Neonatal Skin Maturation—Vernix Caseosa and Free Amino Acids

Authors

  • Marty O. Visscher Ph.D.,

    1. The Skin Sciences Institute, Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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  • Radhika Utturkar M.S.,

    1. James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
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  • William L. Pickens B.S.,

    1. The Skin Sciences Institute, Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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  • Angela A. LaRuffa R.N., M.S.N.,

    1. The Skin Sciences Institute, Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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  • Marisa Robinson Ph.D.,

    1. James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
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  • R. Randell Wickett Ph.D.,

    1. James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
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  • Vivek Narendran M.D.,

    1. The Skin Sciences Institute, Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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  • Steven B. Hoath M.D.

    1. The Skin Sciences Institute, Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Address correspondence to Marty O. Visscher, Ph.D., The Skin Sciences Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, or e-mail: Marty.Visscher@cchmc.org.

Abstract

Abstract:  Neonatal skin hydration decreases rapidly postnatally and then increases, indicating adaptive changes in stratum corneum water handling properties. Transition from high to low humidity at birth may initiate filaggrin proteolysis to free amino acids. Neonatal skin with vernix caseosa retained is more hydrated than skin with vernix removed. This study examines the potential roles of free amino acids and vernix in postnatal adaptation of infant stratum corneum in vivo. Specifically, the ontogeny of free amino acid generation in neonatal stratum corneum and the role of vernix caseosa in postnatal adaptation were examined using high performance liquid chromatography. Free amino acids were quantified for infant skin samples collected at (i) birth and 1 month and (ii) birth and 24 hours after vernix caseosa retention or removal and compared to neonatal foreskin, vernix caseosa, and adult stratum corneum using t-tests, analysis of variance, or univariate procedures. Free amino acids were extremely low at birth, significantly higher 1 month later but lower than in adults. Vernix caseosa retention led to significantly higher free amino acids 24 hours after birth compared to infants with vernix caseosa removed, and it paralleled the higher stratum corneum hydration of vernix caseosa-retained skin. Vernix caseosa contained free amino acids, with glutamic acid and histidine levels higher than in infants. Free amino acids in vernix caseosa-retained skin appear to originate from vernix caseosa. Free amino acids were lower in neonatal foreskin than adult forearm stratum corneum. Arginine was higher than citrulline at birth, but levels were comparable in older infants. The free amino acid increase at 1 month may be initiated by the humidity transition at birth and supports results in animals. The findings have implications for infant skin care practices.

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