A pilot trial of skin barrier restoration to reduce systemic inflammation

PROJECT SUMMARY
A chronic inflammatory state, termed inflammageing, is a major driver of morbidity and premature death among
older adults. Although the identification of inflammatory triggers has been identified as a critical area for aging
research, little attention has focused on the skin, despite its role as a primary immunoregulatory organ. Normal
aging is associated with increased skin barrier permeability, which leads to subclinical inflammatory cascades
in the skin and serum. We hypothesize that age-associated decline of skin barrier function contributes to
inflammageing and that restoring the skin barrier with moisturizers will reduce systemic inflammation.
We propose a pilot trial designed to determine the best measures of skin barrier function in older adults, the
most sensitive measures of systemic inflammation, the role of the cutaneous microbiome, and the feasibility
and acceptability of moisturizer use. In a parallel, 8-week, self-controlled design, 32 subjects ≥70 years of age
will be randomized to treatment with a ceramide moisturizing cream or petrolatum ointment. Changes in
inflammatory markers, skin barrier function, and microbial diversity will be compared between a 4-week
treatment period of moisturizer application and a 4-week placebo period. We will also examine recruitment
efficacy, retention rates, fidelity to the treatment, data integrity, and the acceptability of the intervention and
protocol. The results will be used to design a future randomized efficacy trial of moisturizers to reduce systemic
inflammation. While many other pharmacologic strategies for reducing inflammation in older adults are
considered too risky or expensive for widespread use, moisturizers are a promising intervention that is safe
and accessible in diverse community settings.

Grant Number: 5R21AR082620-02
NIH Institute/Center: NIH
Principal Investigator: Katrina Abuabara