New natural PPAR-a agonist for childhood atopic dermatitis: Dermocorticoid- sparing and quality of life improvement
Atopic dermatitis (AD) is associated with skin barrier disruption resulting from major lipids metabolism dysfunctions. _ Dermo-corticosteroids (DC) are used for AD flares but have potential side effects. PPAR-a (peroxysomeproliferative-activated receptors) are transcription factors involved in the regulation of epidermal homeostasis (differentiation, proliferation, inflammation. . .).
A new emollient, containing a patented sunflower oleodistillate (SO), has been formulated for AD. We have previously shown that SO: (1) activates of PPAR-a in CV1 cells; (2) induces the synthesis of key epidermal lipids (eg, ceramides 33, cholesterol 32) in human skin explants; and (3) reduces TPA-induced inflammation (oedema and cytokines mRNA production).
Materials and methods:
In our study,we have investigated the potential role of a new patented PPAR-a agonist emollient on DC sparing and on quality of life (QoL) of young atopic children and their family. Eighty-six patients, (4-48 months), were randomised into 5 treatment groups: DC (desonide 0,05%) 23/D, 13/D with or without PPAR-a agonist and DC 1D/2 with PPAR-a agonist for 21 days. Evaluations of SCORAD and QoL (DFI = Dermatitis Family Impact and IDQLI = Infant’s Dermatitis Quality of Life Index) were performed at D7 and D21.
At D7, all groups had a statistical improvement of their SCORAD ([60%, P\.001) without differences between them (P = .715). This illustrates rapid action of steroids.
At D21, the 5 groups were also statistically improved (P\.001) but with better results in the 3 PPAR-a agonist groups (mean improvement 73.7%) than in the 2 other groups (mean 60.5%). PPAR-a agonist impact was noticed mostly on lichenification, excoriation and dryness. Global evaluation of QoL at D21 revealed that PPAR-a agonist1DC offers a better improvement (73%, P\.001) than DC alone (52%, P\.01).
A twice-daily application of new PPAR-a agonist emollient permits a corticoid sparing of 50 to 75% and a higher quality of life improvement for children and parents.