Ectoine-Containing Cream in the Treatment of Mild to Moderate Atopic Dermatitis: A Randomised, Comparator-Controlled, Intra-Individual Double-Blind, Multi-Center Trial

Abstract

Introduction: The natural cyclic tetrahydropyrimidine, ectoine, is a low-molecular, water-binding, organic osmolyte. Previously, topical application of ectoine to healthy human skin was shown to improve skin hydration as well as skin barrier function. Objectives: We therefore speculated that topical application of ectoine would be beneficial for patients with atopic dermatitis (AD), in which a genetically defined defect in skin barrier function is of major pathogenetic relevance. We assessed the efficacy of an ectoine-containing cream (EHK02-01) in the management of 65 patients with mild to moderate AD in a randomized, intra-individual, double-blind, multi-center trial, in which the efficacy of ectoine was compared to a nonsteroidal anti-inflammatory cream previously found to primarily act on skin barrier function and therefore with a comparable mode of action. Methods: Sixty-five patients with mild to moderate AD aged 18-65 years were enrolled. The patients applied EHK02-01 and the control cream on two symmetrical lesions twice daily for 28 days. At the beginning, after 7 and after 28 days, treated skin areas were assessed by modified, objective local SCORAD (Scoring Atopic Dermatitis) and IGA (Investigator's Global Assessment) as well as the patients' judgment of efficacy and their assessment of pruritus. Results: EHK02-01 was found to be very well tolerated. Even more important, efficacy of EHK02-01 treatment was equivalent to that achieved with the reference product. Conclusion: These results indicate that topical treatment with EHK02-01 may represent a novel option for the treatment of patients with AD.

Meta-Analysis of the Efficacy of Ectoine Nasal Spray in Patients with Allergic Rhinoconjunctivitis

“…Clinical studies have shown that treatment with ectoine results in very few adverse events (frequency comparable to placebo) and virtually no safety concerns [20, 33, 34]. In contrast, the traditional drugs are still associated with side effects, warranting the search for alternative treatments.…”

Signalling-Dependent Adverse Health Effects of Carbon Nanoparticles Are Prevented by the Compatible Solute Mannosylglycerate (Firoin) In Vitro and In Vivo

“…These properties make them ideal candidates for biotechnological applications [15]. But also medical applications and therapeutic approaches in which stabilization of cellular structures and functions are considered to be beneficial have been suggested and were successfully tested in pre-clinical and clinical studies [16],[17]. Although compatible solutes are found in almost all living organisms, in particular extremophilic bacteria are important sources for these substances.…”

Bacterial Derivatives of Lactococcus lactis and Ectoin for Atopic Dermatitis: Dermal Compatibility and Cosmetic Acceptability

“…It has been shown that it protects the cellular membrane from the damage caused by surfactants (present in many cosmetic products) and reinforces the barrier function against water loss, improving skin resistance and preventing dehydration [27]. Like Marini et al [26] demonstrated that the application of a cream containing ectoin twice a day over a 28 day period to the damaged skin of patients with light to moderate AD reduced the seriousness of the condition and was very well tolerated. The other components of the product include panthenol, squalene and shea butter.…”

“…A new product specifically designed for use on atopic skin now exists. It is an emollient that combines lysate of Lactococcus Lactis (ProRenew Complex CLR TM ), which acts by promoting skin regeneration and barrier function recovery, and ectoin, a substance that prevents dehydration and reinforces the barrier function [26,27]. In addition, the product also contains other components with emollient properties already widely used in the manufacture of cosmetics and creams, including squalene, panthenol and shea butter [28][29][30].…”