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KMID : 0984920110130010031
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Journal of Skin Barrier Research
2011 Volume.13 No. 1 p.31 ~ p.37
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From "Saran Wrap" to Current Understanding of the Cutaneous Barrier
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Peter M. Elias
Wakefield Joan S.
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Abstract
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This short article reviews key milestones and insights that led to our current concept of the permeability barrier. In the 1960`s, the stratum corneum (SC) was considered an inconsequential layer of desquamating cells. Then came the realization that the SC is highly resilient, followed by the appreciation of its unique twocompartment organization, with lipids segregated within intracellular domains. Now, we view the SC as a metabolically-active tissue that self-regulates desquamation, and as a biosensor that signals metabolic responses in the underlying epidermis in response to environmental alterations. However, the permeability barrier is but one of a set of co-regulated and interdependent defensive functions that is mediated by this unique, protective tissue. Finally, genetic mutations and acquired insults that lead to pathophysiologic processes provoke not only ichthyosis, but also downstream inflammation, the so-called ``outside-to-inside`` view of the pathogenesis of inflammatory dermatoses. Accordingly, next-generation therapy for these disorders should be directed at correcting the primary barrier abnormality, rather than interdicting downstream inflammation, which should result in a large improvement in specificity, efficacy and safety.
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KEYWORD
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Permeability barrier, Stratum corneum
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