Transepidermal water loss reflects permeability barrier status: validation in human and rodent in vivo and ex vivo models

Authors

  • Joachim W. Fluhr,

    Corresponding author
    1. Department of Dermatology and Allergology, Friedrich-Schiller-University Jena, Germany;
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  • Kenneth R. Feingold,

    1. Dermatology and Medical (Metabolism) Services, Veterans Affairs Medical Center, and Departments of Dermatology & Medicine, University of California, San Francisco, CA, USA
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  • Peter M. Elias

    1. Dermatology and Medical (Metabolism) Services, Veterans Affairs Medical Center, and Departments of Dermatology & Medicine, University of California, San Francisco, CA, USA
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Joachim Fluhr, MD
Department of Dermatology and Allergology
Skin Physiology Laboratory
Friedrich Schiller University
Erfurter Strasse 35
Jena 07740
Germany
Tel.: +49 36 41 937 399
Fax: +49 36 41 937 435
e-mail: Joachim.Fluhr@med.uni-jena.de

Abstract

Abstract:  Permeability barrier function is measured with instruments that assess transepidermal water loss (TEWL), either with closed- or open-loop systems. Yet, the validity of TEWL as a measure of barrier status has been questioned recently. Hence, we tested the validity of this measure by comparing TEWL across a wide range of perturbations, with a variety of methods, and in a variety of models. TEWL rates with two closed-chamber systems (VapoMeter and H4300) and one closed-loop system (MEECO) under different experimental in vivo conditions were compared with data from four open-loop instruments, i.e. TM 210, TM 300, DermaLab and EP 1. The instruments were compared in vivo both in humans and hairless mice skin subjected to different degrees of acute barrier disruption. The values obtained with bioengineering systems were correlated with absolute water loss rates, determined gravimetrically. Measurements with both closed and open systems correlated not only with each other, but each method detected different degrees of barrier dysfunction. Although all instruments differentiated among gradations in TEWL in the mid-range of barrier disruption in vivo, differences in very low and very high levels of disruption were less accurately measured with the H4300 and DermaLab systems. Nevertheless, a high Pearson correlation coefficient (r) was calculated for data from all instruments vs. gravimetrically assessed TEWL. Together, these results verify the utility of TEWL as a measure of permeability barrier status. Moreover, all tested instruments are reliable tools for the assessment of variations in permeability barrier function.

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