La peau est l’organe le plus grand du corps humain et représente ~10% de la masse corporelle. La bonne qualité de son état et de ses fonctionnalités est primordiale pour la santé d’un individu. La sécheresse cutanée constitue un phénomène commun dans différents dysfonctionnements physiopathologiques. Grâce à ses propriétés de protection de l’organisme vis-à-vis de son environnement, le stratum corneum (SC) est considéré comme le principal élément contrôlant l’hydratation. Ce travail de thèse, associant des développements techniques et méthodologiques, a conduit à la mise en évidence par microspectroscopie Raman confocale, des mécanismes moléculaires impliqués dans les phénomènes de sécheresse cutanée. Le lien moléculaire entre hydratation et stress mécanique du SC ex vivo est décrit de manière approfondie impliquant lipides et protéines tissulaires. Ces travaux ont également porté sur la caractérisation des modifications supramoléculaires responsables des déformations du SC sous stress mécanique. En parallèle, ce travail illustre l’intérêt des spectroscopies vibrationnelles comme outil d’évaluation des mécanismes d’action des produits hydratants.Le caractère non-invasif de la spectroscopie Raman a permis d’exploiter les fortes potentialités de cette technique en transposant in vivo l’utilisation des descripteurs spectraux obtenus ex vivo. Ainsi, nous avons développé une approche in vivo couplant la spectroscopie Raman et la méthode des moindres carrés partiels (PLS) pour la quantification indirecte de différents paramètres physico-chimiques et fonctionnels du SC y compris les lipides et l’eau conduisant à une caractérisation globale du statut physiopathologique du SC. / The skin is the largest organ of the human body, accounting for ~10% of the body weight. The quality of its state and functionality is essential for the human health. Dry skin is a common phenomenon in various physiopathological dysfunctions. The uppermost layer of the skin, the stratum corneum assumes the first barrier between organism and environment, it is thus considered as the main element controlling skin hydration. This work, combining technical and methodological developments, led to highlight the molecular mechanisms involved in skin dryness phenomena by confocal Raman microspectroscopy. The molecular link between hydration and mechanical stress of SC ex vivo is described in detail involving lipids and proteins. This work has also focused on the characterization of supramolecular changes related to the deformations of the SC under mechanical stress. In parallel, this work illustrates the effectiveness of vibrational spectroscopy for evaluation of moisturizers mechanisms of action. The non-invasive nature of Raman spectroscopy allowed exploiting the high potential of this technique by transposing spectral descriptors obtained ex vivo to in vivo. Thus, we developed an in vivo approach coupling Raman spectroscopy and partial least squares method (PLS) for indirect quantification of different physico-chemical and functional parameters including the SC lipids and water leading to an overall characterization of the SC physiopathological status.

Moisturizers are used in various types of dry skin disorders, but also by people with healthy skin. It is not unusual that use of moisturizers is continued for weeks, months, or even years. A number of moisturizers have been shown to improve the skin barrier function, while others to deteriorate it, but the reason for observed effects remains unknown. Further understanding of the mechanism by which long-term treatment with moisturizers influences the skin barrier would have clinical implications, as barrier-deteriorating creams may enhance penetration of allergens or irritants and predispose to dry skin and eczema, while barrier-improving ones could reduce many problems. The present research combined non-invasive techniques with analyses of skin biopsies, allowing studies of the epidermis at molecular and cellular level. Test moisturizers were examined on healthy human volunteers for their effect on the skin barrier, with regard to such factors as pH, lipid type, and presence of a humectant, as well as complexity of the product. After a 7-week treatment with the moisturizers, changes in transepidermal water loss, skin capacitance, and susceptibility to an irritant indicated a modified skin barrier function. Moreover, the mRNA expression of several genes involved in the assembly, differentiation and desquamation of the stratum corneum, as well as lipid metabolism, was altered in the skin treated with one of the moisturizers, while the other moisturizer induced fewer changes. In conclusion, long-term use of moisturizers may strengthen the barrier function of the skin, but also deteriorate it and induce skin dryness. Moisturizers have also a significant impact on the skin biochemistry, detectable at molecular level. Since the type of influence is determined by the composition of a moisturizer, more careful selection of ingredients could help to design moisturizers generating a desired clinical effect, and to avoid ingredients with a negative impact on the skin.

Atopic dermatitis (AD), ichthyosis vulgaris (IV), and X-linked recessive ichthyosis (XLRI) are characterized by dry skin and impaired skin barrier. AD and IV are related to loss-of-function mutations in FLG (encoding filaggrin), whereas XLRI is caused by deletions or inactivating mutations in the steroid sulphatase gene (STS). Patients regularly use moisturizing creams, but little is known about the creams’ effects on the skin barrier. The present work combines objective scorings, non-invasive techniques, and molecular analyses of skin biopsies to characterize the skin in 57 patients with AD, IV, or XLRI, and in 14 healthy controls. Patients were classified according to their FLG and STS mutation status: AD with FLG+/+ (n = 14), AD with FLG+/– (n = 14), AD/IV with FLG–/– (n = 15), and XLRI with STS– (n = 14), as well as one man with a novel point mutation. Assessments were conducted at baseline and after four weeks of treatment with three different moisturizers applied to volar forearm skin. At baseline, dryness scoring and non-invasive assessments verified impaired skin barrier function in all patients. In patients with AD/IV, microarray analysis identified 300–3000 up- or downregulated mRNA transcripts involved in signalling pathways important for inflammation and barrier repair. The skin phenotype and number of altered transcripts were correlated with the FLG mutation status, with FLG–/– patients displaying the highest transepidermal water loss (TEWL) and the most altered transcript levels. In contrast, despite an equally dysfunctional skin barrier, only limited changes in mRNA transcripts occurred in XLRI patients. Treatment with moisturizers improved skin dryness similarly in all groups, but TEWL behaved differently: it decreased slightly in the AD/IV group and increased in the XLRI group, especially after urea treatment. Only minute effects on skin pH and mRNA expression were observed. In conclusion, FLG mutations elicit pro-inflammatory mechanisms probably aimed at restoring barrier competence. This does not occur in patients with XLRI, presumably because STS deficiency automatically increases the barrier thickness. Moisturizing treatment improves skin dryness in patients with AD, IV, or XLRI, but does not seem to normalize the altered epidermal gene expression profile in AD/IV patients.