon dioxide laser application for in-vitro blood glucose measurements.   J Biomed Opt 13: 1. Jan/Feb  
Abstract: To develop a fast and easy clinical method for glucose measurements on whole blood samples, changes in glucose spectra are investigated varying temperature, glucose concentration, and solvent using attenuated total reflection Fourier transform infrared (ATR- FTIR) measurements. The results show a stability of the spectra at different temperatures and wavelength shifts of the absorption bands when water is replaced by blood. Because the ATR measurements are influenced by sedimentation of the red blood cells, a two-wavelength CO2 laser is used to determine the glucose concentration in whole blood samples. For this purpose, the first laser wavelength lambda(1) is tuned to the maximum of the glucose absorption band in blood at 1080 cm(-1), and the second laser wavelength lambda 2 is tuned to 950 cm(-1) for background measurements. The transmitted laser power through the optical cell containing the whole blood sample at lambda 1 and lambda 2 is used to determine the ratio. This signal correlates well with the glucose concentration in the whole blood samples. The CO2 laser measurement is too fast to be influenced by the red blood cell sedimentation, and will be a suitable method for glucose determination in whole blood.
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Roger von Moos, Beat J K Thuerlimann, Matti Aapro, Daniel Rayson, Karen Harrold, Jalid Sehouli, Florian Scotte, Domenica Lorusso, Reinhard Dummer, Mario E Lacouture, Jürgen Lademann, Axel Hauschild (2008)  Pegylated liposomal doxorubicin-associated hand-foot syndrome: recommendations of an international panel of experts.   Eur J Cancer 44: 6. 781-790 Apr  
Abstract: BACKGROUND: Hand-foot syndrome (HFS) is dose-limiting and the most common cumulative toxicity associated with pegylated liposomal doxorubicin (PLD). It can cause considerable discomfort and lead to therapy interruption. Numerous approaches to HFS management have been reported, but there is no consensus. METHODS: Published literature (identified via Medline and internet search) and expert experience regarding HFS and its pathogenesis, incidence, risk factors, prevention and treatment in patients undergoing treatment with PLD were collected and reviewed by a panel of experts. A consensus technique was used to develop recommendations. FINDINGS: The pathogenesis of PLD-associated HFS has been recently elucidated. Systems used to grade, prevent and treat HFS in individuals treated with PLD vary widely. A randomised clinical study demonstrated that PLD dose intensity reduction can prevent HFS. While there is limited literature support, patient education and supportive measures were endorsed by the expert panel as effective strategies for HFS prevention and treatment. An easy to use HFS grading and management algorithm was developed, early signs and symptoms of HFS outlined and specific recommendations for supportive care developed. INTERPRETATION: The paucity of data on the management of PLD-associated HFS led the expert panel to develop consensus-based recommendations. Patient education and supportive measures are important elements in the management of HFS and dose intensity reduction has documented efficacy in prevention. At a PLD dose intensity not exceeding 10mg/m(2) weekly, HFS can be easily managed. Phase III research to support the efficacy other interventions is lacking.
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Maxim Darvin, Alexa Patzelt, Saskia Gehse, Sabine Schanzer, Christian Benderoth, Wolfram Sterry, Juergen Lademann (2008)  Cutaneous concentration of lycopene correlates significantly with the roughness of the skin.   Eur J Pharm Biopharm 69: 3. 943-947 Aug  
Abstract: Antioxidant substances in the skin are expected to slow down photo ageing. We therefore developed the hypothesis that high levels of antioxidant substances may be correlated to lower levels of skin roughness. By utilizing modern optical non-invasive in vivo methods, the structures of the furrows and wrinkles as well as the concentration of lycopene were analyzed quantitatively on the forehead skin of 20 volunteers aged between 40 and 50 years. In a first step, the age of the volunteers was correlated to their skin roughness. Here, no significant correlation was found. In a second step, a significant correlation was obtained between the skin roughness and the lycopene concentration (R=0.843). These findings indicate that higher levels of antioxidants in the skin effectively lead to lower levels of skin roughness, and therefore support our hypothesis.
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Alena Alborova, Jürgen Lademann, Axel Kramer, Heike Richter, Alexa Patzelt, Wolfram Sterry, Stefan Koch (2008)  In vivo analysis of wound healing by optical methods.   GMS Krankenhhyg Interdiszip 3: 1. 11  
Abstract: The analysis of wound healing is important for the therapy control and for the development of drugs stimulating the healing process. Wounds cause damage to the skin barrier. A damaged stratum corneum leads to an increased water loss through the skin barrier. The standard measuring procedure for characterization of wound healing is the measurement of transepidermal water loss (TEWL). The disadvantage of this method is that it can be easily disturbed by the perspiration of the volunteers and by topically applied substances, for instance wound healing creams. In the study presented, in vivo laser scanning microscopy and optical coherent tomography were compared concerning the application for their analysis of wound healing processes. The laser scanning microscopy allows the analysis of the healing process on a cellular level. The course of wound healing determined by laser scanning microscopy was correlated with numerical values, allowing the numerical characterization of the wound healing process.
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J Lademann, H Richter, U Jacobi, A Patzelt, F Hueber-Becker, C Ribaud, F Benech-Kieffer, E K Dufour, W Sterry, H Schaefer, J Leclaire, H Toutain, G J Nohynek (2008)  Human percutaneous absorption of a direct hair dye comparing in vitro and in vivo results: implications for safety assessment and animal testing.   Food Chem Toxicol 46: 6. 2214-2223 Jun  
Abstract: Although in vitro skin absorption studies often detect small residues of applied test material in the epidermis/dermis, it is uncertain whether the residue is within the living skin. We studied the dermal absorption of a hair dye hydroxyanthraquinone-aminopropyl methyl morpholinium methosulphate (HAM) in human skin in vivo and in vitro. In vivo, skin (back and scalp) received 0.5% HAM in a commercial formulation at 20microg/cm2 After 0.5 or 48h, skin was tape stripped, followed by cyanoacrylate biopsies (CAB). Sebum from scalp sites was collected for 48h. In vitro, skin was treated with 20mg/cm2 dye for 0.5h, penetration determined after 24h. In vivo, at 0.5h, total recovery (back) was 0.67microg/cm2 (tape strips+CAB). Fluorescence microscopy showed HAM in the hair follicle openings (HFO). At 0.5h, scalp tape strips contained 1.80microg/cm2, HFO 0.82microg/cm2. At 48h, HFO contained 0.21microg/cm2, sebum 0.80microg/cm2. In vivo, skin residues were in the non-living skin and eliminated via desquamation and sebum secretion. In vitro, the SC contained 1.50microg/cm2, epidermis/dermis 0.86microg/cm2, receptor fluid<0.04microg/cm2, a total of 0.90microg/cm2 was considered to be bioavailable. In vitro epidermis/dermis residues were nearly identical to those located in non-living skin in vivo. In conclusion, in vitro percutaneous penetration studies may produce seemingly bioavailable material , which raises the need for a Threshold of Skin Absorption (TSA) addressing a negligible dermal absorption in order to avoid unnecessary in vivo toxicity studies on substances that produce no significant human systemic exposure.
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Nina Otberg, Alexa Patzelt, Utkur Rasulev, Timo Hagemeister, Michael Linscheid, Ronald Sinkgraven, Wolfram Sterry, Jürgen Lademann (2008)  The role of hair follicles in the percutaneous absorption of caffeine.   Br J Clin Pharmacol 65: 4. 488-492 Apr  
Abstract: WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * In recent years, it has been suggested that hair follicles represent important shunt routes into the skin for drugs and chemicals [1-3]. * In vitro studies have shown the importance of skin appendages for skin penetration by hydrophilic compounds [4]. Investigation of follicular penetration in vivo has been difficult due to the absence of appropriate analytical methods or suitable animal model systems. * Recently, a new method was described that quantifies follicular penetration in vivo by using selective closure of hair follicles [5]. * Caffeine is frequently used in skin penetration experiments as a model for highly water-soluble compounds. Occlusion [6] and skin thickness [7] seem to have little influence on the penetration of caffeine. However, percutaneous absorption rates for caffeine exhibit regional skin differences in humans in vivo[1]. WHAT THIS STUDY ADDS: * The results of the present study demonstrate that a fast drug delivery of caffeine occurs through shunt routes. Therefore, hair follicles are considerable weak spots in our protective sheath against penetration into the body by hydrophilic substances. * We showed that there is a quantitative distinction between follicular penetration and interfollicular diffusion of caffeine in vivo. * These findings are of importance for the development and optimization of topically applied drugs and cosmetics. In addition, such properties must be considered in the development of skin protection measures. AIMS: The skin and its appendages are our protective shield against the environment and are necessary for the maintenance of homeostasis. Hypotheses concerning the penetration of substances into the skin have assumed diffusion through the lipid domains of the stratum corneum. It is believed that while hair follicles represent a weakness in the shield, they play a subordinate role in the percutaneous penetration processes. Previous investigation of follicular penetration has mostly addressed methodical and technical problems. Our study utilized a selective closure technique of hair follicle orifices in vivo, for the comparison of interfollicular and follicular absorption rates of caffeine in humans. METHODS: Every single hair follicle within a delimited area of skin was blocked with a microdrop of a special varnish-wax-mixture in vivo. Caffeine in solution was topically applied and transcutaneous absorption into the blood was measured by a new surface ionization mass spectrometry (SI/MS) technique, which enabled a clear distinction to be made between interfollicular and follicular penetration of a topically applied substance. RESULTS: Caffeine (3.75 ng ml(-1)) was detected in blood samples, 5 min after topical application, when the follicles remained open. When the follicles were blocked, caffeine was detectable after 20 min (2.45 ng ml(-1)). Highest values (11.75 ng caffeine ml(-1)) were found 1 h after application when the follicles were open. CONCLUSIONS: Our findings demonstrate that hair follicles are considerable weak spots in our protective sheath against certain hydrophilic drugs and may allow a fast delivery of topically applied substances.
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Nina Otberg, Diego Grone, Lars Meyer, Sabine Schanzer, Gerd Hoffmann, Hanns Ackermann, Wolfram Sterry, Jürgen Lademann (2008)  Water-filtered infrared-A (wIRA) can act as a penetration enhancer for topically applied substances.   Ger Med Sci 6: 07  
Abstract: BACKGROUND: Water-filtered infrared-A (wIRA) irradiation has been shown to enhance penetration of clinically used topically applied substances in humans through investigation of functional effects of penetrated substances like vasoconstriction by cortisone. AIM OF THE STUDY: Investigation of the influence of wIRA irradiation on the dermatopharmacokinetics of topically applied substances by use of optical methods, especially to localize penetrating substances, in a prospective randomised controlled study in humans. METHODS: The penetration profiles of the hydrophilic dye fluorescein and the lipophilic dye curcumin in separate standard water-in-oil emulsions were determined on the inner forearm of test persons by tape stripping in combination with spectroscopic measurements. Additionally, the penetration was investigated in vivo by laser scanning microscopy. Transepidermal water loss, hydration of the epidermis, and surface temperature were determined. Three different procedures (modes A, B, C) were used in a randomised order on three separate days of investigation in each of 12 test persons. In mode A, the two dyes were applied on different skin areas without water-filtered infrared-A (wIRA) irradiation. In mode B, the skin surface was irradiated with wIRA over 30 min before application of the two dyes (Hydrosun radiator type 501, 10 mm water cuvette, orange filter OG590, water-filtered spectrum: 590-1400 nm with dominant amount of wIRA). In mode C, the two dyes were applied and immediately afterwards the skin was irradiated with wIRA over 30 min. In all modes, tape stripping started 30 min after application of the formulations. Main variable of interest was the ratio of the amount of the dye in the deeper (second) 10% of the stratum corneum to the amount of the dye in the upper 10% of the stratum corneum. RESULTS: The penetration profiles of the hydrophilic fluorescein showed in case of pretreatment or treatment with wIRA (modes B and C) an increased penetration depth compared to the non-irradiated skin (mode A): The ratio of the amount of the dye in the deeper (second) 10% of the stratum corneum to the amount of the dye in the upper 10% of the stratum corneum showed medians and interquartile ranges for mode A of 0.017 (0.007/0.050), for mode B of 0.084 (0.021/0.106), for mode C of 0.104 (0.069/0.192) (difference between modes: p=0.0112, significant; comparison mode A with mode C: p<0.01, significant). In contrast to fluorescein, the lipophilic curcumin showed no differences in the penetration kinetics, in reference to whether the skin was irradiated with wIRA or not. These effects were confirmed by laser scanning microscopy. Water-filtered infrared-A irradiation increased the hydration of the stratum corneum: transepidermal water loss rose from approximately 8.8 g m(-2) h(-1) before wIRA irradiation to 14.2 g m(-2) h(-1) after wIRA irradiation and skin hydration rose from 67 to 87 relative units. Skin surface temperature increased from 32.8 degrees C before wIRA to 36.4 degrees C after wIRA irradiation. DISCUSSION: The better penetration of the hydrophilic dye fluorescein after or during skin irradiation (modes B and C) can be explained by increased hydration of the stratum corneum by irradiation with wIRA. CONCLUSIONS: As most topically applied substances for the treatment of patients are mainly hydrophilic, wIRA can be used to improve the penetration of substances before or after application of substances - in the first case even of thermolabile substances - with a broad clinical relevance as a contact free alternative to an occlusive dressing.
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Axel Kramer, Nils-Olaf Hübner, Klaus-Dieter Weltmann, Jürgen Lademann, Axel Ekkernkamp, Peter Hinz, Ojan Assadian (2008)  Polypragmasia in the therapy of infected wounds - conclusions drawn from the perspectives of low temperature plasma technology for plasma wound therapy.   GMS Krankenhhyg Interdiszip 3: 1. 11  
Abstract: As long as a wound is infected, the healing process cannot begin. The indication for wound antiseptic is dependent on the interaction between the wound, the causative micro-organisms, and the host immune system. An uncritical colonisation is a condition whereby micro-organisms on a wound will proliferate, yet the immune system will not react excessively. Wound antiseptic is most often not necessary unless for epidemiologic reasons like colonisation with multi-resistant organisms. In most instances of a microbial contamination of the wound and colonisation, thorough cleaning will be sufficient.Bacterial counts above 10(5) to 10(6) cfu per gram tissue (critical colonisation) might decrease wound healing due to release of toxins, particularly in chronic wounds. Traumatic and heavily contaminated wounds therefore will require anti-infective measures, in particular wound antiseptic. In such situations, even a single application of an antiseptic compound will significantly reduce the number of pathogens, and hence, the risk of infection. If a wound infection is clinically manifest, local antiseptics and systemic antibiotics are therapeutically indicated.The prophylactic and therapeutic techniques for treatment of acute and chronic wounds (chemical antiseptics using xenobiotics or antibiotics, biological antiseptic applying maggots, medical honey or chitosan, physical antiseptic using water-filtered infrared A, UV, or electric current) mostly have been empirically developed without establishing a fundamental working hypothesis for their effectiveness.The most important aspect in controlling a wound infection and achieving healing of a wound is meticulous debridement of necrotic material. This is achieved by surgical, enzymatic or biological means e.g. using maggots. However, none of these methods (with some exception for maggots) is totally gentle to vital tissue and particularly chemical methods possess cytotoxicity effects.DERIVED FROM THE GENERAL PRINCIPLES OF ANTISEPTIC WOUND TREATMENT, THE FOLLOWING WORKING HYPOTHESIS IS POSTULATED: the most ideal constellation for treatment of wounds is the superficial destruction of microbial layers without deep tissue alteration, like it is caused by antiseptics, in order not to endanger the regenerative granulation tissue. At the same time, it is desirable to support and increase cell proliferation and granulation capacities. These two aspects might be achieved by using low temperature plasma technology.
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Susanne Astner, Susanne Dietterle, Nina Otberg, Hans-Joachim Röwert-Huber, Eggert Stockfleth, Jürgen Lademann (2008)  Clinical applicability of in vivo fluorescence confocal microscopy for noninvasive diagnosis and therapeutic monitoring of nonmelanoma skin cancer.   J Biomed Opt 13: 1. Jan/Feb  
Abstract: Excisional biopsies and routine histology remains the gold standard for the histomorphologic evaluation of normal and diseased skin. However, there is increasing interest in the development of noninvasive optical technologies for evaluation, diagnosis, and monitoring of skin disease in vivo. Fluorescent confocal microscopy is an innovative optical technology that has previously been used for morphologic evaluation of live human tissue. We evaluate the clinical applicability of a fluorescent confocal laser scanning microscope (FLSM) for a systematic evaluation of normal and diseased skin in vivo and in correlation with routine histology. A total of 40 patients were recruited to participate in the study. Skin sites of 10 participants with no prior history of skin disease served as controls and to evaluate topographic variations of normal skin in vivo. Thirty patients with a suspected diagnosis of nonmelanoma skin cancer were evaluated, whereby FLSM features of actinic keratoses (AK) and basal cell carcinoma (BCC) were recorded in an observational analysis. Selected BCCs were monitored for their skin response to topical therapy using Imiquimod as an immune-response modifier. A commercially available fluorescence microscope (OptiScan Ltd., Melbourne, Australia) was used to carry out all FLSM evaluations. Common FLSM features to AK and BCC included nuclear pleomorphism at the level of the granular and spinous layer and increased vascularity in the superficial dermal compartment. Even though the presence of superficial disruption and mere atypia of epidermal keratinocytes was more indicative of AK, the nesting of atypical basal cells, increased blood vessel tortuosity, and nuclear polarization were more typical for BCC. All diagnoses were confirmed by histology. FLSM allowed a monitoring of the local immune response following therapy with Imiquimod and demonstrated a continuous normalization of diseased skin on repeated evaluations over time. This study illustrates potential applications of FLSM in clinical dermatology for the evaluation of dynamic skin conditions and monitoring of cutaneous response to noninvasive therapies. The findings are of preliminary nature and warrant further investigations in the future.
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Ragna Pels, Wolfram Sterry, Jürgen Lademann (2008)  Clobetasol propionate--where, when, why?   Drugs Today (Barc) 44: 7. 547-557 Jul  
Abstract: Clobetasol propionate is the most potent of all topical steroids. It is successfully applied in the treatment of various skin diseases such as atopic dermatitis, psoriasis and vulvar lichen sclerosus. The therapy is, however, mainly symptomatic. A preventive effect is only reported in the treatment of the latter. Clobetasol propionate exerts antiinflammatory, immunosuppressive and antimitotic effects influencing the growth, differentiation and function of various cells and inhibiting cytokine production. Seven different dosage forms are available to deliver the drug to the living cells of the skin. Their choice might additionally affect patient compliance. The potency of clobetasol propionate, however, is accompanied by local and systemic side effects, such as skin atrophy and hypothalamic-pituitary-adrenal axis suppression. Patients applying clobetasol propionate must be well instructed in how to use it. Physicians prescribing clobetasol propionate should consider a diversity of factors and be able to answer the questions where, when and why.
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Peter Schroeder, Juergen Lademann, Maxim E Darvin, Helger Stege, Corinna Marks, Susanne Bruhnke, Jean Krutmann (2008)  Infrared radiation-induced matrix metalloproteinase in human skin: implications for protection.   J Invest Dermatol 128: 10. 2491-2497 Oct  
Abstract: Human skin is exposed to infrared radiation (IR) from natural and artificial sources. In previous studies, near IR radiation (IRA; 760-1,440 nm) was shown to elicit a retrograde mitochondrial signaling response leading to induction of matrix metalloproteinase-1 (MMP-1) expression. These studies, however, have exclusively employed cultured human skin fibroblasts ex vivo. Here, we have assessed the in vivo relevance of these observations by exposing healthy human skin in vivo to physiologically relevant doses of IRA. Eighty percent of the tested individuals responded to IRA radiation by upregulating of MMP-1 expression. Specifically, IRA irradiation caused increased expression of MMP-1 in the dermis, but not in the epidermis. Raman spectroscopy revealed that IRA radiation also caused a significant decrease in the antioxidant content of human skin. In vitro studies had previously shown that IRA-induced MMP-1 expression was mediated through an oxidative stress response, which originates from the mitochondrial electron transport chain. We now report that incubation of cultured human dermal fibroblasts or treatment of human skin with specific antioxidants prevented IRA radiation-induced MMP-1 expression in vitro and in vivo. Thus, IRA irradiation most likely promotes premature skin aging and topical application of appropriate antioxidants represents an effective photoprotective strategy.
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Maxim E Darvin, Alexa Patzelt, Fanny Knorr, Ulrike Blume-Peytavi, Wolfram Sterry, Juergen Lademann (2008)  One-year study on the variation of carotenoid antioxidant substances in living human skin: influence of dietary supplementation and stress factors.   J Biomed Opt 13: 4. Jul/Aug  
Abstract: Variation in the level of the carotenoid antioxidant substances beta-carotene and lycopene in the human skin of ten healthy volunteers was measured with resonance Raman spectroscopy in an in vivo experiment over the course of 12 months. Information on the lifestyle of the volunteers concerning dietary supplementation and stress factors was obtained daily by the completion of questionnaires. The results showed individual variations in the levels of carotenoid antioxidant substances in the skin of the volunteers, which strongly correlated to specific lifestyles, such as the intake of dietary supplementations rich in carotenoids, and the influence of stress factors. A carotenoid-rich nutrition, based on large amounts of fruit and vegetables, increased the measured carotenoid levels of skin, while stress factors such as fatigue, illness, smoking, and alcohol consumption gave rise to a decrease in carotenoid levels of the skin. These decreases occurred relatively quickly over the course of one day, while the subsequent increases lasted for up to 3 days. During the summer and autumn months, an increase in the level of carotenoids in the skin was measured for all volunteers. The average "seasonal increase" of the carotenoid content in the skin was determined to be 1.26-fold.
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J Lademann, J Shevtsova, A Patzelt, H Richter, N D Gladkowa, V M Gelikonov, S A Gonchukov, W Sterry, A M Sergeev, U Blume-Peytavi (2008)  Optical coherent tomography for in vivo determination of changes in hair cross section and diameter during treatment with glucocorticosteroids--a simple method to screen for doping substances?   Skin Pharmacol Physiol 21: 6. 312-317 09  
Abstract: Eighty percent of hair follicles are in the growing phase. They grow approximately 0.3 mm/day. The hair follicles are surrounded by a close network of capillaries, which supplies them with nutrients. It is well known that substances which influence the metabolic processes of humans also influence hair growth. Steroids, which are used for doping in sport, are among these substances. In the present paper, optical coherent tomography is used for the analysis of changes in the hair structure during the application of steroids for the treatment of patients suffering from auto-immune diseases. Significant differences in the hair cross section could be detected during treatment, while the shape of the hairs was not influenced. It could be demonstrated that optical coherence tomography is a suitable, non-invasive and low-cost measuring technique that can be applied for doping control and screening. As a result of this screening process, only those athletes who show abnormalities in hair parameters would need to be investigated by classical analytical methods. The results presented in this study are not only important for doping controls, but also for several clinical applications, such as therapy and compliance control in cases where the applied substances induce changes in the hair structure.
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J Lademann, H Richter, K Golz, L Zastrow, W Sterry, A Patzelt (2008)  Influence of microparticles on the homogeneity of distribution of topically applied substances.   Skin Pharmacol Physiol 21: 5. 274-282 07  
Abstract: The uppermost layer of the skin--the stratum corneum--represents a barrier of the human organism to the environment. It prevents the penetration of substances coming into contact with the skin into the human body. In cases of strong exposure, the skin has to be protected additionally by barrier creams. In the present study, the influence of microparticles on the homogeneity of distribution of the protection cream on the skin was investigated by laser scanning microscopy. The protection cream contained antioxidant substances with a high radical protection factor for the prevention of palmar-plantar erythema often occurring during chemotherapy with doxorubicin. In this case, the chemotherapeutic substance comes out with the sweat onto the skin surface, from which it penetrates into the skin like topically applied. It was found that particles increase the homogeneity of distribution and, thus, the protection efficacy is significantly increased. The obtained results are important, not only for the prevention of side effects during chemotherapy, but also for the development and application of sunscreens and all types of topically applied drugs and cosmetics, which should form an efficient protection film on the skin.
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Alexa Patzelt, Heike Richter, Rolf Buettemeyer, Hans Joachim Roewert Huber, Ulrike Blume-Peytavi, Wolfram Sterry, Juergen Lademann (2008)  Differential stripping demonstrates a significant reduction of the hair follicle reservoir in vitro compared to in vivo.   Eur J Pharm Biopharm 70: 1. 234-238 Sep  
Abstract: Penetration studies are commonly performed on in vitro models, presumably due to a lack of non-invasive in vivo methods. To date, it is not clear whether in vitro models are suitable to reflect the in vivo conditions for percutaneous penetration. Apart from inter and intraspecies skin differences, the excision of a skin sample may influence the penetration rate inter alia as a result of the contraction of the elastic fibres in the skin during excision. Therefore, the aim of the present study was to investigate the follicular reservoir of the hair follicles of human skin in vivo and in vitro utilizing the method of differential stripping. The results obtained revealed a significantly reduced follicular reservoir in vitro, which was only 9.5+/-10.6% of the in vivo reservoir. These results are important for the interpretation of earlier and future penetration investigations. It can thus be assumed that excised skin models are suitable for penetration studies only to a limited extent, as follicular penetration is greatly diminished due to the contraction of the elastic fibres of the skin.
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J Lademann, F Knorr, H Richter, U Blume-Peytavi, A Vogt, C Antoniou, W Sterry, A Patzelt (2008)  Hair follicles--an efficient storage and penetration pathway for topically applied substances. Summary of recent results obtained at the Center of Experimental and Applied Cutaneous Physiology, Charité -Universitätsmedizin Berlin, Germany.   Skin Pharmacol Physiol 21: 3. 150-155 06  
Abstract: In the past, it was assumed that the intercellular route was the only relevant penetration pathway for topically applied substances. Recent results on follicular penetration obtained at the Center for Experimental and Applied Cutaneous Physiology, Charité - Universitätsmedizin Berlin, Germany, emphasize that the hair follicles represent a highly relevant and efficient penetration pathway and reservoir for topically applied substances.
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2007
Juergen Lademann, Nina Otberg, Heike Richter, Lars Meyer, Heike Audring, Alexa Teichmann, Steven Thomas, Alexander Knüttel, Wolfram Sterry (2007)  Application of optical non-invasive methods in skin physiology: a comparison of laser scanning microscopy and optical coherent tomography with histological analysis.   Skin Res Technol 13: 2. 119-132 May  
Abstract: BACKGROUND/PURPOSE: Optical, non-invasive methods, such as fluorescence laser scanning microscopy (LSM) and optical coherent tomography (OCT), have become efficient tools for the characterization of the skin structure in vivo, as well as real-time investigation of distribution and penetration of topically applied substances. METHODS: In the present paper, the results obtained with both non-invasive methods - OCT and LSM - were compared to conventional light microscopy of histological sections. Skin structure and the distribution of topically applied particulate and non-particulate substances on the skin surface and in the epidermis were analyzed. RESULTS: None of the methods used are suitable for the realization of all diagnostic tasks, however, each method has advantages for particular applications. Fluorescence LSM is well suited for the investigation of the upper 150 microm of the skin as well as for the investigation of the kinetics of substances applied onto or into the epidermis. OCT can be applied for the investigation of vertical cross-sections of the skin up to a depth of 2 mm, albeit at lower resolution than achieved by LSM or conventional light microscopy. Conventional light microscopy of histological sections of biopsy specimens produces familiar high-resolution images of deeper tissue layers. However, the analysis of the kinetic processes is limited in this case. CONCLUSIONS: LSM- and OCT-measurements are efficient non-invasive tools for the characterization of morphological structures of the skin. On the one hand, the optical methods have a clear advantage in the case of kinetic measurements. On the other hand, histological investigations are characterized by a high information density and a high resolution, also in deep tissue layers. The selection of the best method for the analysis of the skin morphology depends on the target and the task of the investigation.
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N Otberg, A Teichmann, U Rasuljev, R Sinkgraven, W Sterry, J Lademann (2007)  Follicular penetration of topically applied caffeine via a shampoo formulation.   Skin Pharmacol Physiol 20: 4. 195-198 03  
Abstract: AIMS: Follicular drug delivery is the prerequisite for an effective treatment of androgenetic alopecia or other reasons of premature hair loss. METHODS: The follicular penetration of caffeine, applied topically in a shampoo formulation for 2 min, was measured with highly sensitive surface ionization in combination with mass spectroscopy, a selective method for the detection of very small quantities of transcutaneously absorbed substances in the blood. An experimental protocol, developed to selectively block the follicular pathway within the test area, was used. Based on this principle, a clear distinction between interfollicular and follicular penetration of topically applied caffeine was feasible. RESULTS: After 2 min, caffeine penetrated via the hair follicles and stratum corneum. CONCLUSION: It was found that the penetration via hair follicles was faster and higher compared with the interfollicular route and that hair follicles are the only pathway for fast caffeine absorption during the first 20 min after application.
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Gerhard J Nohynek, Jürgen Lademann, Christele Ribaud, Michael S Roberts (2007)  Grey goo on the skin? Nanotechnology, cosmetic and sunscreen safety.   Crit Rev Toxicol 37: 3. 251-277 Mar  
Abstract: Many modern cosmetic or sunscreen products contain nano-sized components. Nanoemulsions are transparent and have unique tactile and texture properties; nanocapsule, nanosome, noisome, or liposome formulations contain small vesicles (range: 50 to 5000 nm) consisting of traditional cosmetic materials that protect light-or oxygen-sensitive cosmetic ingredients. Transdermal delivery and cosmetic research suggests that vesicle materials may penetrate the stratum corneum (SC) of the human skin, but not into living skin. Depending on the physical/chemical properties of the ingredient and the formulation, nano-sized formulations may enhance or reduce skin penetration, albeit at a limited rate. Modern sunscreens contain insoluble titanium dioxide (TiO(2)) or zinc oxide (ZnO) nanoparticles (NP), which are colorless and reflect/scatter ultraviolet (UV) more efficiently than larger particles. Most available theoretical and experimental evidence suggests that insoluble NP do not penetrate into or through normal as well as compromised human skin. Oral and topical toxicity data suggest that TiO(2) and ZnO NP have low systemic toxicity and are well tolerated on the skin. In vitro cytotoxicity, genotoxicity, and photogenotoxicity studies on TiO(2) or other insoluble NP reporting uptake by cells, oxidative cell damage, or genotoxicity should be interpreted with caution, since such toxicities may be secondary to phagocytosis of mammalian cells exposed to high concentrations of insoluble particles. Caution needs to be exercised concerning topical exposure to other NP that either have characteristics enabling some skin penetration and/or have inherently toxic constituents. Studies on wear debris particles from surgical implants and other toxicity studies on insoluble particles support the traditional toxicology view that the hazard of small particles is mainly defined by the intrinsic toxicity of particles, as distinct from their particle size. There is little evidence supporting the principle that smaller particles have greater effects on the skin or other tissues or produce novel toxicities relative to micro-sized materials. Overall, the current weight of evidence suggests that nano-materials such as nano-sized vesicles or TiO(2) and ZnO nanoparticles currently used in cosmetic preparations or sunscreens pose no risk to human skin or human health, although other NP may have properties that warrant safety evaluation on a case-by-case basis before human use.
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Juergen Lademann, Heike Richter, Alexa Teichmann, Nina Otberg, Ulrike Blume-Peytavi, Javiana Luengo, Barbara Weiss, Ulrich F Schaefer, Claus-Michael Lehr, Roger Wepf, Wolfram Sterry (2007)  Nanoparticles--an efficient carrier for drug delivery into the hair follicles.   Eur J Pharm Biopharm 66: 2. 159-164 May  
Abstract: The penetration and storage behavior of dye-containing nanoparticles (diameter 320 nm) into the hair follicles was investigated. The results were compared to the findings obtained with the same amount of dye in the non-particle form. In the first part of the experiments, the penetration of the dye into the hair follicles was investigated in vitro on porcine skin, which is an appropriate model for human tissue. It was found that the nanoparticles penetrate much deeper into the hair follicles than the dye in the non-particle form, if a massage had been applied. Without massage, similar results were obtained for both formulations. Subsequently, the storage behavior of both formulations in the hair follicles was analyzed in vivo on human skin by differential stripping. Using the same application protocol, the nanoparticles were stored in the hair follicles up to 10 days, while the non-particle form could be detected only up to 4 days. Taking into consideration the surface structure of the hair follicles, it was assumed that the movement of the hairs may act as a pumping mechanism pushing the nanoparticles deep into the hair follicles.
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R Bimczok, H Gers-Barlag, C Mundt, E Klette, S Bielfeldt, T Rudolph, F Pflucker, U Heinrich, H Tronnier, W Johncock, B Klebon, H Westenfelder, H Flosser-Muller, K Jenni, D Kockott, J Lademann, B Herzog, M Rohr (2007)  Influence of applied quantity of sunscreen products on the sun protection factor--a multicenter study organized by the DGK Task Force Sun Protection.   Skin Pharmacol Physiol 20: 1. 57-64 10  
Abstract: It is often debated that the protection against solar-induced erythema under real conditions is dependent upon the amount of sunscreen applied. It is believed that when too little is applied a lower sun protection than indicated on the label will result. The aim of this study was to quantify this effect. In this multicenter study, the influence of three different amounts (0.5, 1.0, 2.0 mg/cm(2)) of three commercial sunscreen products in three reliable test centers was investigated according to the test protocol of The International Sun Protection Factor Test Method. The main result was a linear dependence of the SPF on the quantity applied. Taking into consideration the volunteer-specific variations, an exponential dependence of confidence interval of the in vivo SPF and amount applied was found. The highest amount applied (2.0 mg/cm(2)) was linked to the lowest confidence intervals. Thus, from the point of view of producing reliable and reproducible in vivo results under laboratory conditions, the recommendation of this multicenter study is an application quantity of 2.0 mg/cm(2).
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Mark Hartel, Peter Illing, James B Mercer, Jürgen Lademann, Georg Daeschlein, Gerd Hoffmann (2007)  Therapy of acute wounds with water-filtered infrared-A (wIRA).   GMS Krankenhhyg Interdiszip 2: 2. 12  
Abstract: Water-filtered infrared-A (wIRA) as a special form of heat radiation with a high tissue penetration and with a low thermal load to the skin surface acts both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA produces a therapeutically usable field of heat in the tissue and increases tissue temperature, tissue oxygen partial pressure, and tissue perfusion. These three factors are decisive for a sufficient tissue supply with energy and oxygen and consequently as well for wound healing and infection defense. wIRA can considerably alleviate the pain (with remarkably less need for analgesics) and diminish an elevated wound exudation and inflammation and can show positive immunomodulatory effects. wIRA can advance wound healing or improve an impaired wound healing both in acute and in chronic wounds including infected wounds. Even the normal wound healing process can be improved.A prospective, randomized, controlled, double-blind study with 111 patients after major abdominal surgery at the University Hospital Heidelberg, Germany, showed with 20 minutes irradiation twice a day (starting on the second postoperative day) in the group with wIRA and visible light VIS (wIRA(+VIS), approximately 75% wIRA, 25% VIS) compared to a control group with only VIS a significant and relevant pain reduction combined with a markedly decreased required dose of analgesics: during 230 single irradiations with wIRA(+VIS) the pain decreased without any exception (median of decrease of pain on postoperative days 2-6 was 13.4 on a 100 mm visual analog scale VAS 0-100), while pain remained unchanged in the control group (p<0.001). The required dose of analgesics was 57-70% lower in the subgroups with wIRA(+VIS) compared to the control subgroups with only VIS (median 598 versus 1398 ml ropivacaine, p<0.001, for peridural catheter analgesia; 31 versus 102 mg piritramide, p=0.001, for patient-controlled analgesia; 3.4 versus 10.2 g metamizole, p=0.005, for intravenous and oral analgesia). During irradiation with wIRA(+VIS) the subcutaneous oxygen partial pressure rose markedly by approximately 30% and the subcutaneous temperature by approximately 2.7 degrees C (both in a tissue depth of 2 cm), whereas both remained unchanged in the control group: after irradiation the median of the subcutaneous oxygen partial pressure was 41.6 (with wIRA) versus 30.2 mm Hg in the control group (p<0.001), the median of the subcutaneous temperature was 38.9 versus 36.4 degrees C (p<0.001). The overall evaluation of the effect of irradiation, including wound healing, pain and cosmesis, assessed on a VAS (0-100 with 50 as indifferent point of no effect) by the surgeon (median 79.0 versus 46.8, p<0.001) or the patient (79.0 versus 50.2, p<0.001) was markedly better in the group with wIRA compared to the control group. This was also true for single aspects: Wound healing assessed on a VAS by the surgeon (median 88.6 versus 78.5, p<0.001) or the patient (median 85.8 versus 81.0, p=0.040, trend) and cosmetic result assessed on a VAS by the surgeon (median 84.5 versus 76.5, p<0.001) or the patient (median 86.7 versus 73.6, p=0.001). In addition there was a trend in favor of the wIRA group to a lower rate of total wound infections (3 of 46, approximately 7%, versus 7 of 48, approximately 15%, p=0.208) including late infections after discharge, caused by the different rate of late infections after discharge: 0 of 46 in the wIRA group and 4 of 48 in the control group. And there was a trend towards a shorter postoperative hospital stay: 9 days in the wIRA group versus 11 days in the control group (p=0.037). The principal finding of this study was that postoperative irradiation with wIRA can improve even a normal wound healing process.A prospective, randomized, controlled, double-blind study with 45 severely burned children at the Children's Hospital Park Schönfeld, Kassel, Germany, showed with 30 minutes irradiation once a day (starting on the first day, day of burn as day 1) in the group with wIRA and visible light VIS (wIRA(+VIS), approximately 75% wIRA, 25% VIS) compared to a control group with only VIS a markedly faster reduction of wound size. On the fifth day (after 4 days with irradiation) decision was taken, whether surgical debridement of necrotic tissue was necessary because of deeper (second degree, type b) burns (11 of 21 in the group with wIRA, 14 of 24 in the control group) or non-surgical treatment was possible (second degree, type a, burns). The patients treated conservatively were kept within the study and irradiated till complete reepithelialization. The patients in the group with wIRA showed a markedly faster reduction of wound area: a median reduction of wound size of 50% was reached already after 7 days compared to 9 days in the control group, a median reduction of wound size of 90% was already achieved after 9 days compared to 13 days in the control group. In addition the group with wIRA showed superior results till 3 months after the burn in terms of the overall surgical assessment of the wound, cosmesis, and assessment of effects of irradiation compared to the control group. In a prospective, randomized, controlled study with 12 volunteers at the University Medical Center Charité, Berlin, Germany, within each volunteer 4 experimental superficial wounds (5 mm diameter) as an acute wound model were generated by suction cup technique, removing the roof of the blister with a scalpel and a sterile forceps (day 1). 4 different treatments were used and investigated during 10 days: no therapy, only wIRA(+VIS) (approximately 75% wIRA, 25% VIS; 30 minutes irradiation once a day), only dexpanthenol (= D-panthenol) cream once a day, wIRA(+VIS) and dexpanthenol cream once a day. Healing of the small experimental wounds was from a clinical point of view excellent with all 4 treatments. Therefore there were only small differences between the treatments with slight advantages of the combination wIRA(+VIS) and dexpanthenol cream and of dexpanthenol cream alone concerning relative change of wound size and assessment of feeling of the wound area. However laser scanning microscopy with a scoring system revealed differences between the 4 treatments concerning the formation of the stratum corneum (from first layer of corneocytes to full formation) especially on the days 5-7: fastest formation of the stratum corneum was seen in wounds treated with wIRA(+VIS) and dexpanthenol cream, second was wIRA(+VIS) alone, third dexpanthenol cream alone and last were untreated wounds. Bacterial counts of the wounds (taken every 2 days) showed, that wIRA(+VIS) and the combination of wIRA(+VIS) with dexpanthenol cream were able to inhibit the colonisation with physiological skin flora up to day 5 when compared with the two other groups (untreated group and group with dexpanthenol cream alone). At any investigated time, the amount of colonisation under therapy with wIRA(+VIS) alone was lower (interpreted as more suppressed) compared with the group with wIRA(+VIS) and dexpanthenol cream. During rehabilitation after hip and knee endoprosthetic operations the resorption of wound seromas and wound hematomas was both clinically and sonographically faster and pain was reduced by irradiation with wIRA(+VIS). wIRA can be used successfully for persistent postoperative pain e.g. after thoracotomy.As perspectives for wIRA it seems clinically prudent to use wIRA both pre- and postoperatively, e.g. in abdominal and thoracic operations. wIRA can be used preoperatively (e.g. during 1-2 weeks) to precondition donor and recipient sites of skin flaps, transplants or partial-thickness skin grafts, and postoperatively to improve wound healing and to decrease pain, inflammation and infections at all mentioned sites. wIRA can be used to support routine pre- or intraoperative antibiotic administration or it might even be discussed to replace this under certain conditions by wIRA.
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Ute Jacobi, Marco Kaiser, Rani Toll, Susanne Mangelsdorf, Heike Audring, Nina Otberg, Wolfram Sterry, Juergen Lademann (2007)  Porcine ear skin: an in vitro model for human skin.   Skin Res Technol 13: 1. 19-24 Feb  
Abstract: BACKGROUND/PURPOSE: Porcine ear skin is used in studies of percutaneous penetration as a substitute for human skin. The structure of this tissue, including hair follicles, was studied qualitatively and quantitatively in comparison with human skin. METHODS: Sections of shock-frozen biopsies, biopsies embedded in paraffin and cyanoacrylate skin surface biopsies were investigated using microscopy. The thickness of the different skin layers and the follicular characteristics were determined. RESULTS: The thickness of the stratum corneum was 17-28 microm, whereas the viable epidermis was 60-85 microm thick. On 1 cm(2), 11-25 hairs were detected, showing a diameter of 58-97 microm and a maximal extension depth of 0.96-1.38 mm into the skin. The orifices of the porcine infundibula showed a diameter of approximately 200 microm. CONCLUSIONS: The results obtained are similar to those of human skin, indicating the suitability of this porcine tissue as a model for human skin.
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U Jacobi, K Engel, A Patzelt, M Worm, W Sterry, J Lademann (2007)  Penetration of pollen proteins into the skin.   Skin Pharmacol Physiol 20: 6. 297-304 09  
Abstract: Atopic dermatitis is a chronic remittent skin disease. In the extrinsic form of atopic dermatitis, type IgE-mediated reactions play an important pathophysiological role. The aim of the present study was to examine whether type I allergens can penetrate into the skin. Therefore, pollen proteins were labeled with fluorescein isothiocyanate (FITC), and their penetration profile was studied qualitatively. Solutions of FITC-labeled pollen proteins were applied in vitro on porcine skin and in vivo on human skin. In vitro, the FITC-labeled proteins were observed within the complete stratum corneum (SC) and inside the hair follicles even 15 min after application. They were also distributed inside the dermis around the hair follicles. In vivo, a similar pattern of distribution within the SC and the hair follicles was observed. These results indicate penetration via the SC lipid layers and a faster penetration via the hair follicles. The FITC-labeled proteins entered the dermis via the follicular pathway. Therefore, the follicular penetration should be considered in the development of skin protection strategies. To evaluate such strategies, the developed method can be used, and further studies in atopic dermatitis patients are necessary to determine whether the penetration of type I allergens is increased.
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M Ossadnik, V Czaika, A Teichmann, W Sterry, H - J Tietz, J Lademann, S Koch (2007)  Differential stripping: introduction of a method to show the penetration of topically applied antifungal substances into the hair follicles.   Mycoses 50: 6. 457-462 Nov  
Abstract: Investigations concerning the penetration of topically applied drugs are the subject of a multiplicity of research, as the exact knowledge of these mechanisms is the prerequisite for the optimization of such substances. As the hair follicles represent a good long-term reservoir for topically applied substances, it can be assumed that they also represent a reservoir for microorganisms residing on and in the skin. Therefore, the hair follicles must be seen as one main site of action for antimicrobial substances and a simple non-invasive in vivo method for the determination of penetration of antimicrobial substances into the hair follicles. The aim of the present study was to show that differential stripping, by removing the hair follicle content selectively, represents a suitable method to demonstrate the penetration of antifungal substances into the hair follicles. The follicular casts, removed from skin areas of human volunteers, which were partially pre-treated with brilliant green (well-known antifungal properties), were applied on agar plates inoculated with Candida albicans. The results showed inhibited growth of C. albicans, if the follicular casts were removed from skin areas pre-treated with brilliant green. This indicates clear evidence that brilliant green had penetrated into the hair follicles. Therefore, differential stripping represents a suitable method to determine the penetration of antifungal substances into the hair follicles, which is of clinical importance for the optimization of topical antifungal therapeutics.
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Judith M Gottwein, Troels K H Scheel, Anne M Hoegh, Jacob B Lademann, Jesper Eugen-Olsen, Gorm Lisby, Jens Bukh (2007)  Robust hepatitis C genotype 3a cell culture releasing adapted intergenotypic 3a/2a (S52/JFH1) viruses.   Gastroenterology 133: 5. 1614-1626 Nov  
Abstract: BACKGROUND & AIMS: Recently, full viral life cycle hepatitis C virus (HCV) cell culture systems were developed for strain JFH1 (genotype 2a) and an intragenotypic 2a/2a genome (J6/JFH). We aimed at exploiting the unique JFH1 replication characteristics to develop culture systems for genotype 3a, which has a high prevalence worldwide. METHODS: Huh7.5 cells were transfected with RNA transcripts of an intergenotypic 3a/JFH1 recombinant with core, E1, E2, p7, and NS2 of the 3a reference strain S52, and released viruses were passaged. Cultures were examined for HCV core and/or NS5A expression (immunostaining), HCV RNA titers (real-time PCR), and infectivity titers (50% tissue culture infectious dose). The role of mutations identified by sequencing of recovered S52/JFH1 viruses was analyzed by reverse genetics studies. RESULTS: S52/JFH1 and J6/JFH viruses passaged in Huh7.5 cells showed comparable growth kinetics and similar peak HCV RNA and infectivity titers. However, analysis of S52/JFH1 viruses identified 9 putative adaptive mutations in core, E2, p7, NS3, and NS5A. All 7 S52/JFH1 recombinants with an amino acid change in p7 combined with a change in NS3 or NS5A, but only 2 of 9 recombinants with individual mutations (in p7 and NS3, respectively) were fully viable without the requirement for additional mutations. The biological relevance of our system was shown by studying dependence of 3a/JFH1 infection on CD81, and its impact on distribution of intracellular lipids. CONCLUSIONS: We developed a robust intergenotypic recombinant cell culture system for HCV genotype 3a, providing a valuable tool for studies of 3a core-NS2 and related therapeutics.
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David B Warheit, Paul J A Borm, Christa Hennes, Jürgen Lademann (2007)  Testing strategies to establish the safety of nanomaterials: conclusions of an ECETOC workshop.   Inhal Toxicol 19: 8. 631-643 Jun  
Abstract: The European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) convened a workshop in Barcelona, Spain, in November 2005 to develop testing strategies to establish the safety of nanomaterials. It brought together about 70 scientific and clinical experts from industry, academia, government agencies, research institutes, and nongovernmental organizations. The primary questions to be addressed were the following: What can we do today, and what do we need tomorrow? The three major themes of the workshop were: (1) the need for enhanced efforts in nanomaterial characterization; (2) methodologies for assessments of airborne and internal exposures to nanomaterials; and (3) evaluation of the hazard potential--primarily focusing on pulmonary or dermal routes of exposures. Some of the summary conclusions of the workshop included the following: For the development of nanoparticle characterization, the working definition of nanoparticles was defined as < 100 nm in one dimension or < 1000 nm to include aggregates and agglomerates. Moreover, it was concluded that although many physical factors can influence toxicity, including nanoparticle composition, it is dissolution, surface area and characteristics, size, size distribution, and shape that largely determine the functional, toxicological and environmental impact of nanomaterials. In addition, most of the information on potential systemic effects has thus far been derived from combustion-generated particles. With respect to the assessment of external exposures and metrics appropriate for nanoparticles, the general view of the meeting was that currently it is not possible or desirable to select one form of dose metric (i.e., mass, surface area, or particle number) as the most appropriate measure source. However, it was clear that the surface area metric was likely to be of interest and requires further development. In addition, there is a clear and immediate need to develop instruments which are smaller, more portable, and less expensive than the currently available state of the art instrumentation. With regard to a general testing approach for human health hazard evaluation of nanoparticles, a first step to determine potency may include a prioritization-related in vitro screening strategy to assess the possible reactivity, biomarkers of inflammation and cellular uptake of nanoparticles; however this process should be validated using in vivo techniques. A Tier 1 in vivo testing strategy could include a short-term inhalation or intratracheal instillation of nanoparticles as the route of exposure in the lungs of rats or mice. The endpoints that should be assessed include indices of lung inflammation, cytotoxicity, and cell proliferation, as well as histopathology of the respiratory tract and the major extrapulmonary organs. For Tier 2 in vivo testing for hazard identification, a longer term inhalation study is recommended, and this would include more substantive mechanistic endpoints such as determination of particle deposition, translocation, and disposition within the body. Additional studies could be designed with specific animal models to mimic sensitive populations. With regard to dermal exposures, currently there is little evidence that nanoparticles at a size exceeding 100 nm penetrate through the skin barrier into the living tissue (i.e., dermal compartment). The penetration of nanoparticles at a size less than 100 nm should be a topic of further investigation. Moreover, considering the impacts of dermal exposures and corresponding hazard potential of nanoparticles, it must be taken into consideration that the dermal uptake of nanoparticles will be an order of magnitude smaller than the uptake via the inhalation or oral routes of exposure. For the evaluation of the health risk of nanoparticles, it has to be determined whether they are harmful to living cells and whether, under real conditions, they penetrate through the skin barrier into the living tissue. For the evaluation of the penetration processes, in principle, three methods are available. Using the method of differential stripping, the penetration kinetics of nanoparticles in the stratum corneum and the hair follicles can be evaluated. This analysis can be carried out in vivo. Diffusion cell experiments are an efficient method for in vitro penetration studies. Also, laser scanning microscopy is well suited to test penetration kinetics, although requiring fluorescent-labeled nanoparticles. Emerging topics such as (1) environmental safety testing, (2) applications of nanoparticles for medical purposes, and (3) pathways of inhaled nanoparticles to the central nervous system were also briefly addressed during this workshop. However, it has become clear that these topics should be the subjects of separate workshops and they are not further addressed in this report.
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Annika Vogt, Sabrina Hadam, Marc Heiderhoff, Heike Audring, Juergen Lademann, Wolfram Sterry, Ulrike Blume-Peytavi (2007)  Morphometry of human terminal and vellus hair follicles.   Exp Dermatol 16: 11. 946-950 Nov  
Abstract: Previous studies suggest that drug delivery systems based on particles can be used to deposit active compounds in hair follicles and to target hair follicle-associated cell populations. The development of application protocols is complicated by the fact that there is no information available on the size and the position of key target structures in the different hair follicle types and their intra- and interindividual variation. Therefore, we performed morphometric measurements on histological sections of human terminal (THF) and vellus hair follicles (VHF) from the scalp and the retroauricular region. With 3864 +/- 605 microm and 580 +/- 84 microm in THF compared to 646 +/- 140 microm and 225 +/- 34 microm in VHF, the total length and the length of the infundibulum differed significantly as determined by paired t-test (P < 0.0001). The same level of significance was observed for the position and the length of the bulge region. The thickness of the epithelial lining was lowest in VHF (45 +/- 14 microm at 100 microm from skin surface) compared to 65 +/- 20 microm at 150 microm in THF, while the thickness of the interfollicular epidermis ranged between 64 +/- 12 microm and 99 +/- 18 microm in VHF-bearing skin and 72 +/- 16 microm and 136 +/- 37 microm in THF-bearing skin. In addition, the diameter of the hair follicle opening was determined at 50 microm intervals from the skin surface. Our data suggest that hair follicle types in defined body regions represent rather homogenous groups and that particle-based drug delivery may be a feasible approach, also in larger numbers of individuals. We provide precise information on the size and the position of key target structures in VHF and THF.
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Tina Rieger, Alexa Teichmann, Heike Richter, Sabine Schanzer, Wolfram Sterry, Jürgen Lademann (2007)  Evaluation of barrier creams - introduction and comparison of 3 in vivo methods.   Contact Dermatitis 56: 6. 347-354 Jun  
Abstract: Often barrier creams (BC) do not fulfil their protecting behaviour, even when promised by the manufacturers. Therefore, it is of great importance to develop standardized in vivo techniques to prove the potency of BC in humans. In the present study, 3 promising techniques for the analysis of BC were evaluated: laser scanning microscopy, laser doppler flowmetry, and the tape-stripping procedure. Sodium fluorescein and glycerol trinitrate acted as hydrophilic model-penetrating substances. By means of these methods, 3 different BC were tested and compared for their potency. The investigations showed that primarily the tape-stripping procedure and also the laser scanning microscopy are promising tools for the evaluation of BC. In contrast, the laser doppler flowmetry represents a less feasible technique. In addition, the evaluation of BC showed that Vaseline enfolds a 100% barrier on the skin surface for the penetration of a hydrophilic dye, whereas BC1 only partially showed a protective effect and BC2 exhibited almost no potency. In conclusion, it can be referred that laser scanning microscopy and the tape-stripping procedure represent 2 non-invasive in vivo techniques, which enable a fast investigation concerning the potency of BC.
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Alexa Teichmann, Sandra Heuschkel, Ute Jacobi, Gaëlle Presse, Reinhard H H Neubert, Wolfram Sterry, Jürgen Lademann (2007)  Comparison of stratum corneum penetration and localization of a lipophilic model drug applied in an o/w microemulsion and an amphiphilic cream.   Eur J Pharm Biopharm 67: 3. 699-706 Nov  
Abstract: Vehicle dependent effects on the penetration behavior of drugs following topical application are well known from the literature. In this context, many reports concerning the enhancing activities for hydrophilic as well as lipophilic substances by colloidal drug carrier systems, particularly microemulsions, are available. However, there is little knowledge about the localization of the drugs within the skin and the stratum corneum, respectively. In the present study, the lipophilic dye curcumin incorporated in an oil-in-water microemulsion and in an amphiphilic cream was applied onto the skin of human volunteers. Using the method of tape stripping to remove the stratum corneum (SC), the depth profiles of the dye within the horny layer were compared. Applying the microemulsion, a deeper part of the SC was accessible by a number of 20 tapes removed and significantly smaller amounts of curcumin were found on the skin surface. Also differences in the distribution and localization of the dye within the stratum corneum were observed by laser scanning microscopy. Furthermore, curcumin was detected in hair follicles. It was obvious that the microemulsion led to a penetration into the complete follicular infundibula, whereas, following application of the cream, a fluorescence signal was only received from the follicular orifices.
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Hans-Juergen Weigmann, Sabine Schanzer, Alexa Teichmann, Fabienne Durat, Christina Antoniou, Hans Schaefer, Wolfram Sterry, Juergen Lademann (2007)  Ex-vivo spectroscopic quantification of sunscreen efficacy: proposal of a universal sun protection factor.   J Biomed Opt 12: 4. Jul/Aug  
Abstract: The sun protection factor (SPF) describes the protective behavior of sunscreens insufficiently, because this factor takes into account only the UVB spectral range, and strains the volunteers during its determination by invasively invoking an erythema. A new noninvasive method is proposed that is based on the UV spectroscopic measurement of tape strips taken from a sunscreen-treated skin area. The resulting sum transmission spectra of the tape strips reflect the in-vivo distribution of the absorber on the skin and quantify the protective efficacy of the applied sunscreens over the complete UV spectral range. The spectroscopic data provide a basis for the calculation of a universal sun protection factor (USPF). The comparison of the concrete values of USPF and SPF results in the following statements. 1. An unique functional correlation is not to be expected because a different UVB / UVA dependence exists. 2. The size of the differences between both values is influenced clearly by the intensity relation of the average sum transmission in the UVB in comparison to the UVA range. 3. The USPF values objectively assess the efficacy of sunscreens considering a protection against all irradiation injuries.
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2006
Annika Vogt, Behazine Combadiere, Sabrina Hadam, Karola M Stieler, Juergen Lademann, Hans Schaefer, Brigitte Autran, Wolfram Sterry, Ulrike Blume-Peytavi (2006)  40 nm, but not 750 or 1,500 nm, nanoparticles enter epidermal CD1a+ cells after transcutaneous application on human skin.   J Invest Dermatol 126: 6. 1316-1322 Jun  
Abstract: Although conventional vaccines have generated major successes in the control of infectious diseases, several obstacles remain in their development against chronic diseases (HIV, tuberculosis), against which no current candidate vaccines yet ensure protection. The transcutaneous route of vaccine administration appears to be a promising approach of targeting vaccines toward antigen-presenting cells (APCs) and thus improving immune responses. We investigated the suitability of nanoparticles in this approach. We found a high density of Langerhans cells (LCs) around hair follicles that, when sorted, readily internalized all size particles. However, flow cytometry after transcutaneous application of 40, 750, or 1,500 nm nanoparticles on human skin samples revealed that only 40 nm particles entered epidermal LC. Fluorescence and laser scan microscopies, which were carried out to identify the penetration pathway of transcutaneously applied nanoparticles, revealed that only 40 nm particles deeply penetrate into vellus hair openings and through the follicular epithelium. We conclude that 40 nm nanoparticles, but not 750 or 1,500 nm nanoparticles, may be efficiently used to transcutaneously deliver vaccine compounds via the hair follicle into cutaneous APCs.
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S Mangelsdorf, N Otberg, H I Maibach, R Sinkgraven, W Sterry, J Lademann (2006)  Ethnic variation in vellus hair follicle size and distribution.   Skin Pharmacol Physiol 19: 3. 159-167 05  
Abstract: It is a given fact that hair follicles play an important role in the penetration process of topically applied drugs and cosmetics. Since exact knowledge of the potential follicular reservoir is essential for understanding and calculating the penetration process, this knowledge may indeed help to optimize the development of topically applied drugs and cosmetic products. We know that variability in skin properties exists among the human population, but it is the deciphering and quantification of these differences that may help to explain racial disparities in dermatological disorders and provide a basic approach for treatment and prevention. Data pertaining to structural and functional differences within ethnic skin types (reviewed in this paper) support the assumption that hair follicles in the various skin types are not equal. Thus, the need to investigate follicular morphology in non-Caucasian skin types becomes more than apparent. The aim of the present study was to determine the potential reservoir of vellus hair follicles in non-Caucasian skin types in order to estimate their contribution to the penetration of topically applied substances. Cyanoacrylate skin surface biopsies were taken from seven body sites of Asians and African-Americans. To determine the follicular reservoir, the samples were evaluated under the light microscope. Follicular parameters were measured with the help of a digital imaging software program. In the evaluation and comparison of the results with those of Caucasians, significant differences were detected. Compared with Whites, follicular density on the forehead is significantly lower in Asians and African-Americans. Smaller values were detected for volume, surface, follicular orifice and hair shaft diameter on the thigh and in calf regions in Asians and African-Americans. Furthermore, the follicular reservoir, characterized by follicular volume, is generally higher in Caucasians. In comparison to African-Americans, larger follicular volumes on the forehead, back and on the upper arm were determined in Asians. The fairly similar density in these sites revealed that Asians have a higher follicular reservoir in these sites. Due to significant ethnic differences in the follicular reservoir, particularly on the calf and forehead, prospective skin absorption experiments need to be performed on different skin types in order to be representative. Likewise, the development of topically applied drugs should take place under adequate consideration of ethnic differences in skin physiology.
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Ute Jacobi, Marco Kaiser, Jürgen Koscielny, Rijk Schütz, Martina Meinke, Wolfram Sterry, Jürgen Lademann (2006)  Comparison of blood flow to the cutaneous temperature and redness after topical application of benzyl nicotinate.   J Biomed Opt 11: 1. Jan/Feb  
Abstract: The topical application of drugs, such as nicotinates, affects cutaneous blood flow. Such a biological response, which is dependent on the drug and the individual, can be measured noninvasively using laser Doppler flowmetry. We illustrate the kinetics of vasodilation caused by topically applied benzyl nicotinate using a new frequency-selective laser Doppler flowmeter. This flowmeter measures the blood flow in the superficial dermal plexus and the deeper lying larger capillaries simultaneously and indirectly by determining the flow velocity. Both sets of data are compared with the skin temperature and redness. Four biological parameters are measured consecutively on a skin area treated with gel containing benzyl nicotinate and on an untreated control area. A linear relationship between both blood flows is observed. However, no correlation is obtained between the microcirculation with either the cutaneous temperature or the redness. These results indicate the transport of the drug in the blood from the upper to the deeper capillaries. Cutaneous temperature and redness are unsuitable parameters to measure the kinetics of the blood flow after topical application of drugs.
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Sascha Jung, Nina Otberg, Gisela Thiede, Heike Richter, Wolfram Sterry, Steffen Panzner, Jürgen Lademann (2006)  Innovative liposomes as a transfollicular drug delivery system: penetration into porcine hair follicles.   J Invest Dermatol 126: 8. 1728-1732 Aug  
Abstract: Liposomes had been widely used for drug delivery in the past. In this study, five different liposomes were used as a follicular delivery system in pig ear skin. The liposomes mainly differed in their sphere diameter, lipid composition, and surface charge. A novel class of liposomes being amphoteric in their charge behavior are compared to established anionic and cationic liposomes. Two different fluorescent dyes, hydrophilic carboxyfluoresceine or lipophilic curcumin, were enclosed in the liposomes and used as model drugs. The fluorescent dyes were also applied in a standard formulation for reference. The penetration depth of the dyes was measured by laser scanning microscopy in histological sections. One hour, 3, 5, and 7 days after application, biopsies were taken and the penetration depth into the hair follicle was measured in longitudinal sections. The liposomes showed a higher penetration depth compared to the standard formulation. The relative penetration depth of the dyes, applied in the standard formulation, averaged 30% of the full follicle length during the whole observation period, whereas the liposomal formulations penetrated considerably deeper into the hair follicles. Amphoteric and cationic liposomes reached an average relative penetration depth of approximately 70% of the full hair follicle length.
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Ute Jacobi, Tatiana Tassopoulos, Christian Surber, Jürgen Lademann (2006)  Cutaneous distribution and localization of dyes affected by vehicles all with different lipophilicity.   Arch Dermatol Res 297: 7. 303-310 Jan  
Abstract: The penetration of topically applied substances into the stratum corneum (SC) depends on several factors, e.g., the physicochemical properties of the vehicle used for application. The penetration of highly hydrophilic and lipophilic dyes into the skin was studied using a pure oil (o) or water (w) for the application compared to an o/w emulsion. The penetration and localization of both dyes, the lipophilic curcumin and the hydrophilic Patent blue V, was investigated in vivo using the method of tape stripping and microscopy. In addition, histological sections of biopsies, removed from porcine ear skin were studied using microscopy. Differences in the distribution and the localization of both dyes within the SC were observed. These differences depend on the physicochemical properties of both the vehicles and the dyes. The vehicle appears to affect, in particular, the pathways of penetration.
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J Lademann, H Richter, U F Schaefer, U Blume-Peytavi, A Teichmann, N Otberg, W Sterry (2006)  Hair follicles - a long-term reservoir for drug delivery.   Skin Pharmacol Physiol 19: 4. 232-236 05  
Abstract: Nanoparticles represent an important drug carrier system. Recently, we have reported on the penetration and storage behavior of particular and non-particular substances revealing the superiority of particular substances in the range of 300-400 nm. In this regard, it was assumed that the rigid hair shaft acts as a geared pump, moving the particles deeper into the hair follicle. In the present investigation, the storage reservoir capacity of the stratum corneum and the hair follicle infundibulum and canal are compared. Interestingly, we could demonstrate a 10 times longer storage within the hair follicles. These results underscore the importance of the hair follicle for drug delivery purposes, mainly highlighting new possibilities for the future concerning retarded delivery, application frequency, and galenic design.
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Alexa Teichmann, Ute Jacobi, Evguenia Waibler, Wolfram Sterry, Jürgen Lademann (2006)  An in vivo model to evaluate the efficacy of barrier creams on the level of skin penetration of chemicals.   Contact Dermatitis 54: 1. 5-13 Jan  
Abstract: The reservoir function and the barrier function are important properties of the skin. The reservoir function is dependent on the barrier function which, however, needs support by protective measures, in particular under working conditions. Barrier creams represent a possibility to protect the skin. In the present study, a method was developed to investigate the effectiveness of reservoir closure by different formulations. Patent Blue V in water was used as a model penetrant. Its penetration, with and without barrier cream treatment, was analyzed by tape stripping in combination with UV/VIS spectroscopic measurements. The investigations showed that the stratum corneum represents a reservoir for topically applied Patent Blue V in water. Furthermore, the barrier investigations showed that vaseline and bees wax form a 100% barrier on the skin surface. The third barrier cream, containing waxes and surfactant, only partially showed a protective effect against the penetration of Patent Blue V in water. Strong interindividual differences were observed for this barrier product. In conclusion, it was assumed that the application of barrier creams cannot replace other protective measures and should be maximally used to inhibit low-grade irritants or in combination with other protectants or in body areas where other protective measures are not applicable.
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M Darwin, S Schanzer, A Teichmann, U Blume-Peytavi, W Sterry, J Lademann (2006)  Functional food and bioavailability in the target organ skin   Hautarzt 57: 4. 286, 288-286, 290 Apr  
Abstract: Reactive free radicals can be produced in the skin by the action of environmental factors, such as sun radiation and toxins. These radicals can damage the DNA, proteins and lipids of the living cells. The consequences can be skin aging, immune suppression and even skin cancer. Humans have developed a protective mechanism against the action of free radicals in the form of antioxidant substances. Several of these antioxidants cannot be produced by humans and have to be acquired via food, such as carotenoids. Optical, non-invasive methods, like resonance Raman spectroscopy, allow a qualitative and quantitative online detection of the kinetics of antioxidants such as carotenoids in the skin. By employing this method it has been shown that the uptake of carotenoids in food can lead to an accumulation in the skin. On the other hand, stress, illness and UV-radiation can reduce the concentration of antioxidant substances in the skin. A high concentration of antioxidant substances is protective and associated with a reduction in skin wrinkling.
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Alexa Teichmann, Nina Otberg, Ute Jacobi, Wolfram Sterry, Jürgen Lademann (2006)  Follicular penetration: development of a method to block the follicles selectively against the penetration of topically applied substances.   Skin Pharmacol Physiol 19: 4. 216-223 05  
Abstract: Investigations into the penetration pathways of topically applied substances through the skin play an important role in dermatological science. Recently, the hair follicles have increasingly been recognized as an important pathway for percutaneous penetration, although the role of the follicles has still not been clarified in detail. Therefore, the aim of the present study was to develop an in vivo method for the analysis of the follicular rate of penetration processes. In order to reach this goal, the follicles were excluded from the penetration process of topically applied substances. Different study designs were evaluated, and we were able to show that the application of nail varnish to each follicular orifice represents an effective method of blocking the follicles selectively against the penetration of topically applied substances. In dermatological science, there is new information on the physiology of skin penetration processes, thus allowing examination of the follicular rate of penetration and improvement of the pharmacokinetics of topically applied substances.
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J Lademann, A Ilgevicius, O Zurbau, H D Liess, S Schanzer, H J Weigmann, C Antoniou, R V Pelchrzim, W Sterry (2006)  Penetration studies of topically applied substances: Optical determination of the amount of stratum corneum removed by tape stripping.   J Biomed Opt 11: 5. Sep/Oct  
Abstract: Tape stripping is a standard measuring method for the investigation of the dermatopharmacokinetics of topically applied substances using adhesive films. These tape strips are successively applied and removed from the skin after application and penetration of topically applied substances. Thus, layers of corneocytes and some amount of topical applied substances are removed. The amount of substances and the amount of stratum corneum removed with a single tape strip has to be determined for the calculation of the penetration profile. The topically applied substances removed from the skin can be determined by classical analytical methods like high-pressure liquid chromatography, mass spectroscopy, and spectroscopic measurements. The amount of corneocytes on the tape strips can be easily detected by their pseudoabsorption. In the present paper, an easy and cheap corneocyte density analyzer is presented that is based on a slide projector. Comparing the results of the measurements obtained by the corneocyte density analyzer and by uv-visible spectrometry, identical results were obtained.
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Alexa Teichmann, Marc Pissavini, Louis Ferrero, Adeline Dehais, Leonhard Zastrow, Heike Richter, Jürgen Lademann (2006)  Investigation of the homogeneity of the distribution of sunscreen formulations on the human skin: characterization and comparison of two different methods.   J Biomed Opt 11: 6. Nov/Dec  
Abstract: The efficacy of sun protection, mostly realized by the application of sunscreen formulations, is commonly described by the sun protection factor (SPF). Previous investigations have shown that the efficacy of the sun protection inter alia depends on the homogeneity of the distribution of the topically applied sunscreen formulation on the human skin. Therefore, suitable methods are required to determine the homogeneity of topically applied substances on the skin surface. This study provides and compares two different methods, which enable this determination. Laser scanning microscopy allows the analysis of tape strips removed from skin treated with a sunscreen. These reflect the inhomogeneous distribution on the skin that can complementary be determined directly, utilizing a dermatological laser scanning microscope. For the second method, a chromatic confocal setup was utilized, which enables the study of the microtopography of skin replicas before and after the application of a sunscreen product. The two methods were applied for the evaluation of three different sunscreen formulations for each method. A correlation of the homogeneity of distribution with the in vivo SPF could be confirmed. Both methods are suitable to investigate the homogeneity of the tested sunscreen formulations, although they provide different advantages and disadvantages.
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Lars E Meyer, Nina Otberg, Wolfram Sterry, Juergen Lademann (2006)  In vivo confocal scanning laser microscopy: comparison of the reflectance and fluorescence mode by imaging human skin.   J Biomed Opt 11: 4. Jul/Aug  
Abstract: Optical, noninvasive methods have become efficient in vivo tools in dermatological diagnosis and research. From these promising imaging techniques, only the confocal scanning laser microscopy (CSLM) provides visualization of subsurface skin structures with resolutions similar to those of light microscopy. Skin annexes, as well as cutaneous cells from different epidermal layers, can be distinguished excellently. Currently, two forms of application have been established in dermatological practice: the reflectance mode, predominantly in the clinical field, and the fluorescence mode in dermatological research. Differences in both methods exist in the preparative protocol, in maximum imaging depth and, particularly, in the gain of contrast extraction. The reflectance mode demonstrates naturally occurring tissue components, whereas the fluorescent CSLM achieves contrast by administering fluorescence dye, representing the dynamic distribution pattern of the dye's fluorescent emission. Therefore, the reflectance and fluorescent modes highlight various skin microstructures, providing dissimilar in vivo confocal images of the skin. This permits different predications and information on the state of the tissue. We report the advantages and disadvantages of both optical imaging modes. The comparison was drawn by scanning human skin in vivo. Representative images in varying depths were obtained and analyzed; preparation procedures are shown and discussed.
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Ute Jacobi, Marco Kaiser, Wolfram Sterry, Jürgen Lademann (2006)  Kinetics of blood flow after topical application of benzyl nicotinate on different anatomic sites.   Arch Dermatol Res 298: 6. 291-300 Nov  
Abstract: Cutaneous characteristics, e.g., thickness of the SC and density of follicles, affect the penetration of topically applied substances. In the present study, the penetration of benzyl nicotinate, causing a vasodilation, was studied on three anatomic sites (forearm, forehead and calf) differing in their skin characteristics. Therefore, the blood flow of the superficial dermal plexus and that of the larger capillaries in the deeper skin layers was simultaneously measured using a laser Doppler flowmeter. In addition, the cutaneous temperature and redness were determined as a function of time. These four biological reactions were measured in turn on a skin area treated with a gel containing benzyl nicotinate and on an untreated control area. The highest basal levels were observed on the forehead. Topical application of benzyl nicotinate resulted in an increase in each biological response. Compared to the other sites, the maximal values were reached earliest on the forehead, which also showed the fastest decrease. No significant differences were obtained comparing the kinetic data of the calf with that of the forearm. The results indicate an additional contribution by the numerous vellus hair follicles of the forehead to the penetration and exposure of the drug.
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Paul J A Borm, David Robbins, Stephan Haubold, Thomas Kuhlbusch, Heinz Fissan, Ken Donaldson, Roel Schins, Vicki Stone, Wolfgang Kreyling, Jurgen Lademann, Jean Krutmann, David Warheit, Eva Oberdorster (2006)  The potential risks of nanomaterials: a review carried out for ECETOC.   Part Fibre Toxicol 3: 08  
Abstract: During the last few years, research on toxicologically relevant properties of engineered nanoparticles has increased tremendously. A number of international research projects and additional activities are ongoing in the EU and the US, nourishing the expectation that more relevant technical and toxicological data will be published. Their widespread use allows for potential exposure to engineered nanoparticles during the whole lifecycle of a variety of products. When looking at possible exposure routes for manufactured Nanoparticles, inhalation, dermal and oral exposure are the most obvious, depending on the type of product in which Nanoparticles are used. This review shows that (1) Nanoparticles can deposit in the respiratory tract after inhalation. For a number of nanoparticles, oxidative stress-related inflammatory reactions have been observed. Tumour-related effects have only been observed in rats, and might be related to overload conditions. There are also a few reports that indicate uptake of nanoparticles in the brain via the olfactory epithelium. Nanoparticle translocation into the systemic circulation may occur after inhalation but conflicting evidence is present on the extent of translocation. These findings urge the need for additional studies to further elucidate these findings and to characterize the physiological impact. (2) There is currently little evidence from skin penetration studies that dermal applications of metal oxide nanoparticles used in sunscreens lead to systemic exposure. However, the question has been raised whether the usual testing with healthy, intact skin will be sufficient. (3) Uptake of nanoparticles in the gastrointestinal tract after oral uptake is a known phenomenon, of which use is intentionally made in the design of food and pharmacological components. Finally, this review indicates that only few specific nanoparticles have been investigated in a limited number of test systems and extrapolation of this data to other materials is not possible. Air pollution studies have generated indirect evidence for the role of combustion derived nanoparticles (CDNP) in driving adverse health effects in susceptible groups. Experimental studies with some bulk nanoparticles (carbon black, titanium dioxide, iron oxides) that have been used for decades suggest various adverse effects. However, engineered nanomaterials with new chemical and physical properties are being produced constantly and the toxicity of these is unknown. Therefore, despite the existing database on nanoparticles, no blanket statements about human toxicity can be given at this time. In addition, limited ecotoxicological data for nanomaterials precludes a systematic assessment of the impact of Nanoparticles on ecosystems.
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M Darvin, L Zastrow, W Sterry, J Lademann (2006)  Effect of supplemented and topically applied antioxidant substances on human tissue.   Skin Pharmacol Physiol 19: 5. 238-247 06  
Abstract: Systemic and topical application of antioxidant substances for the medical treatment and prophylaxis of many diseases as well as additional protection of the skin against the destructive action of free radicals and other reactive species has become very popular during the past years. Stimulated by the positive results of a fruit and vegetable diet in supporting medical treatment and in cosmetics, artificial and extracted antioxidant substances have been broadly applied. Surprisingly, not only positive but also strong negative results have been obtained by different authors. According to study reports artificial and extracted antioxidant substances support different kinds of medical therapies, if they are applied in mixtures of different compounds at low concentration levels. In the case of the application of high concentration of some single compounds, side effects were often observed. Regarding skin treatment by systemically applied antioxidant substances for cosmetic purposes, positive cosmetic effects as well as no effects, but almost no side effects, apart from a number of allergic reactions, were reported. One reason for this seems to be the lower concentration of systemically applied antioxidant substances in comparison with a medical application. Topical application of antioxidant substances is closely related to cosmetic treatment for skin protection and anti-aging. Positive results were also obtained in this case. The present review is an attempt to classify and summarize the published literature concerning the efficiency of action of systemic and topical applications of antioxidant substances, such as carotenoids and vitamins, on human organism and especially on the skin. The available literature on this topic is very extensive and the results are often contradictory. Nevertheless, there are some clear tendencies concerning systemic and topical application of antioxidant substances in medicine and cosmetics, and we summarize them in the present paper.
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A Teichmann, M Ossadnik, H Richter, W Sterry, J Lademann (2006)  Semiquantitative determination of the penetration of a fluorescent hydrogel formulation into the hair follicle with and without follicular closure by microparticles by means of differential stripping.   Skin Pharmacol Physiol 19: 2. 101-105 05  
Abstract: Recently, hair follicles were shown to be of great importance concerning the penetration and reservoir behavior of topically applied substances. Especially microparticles are known to be efficient drug carriers into the hair follicles. It has been shown in various investigations that, depending on their size, microparticles can be utilized to enhance the penetration of substances into the hair follicles. In the present study, it was investigated whether they could also be used to block the hair follicles to stop penetration. For this purpose, the follicular penetration of a sodium fluorescein-containing hydrogel and follicular reservoir depletion were investigated by means of differential stripping in vivo. In a second study design, the skin areas were pretreated with microparticles 5 microm in diameter. Subsequently, the follicular penetration of sodium fluorescein-containing hydrogel was likewise investigated by differential stripping. The results showed that the hair follicle infundibula contained a significant fluorescent signal when sodium fluorescein in hydrogel was applied. In contrast, in the case of pretreatment with microparticles, only a very low fluorescence signal was measurable in the hair follicle infundibula. The microparticles clearly blocked the follicular orifices so that a penetration of sodium fluorescein was almost completely inhibited. This was confirmed by histological investigations. Thus, depending on their size, microparticles act as efficient drug carriers or can be utilized as follicle blockers to stop the penetration of topically applied substances. This could be very useful in skin protection to prevent the storage of harmful topically applied substances in the hair follicles, known to represent long-term reservoirs.
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2005
U Jacobi, H - J Weigmann, J Ulrich, W Sterry, J Lademann (2005)  Estimation of the relative stratum corneum amount removed by tape stripping.   Skin Res Technol 11: 2. 91-96 May  
Abstract: BACKGROUND/PURPOSE: The tape stripping procedure is a suitable minimal invasive tool to study, e.g. the penetration and dermatopharmacokinetics of topically applied substances. In the present study, this procedure was used to remove the stratum corneum (SC) completely and to study the penetration of the UVA filter substance butyl methoxydibenzoylmethane after application in two different vehicles. METHODS: The amount of corneocytes removed by each tape strip from the flexor forearm of human volunteers was determined via their pseudo-absorption. In a second part, the penetration profiles of a UVA filter substance applied in two different vehicles were determined following the developed standard protocol using the tape stripping procedure in combination with UV/VIS spectroscopy. RESULTS: The amount of corneocytes removed by each tape strip was related to the number of tape strips used for removal. Mean values with a deviation of less than 20% concerning the relative amount of SC removed by a constant number of tape strips were obtained. For instance, a relative amount of 66 +/- 12% was removed with the first 20 tape strips, while nearly the complete SC (95 +/- 3%) was removed using 50 tape strips. In addition, these results were used to estimate the relative SC amounts removed, studying the penetration of the UVA filter substance after application in two different vehicles. No significant differences between the distributions of the UV filter substance applied in both emulsions were obtained (P > 0.05). CONCLUSIONS: The reported procedure for the estimation of the removed SC amount provides the possibility to avoid the complete removal of the SC and to compare the penetration characteristics obtained for different volunteers and different products in relation to the relative horny layer profile.
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J Lademann, S Schanzer, U Jacobi, H Schaefer, F Pflücker, H Driller, J Beck, M Meinke, A Roggan, W Sterry (2005)  Synergy effects between organic and inorganic UV filters in sunscreens.   J Biomed Opt 10: 1. Jan/Feb  
Abstract: The influence of the synergy effects between organic and inorganic UV filter substances on the sun protection factor (SPF) of topically applied sunscreen formulations is investigated. The medium is considered to have reflection, absorption, and scattering properties. The distribution of photons in this medium is investigated by Monte Carlo calculation. Typical optical parameters of the skin and substances are used to characterize the synergy effect. The results of the model calculation are checked by in vitro and in vivo measurements investigating the influence of different types of scattering microparticles on the absorption efficacy of topically applied formulations. It is found that the inorganic filter substances act as scattering microparticles in the upper skin layers. They increase the optical pathway of the photons in the topically applied absorbing formulation also localized there. In this way, more photons are absorbed, increasing the SPF. The results obtained are important for the optimization of the SPF of sunscreen formulation containing organic and inorganic UV-filter components.
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Hans-Jürgen Weigmann, Ute Jacobi, Christina Antoniou, George N Tsikrikas, Volker Wendel, Claudius Rapp, Heiner Gers-Barlag, Wolfram Sterry, Jürgen Lademann (2005)  Determination of penetration profiles of topically applied substances by means of tape stripping and optical spectroscopy: UV filter substance in sunscreens.   J Biomed Opt 10: 1. Jan/Feb  
Abstract: Penetration profiles of topically applied drugs and cosmetic products provide important information on their efficacy. The application of tape stripping in combination with UV/VIS spectroscopy is checked to determine the local position of topically applied substances inside the stratum corneum, the penetration profile. The amount of corneocytes removed with each tape strip is quantified via the particle-dependent absorption, the pseudoabsorption, in the visible spectral range. The concentration of a typical UV filter substance, 4-methylbenzylidene camphor, is determined by optical spectroscopy using the tape strips removed originally. In this case, a time-dependent increase in the absorbance must be taken into account. Laser scanning microscopic investigations confirm that the nonhomogeneous distribution of the filter substance, on the strips, can explain this spectroscopic behavior. When reaching a homogeneous distribution, the UV spectroscopic signal reflects the correct concentration. These spectroscopic values are compared with high performance liquid chromatography (HPLC) data. The values obtained with both methods for the concentrations of 4-methylbenzylidene camphor are in good agreement. The data obtained are used to illustrate the determination of a penetration profile of a UV filter substance. The results demonstrate that the described protocol is well suited to characterize, in a simple manner, topically applied substances that have a characteristic UV/VIS absorption band.
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U Jacobi, H Taube, U F Schäfer, W Sterry, J Lademann (2005)  Comparison of four different in vitro systems to study the reservoir capacity of the stratum corneum.   J Control Release 103: 1. 61-71 Mar  
Abstract: Four in vitro test systems were used to study the reservoir capacity of porcine stratum corneum (SC) for flufenamic acid and its drainage via penetration into the deeper skin layers: Franz diffusion cell using full thickness skin and split skin of 300 mum; Saarbruecken penetration model (SB) and intact porcine tissue (IP). Each skin sample was segmented 1, 4 and 21 h after application of an 'infinite dose' of flufenamic acid. The lipophilic drug was extracted from the SC and the deeper skin layers (viable epidermis and dermis) and determined using high-performance liquid chromatography (HPLC). For each test system, an increase in the drug amount in the deeper skin layers and the acceptor fluid, respectively, was observed in combination with a decreased amount in the SC with increasing time after application. The drainage of the SC reservoir was only reflected by a linear correlation of the drug amount in the SC with the amount in the deeper skin layers in the case of IP. The absolute drug concentrations previously detected in human skin in vivo and in vitro were compared with the present data, affording the best accordance in the case of IP.
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U Jacobi, R Toll, H Audring, W Sterry, J Lademann (2005)  The porcine snout--an in vitro model for human lips?   Exp Dermatol 14: 2. 96-102 Feb  
Abstract: The morphology and histology of test sites commonly used to study the penetration of lip products differ significantly from those of the human lip itself. The aim of this study was to investigate whether the porcine snout could serve as an equivalent in vitro model for human lips. The lips of human test subjects and biopsies of porcine snout tissue were compared using histological and microscopic techniques. Using a dermatological laser scanning microscope, the penetration of topically applied fluorescent sodium fluorescein was investigated in vivo on human lips and in vitro on the porcine snout. Biopsies from the in vitro experiments were studied using fluorescence microscopy. Some parts of the porcine snout show a similar morphology and histology as human lips. The stratum corneum (SC) and the epidermis of the porcine snout are thicker than those of human tissue. Both in vivo and in vitro, the topically applied fluorescent dye was detected only on the skin surface and within the uppermost SC layer. These results indicate that porcine snout can be used as an in vitro model for human lips in penetration studies. Both human and porcine tissues exhibit an efficient barrier against the penetration of topically applied substances.
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U Jacobi, M Kaiser, H Richter, H Audring, W Sterry, J Lademann (2005)  The number of stratum corneum cell layers correlates with the pseudo-absorption of the corneocytes.   Skin Pharmacol Physiol 18: 4. 175-179 Jul/Aug  
Abstract: The removal of the stratum corneum (SC) using adhesive tapes is a common technique in cutaneous studies. The determination of the varying amounts of the SC removed would be a helpful tool in such investigations. In the present study, the cell layers of porcine SC were counted before and after removal of several tape strips using histological techniques. In addition, the pseudo-absorption of the corneocytes reflecting the amount of these cells was determined using spectroscopy. Different amounts of SC were removed using 20 tape strips. The spectroscopically determined data correlate linearly with the number of removed cell layers. Based on these results, the pseudo-absorption of the corneocytes can be used to calculate the absolute number of cell layers removed with a standard deviation of less than 11%. In this way, the SC can be quantified using the procedure of tape stripping in combination with the spectroscopic determination of the corneocytes.
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H Kamp, H - J Tietz, M Lutz, H Piazena, P Sowyrda, J Lademann, U Blume-Peytavi (2005)  Antifungal effect of 5-aminolevulinic acid PDT in Trichophyton rubrum.   Mycoses 48: 2. 101-107 Mar  
Abstract: In the present investigation, we have shown for the first time that the onychomycosis-inducing dermatophyte Trichophyton rubrum was able to metabolize 5-aminolevulinic acid (ALA) to protoporphyrin IX (PpIX) in liquid culture medium. We have established and optimized the culture conditions and could show the typical PpIX-induced red fluorescence which was evaluated qualitatively by Wood's light examination and fluorescent microscopic analysis. The optimum concentration of ALA was in the range of 1-10 mmol l(-1). If used in higher concentrations, ALA leads to a significantly reduced growth rate and absence of PpIX formation due to highly acidic conditions. The first observation of red fluorescence was detected between 10 and 14 days poststimulation with ALA, increasing thereafter. Fluorescent microscopic examinations demonstrated that formation of PpIX was restricted to selected parts of the fungal mycelium. Repeated application of ALA in order to achieve the highest formation of PpIX in T. rubrum failed, probably due to the sustained low pH values. ALA treatment and irradiation of T. rubrum clearly demonstrated the growth-inhibiting effect of ALA PDT, either leading to reduced numbers of colonies or reduced diameters of single fungal colonies. Summarizing our results, ALA PDT might be a promising approach in the reduction of T. rubrum colonization in onychomycosis.
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A Teichmann, U Jacobi, H - J Weigmann, W Sterry, J Lademann (2005)  Reservoir function of the stratum corneum: development of an in vivo method to quantitatively determine the stratum corneum reservoir for topically applied substances.   Skin Pharmacol Physiol 18: 2. 75-80 Mar/Apr  
Abstract: Investigations on the stratum corneum (SC) reservoir for topically applied substances are of importance in dermatologic science in order to assess the pharmacokinetics of these substances. In the present study, an in vivo method was developed to determine the SC reservoir quantitatively and to investigate the temporal behavior of this reservoir. Therefore, increasing amounts of an oil-in-water emulsion (o/w emulsion) containing 4% of a chemical UV filter were topically applied onto the flexor forearms of 5 healthy volunteers. The saturation of the SC reservoir was determined utilizing the tape stripping technique 1 and 6 h after application. The capacity of the SC reservoir for the o/w emulsion was found to be approximately 2.7 mg/cm(2). Furthermore, a correlation of the capacity of the SC with transepidermal water loss was observed. Extending the time between the topical application and SC removal did not affect the distribution or the recovery rate of the UV filter in the SC. The results indicate that the reservoir of the SC is limited. This is reflected by the saturation level, which depends on the individual volunteer and, presumably, the topically applied substances and formulations used. The results show that the method developed is suited to quantitatively determine in vivo the SC reservoir for topically applied substances.
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Ute Jacobi, Jens Bartoll, Wolfram Sterry, Jürgen Lademann (2005)  Orally administered ethanol: transepidermal pathways and effects on the human skin barrier.   Arch Dermatol Res 296: 7. 332-338 Jan  
Abstract: Ethanol intake is associated with a variety of skin diseases. The aim of the present study was (1) to identify the pathways of release of orally administered ethanol through the skin, and (2) to investigate the effects of a single oral dose of ethanol on the penetration of topically applied substances into the skin. Ethanol evaporation via the skin was measured using the new technique of ion mobility spectrometry (IMS). Transepidermal water loss (TEWL) and skin surface temperature were simultaneously measured before and after ethanol consumption. Measurements were performed on skin sites with different stratum corneum (SC) thickness, and density of follicles and sweat glands. These appendages were selectively sealed to investigate their participation in ethanol evaporation. The penetration of a topically applied UV filter substance was studied before and after ethanol consumption after removing the SC with adhesive tape. Ethanol evaporation was measured within 5 min of consumption, while the skin surface temperature remained nearly constant. The sealing of the appendages did not have a significant effect on ethanol evaporation. On the forehead, a higher TEWL value was measured than on the forearm. On both skin sites, an increase in TEWL was observed after ethanol ingestion. No influence of orally administered ethanol on the penetration of the topically applied UV filter substance was observed. The results indicate that ethanol evaporation occurs via the lipid layers without a significant effect on the penetration of the topically applied substance.
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H - J Weigmann, J Ulrich, S Schanzer, U Jacobi, H Schaefer, W Sterry, J Lademann (2005)  Comparison of transepidermal water loss and spectroscopic absorbance to quantify changes of the stratum corneum after tape stripping.   Skin Pharmacol Physiol 18: 4. 180-185 Jul/Aug  
Abstract: The objective and quantitative application of tape stripping in pharmaceutics and dermatopharmacokinetics requires the determination of the exact position of each removed tape strip inside the stratum corneum (SC) and/or the determination of the relative SC thickness. In this study, transepidermal water loss (TEWL) and the optical spectroscopic data of the corneocytes were measured simultaneously during the complete removal of the SC by tape stripping. The spectroscopic data quantitatively reflect the amount of corneocytes removed by the individual tape strips, whereas TEWL and 1/TEWL are not sensitive enough to measure the relatively small changes in the SC thickness realized by the removal of the individual strips. The relative SC thickness can be determined directly by the spectroscopic data, while the 1/TEWL values require a second independent method. The results demonstrate the importance of tape stripping characterizing the behaviour of topically applied substances.
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Annika Vogt, Nathalie Mandt, Juergen Lademann, Hans Schaefer, Ulrike Blume-Peytavi (2005)  Follicular targeting--a promising tool in selective dermatotherapy.   J Investig Dermatol Symp Proc 10: 3. 252-255 Dec  
Abstract: The penetration of topically applied compounds varies considerably in the different regions of the human body. The presence of hair follicles significantly contributes to this effect by an increase in surface area and a disruption of the epidermal barrier towards the lower parts of the hair follicle. The human hair follicle, hereby, serves not only as a reservoir, but also as a major entry point for topically applied compounds. Topical delivery of active compounds to specific targets within the skin may help reduce side-effects caused by unspecific reactions, and may help develop new strategies in the prevention and treatment of skin diseases. Various drug carrier and drug delivery systems are currently being investigated. The aim of these investigational efforts is to direct topically applied compounds to the different types of hair follicles and, ideally, to specific compartments and cell populations within the hair follicles. Follicular targeting offers opportunities for new developments, not only in hair therapy and in the treatment of hair follicle associated diseases but also in gene therapy and immunotherapy.
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Jürgen Lademann, Nina Otberg, Ute Jacobi, Robert M Hoffman, Ulrike Blume-Peytavi (2005)  Follicular penetration and targeting.   J Investig Dermatol Symp Proc 10: 3. 301-303 Dec  
Abstract: In the past, intercellular penetration was assumed to be the most important penetration pathway of topically applied substances. First hints that follicular penetration needs to be taken into consideration were confirmed by recent investigations, presented during the workshop "Follicular Penetration and Targeting" at the 4th Intercontinental Meeting of Hair Research Societies", in Berlin 2004. Hair follicles represent an efficient reservoir for the penetration of topically applied substances with subsequent targeting of distinct cell populations, e.g., nestin-expressing follicular bulge cells. The volume of this reservoir can be determined by differential stripping technology. The follicular penetration processes are significantly influenced by the state of the follicular infundibulum; recent experimental investigations could demonstrate that it is essential to distinguish between open and closed hair follicles. Topically applied substances can only penetrate into open hair follicle. Knowledge of follicular penetration is of high clinical relevance for functional targeting of distinct follicular regions. Human hair follicles show a hair-cycle-dependent variation of the dense neuronal and vascular network. Moreover, during hair follicle cycling with initiation of anagen, newly formed vessels occur. Thus, the potential of nestin-expressing hair follicle stem cells to form neurons and blood vessels was investigated.
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Alexey P Popov, Jürgen Lademann, Alexander V Priezzhev, Risto Myllylä (2005)  Effect of size of TiO2 nanoparticles embedded into stratum corneum on ultraviolet-A and ultraviolet-B sun-blocking properties of the skin.   J Biomed Opt 10: 6. Nov/Dec  
Abstract: Recently there has been a strong demand to protect human skin against negative effects of the UV solar light. This problem is interesting due to the increased frequency of human diseases caused by such radiation. We aim to evaluate how the optical properties of the horny layer of skin can be effectively changed by imbedding TiO2 fine particles to achieve the maximal attenuation of the UV solar radiation. In-depth distribution of TiO2 particles embedded into the skin by multiple administration of sunscreens is determined experimentally using the tape-stripping technique. A computer code implementing the Monte Carlo method is developed to simulate photon migration within the 20-microm-thick horny layer filled with nanosized TiO2 spheres, 25 to 200 nm in diameter. Dependencies of the UV radiation of two wavelengths (310 and 400 nm) absorbed by and totally reflected from, as well as transmitted through the horny layer on the size of TiO2 particles are obtained and analyzed. The most attenuating particles are found to be 62 and 122 nm in diameter for 310- and 400-nm light, respectively. The former could be suggested as the main fraction to be used in sunscreens to prevent erythema.
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Ute Jacobi, Julien Gautier, Wolfram Sterry, Jürgen Lademann (2005)  Gender-related differences in the physiology of the stratum corneum.   Dermatology 211: 4. 312-317  
Abstract: BACKGROUND: Only few studies on gender-related differences in skin physiology have been performed--and they provided conflicting results. OBJECTIVE: In the present study, the effect of gender on the physiology of the stratum corneum was studied. METHODS: The physiological parameters transepidermal water loss, pH value, hydration and sebum content were determined on the flexor forearms of 6 female and 6 male volunteers. In addition, stratum corneum samples, removed by tape stripping, were studied for amount, spectroscopic properties, protein content, and mass. RESULTS: The skin of women was characterized by a significantly higher pH value (5.6 +/- 0.4) than that of men (4.3 +/- 0.4, p < 0.05). Protein absorption was the only other parameter significantly dependent on gender (p < 0.05). Both effects might be caused by differences in human biology, such as hormonal status. CONCLUSION: Therefore, the gender of the volunteers should be considered in dermatologic studies.
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Juergen Lademann, Hans-Juergen Weigmann, Sabine Schanzer, Heike Richter, Heike Audring, Christina Antoniou, George Tsikrikas, Heiner Gers-Barlag, Wolfram Sterry (2005)  Optical investigations to avoid the disturbing influences of furrows and wrinkles quantifying penetration of drugs and cosmetics into the skin by tape stripping.   J Biomed Opt 10: 5. Sep/Oct  
Abstract: Furrows and wrinkles, as typical structures of human skin, represent a reservoir for topically applied substances. This reservoir can influence penetration experiments of topically applied substances into the stratum corneum by tape stripping. Optical methods such as laser-scanning microscopy, optical coherent tomography, and the microscopical investigation of histological sections obtained by biopsies were used to check a special protocol, which avoids these potential disturbances. The use of a transparent adhesive film with high flexibility and the realization of an intense contact to the stretched skin by pressing the tape with a roll, moved laterally on the tape, are the prerequisites to obtain correct data. The application of this experimental technique and the performance of tape stripping allow the determination of the horny layer profile and the local distribution of topically applied substance, undisturbed by the characteristic structure of the natural skin. These results demonstrate that the presented tape stripping procedure is a valuable tool to determine, quantitatively, the penetration and the bioavailability of drugs and cosmetics inside the human stratum corneum, in relation to the horny layer profile.
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Alexa Teichmann, Ute Jacobi, Michael Ossadnik, Heike Richter, Stefan Koch, Wolfram Sterry, Jürgen Lademann (2005)  Differential stripping: determination of the amount of topically applied substances penetrated into the hair follicles.   J Invest Dermatol 125: 2. 264-269 Aug  
Abstract: The determination of penetration pathways of topically applied substances into the skin is the subject of several investigations. Recently, follicular penetration has become a major focus of interest. To date, a direct, non-invasive quantification of the amount of topically applied substance penetrated into the follicles had not been possible. The development of such a method was the aim of this study. Therefore, the advantages of both stripping techniques, tape stripping and cyanoacrylate skin surface biopsy, were combined and evaluated. Tape stripping was used to remove the part of the stratum corneum that contained the topically applied dye. Subsequently, the follicular contents were ripped off by cyanoacrylate skin surface biopsy. The combined method termed "differential stripping" was evaluated in vitro and in vivo, and the amount of topically applied fluorescent dye penetrated into the hair follicles was quantified after different penetration times. After 30 min, 5% of the recovered concentration of sodium fluorescein was found in the follicular infundibula, where it was still detectable after 48 h. Altogether, the results of this investigation revealed that differential stripping is a new method that can be used to study the penetration of topically applied substances into the follicular infundibula non-invasively and selectively.
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2004
Ute Jacobi, Mai Chen, Gottfried Frankowski, Ronald Sinkgraven, Martina Hund, Berthold Rzany, Wolfram Sterry, Jürgen Lademann (2004)  In vivo determination of skin surface topography using an optical 3D device.   Skin Res Technol 10: 4. 207-214 Nov  
Abstract: BACKGROUND/PURPOSE: Topography of the skin surface is a mirror of the functional skin status. Therefore, its evaluation is of great interest for dermatological research. In the present study, a new optical measuring system was applied to evaluate human skin surface topography in vivo and non-invasively, in order to determine elastotic and mimic wrinkles dependent on age, body site and therapy. METHODS: The measurements were performed on the back (n=5), the flexor forearm (n=14) of volunteers in different age groups and on the face of women (n=4) participating in an anti-wrinkle study. The evaluation of the three-dimensional-profiles was performed determining skin surface parameters (mean roughness (R(a)), mean depth of roughness (R(z)), maximum roughness (R(m)) and waviness (W(t))) and applying Fourier analysis. RESULTS: Significant increases in all surface parameters were obtained on the forearms with increasing age. Differences between the surface topographies of forearm and back were only expressed by the waviness and the Fourier analysis. The treatment with botulinum Toxin A led to a diminution of mimic wrinkles as reflected by the furrow profiles. CONCLUSIONS: The results show a significant dependence of the skin surface topography on the age of the volunteer and the body site measured. Particularly the waviness, the Fourier analysis and the furrow profiles reflect such dependencies. The system used also fulfils the requirements for the testing of therapies, as was demonstrated by the reduction of mimic wrinkles after treatment with botulinum Toxin A.
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R Toll, U Jacobi, H Richter, J Lademann, H Schaefer, U Blume-Peytavi (2004)  Penetration profile of microspheres in follicular targeting of terminal hair follicles.   J Invest Dermatol 123: 1. 168-176 Jul  
Abstract: The transfollicular administration of pharmacologically active molecules is of current therapeutic interest, mainly with regard to delivery to specific sites of the hair follicle (HF) and the reduction of hepatic metabolism and systemic toxicity. HF are privileged pathways for specific molecules depending on formulations, which enter faster into these shunts than through the stratum corneum. The aim was to optimize the delivery of fluorescent microspheres into the HF, thereby, developing a standardized protocol for follicular targeting with microspheres. The number of HF showing penetration, as well as the depth of penetration, was determined. Freshly excised skin samples with terminal HF were divided into groups, with or without prior treatment with cyanoacrylate skin surface stripping-technique (CSSS). Thereafter microspheres at a size of 0.75-6.0 microm were applied according to the developed standardized protocol. Skin biopsies were obtained, shock-frozen, and sectioned in 5 microm slices. We demonstrated a selective penetration route of the microspheres into the HF. Optimal microsphere size proved to be approximately 1.5 microm, with a 55% rate of all HF, and with a maximum penetration depth of >2300 microm. Without previous CSSS treatment of the skin, the transfollicular microsphere penetration was below 27% with a maximum penetration depth of 1000 microm. Thus, the basis for follicular targeting of essential structures containing stem cells for keratinocytes, melanocytes, and mast cells has been laid.
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U Jacobi, H - J Weigmann, M Baumann, A - I Reiche, W Sterry, J Lademann (2004)  Lateral spreading of topically applied UV filter substances investigated by tape stripping.   Skin Pharmacol Physiol 17: 1. 17-22 Jan/Feb  
Abstract: The lateral spreading of topically applied substances is a competitive process to the penetration into the stratum corneum (SC). The penetration of topically applied UV filter substances into the human SC and the lateral spreading were investigated in vivo. Tape stripping in combination with spectroscopic measurements was used to study both processes of two UV filter substances. The concentration of both UV filters was determined inside and outside the application area by varying the application and tape stripping protocol. A spreading of the topically applied substances from the treated to the untreated areas was observed, which caused a concentration gradient. This lateral spreading depends on the time between application and tape stripping and the size of the treated skin area. Significant amounts of topically applied substances were found adjoining the application area, due to the lateral spreading which takes place on the skin surface. In general, the lateral spreading must be considered to be a competitive process when studying penetration processes of topically applied substances. It has to be considered during drug treatment of small limited skin areas and for the interpretation of recovery rates obtained in penetration studies.
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J Lademann, H Schaefer, N Otberg, A Teichmann, U Blume-Peytavi, W Sterry (2004)  Penetration of microparticles into human skin   Hautarzt 55: 12. 1117-1119 Dec  
Abstract: The efficacy of the penetration of microparticles into the human skin depends on the size and the type of the formulation with which they are topically applied. Microparticles with a diameter of >1 microm barely penetrate into the human skin. They are located on the skin surface and form a film which, for instance, can be used for camouflage or protection against UV radiation in sunscreens. While the penetration of the microparticles in the lipid layers of the stratum corneum is limited, they penetrate efficiently into the hair follicles up to a depth >2 mm, providing their diameter is <1.5 microm. Thus, microparticles can be used for drug delivery into the hair follicles.
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Igor V Ermakov, Maia R Ermakova, Werner Gellermann, Jürgen Lademann (2004)  Noninvasive selective detection of lycopene and beta-carotene in human skin using Raman spectroscopy.   J Biomed Opt 9: 2. 332-338 Mar/Apr  
Abstract: The predominant long-chain carotenoids found in human skin are lycopene and beta-carotene. They are powerful antioxidants and thought to act as scavengers for free radicals and singlet oxygen formed by normal metabolism as well as excessive exposure of skin to sunlight. The specific importance of the particular representatives of the carotenoid antioxidants regarding skin defense mechanisms is of strong current interest. We demonstrate fast and noninvasive detection of beta-carotene and lycopene concentrations in living human skin using Raman detection of the molecules' carbon-carbon double bond stretch vibrations. Employing excitation with suitable blue and green laser lines, and taking advantage of differing Raman cross sectional profiles for beta-carotene and lycopene, we determine the relative concentration of each carotenoid species. This novel technique permits the quantitative assessment of individual long-chain carotenoid species rather than their composite level in human skin. The obtained results reveal significant differences in the carotenoid composition of the subjects' skin and show that the ratio between beta-carotene and lycopene concentration can vary from 0.5 to 1.6. The technique holds promise as a method for rapid screening of carotenoid compositions in human skin in large populations and should be suitable for clinical studies correlating carotenoid status with risk for cutaneous diseases.
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Nina Otberg, Heike Richter, Hans Schaefer, Ulrike Blume-Peytavi, Wolfram Sterry, Jürgen Lademann (2004)  Variations of hair follicle size and distribution in different body sites.   J Invest Dermatol 122: 1. 14-19 Jan  
Abstract: For the evaluation and quantification of follicular penetration processes, the knowledge of variations of hair follicle parameters in different body sites is basic. Characteristics of follicle sizes and potential follicular reservoir were determined in cyanoacrylate skin surface biopsies, taken from seven different skin areas (lateral forehead, back, thorax, upper arm, forearm, thigh, and calf region). The highest hair follicle density and percentage of follicular orifices on the skin surface and infundibular surface were found on the forehead, whereas the highest average size of the follicular orifices was measured in the calf region. The highest infundibular volume and therefore a potential follicular reservoir was calculated for the forehead and for the calf region, although the calf region showed the lowest hair follicle density. The calculated follicular volume of these two skin areas was as high as the estimated reservoir of the stratum corneum. The lowest values for every other parameter were found on the forearm. The present investigation clearly contradicts former hypothesis that the amount of appendages of the total skin surface represents not more than 0.1%. Every body region disposes its own hair follicle characteristics, which, in the future, should lead us to a differential evaluation of skin penetration processes and a completely different understanding of penetration of topically applied drugs and cosmetics.
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Ragna v Pelchrzim, Hans-Jürgen Weigmann, Hans Schaefer, Timo Hagemeister, Michael Linscheid, Vinod P Shah, Wolfram Sterry, Jurgen Lademann (2004)  Determination of the formation of the stratum corneum reservoir for two different corticosteroid formulations using tape stripping combined with UV/VIS spectroscopy.   J Dtsch Dermatol Ges 2: 11. 914-919 Nov  
Abstract: BACKGROUND: The stratum corneum, the outermost layer of the skin, not only represents a barrier, but also a reservoir for topically applied substances. Both properties influence the penetration process, as does the vehicle. It determines the penetration pathway and the retention time of the topically applied substances. METHODS: Two commercial products (Temovate Cream and Temovate Emollient), both containing 0.05% clobetasol propionate, were applied on the inner forearms of healthy volunteers. 20 tape strips were removed from each treated skin area. The horny layer profile was determined measuring the absorption of the corneocytes at 430 nm. The concentration of clobetasol propionate on the individual tapes was then analyzed. RESULTS: We found differences in the reservoir formation depending on the formulation applied, which correlated to the biological response in the form of a blanching effect. CONCLUSIONS: The method applied is well-suited to determine the reservoir formation in the stratum corneum for topically applied substances.
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J Lademann, S Schanzer, H Richter, R V Pelchrzim, L Zastrow, K Golz, W Sterry (2004)  Sunscreen application at the beach.   J Cosmet Dermatol 3: 2. 62-68 Apr  
Abstract: BACKGROUND: The sun protection factor (SPF) of sunscreens is determined after application of a standard amount. The European Cosmetic Toiletry and Perfumery Association (COLIPA) standard amount is 2 mg/cm(2). Real-life application of sunscreen is probably less than this. AIM: To determine the amount of sunscreen present on the skin of people at the beach. METHODS: Volunteers at the beach were selected randomly and were not aware of being tested for the adequacy of their sunscreen application. All volunteers had applied sunscreen. Application had been more than 30 min before testing (sometimes up to 4 h earlier). The amounts of sunscreen applied to different body sites were determined quantitatively by tape stripping. Actual amounts of sunscreen applied were compared with the COLIPA standard. Also, sunscreen containing a fluorescent dye was applied to the skin of volunteers in a laboratory setting. The distribution of sunscreen application was visualized by UVA photography in a darkened room. RESULTS: Sixty volunteers, 33 males and 27 females, aged 17-68 years (median 32 years), were recruited at the beach. Sunscreen coverage was inadequate at all body sites. Coverage at various body sites differed greatly. Most volunteers had applied 10% or less of the COLIPA standard amount to all body sites assessed. The best protected areas were the upper arm and décolleté but, even in these areas, most volunteers had only applied 10% of the COLIPA standard amount. The worst protected areas were the ears and top of the feet. The back was typically badly protected if treated by the volunteers themselves. The back was better protected if another person had applied the sunscreen. In the laboratory, the fluorescent dye-containing sunscreen showed the same pattern of sunscreen application as at the beach. CONCLUSIONS: In real life, at the beach, very little sunscreen remains present on the skin.
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Jürgen Lademann, Andreas Rudolph, Ute Jacobi, Hans-Jürgen Weigmann, Hans Schaefer, Wolfram Sterry, Martina Meinke (2004)  Influence of nonhomogeneous distribution of topically applied UV filters on sun protection factors.   J Biomed Opt 9: 6. 1358-1362 Nov/Dec  
Abstract: The aim of the present study is the development of a method to determine quantitatively in vivo the influence of homogeneity of the distribution of sunscreen containing UV filters on the sun protection factor (SPF). The SPF of a sunscreen applied either topically or inside an optical cell (pure or in a solvent) fixed above the skin is determined in vivo. In both cases, in vivo measurements using the erythema formation are carried out. Identical optical parameters of the skin are realized in both experiments. In addition, both in vitro (using tape stripping) and in vivo microscopic measurements are performed to analyze the homogeneity of distribution of the topically applied substances. An SPF of 8 is measured in the experiment applying the UV filters topically, whereas this value increases by a factor of 10 if the same amount of filter substances is distributed homogeneously in solution inside the optical cell. Tape strips removed from skin treated with the sunscreen reflect the inhomogeneous distribution of the topically applied substances on the skin. The direct correlation of homogeneity of distribution with the SPF opens up the possibility to increase the SPF by optimizing the formulation.
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2003
H - J Weigmann, U Lindemann, C Antoniou, G N Tsikrikas, A I Stratigos, A Katsambas, W Sterry, J Lademann (2003)  UV/VIS absorbance allows rapid, accurate, and reproducible mass determination of corneocytes removed by tape stripping.   Skin Pharmacol Appl Skin Physiol 16: 4. 217-227 Jul/Aug  
Abstract: The accurate determination of the mass of the horny layer removed by tape stripping is a decisive prerequisite for the application of this technique in penetration studies. A novel method using optical spectroscopy to determine the amount of stratum corneum (SC) is presented. We could show that the absorbance measured in the visible spectral range accurately reflects the mass of the SC fixed on individual tapes. Furthermore, absorbance measurement allows determination of the absolute mass of corneocyte aggregates on the removed tape strips. Topically applied substances do not disturb the spectroscopic measurements in contrast to the conventionally employed weight determination. Identical results were obtained when performing spectroscopic horny layer quantification independently in two separate institutions. Taken together, this new method is rapid, sensitive, reproducible, and accurate. We anticipate a wide application in penetration studies as well as in dermatopharmacokinetics.
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J Lademann, N Otberg, H Richter, U Jacobi, H Schaefer, U Blume-Peytavi, W Sterry (2003)  Follicular penetration. An important pathway for topically applied substances   Hautarzt 54: 4. 321-323 Apr  
Abstract: The knowledge of penetration pathways in and through the skin is a prerequisite for the development and optimization of topically applied drugs and cosmetics. Skin penetration has been assumed to occur via diffusion though the lipid domains of the stratum corneum. Recent studies show that the skin appendages, especially the hair follicles, play an important role in skin penetration processes. Topically applied substances cannot enter all follicles. We discuss the reasons for the phenomenon of open and closed hair follicles.
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U Lindemann, H - J Weigmann, H Schaefer, W Sterry, J Lademann (2003)  Evaluation of the pseudo-absorption method to quantify human stratum corneum removed by tape stripping using protein absorption.   Skin Pharmacol Appl Skin Physiol 16: 4. 228-236 Jul/Aug  
Abstract: Tape stripping is a well-known method to study the barrier function of the stratum corneum (SC) and penetration processes of topically applied substances into the horny layer. The quantification of the removed corneocytes for each tape strip is the prerequisite for these studies. The pseudo-absorption of the corneocytes was proposed as a measure for the quantification of the removed corneocyte aggregates. In this study, the pseudo-absorption of the corneocytes in the visible range (430 nm) is compared with the protein absorption in the UV range (278 nm) and an absorption at 652 nm obtained after staining of the SC proteins with Trypan blue. Both the protein absorption and the absorption measured after staining correlate well with the pseudo-absorption measured at 430 nm (R(2) = 0.92 +/- 0.04 and R(2) = 0.95 +/- 0.04, respectively).
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Ute Jacobi, Nuschin Meykadeh, Wolfram Sterry, Jürgen Lademann (2003)  Effect of the vehicle on the amount of stratum corneum removed by tape stripping.   J Dtsch Dermatol Ges 1: 11. 884-889 Nov  
Abstract: BACKGROUND: The penetration of topically applied substances into the stratum corneum can non-invasively be studied using the tape stripping procedure. This method was applied to investigate in vivo the penetration of a fragrance, vanillin, applied in ethanol and a w/o emulsion. METHODS: Twenty tape strips were removed from each skin area treated with vanillin in ethanol or w/o emulsion, respectively. The concentration of vanillin was determined for each tape strip. In addition, the pseudo-absorption of the corneocytes was determined to calculate the SC profile. RESULTS: The vanillin concentration was correlated both with the tape number and with the stratum corneum profile. Depending on whether the tape number or the profile of the stratum corneum were correlated with the vanillin concentration, different distributions within the stratum corneum were obtained. Different amounts of stratum corneum were removed with 20 tape strips dependent on the vehicle applied previously. The application of the w/o emulsion led to the removal of nearly the half the amount of corneocytes stripped from the ethanol-treated area. CONCLUSIONS: The results obtained underline the general necessity to correlate the amount of stratum corneum with the amount of substance in penetration studies.
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Ute Lindemann, Kathrin Wilken, Hans-Jürgen Weigmann, Hans Schaefer, Wolfram Sterry, Jürgen Lademann (2003)  Quantification of the horny layer using tape stripping and microscopic techniques.   J Biomed Opt 8: 4. 601-607 Oct  
Abstract: Tape stripping is a method well suited for studying the penetration of topically applied substances into the upper part of the skin, the stratum corneum (SC). The amount of topically applied substances removed by each tape strip can be determined by common analytical methods. These amounts have to be correlated with their location within the horny layer in order to determine penetration profiles. Therefore the amount of SC on each removed strip must be determined. In the study reported, this amount was derived from the covering density of the SC cells, the corneocytes, on tape strips using classic microscopic techniques and laser scanning microscopy. The amount of corneocytes determined by both microscopic methods shows a good correlation (R2 +/- S.D.= 0.95 +/- 0.02) with the pseudoabsorption of the corneocytes, a method usually used to determine the SC amount on the removed strips. These measurements require the application of a special spectrometer, whereas the covering density can easily be determined using widely available microscopic equipment. The penetration of a typical UV filter, butyl methoxydibenzoylmethane, applied at two different formulations, was studied using the microscopic method developed. The calculated penetration profiles show that the applied formulation influences the amount of corneocytes on the removed strips.
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2002
2001
H J Weigmann, J Lademann, S Schanzer, U Lindemann, R von Pelchrzim, H Schaefer, W Sterry, V Shah (2001)  Correlation of the local distribution of topically applied substances inside the stratum corneum determined by tape-stripping to differences in bioavailability.   Skin Pharmacol Appl Skin Physiol 14 Suppl 1: 98-102  
Abstract: Tape-stripping and optical spectroscopy are used as a suitable combined method to determine the horny layer profile. Firstly, typical ultraviolet filter substances are used as active substances which are fixed inside the horny layer. Secondly, clobetasol propionate was applied topically in two formulations, Temovate Cream and Temovate and Emollient. The measured changes in the local distribution of the drug inside stratum corneum reflect the observed differences in the biological response visualized as blanching. The concentration of the drug in deeper parts of the horny layer proposes the existence of a small channel available for the percutaneous absorption. The observed low intensity blanching is correlated to the follicle orifices of the skin. After application of Temovate and Emollient, a lateral spreading of the drug must be taken into account.
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J Lademann, N Otberg, H Richter, H J Weigmann, U Lindemann, H Schaefer, W Sterry (2001)  Investigation of follicular penetration of topically applied substances.   Skin Pharmacol Appl Skin Physiol 14 Suppl 1: 17-22  
Abstract: The influence of specific follicle properties, sebum production and hair growth on the follicular penetration of topically applied substances was investigated. The behavior of follicles identified in selected skin areas of volunteers was analyzed by various tape stripping and staining methods in combination with laser scanning microscopy. Furthermore hair growth in the selected skin areas was determined. A correlation between sebum production, hair growth activity and follicular penetration was observed.
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H Schaefer, J Lademann (2001)  The role of follicular penetration. A differential view.   Skin Pharmacol Appl Skin Physiol 14 Suppl 1: 23-27  
Abstract: Textbooks describe percutaneous absorption through normal skin as diffusion through the stratum corneum barrier, i.e., in a simplified view, as a physiochemical interaction of a penetrating compound with the horizontal multilayer lipid structures and the underlying corneocytes within the horny layer. Hair follicles and sweat glands are vertical structures and are considered of little importance since 'they represent a small and insignificant percentage of the skin surface'. To this integral view, a differentiated hypothesis is proposed: the more perfect the barrier function of the horny layer, the greater the relative role of the imperfections within the skin as a defence organ. Three kinds of imperfections should be taken into account: (1) the follicular apparatus of hair follicles; (2) the sweat glands, and (3) microlesions in the interfollicular horny layer. Each of these can theoretically represent a vertical pathway for percutaneous absorption, i.e. a 'shunt'.
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2000
J Lademann, H Weigmann, H Schäfer, G Müller, W Sterry (2000)  Investigation of the stability of coated titanium microparticles used in sunscreens.   Skin Pharmacol Appl Skin Physiol 13: 5. 258-264 Sep/Oct  
Abstract: Due to its UV-light-absorbing properties, titanium dioxide is used in many sunscreen products. However, concern has been raised about a possible photocatalytic activity of titanium dioxide on living tissues. To reduce potential adverse effects, titanium dioxide used in cosmetic preparations is often coated. The coating should be stable under conditions of use. In order to verify the coating stability, sunscreen-grade-coated titanium microparticles were investigated by laser-induced plasma spectroscopy. No changes in the mechanical stability of the coated microparticles could be detected during the manufacturing and penetration of the sunscreen. Applying strong forces on the microparticles by centrifugation, exceeding by far in use conditions, resulted only in small changes in the coating.
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1999
H Weigmann, J Lademann, H Meffert, H Schaefer, W Sterry (1999)  Determination of the horny layer profile by tape stripping in combination with optical spectroscopy in the visible range as a prerequisite to quantify percutaneous absorption.   Skin Pharmacol Appl Skin Physiol 12: 1-2. 34-45 Jan/Apr  
Abstract: A new method was developed to determine the horny layer profile of volunteers using tape stripping in combination with UV/visible spectroscopy. The optical absorbance and the weight of corneocyte aggregates were compared as parameters for the determination of the mass of the horny layer particles fixed to the individual tapes. It was shown that the potential disturbances influencing both parameters must be considered critically before calculating the correlation factor, found as R2mean = 0.93 +/- 0.05. It was proven that the absorbance in the visible range is better suited than the weight to quantify the amount of corneocyte aggregates removed by a single strip. The new method allows an exact anatomical localization of the individual tapes and all data obtained within the depth profile of the stratum corneum. This was exemplified by the determination of the penetration of chemical and physical UV filters into the horny layer.
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J Lademann, H Weigmann, C Rickmeyer, H Barthelmes, H Schaefer, G Mueller, W Sterry (1999)  Penetration of titanium dioxide microparticles in a sunscreen formulation into the horny layer and the follicular orifice.   Skin Pharmacol Appl Skin Physiol 12: 5. 247-256 Sep/Oct  
Abstract: Coated titanium dioxide (TiO2) microparticles are commonly used as UV filter substances in commercial sunscreen products. The penetration of these microparticles into the horny layer and the orifice of the hair follicle was investigated. The distribution of the microparticles in the horny layer was analyzed using the method of tape stripping in combination with spectroscopic measurements. Deeper layers of the stratum corneum were devoid of TiO(2) even after repetitive application of sunscreen preparation when analyzing interfollicular areas. Only in the areas of the pilosebaceous orifices could microparticles be identified. The penetration of TiO(2) was investigated in histological skin sections. A biopsy was taken from a skin area from which the horny layer had been removed by tape stripping. In isolated areas, a penetration of coated TiO2 into the open part of the follicle was observed. The amount of TiO2 found in a given follicle was less than 1% of the applied total amount of sunscreens. A penetration of microparticles into viable skin tissue could not be detected.
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H Weigmann, J Lademann, R v Pelchrzim, W Sterry, T Hagemeister, R Molzahn, M Schaefer, M Lindscheid, H Schaefer, V P Shah (1999)  Bioavailability of clobetasol propionate-quantification of drug concentrations in the stratum corneum by dermatopharmacokinetics using tape stripping.   Skin Pharmacol Appl Skin Physiol 12: 1-2. 46-53 Jan/Apr  
Abstract: The concentration of clobetasol propionate in the stratum corneum after application of three different formulations was determined, quantifying the influence of the formulations on the bioavailability of the drug. The stratum corneum was sampled by tape stripping. The concentrations of clobetasol propionate were determined quantitatively by HPLC. After application of Clobetasol Propionate Cream USP, 0.05%, and Temovate Cream, 0.05%, identical amounts of the drug were found in the stratum corneum, whereas after application of Temovate epsilon Emollient, 0.05%, the quantity was clearly decreased. From results obtained measuring the drug concentration in the adjacent sites of the skin where the creams had not been applied, it became clear that clobetasol propionate in Temovate epsilon Emollient, migrated to a large extent in the lateral direction. This explains the lower concentration measured for this formulation in the skin areas where the cream had been applied. In general, a lateral distribution of the applied drug must be taken into account when positioning the application areas on the forearm.
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1997
H Wurzer, R Maeckel, J Lademann, H Audring, H D Liess (1997)  A spark counter as a control unit of a radio frequency surgery device.   IEEE Trans Biomed Eng 44: 9. 831-838 Sep  
Abstract: A new approach in radio frequency (rf) electrosurgery, used for tissue treatment, is achieved by using a new process control method. An external control unit allows a commonly available rf-generator to automatically supply the appropriate power for differing tissue types, thus ensuring best cutting quality. The sparks, generated during the scalpel electrode interaction with the tissue, appear statistically distributed. The spark rate depends on various factors and is monotonic with the supplied electrical power. This allows it to be used as the controlled variable in the cutting process. The ac current passing through the tissue is evaluated by an external control unit using an analyzation algorithm to determine the number of sparks. The external unit is comprised of a system, which measures the spark rate, and a subsequent proportional integral (P.I.) controller. The functionality of the control method as well as the electrical circuitry is verified through cuts with different degrees of carbonization and cuts through tissue heterojunctions.
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