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Article ; Online: The Relationship of Proper Skin Cleansing to Pathophysiology, Clinical Benefits, and the Concomitant Use of Prescription Topical Therapies in Patients with Acne Vulgaris.

Levin, Jacquelyn

2016 Volume 34, Issue 2, Page(s) 133–145

Abstract: Patients often perceive the cause of their acne to be related to a lack of proper cleansing, therefore many patients attempt to treat their acne either alone or with prescription therapy by frequent aggressive cleansing with harsh cleansing agents. ... ...

Abstract	Patients often perceive the cause of their acne to be related to a lack of proper cleansing, therefore many patients attempt to treat their acne either alone or with prescription therapy by frequent aggressive cleansing with harsh cleansing agents. Altered epidermal barrier function, inflammation, and Propionibacterium acnes are related to acne vulgaris (AV) pathophysiology; proper cleansing can favorably modulate the development of AV. The available clinical studies support gentle cleansing in AV by showing the ability to contribute to improving AV lesion counts and severity and minimizing the irritation seen with topical AV therapies such as retinoids and BP.
MeSH term(s)	Acne Vulgaris/drug therapy ; Administration, Cutaneous ; Anti-Bacterial Agents/administration & dosage ; Dermatologic Agents/administration & dosage ; Humans ; Retinoids/administration & dosage
Chemical Substances	Anti-Bacterial Agents ; Dermatologic Agents ; Retinoids
Language	English
Publishing date	2016-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	82798-8
ISSN	1558-0520 ; 0733-8635
ISSN (online)	1558-0520
ISSN	0733-8635
DOI	10.1016/j.det.2015.11.001
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Article ; Online: Unsatisfactory Fecal Immunochemical Tests for Colorectal Cancer Screening: Prevalence, Reasons, and Subsequent Testing.

Liu, Po-Hong / Nair, Rasmi G / Skinner, Celette Sugg / Murphy, Caitlin C / Kim, Eric J / Ortiz, Cynthia / Wang, Lei / Hu, Ellen / Lykken, Jacquelyn M / Levin, Theodore R / Green, Beverly B / Hahn, Erin E / Santini, Noel / Halm, Ethan A

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

2023 Volume 33, Issue 2, Page(s) 215–223

Abstract: Background: Fecal immunochemical test (FIT) is an effective colorectal cancer screening modality. Little is known about prevalence, reasons, and testing after unsatisfactory FIT, or a FIT that cannot be processed by the laboratory due to inadequate ... ...

Abstract	Background: Fecal immunochemical test (FIT) is an effective colorectal cancer screening modality. Little is known about prevalence, reasons, and testing after unsatisfactory FIT, or a FIT that cannot be processed by the laboratory due to inadequate stool specimen or incomplete labeling. Methods: Our retrospective cohort study examined unsatisfactory FIT among average-risk individuals aged 50-74 years in a large, integrated, safety-net health system who completed an index FIT from 2010 to 2019. We determined prevalence of unsatisfactory FIT and categorized reasons hierarchically. We used multivariable logistic regression models to identify factors associated with: (i) unsatisfactory FIT; and (ii) subsequent testing within 15 months of the unsatisfactory FIT. Results: Of 56,980 individuals completing an index FIT, 10.2% had an unsatisfactory FIT. Reasons included inadequate specimen (51%), incomplete labeling (27%), old specimen (13%), and broken/leaking container (8%). Unsatisfactory FIT was associated with being male [OR, 1.10; confidence interval (CI), 1.03-1.16], Black (OR, 1.46; CI, 1.33-1.61), Spanish speaking (OR, 1.12; CI, 1.01-1.24), on Medicaid (OR, 1.42; CI, 1.28-1.58), and received FIT by mail (OR, 2.66; CI, 2.35-3.01). Among those with an unsatisfactory FIT, fewer than half (41%) completed a subsequent test within 15 months (median, 4.4 months). Adults aged 50-54 years (OR, 1.16; CI, 1.01-1.39) and those who received FIT by mail (OR, 1.92; CI, 1.49-2.09) were more likely to complete a subsequent test. Conclusions: One in ten returned a FIT that could not be processed, mostly due to patient-related reasons. Fewer than half completed a subsequent test after unsatisfactory FIT. Impact: Screening programs should address these breakdowns such as specimen collection and labeling to improve real-world effectiveness. See related In the Spotlight, p. 183.
MeSH term(s)	Humans ; Male ; Female ; Retrospective Studies ; Prevalence ; Early Detection of Cancer ; Medicaid ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Occult Blood ; Mass Screening ; Colonoscopy
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1153420-5
ISSN	1538-7755 ; 1055-9965
ISSN (online)	1538-7755
ISSN	1055-9965
DOI	10.1158/1055-9965.EPI-23-0507
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Article ; Online: Interindividual variation in transdermal and oral drug deliveries.

Levin, Jacquelyn / Maibach, Howard

Journal of pharmaceutical sciences

2012 Volume 101, Issue 11, Page(s) 4293–4307

Abstract: It is generally assumed that the topical absorption of drugs is subject to more interindividual variation than the oral absorption of drugs. To date, we are unaware of any clinical studies or meta-analyses that compare the interindividual variation of ... ...

Abstract	It is generally assumed that the topical absorption of drugs is subject to more interindividual variation than the oral absorption of drugs. To date, we are unaware of any clinical studies or meta-analyses that compare the interindividual variation of transdermal and oral drug deliveries for a large number of medications. In this research article, the absorption data for 10 medications that can be used as an oral medication or a transdermal patch were compiled, and from the collected data, the interindividual variance was calculated for topical and oral absorption as an overall average and by drug. This research article also briefly reviews the pharmacokinetics and pharmacodynamics of transdermal and oral drug absorption. Our results indicate that there is considerable interindividual variation in topical and oral absorption for the 10 medications investigated. Yet, surprisingly, the calculated overall mean and median coefficient of variation (CV) for topical and oral absorption were comparable (within 10% of each other). Therefore, the interindividual variation in topical and oral absorption may not be as divergent as assumed previously. In a drug-by-drug comparison, certain medications demonstrated considerably more variation when absorbed orally versus topically and vice versa. It is unclear why certain drugs had less variation in absorption when delivered topically versus orally (or vice versa). However, patterns in drug molecular weight (MW) or octanol partition coefficient (log K(OCT) ) could not totally explain these findings. In our analysis, the previously reported correlation between MW or log K(OCT) and interindividual variation in absorption could only be replicated when plotting the topical absorption CV and MW. What became clear from our analysis is that the drug itself is an important variable when considering which route of delivery (oral or topical) will provide the least amount of interindividual variation. Our study had many limitations because of study design, which may have affected our calculations and conclusions. Further experimentation is needed to support and reveal the basic science of skin or drug chemistry that can further explain these findings.
MeSH term(s)	Administration, Cutaneous ; Administration, Oral ; Drug Delivery Systems ; Humans
Language	English
Publishing date	2012-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	3151-3
ISSN	1520-6017 ; 0022-3549
ISSN (online)	1520-6017
ISSN	0022-3549
DOI	10.1002/jps.23270
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Article ; Online: A Guide to the Ingredients and Potential Benefits of Over-the-Counter Cleansers and Moisturizers for Rosacea Patients.

Levin, Jacquelyn / Miller, Richard

The Journal of clinical and aesthetic dermatology

2011 Volume 4, Issue 8, Page(s) 31–49

Abstract: It is difficult for rosacea patients to discern which products and ingredients will be beneficial to their skin and which products will lead to an exacerbation of the signs and symptoms of rosacea. In this paper, the authors provide a brief overview of ... ...

Abstract	It is difficult for rosacea patients to discern which products and ingredients will be beneficial to their skin and which products will lead to an exacerbation of the signs and symptoms of rosacea. In this paper, the authors provide a brief overview of rosacea, its pathogenesis, signs and symptoms, and the management of the two major rosacea subtypes-erythematotelangiectatic rosacea and papular pustular rosacea. Reviewed in greater detail are the common ingredients used in over-the-counter cleansers and moisturizers with discussion of how these ingredients potentially benefit or harm the skin of patients with rosacea. Clinical studies investigating the benefits of using certain over-the-counter cleansers and moisturizers in patients with erythematotelangiectatic rosacea and papular pustular rosacea with or without topical prescription therapy are also reviewed. The specific formulas used in the clinical studies include a sensitive skin synthetic detergent bar, a nonalkaline cleanser and moisturizer, polyhydroxy acid containing cleanser and moisturizer, and a ceramide-based cleanser and moisturizer formulated in a multivesicular emulsion. Based on review of available data, the authors conclude that the use of mild over-the-counter cleansers and moisturizers is beneficial for patients with erythematotelangiectatic rosacea and papular pustular rosacea. The properties of over-the-counter cleansers and moisturizers that contribute to their mildness include an acidic-neutral pH to minimize the flux in skin pH; surfactants or emulsifiers that will not strip the skin of its moisture or strip the lipids and proteins of the stratum corneum; moisturizing ingredients such as emollients, humectants, and occlusives; and formulas without potential irritants and allergens. The most consistent clinical benefits demonstrated in the reviewed studies were a subjectively perceived improvement in subjective symptoms of dryness and irritation as well as an objective improvement in dryness.
Language	English
Publishing date	2011-09-06
Publishing country	United States
Document type	Journal Article
ISSN	2689-9175
ISSN (online)	2689-9175
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Article: Clinical relevance of maintaining the structural and functional integrity of the stratum corneum: why is it important to you?

Del Rosso, James Q / Levin, Jacquelyn

Journal of drugs in dermatology : JDD

2011 Volume 10, Issue 10 Suppl, Page(s) s5–12

MeSH term(s)	Dermatitis, Atopic/physiopathology ; Epidermis/chemistry ; Epidermis/cytology ; Epidermis/physiology ; Humans ; Permeability ; Skin Diseases/physiopathology ; Skin Diseases/therapy
Language	English
Publishing date	2011-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2145090-0
ISSN	1545-9616
ISSN	1545-9616
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Article ; Online: How much do we really know about our favorite cosmeceutical ingredients?

Levin, Jacquelyn / Momin, Saira B

The Journal of clinical and aesthetic dermatology

2010 Volume 3, Issue 2, Page(s) 22–41

Abstract: To date, we are unaware of a review that has investigated common cosmeceutical ingredients in order to answer the three specific questions proposed by the father of cosmeceuticals, Dr. Albert Kligman. It is the goal of this review to gather all the ... ...

Abstract	To date, we are unaware of a review that has investigated common cosmeceutical ingredients in order to answer the three specific questions proposed by the father of cosmeceuticals, Dr. Albert Kligman. It is the goal of this review to gather all the published scientific data on five common cosmeceutical ingredients, answer the three major questions about the scientific rationale for their use, and ascertain how much we really know about consumers' favorite cosmeceutical ingredients.Most of the research concerning cosmeceutical retinoid ingredients is based upon the effects of retinoic acid on the skin. Clinical trials concerning retinol and retinaldehyde are scant and lacking in statistical evaluation for significance. There is research substantiating the effects of kinetin in plants and also in-vitro antioxidant effects. However, proof of anti-aging activity remains elusive, and the clinical efficacy of kinetin is based on limited data. Niacinamide is the ingredient investigated that most closely upholds the "Kligman standards" of cosmeceutical-ingredient analysis. With the available scientific evidence on topical niacinamide, clinicians are able to adequately answer questions about permeability, mechanism, and clinical effect. Both green tea and soy have been popularized commercially based on their antioxidant effects, yet there is a paucity of clinical studies concerning their efficacy as topical anti-aging agents. It may be that soy and green tea are better at preventing the signs and symptoms of skin aging than actually reversing them. Since cosmeceutical products are claiming to therapeutically affect the structure and function of the skin, it is rational and necessary to hold them to specified scientific standards that substantiate efficacy claims.
Language	English
Publishing date	2010-02
Publishing country	United States
Document type	Journal Article
ISSN	2689-9175
ISSN (online)	2689-9175
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Article: Atopic dermatitis and the stratum corneum: part 2: other structural and functional characteristics of the stratum corneum barrier in atopic skin.

Levin, Jacquelyn / Friedlander, Sheila Fallon / Del Rosso, James Q

The Journal of clinical and aesthetic dermatology

2013 Volume 6, Issue 11, Page(s) 49–54

Abstract: This three-part review presents what is currently known about the involvement and interdependency of the epidermal barrier and immune response in the etiopathogenesis of atopic dermatitis. Part 1 of this review depicted the role of filaggrin in atopic ... ...

Abstract	This three-part review presents what is currently known about the involvement and interdependency of the epidermal barrier and immune response in the etiopathogenesis of atopic dermatitis. Part 1 of this review depicted the role of filaggrin in atopic dermatitis while this article, Part 2, evaluates the role of serine proteases and specific lipids in the structural and functional integrity of the stratum corneum and its multiple barrier functions in atopic dermatitis. Upregulation of serine protease activity causes adverse structural changes of the stratum corneum due to degradation of certain stratum corneum proteins that are integral to epidermal structure and functions, interference with the formation of the stratum corneum intercellular lipid membrane, which normally regulates epidermal water flux and gradient, and induction of a TH2 pattern of inflammation, which is the hallmark profile of atopic skin. Alteration in lipid ratios and changes in lipid-directed enzymes may play a role in the impairment of barrier functions that are associated with atopic dermatitis. In Part 3, immune dysregulation, including upregulation of a TH2 inflammation pattern, augmented allergic sensitization, sustained wound healing inflammation, and impaired innate immunity are discussed. The roles of the stratum corneum permeability barrier, the immune defense barrier, and antimicrobial barrier in AD pathogenesis are explained in detail. With this explanation, the interdependence of the multitude of polymorphisms and dysregulations seen in AD skin will become clear. The condensing of these impaired and/or dysregulated functions and how they interact should provide further knowledge about the pathogenic mechanisms that cause atopic dermatitis, how they are clinically relevant, and how they may assist in developing more specific therapies directed at the pathogenesis of atopic dermatitis.
Language	English
Publishing date	2013-11-06
Publishing country	United States
Document type	Journal Article
ISSN	1941-2789
ISSN	1941-2789
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Article ; Online: Septin-5 and -7-IgGs: Neurologic, Serologic, and Pathophysiologic Characteristics.

Annals of neurology

2022 Volume 92, Issue 6, Page(s) 1090–1101

Abstract: Background and objectives: We sought to determine clinical significance of neuronal septin autoimmunity and evaluate for potential IgG effects.: Methods: Septin-IgGs were detected by indirect immunofluorescence assays (IFAs; mouse tissue and cell ... ...

Abstract	Background and objectives: We sought to determine clinical significance of neuronal septin autoimmunity and evaluate for potential IgG effects. Methods: Septin-IgGs were detected by indirect immunofluorescence assays (IFAs; mouse tissue and cell based) or Western blot. IgG binding to (and internalization of) extracellular septin epitopes were evaluated for by live rat hippocampal neuron assay. The impact of purified patient IgGs on murine cortical neuron function was determined by recording extracellular field potentials in a multielectrode array platform. Results: Septin-IgGs were identified in 23 patients. All 8 patients with septin-5-IgG detected had cerebellar ataxia, and 7 had prominent eye movement disorders. One of 2 patients with co-existing septin-7-IgG had additional psychiatric phenotype (apathy, emotional blunting, and poor insight). Fifteen patients had septin-7 autoimmunity, without septin-5-IgG detected. Disorders included encephalopathy (11; 2 patients with accompanying myelopathy, and 2 were relapsing), myelopathy (3), and episodic ataxia (1). Psychiatric symptoms (≥1 of agitation, apathy, catatonia, disorganized thinking, and paranoia) were prominent in 6 of 11 patients with encephalopathic symptoms. Eight of 10 patients with data available (from 23 total) improved after immunotherapy, and a further 2 patients improved spontaneously. Staining of plasma membranes of live hippocampal neurons produced by patient IgGs (subclasses 1 and 2) colocalized with pre- and post-synaptic markers. Decreased spiking and bursting behavior in mixed cultures of murine glutamatergic and GABAergic cortical neurons produced by patient IgGs were attributable to neither antigenic crosslinking and internalization nor complement activation. Interpretation: Septin-IgGs are predictive of distinct treatment-responsive autoimmune central nervous system (CNS) disorders. Live neuron binding and induced electrophysiologic effects by patient IgGs may support septin-specific pathophysiology. ANN NEUROL 2022;92:1090-1101.
MeSH term(s)	Animals ; Rats ; Mice ; Septins/metabolism ; Autoimmunity ; Neurons/metabolism ; Brain Diseases ; Immunoglobulin G/metabolism ; Spinal Cord Diseases
Chemical Substances	Septins (EC 3.6.1.-) ; Immunoglobulin G
Language	English
Publishing date	2022-08-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	80362-5
ISSN	1531-8249 ; 0364-5134
ISSN (online)	1531-8249
ISSN	0364-5134
DOI	10.1002/ana.26482
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Article: Atopic dermatitis and the stratum corneum: part 1: the role of filaggrin in the stratum corneum barrier and atopic skin.

Levin, Jacquelyn / Friedlander, Sheila Fallon / Del Rosso, James Q

The Journal of clinical and aesthetic dermatology

2013 Volume 6, Issue 10, Page(s) 16–22

Abstract: This three-part review presents what is currently known about the involvement and interdependency of the barrier properties of the epidermis, especially the stratum corneum and various specific immunological responses in the etiopathogenesis of atopic ... ...

Abstract	This three-part review presents what is currently known about the involvement and interdependency of the barrier properties of the epidermis, especially the stratum corneum and various specific immunological responses in the etiopathogenesis of atopic dermatitis. Part 1 of this review depicts the role of filaggrin in atopic dermatitis while Part 2 (which will be published in an upcoming issue of The Journal of Clinical and Aesthetic Dermatology) evaluates the role of serine proteases and specific lipids in the structural and functional integrity of the stratum corneum and related barrier functions in atopic dermatitis. Filaggrin is a key component of the stratum corneum that is derived from a larger precursor protein and contributes to its physical strength, hydration status, skin pH, and buffering capacity among other physiochemical properties. Filaggrin gene loss of function mutations appear to play a pathophysiological role; however, they are not the sole pathogenic factor in atopic dermatitis. Adverse structural changes of the stratum corneum are caused by upregulation of serine proteases activity, which causes degradation of certain stratum corneum proteins that are integral to barrier functions; interference with the formation of the stratum corneum intercellular lipid membrane, which normally regulates epidermal water flux and gradient; and induction of a TH2 pattern of inflammation, which is characteristic of atopic skin. Alteration in lipid ratios and changes in lipid-directed enzymes may play a role in the impairment of epidermal barrier functions that are associated with atopic dermatitis. Part 3 of this review (which will be published in an upcoming issue of The Journal of Clinical and Aesthetic Dermatology) discusses how immune dysregulation, including upregulation of a TH2 inflammation pattern, augmented allergic sensitization, sustained wound healing inflammation, and impaired innate immunity all play a role in the development of atopic dermatitis. An increased understanding of the interdependence, polymorphisms, and dysregulations of epidermal barrier functions, including the stratum corneum permeability barrier, immune response barrier, and antimicrobial barrier, should provide further knowledge about the pathophysiological mechanisms that are related to the development of atopic dermatitis, are clinically relevant, and can better direct researchers to develop therapies that are targeted at important pathogenic components of the disease state.
Language	English
Publishing date	2013-10-14
Publishing country	United States
Document type	Journal Article
ISSN	1941-2789
ISSN	1941-2789
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Article ; Online: Human skin buffering capacity: an overview.

Levin, Jacquelyn / Maibach, Howard

Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI)

2008 Volume 14, Issue 2, Page(s) 121–126

Abstract: Skin surface acidity can be measured according to two criteria, its value given by pH and its strength determined by the ability of the skin to resist an acidic/alkaline aggression (i.e. acidic/alkaline resistance and neutralization tests). It is the ... ...

Abstract	Skin surface acidity can be measured according to two criteria, its value given by pH and its strength determined by the ability of the skin to resist an acidic/alkaline aggression (i.e. acidic/alkaline resistance and neutralization tests). It is the quantitative extent to which the skin resists these changes that defines the term buffer capacity or acid/alkali resistance and neutralization capacity of skin. We review studies investigating the possible mechanisms contributing to the buffering capacity of the epidermis via alkali/acidic aggression tests. This paper discerns which components of the epidermis are most likely responsible for the epidermal buffering ability.
MeSH term(s)	Animals ; Buffers ; Carbon Dioxide/chemistry ; Carbon Dioxide/metabolism ; Electrolytes/chemistry ; Electrolytes/metabolism ; Humans ; Hydrogen-Ion Concentration ; Keratins/chemistry ; Keratins/metabolism ; Models, Biological ; Sebum/chemistry ; Sebum/metabolism ; Skin/chemistry ; Skin Physiological Phenomena ; Water-Electrolyte Balance/physiology
Chemical Substances	Buffers ; Electrolytes ; Carbon Dioxide (142M471B3J) ; Keratins (68238-35-7)
Language	English
Publishing date	2008-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1229160-2
ISSN	1600-0846 ; 0909-752X ; 1397-1344
ISSN (online)	1600-0846
ISSN	0909-752X ; 1397-1344
DOI	10.1111/j.1600-0846.2007.00271.x
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