Уход за кожей детей раннего возраста. Новые инновационные подходы

В статье представлены современные данные об онтогенезе кожи, о формировании всех ее элементов и структур во время внутриутробного развития и в постнатальный период. Подробно освещены современные представления об особенностях строения кожи у новорожденного и младенца. Особое внимание уделено как защитным механизмам кожи, обеспечивающим механический барьер, так и факторам врожденного иммунитета, липидам, а также микробиому кожи. Большое внимание в представленной статье уделено значению сыровидной смазки для кожи плода и новорожденного, а также процессам адаптации кожи новорожденного к внеутробной среде. Представлены современные рекомендации по уходу за кожей, основанные на данных об особенностях развития, строения и функционирования кожи новорожденного и младенца.

адаптация, дерма, дети, кожа, микробиота кожи, новорожденные, сыровидная смазка, уход, эпидермис, эмбриогенез

1. Захарова И.Н., Пшеничникова И.И., Мачнева Е.Б. Правильный уход за кожей новорожденных и детей раннего возраста: что нужно знать педиатру. Педиатрия. Приложение к журналу Consilium Medicum, 2016, 1: 24-30.

2. Visscher MO, Adam R, Brink S, Odio M. Newborn infant skin: physiology, development, and care. Clin Dermatol, 2015, 33: 271–280.

3. Kutlubay Z, Tanakol A, Engýn B, Onel C, Sýmsek E, Serdaroglu S, Tuzun Y, Yilmaz E, Eren B. Newborn Skin: Common Skin Problems. Maedica (Buchar), 2017, 12(1): 42-47.

4. Visscher M, Narendran V. The Ontogeny of Skin. Adv Wound Care (New Rochelle), 2014, 3(4): 291-303.

5. Fuchs E. Scratching the surface of skin development. Nature, 2007, 445: 834-842.

6. Blanpain C, Fuchs E. Epidermal homeostasis: a balancing act of stem cells in the skin. Nat Rev Mol Cell Biol, 2009, 10: 207-217.

7. Blume-Peytavi U, Hauser M, Stamatas GN. Skin care practices for newborns and infants: Review of the clinical evidence for best practices. Pediatr Dermatol, 2012, 29: 1-14.

8. Candi E, Schmidt R, Melino G. The cornified envelope: a model of cell death in the skin. Nat Rev Mol Cell Biol, 2005, 6: 328-340.

9. Уход за кожей новорожденного ребенка. Союз педиатров России. 2016: 66 с.

10. Kalinin A, Marekov LN, Steinert PM. Assembly of the epidermal cornified cell envelope. J Cell Sci, 2001, 114: 3069-3070.

11. Pickens WL, Warner RR, Boissy YL, Boissy RE, Hoath SB. Characterization of vernix caseosa: water content, morphology, and elemental analysis. J Invest Dermatol, 2000, 115: 875-881.

12. Visscher MO, Narendran V, Pickens WL, LaRuffa AA, Meinzen-Derr J, Allen K, Hoath SB. Vernix caseosa in neonatal adaptation. J Perinatol, 2005, 25: 440-446.

13. Rissmann R, Groenink HW, Weerheim AM, Hoath SB, Ponec M, Bouwstra JA. New insights into ultrastructure, lipid composition and organization of vernix caseosa. J Invest Dermatol, 2006, 126: 1823-1833.

14. Youssef W, Wickett RR, Hoath SB. Surface free energy characterization of vernix caseosa. Potential role in waterproofing the newborn infant. Skin Res Technol, 2001, 7: 10-17.

15. Barai N. Effect of vernix caseosa on epidermal barrier maturation and repair: Implications inwound healing. [PhDthesis]Cincinnati,OHUSA: University of Cincinnati, Pharmacy. 2005. http: //rave.ohiolink.edu/etdc/view?acc_num=ucin1115914411. Accessed March 13, 2014.

16. Oudshoorn MHM, Rissmann R, van der Coelen D. Development of a murine model to evaluate the effect of vernix caseosa on skin barrier recovery. Exp Dermatol, 2009, 18: 178-184.

17. Visscher MO, Barai N, LaRuffa AA. Epidermal barrier treatments based on vernix caseosa. Skin Pharmacol Physiol, 2011, 24: 322-329.

18. Narendran V, Visscher MO, Abril I. Biomarkers of epidermal innate immunity in premature and full-term infants. Pediatr Res, 2010, 67: 382-386.

19. Tollin M, Bergsson G, Kai-Larsen Y. Vernix caseosa as a multicomponent defence system based on polypeptides, lipids and their interactions. Cell Mol Life Sci, 2005, 62: 2390-2399.

20. Visscher MO, Narendran V, Pickens WL. Vernix caseosa in neonatal adaptation. J Perinatol, 2005, 25: 440-446.

21. Нагаева Т.А., Басарева Н.И., Пономарева Д.А. Особенности липидного состава поверхностной гидролипидной пленки кожи новорожденных детей. В сборнике: Актуальные направления фундаментальных и прикладных исследований. Материалы IX международной научно-практической конференции. Н.-и. ц. «Академический». 2016: 28-31.

22. Tansirikongkol A, Wickett RR, Visscher MO. Effect of vernix caseosa on the penetration of chymotryptic enzyme: Potential role inиepidermal barrier development. Pediatr Res, 2007, 62: 49-53.

23. Newborn care until the first week of life: Clinical practice pocket guide. World Health Organization. http: //www.wpro.who.int/immunization/documents/newborncare_final.pdf. [Published 2009. Accessed March 13, 2014].

24. Stamatas GN, Nikolovski J, Mack MC. Infant skin physiology and development during the first years of life: A review of recent findings based on in vivo studies. Int J Cosmet Sci, 2011, 33: 17-24.

25. Darlenski R, Fluhr JW. Influence of skin type, race, sex, and anatomic location on epidermal barrier function. Clin Dermatol, 2012, 30: 269-273.

26. Hoeger PH. Physiology of neonatal skin. In: Irvine AD, Hoeger PH, Yan AC, eds. Harper’s textbook of pediatric dermatology. Oxford, UK: Wiley-Blackwell, 2011. p. 3.1-3.7.

27. Kelleher MM, O’Carroll M, Gallagher A. Newborn transepidermal water loss values: A reference data set. Pediatr Dermatol, 2013, 30: 712-716.

28. Fluhr JW, Darlenski R, Lachmann N. Infant epidermal skin physiology: Adaptation after birth. Br J Dermatol, 2012, 166: 483-490.

29. Sedin G, Hammarlund K, Stromberg B. Transepidermal water loss in full-term and pretermb infants. Acta Paediatr Scand Suppl, 1983, 305: 27-31.

30. Agren J, Sjors G, Sedin G. Ambient humidity influences the rate of skin barrier maturation in extremely preterm infants. J Pediatr, 2006, 148: 613-617.

31. Захарова И.Н., Мачнева Е.Б. Уход за кожей детей раннего возраста. Вопросы современной педиатрии, 2014, 13(2): 95-100.

32. Fluhr JW, Darlenski R, Taieb A. Functional skin adaptation in infancy-almost complete but not fully competent. Exp Dermatol, 2010, 19: 483-492.

33. Nikolovski J, Stamatas GN, Kollias N. Barrier function and water-holding and transport properties of infant stratum corneum are different from adult and continue to develop through the first year of life. J Invest Dermatol, 2008, 128: 1728-1736.

34. Minami-Hori M, Honma M, Fujii M, et al. Developmental alterations of physical properties and components of neonatal-infantile stratum corneum of upper thighs and diaper-covered buttocks during the 1st year of life. J Dermatol Sci, 2014, 73: 67-73.

35. Visscher MO, Chatterjee R, Munson KA. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol, 2000, 17: 45-51.

36. Нагаева Т.А., Басарева Н.И., Пономарева Д.А. Особенности витаминного состава поверхностной гидролипидной пленки кожи у здоровых новорожденных и грудных детей. Международный журнал экспериментального образования, 2016, 9(1): 75-76.

37. Narendran V, Visscher MO, Abril I, Hendrix SW, Hoath SB. Biomarkers of epidermal innate immunity in premature and full-term infants. Pediatr Res, 2010, 67: 382-386.

38. Hirao T, Terui T, Takeuchi I, Kobayashi H, Okada M, Takahashi M, Tagami H. Ratio of immature cornified envelopes does not correlate with parakeratosis in inflammatory skin disorders. Exp Dermatol, 2003, 12: 591-601.

39. Yamane Y, Moriyama K, Yasuda C, Miyata S, Aihara M, Ikezawa Z, Miyazaki K. New horny layer marker proteins for evaluating skin condition in atopic dermatitis. Int Arch Allergy Immunol, 2009, 150: 89-101.

40. Jiang YJ, Lu B, Crumrine D, Man MQ, Elias PM, Feingold KR. IL-1alpha accelerates stratum corneum formation and improves permeability barrier homeostasis during murine fetal development. J Dermatol Sci, 2009, 54: 88-98.

41. Захарова И.Н., Климов Л.Я., Касьянова А.Н., Ягупова А.В., Курьянинова В.А. Долбня С.В., Батурин В.А., Бобрышев Д.В., Анисимов Г.С., Масальский С.С., Болатчиев А.Д. Роль антимикробных пептидов и витамина D в формировании противоинфекционной защиты. Педиатрия, Журнал им. Г.Н. Сперанского, 2017, 96(4): 171–179.

42. Agier J, Brzezinska-Blaszczyk E. Cathelicidins and defensins regulate mast cell antimicrobial activity. Postepy Hig Med Dosw (Online), 2016, 70(0): 618-636.

43. Walker VP, Akinbi HT, Meinzen-Derr J, Narendran V, Visscher M, Hoath SB. Host defense proteins on the surface of neonatal skin: implications for innate immunity. J Pediatr, 2008, 152: 777-781.

44. Pammi M, O’Brien JL, Ajami NJ, Wong MC, Versalovic J, Petrosino JF. Development of the cutaneous microbiome in the preterm infant: A prospective longitudinalstudy. PLoS One, 2017, 12(4): e0176669.

45. Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol, 2011, 9: 244-253.

46. Hoeger PH, Enzmann CC. Skin physiology of the neonate and young infant: a prospective study of functional skin parameters during early infancy. Pediatr Dermatol, 2002, 19: 256-262.

47. Hachem J, Roelandt T, Schürer N. Acute acidification of stratum corneum membrane domains using polyhydroxyl acids improves lipid processing and inhibits degradation of corneodesmosomes. J Invest Dermatol, 2010, 130: 500-510.

48. Eggesbo M, Moen B, Peddada S, Baird D. Development of gut microbiota in infants not exposed to medical interventions. APMIS, 2011, 119(1): 17-35.

49. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA. Ehrenkranz RA Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics, 2002, 110: 285-291.

50. Naik S, Bouladoux N, Wilhelm C, Molloy MJ, Salcedo R, Kastenmuller W. Compartmentalized control of skin immunity by resident commensals. Science, 2012, 337: 1115-1119.

51. Grice EA, Kong HH, Conlan S, Deming CB, Davis J, Young AC. Topographical and temporal diversity of the human skin microbiome. Science, 2009, 324: 1190-1192.

52. Gao Z, Tseng CH, Pei Z, Blaser MJ. Molecular analysis of human forearm superficial skin bacterial biota. Proc Natl Acad Sci U S A, 2007, 104: 2927-2932.

53. Capone KA, Dowd SE, Stamatas GN, Nikolovski J. Diversity of the human skin microbiome early in life. J Invest Dermatol, 2011, 131(10): 2026-32.

54. Dominguez-Bello MG, Costello EK, Contreras M. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA, 2010, 107: 11971–11975.

55. Blume-Peytavi U, Lavender T, Jenerowicz D, Ryumina I, Stalder JF, Torrelo A, Cork MJ. Recommendations from a European Roundtabl e Meeting on Best Practice Healthy Infant Skin Care. Pediatr Dermatol, 2016, b33(3): 311-221.

56. Telofski LS, Morello AP, Mack Correa MC, Stamatas GN. The infant skin barrier: Can we preserve, protect, and enhance the barrier? Dermatol Res Pract, 2012, 2012: 198789.

57. Ananthapadmanabhan KP, Moore DJ, Subramanyan K. Cleansing without compromise: the impact of cleansers on the skin barrier and the technology of mild cleansing. Dermatol Ther, 2004, 17(Suppl 1): 16–25.

58. Garcia Bartels N, Massoudy L, Scheufele R. Standardized diaper care regimen: A prospective, randomized pilot study on skin barrier function and epidermal IL-1α in newborns. Pediatr Dermatol, 2012, 29: 270-276.

59. Тамразова О.Б. Особенности ухода за кожей новорожденных детей. Педиатрия. Приложение к журналу Consilium Medicum, 2014, 1: 77-82.

60. Erasala G, Merlay I, Romain C. Evolution of disposable diapers and reduction of diaper dermatitis. Arch Pediatr, 2007, 14: 495-500.

61. Котлуков В.К., Казюкова Т.В., Антипова Н.В. Наружные дерматологические средства для ухода за кожей детей первых лет жизни. Медицинский совет, 2017, 9: 160-161.

62. Walker VP, Akinbi HT, Meinzen-Derr J. Host defense proteins on the surface of neonatal skin: Implications for innate immunity. J Pediatr, 2008, 152: 777-781.

63. Schürer NY. Implementation of fatty acid carriers to skin irritation and the epidermal barrier. Contact Dermatitis, 2002, 47: 199-205.

64. Nopper AJ, Horii KA, Sookdeo-Drost S, et al. Topical ointment therapy benefits premature infants. J Pediatr, 1996, 128: 660-669.

65. Kiechl-Kohlendorfer U, Berger C, Inzinger R. The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants: A randomized controlled trial. Pediatr Dermatol, 2008, 25: 174-178.