Children's Researchers Hard at Work on Soft Skin
CINCINNATI -- For nine months before birth, infants soak in a watery, urine-filled environment. Just hours after birth, however, they have near-perfect skin. How is it that nature enables infants to develop ideal skin in such a seemingly unsuitable environment?
Researchers at Children's Hospital Medical Center of Cincinnati's Skin Sciences Institute believe the answer to be vernix -- the white, cheesy substance that coats infants for weeks before they are born, then is wiped off and discarded immediately after birth. If they're right, the healthcare implications for newborns and adults could be tremendous.
Armed with a $50,000 grant from the National Institute of Occupational Safety and Health (NIOSH), the researchers are studying whether vernix or an equivalent can be reapplied in situations in which the skin needs protection against the environment -- both in children and adults.
"Would it be useful for nurses, for example, who have to wash their hands between patients and have a high incidence of compromised skin?" asks Steve Hoath, M.D., medical director of the Skin Sciences Institute. "Or, could it be used as a covering for very low-birthweight, pre-term infants, who don't even develop the protection of vernix if they are born before about 27 weeks."
Vernix is a complex mixture of lipids (fats), proteins and water. Babies born at 32-33 weeks are covered with the material. Those who are born full term have already lost a good portion of it.
It is debatable whether it is better for infants to retain what's left of their vernix rather than be "cleaned up to make them more cosmetically attractive, stuck under a radiant warmer and baked under the equivalent of a tropical sun," says Dr. Hoath, a neonatologist.
Dr. Hoath's research team will test whether vernix provides an effective barrier against potential environmental irritants on excised human skin in the laboratory and on newborn rats. The researchers will apply a film of vernix and other potential barriers to the excised human skin and the rats. They will then expose the skin to different irritants and measure damage.
The Skin Sciences Institute, which is pursuing patent protection on advanced technology in regard to vernix, is an educational and research organization of the Children's Hospital Research Foundation. The institute views infant skin as ideal skin and focuses on the skin as a primary care interface -- a biological spacesuit that separates outer from inner space.
"Skin is the largest organ in the body, but it's a neglected organ throughout medicine," says Dr. Hoath. "It's the structural interface with the environment, a psychological organ, an emotional organ, and a huge immune organ. It interacts with tapes and adhesives, soaps and surfactants in infection control, and non-invasive monitoring systems in intensive care environments, yet it's often treated as insignificant.", says Dr. Hoath.
"You can't deliver medical care in the home or hospital without paying attention to this interface, and it has a disproportionate impact on patient satisfaction. People assume you can transplant a liver, but if you can't pull the leads off without hurting them, you're not providing good care.", Dr. Hoath says
In addition to championing the concept of skin as a primary care interface, the institute has established collaborative relationships with major companies involved in skin care as well as skin barrier structure and function. These companies include the Procter&Gamble Co., 3M, and Gore Industries.
Contact Information
Jim Feuer,
jfeuer@chmcc.org
