Petrolatum: Barrier repair and antimicrobial responses underlying this "inert" moisturizer

  • J Allergy Clin Immunol. 2016 Apr;137(4):1091-1102.e7. doi: 10.1016/j.jaci.2015.08.013.
Tali Czarnowicki  1 ,  Dana Malajian  2 ,  Saakshi Khattri  3 ,  Joel Correa da Rosa  4 ,  Riana Dutt  3 ,  Robert Finney  5 ,  Nikhil Dhingra  6 ,  Peng Xiangyu  3 ,  Hui Xu  3 ,  Yeriel D Estrada  6 ,  Xiuzhong Zheng  1 ,  Patricia Gilleaudeau  1 ,  Mary Sullivan-Whalen  1 ,  Mayte Suaréz-Fariñas  7 ,  Avner Shemer  8 ,  James G Krueger  1 ,  Emma Guttman-Yassky  9
Affiliations
  • 1. Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
  • 2. Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Columbia University College of Physicians and Surgeons, New York, NY.
  • 3. Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
  • 4. Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Center for Clinical and Translational Science, The Rockefeller University, New York, NY.
  • 5. Department of Dermatology, Jefferson Medical College, Philadelphia, Pa.
  • 6. Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
  • 7. Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, NY; Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY.
  • 8. Department of Dermatology, Tel-Hashomer Hospital, Tel Aviv, Israel.
  • 9. Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: [email protected].
PMID: 26431582 DOI: 10.1016/j.jaci.2015.08.013
Abstract

Background: Petrolatum is a common moisturizer often used in the prevention of skin infections after ambulatory surgeries and as a maintenance therapy of atopic dermatitis (AD). However, the molecular responses induced by petrolatum in the skin have never been assessed.

Objective: We sought to define the cutaneous molecular and structural effects induced by petrolatum.

Methods: Thirty-six healthy subjects and 13 patients with moderate AD (mean SCORAD score, 39) were studied by using RT-PCR, gene arrays, immunohistochemistry, and immunofluorescence performed on control skin, petrolatum-occluded skin, and skin occluded with a Finn chamber only.

Results: Significant upregulations of antimicrobial peptides (S100A8/fold change [FCH], 13.04; S100A9/FCH, 11.28; CCL20/FCH, 8.36; PI3 [elafin]/FCH, 15.40; lipocalin 2/FCH, 6.94, human β-defensin 2 [DEFB4A]/FCH, 4.96; P < .001 for all) and innate immune genes (IL6, IL8, and IL1B; P < .01) were observed in petrolatum-occluded skin compared with expression in both control and occluded-only skin. Application of petrolatum also induced expression of key barrier differentiation markers (filaggrin and loricrin), increased stratum corneum thickness, and significantly reduced T-cell infiltrates in the setting of "normal-appearing" or nonlesional AD skin, which is known to harbor barrier and immune defects.

Conclusions: Petrolatum robustly modulates antimicrobials and epidermal differentiation barrier measures. These data shed light on the beneficial molecular responses of petrolatum in barrier-defective states, such as AD and postoperative wound care.

Keywords
Petrolatum; antimicrobial peptides; atopic dermatitis; barrier; innate immunity; moisturizer; occlusion; patch tests; skin surgeries.
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