Ceramide Plays a Major Role in the Pathogenesis of Atopic Dermatitis.

We studied that pathophysiological linkage by microanalysis of ceramides using NPLC-ESI Mass Spectrometry comparing before and after topical application of a designed synthetic pseudo-ceramide (pCer). Four weeks of treatment with pCer significantly reduced skin symptoms, accompanied by significant decreases in trans-epidermal water loss (TEWL) and increases in water content.

In the SC ceramide profiles, Cer[NH/NP] increased and Cer[NS/AS] decreased with larger alkyl chain lengths in Cer[NS], distinctly representing a switch from an AD to a healthy skin phenotype. The levels of pCer that penetrated into the SC were significantly correlated with the SC water content but not with TEWL. The levels of Cer[NS] and the average carbon chain length of Cer[NS] were closely correlated with the pCer level in the SC.