Integumentary System Development - Vernix Caseosa: Difference between revisions
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[[File:Newborn - vernix caseosa.jpg|thumb|alt=Newborn vernix caseosa|Newborn vernix caseosa]] | [[File:Newborn - vernix caseosa.jpg|thumb|alt=Newborn vernix caseosa|Newborn vernix caseosa]] | ||
The {{vernix caseosa}} consists of a bilayer formed by corneocytes embedded in a rich lipid matrix, formed by the sebaceous glands and epidermis, that is anchored to the fetal epithelium by hair. | The {{vernix caseosa}} consists of a bilayer formed by corneocytes embedded in a rich lipid matrix, formed by the sebaceous glands and epidermis, that is anchored to the fetal epithelium by lanugo hair. | ||
Prenatally, this thick integumentary surface layer may, like the stratum corneum, protect the fetal skin from the watery environment. At birth, this slippery layer may aid the delivery process. The vernix has also many other known protective and immune as well as potential functions.{{#pmid:11069626|PMID11069626}} The constituent components and their concentrations appear to differ between individuals and the sexes.{{#pmid:24911066|PMID24911066}} | Prenatally, this thick integumentary surface layer may, like the stratum corneum, protect the fetal skin from the watery amniotic environment and the enzymatic agents it contains. At birth, this slippery layer may aid the delivery process. The vernix has also many other known protective and immune as well as potential functions.{{#pmid:11069626|PMID11069626}} The constituent components and their concentrations appear to differ between individuals and the sexes.{{#pmid:24911066|PMID24911066}} | ||
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Vernix has many different known and potential functions.{{#pmid:11069626|PMID11069626}} | Vernix has many different known and potential functions.{{#pmid:11069626|PMID11069626}} | ||
* a highly variable coating of the fetal skin | * a highly variable coating of the fetal skin | ||
* develops cranio-caudally production coincides in utero with terminal differentiation of the epidermis and formation of the stratum corneum | * develops cranio-caudally production coincides in utero with terminal differentiation of the epidermis and formation of the stratum corneum | ||
* primarily composed of sebum, cells that have sloughed off the fetus's skin and shed lanugo hair | * primarily composed of sebum, cells that have sloughed off the fetus's skin and shed lanugo hair | ||
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* towards term fragments of vernix can mix into the amniotic fluid resulting in (normal) turbidity | * towards term fragments of vernix can mix into the amniotic fluid resulting in (normal) turbidity | ||
* fetal swallowing of amniotic fluid mixed with fragments of vernix can also occur | * fetal swallowing of amniotic fluid mixed with fragments of vernix can also occur | ||
==Components== | |||
* high water content (80%) largely compartmentalized within fetal corneocytes (cells forming the stratum corneum) | |||
* cathelicidin LL-37, alpha-defensins, and LL-37 in neutrophils.{{#pmid:15565791|PMID15565791}} | * cathelicidin LL-37, alpha-defensins, and LL-37 in neutrophils.{{#pmid:15565791|PMID15565791}} | ||
* Lysozyme, lactoferrin, human neutrophil peptides 1-3, and secretory leukocyte protease inhibitor | |||
==Abnormalities== | ==Abnormalities== | ||
===Neonatal Aspiration Syndrome=== | ===Neonatal Aspiration Syndrome=== |
Revision as of 11:46, 9 August 2018
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Introduction
The vernix caseosa consists of a bilayer formed by corneocytes embedded in a rich lipid matrix, formed by the sebaceous glands and epidermis, that is anchored to the fetal epithelium by lanugo hair.
Prenatally, this thick integumentary surface layer may, like the stratum corneum, protect the fetal skin from the watery amniotic environment and the enzymatic agents it contains. At birth, this slippery layer may aid the delivery process. The vernix has also many other known protective and immune as well as potential functions.[1] The constituent components and their concentrations appear to differ between individuals and the sexes.[2]
Some Recent Findings
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More recent papers |
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This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Vernix Caseosa <pubmed limit=5>Vernix Caseosa</pubmed> |
Textbooks
- Human Embryology (2nd ed.) Larson Chapter 14 p443-455
- The Developing Human: Clinically Oriented Embryology (6th ed.) Moore and Persaud Chapter 20: P513-529
- Before We Are Born (5th ed.) Moore and Persaud Chapter 21: P481-496
- Essentials of Human Embryology Larson Chapter 14: P303-315
- Human Embryology, Fitzgerald and Fitzgerald
- Color Atlas of Clinical Embryology Moore Persaud and Shiota Chapter 15: p231-236
Integumentary Development Overview
4 weeks
- simple ectoderm epithelium over mesenchyme.
1-3 months
|
Integument Human Embryo (Week 8, Stage 22) |
4 months
Fetal human integumentary histology[6](Weeks in figure are from LMP)
- Basal cell - proliferation generates folds in basement membrane.
- Neural crest cells - melanoblasts migrate into epithelium. These are the future melanocyte pigment cell of the skin.
- Embryonic connective tissue- differentiates into dermis, a loose ct layer over a dense ct layer. Beneath the dense ct layer is another loose ct layer that will form the subcutaneous layer.
- Ectoderm contributes to nails, hair follictles and glands.
- Nails form as thickening of ectoderm epidermis at the tips of fingers and toes. These form germinative cells of nail field.
- Cords of these cells extend into mesoderm forming epithelial columns. These form hair follicles, sebaceous and sweat glands.
5 months
- Hair growth initiated at base of cord, lateral outgrowths form associated sebaceous glands.
- Other cords elongate and coil to form sweat glands.
- Cords in mammary region branch as they elongate to form mammary glands. These glands will complete development in females at puberty. Functional maturity only occurs in late pregnancy.
Embryonic and Fetal Epidermis
Electron Micrographs of the Developing Human Epidermis[7]
6 to 8 weeks (8-9 week EGA) |
7 to 9 weeks (9-11 week EGA) |
22 weeks (about 24 week EGA) |
Functions
Vernix has many different known and potential functions.[1]
- a highly variable coating of the fetal skin
- develops cranio-caudally production coincides in utero with terminal differentiation of the epidermis and formation of the stratum corneum
- primarily composed of sebum, cells that have sloughed off the fetus's skin and shed lanugo hair
- can be absent in preterm infants
- dehydration and rehydration processes occur two to four times faster at 37 degrees celcius than at room temperature[8]
- towards term fragments of vernix can mix into the amniotic fluid resulting in (normal) turbidity
- fetal swallowing of amniotic fluid mixed with fragments of vernix can also occur
Components
- high water content (80%) largely compartmentalized within fetal corneocytes (cells forming the stratum corneum)
- cathelicidin LL-37, alpha-defensins, and LL-37 in neutrophils.[9]
- Lysozyme, lactoferrin, human neutrophil peptides 1-3, and secretory leukocyte protease inhibitor
Abnormalities
Neonatal Aspiration Syndrome
Neonatal aspiration syndrome caused by vernix caseosa is very rare condition, caused by the infant oral cavity becoming filled with aggregates of vernix caseosa.[10]
Vernix Caseosa Peritonitis
Vernix caseosa peritonitis is a very rare post caesarean section inflammatory response occurring maternally after birth.[11]
References
- ↑ 1.0 1.1 Pickens WL, Warner RR, Boissy YL, Boissy RE & Hoath SB. (2000). Characterization of vernix caseosa: water content, morphology, and elemental analysis. J. Invest. Dermatol. , 115, 875-81. PMID: 11069626 DOI.
- ↑ 2.0 2.1 2.2 Míková R, Vrkoslav V, Hanus R, Háková E, Hábová Z, Doležal A, Plavka R, Coufal P & Cvačka J. (2014). Newborn boys and girls differ in the lipid composition of vernix caseosa. PLoS ONE , 9, e99173. PMID: 24911066 DOI.
- ↑ Boiten WA, Berkers T, Absalah S, van Smeden J, Lavrijsen APM & Bouwstra JA. (2018). Applying a vernix caseosa based formulation accelerates skin barrier repair by modulating lipid biosynthesis. J. Lipid Res. , 59, 250-260. PMID: 29217624 DOI.
- ↑ Taïeb A. (2018). Skin barrier in the neonate. Pediatr Dermatol , 35 Suppl 1, s5-s9. PMID: 29596733 DOI.
- ↑ Fuchs E. (2008). Skin stem cells: rising to the surface. J. Cell Biol. , 180, 273-84. PMID: 18209104 DOI.
- ↑ 6.0 6.1 Coolen NA, Schouten KC, Middelkoop E & Ulrich MM. (2010). Comparison between human fetal and adult skin. Arch. Dermatol. Res. , 302, 47-55. PMID: 19701759 DOI.
- ↑ Dale BA, Holbrook KA, Kimball JR, Hoff M & Sun TT. (1985). Expression of epidermal keratins and filaggrin during human fetal skin development. J. Cell Biol. , 101, 1257-69. PMID: 2413039
- ↑ Rissmann R, Groenink HW, Gooris GS, Oudshoorn MH, Hennink WE, Ponec M & Bouwstra JA. (2008). Temperature-induced changes in structural and physicochemical properties of vernix caseosa. J. Invest. Dermatol. , 128, 292-9. PMID: 17671513 DOI.
- ↑ Yoshio H, Lagercrantz H, Gudmundsson GH & Agerberth B. (2004). First line of defense in early human life. Semin. Perinatol. , 28, 304-11. PMID: 15565791
- ↑ Nishijima K, Shukunami K, Inoue S & Kotsuji F. (2005). Management for neonatal aspiration syndrome caused by vernix caseosa. Fetal. Diagn. Ther. , 20, 194-6. PMID: 15824497 DOI.
- ↑ Stuart OA, Morris AR & Baber RJ. (2009). Vernix caseosa peritonitis - no longer rare or innocent: a case series. J Med Case Rep , 3, 60. PMID: 19208257 DOI.
Reviews
Visscher MO, Adam R, Brink S & Odio M. (2015). Newborn infant skin: physiology, development, and care. Clin. Dermatol. , 33, 271-80. PMID: 25889127 DOI.
Visscher M & Narendran V. (2014). The Ontogeny of Skin. Adv Wound Care (New Rochelle) , 3, 291-303. PMID: 24761361 DOI.
Chambers AC, Patil AV, Alves R, Hopkins JC, Armstrong J & Lawrence RN. (2012). Delayed presentation of vernix caseosa peritonitis. Ann R Coll Surg Engl , 94, 548-51. PMID: 23131223 DOI.
Singh G & Archana G. (2008). Unraveling the mystery of vernix caseosa. Indian J Dermatol , 53, 54-60. PMID: 19881987 DOI.
Visscher MO, Narendran V, Pickens WL, LaRuffa AA, Meinzen-Derr J, Allen K & Hoath SB. (2005). Vernix caseosa in neonatal adaptation. J Perinatol , 25, 440-6. PMID: 15830002 DOI.
Articles
Kalužíková A, Vrkoslav V, Harazim E, Hoskovec M, Plavka R, Buděšínský M, Bosáková Z & Cvačka J. (2017). Cholesteryl esters of ω-(O-acyl)-hydroxy fatty acids in vernix caseosa. J. Lipid Res. , 58, 1579-1590. PMID: 28576934 DOI.
Checa A, Holm T, Sjödin MO, Reinke SN, Alm J, Scheynius A & Wheelock CE. (2015). Lipid mediator profile in vernix caseosa reflects skin barrier development. Sci Rep , 5, 15740. PMID: 26521946 DOI.
Visscher MO, Utturkar R, Pickens WL, LaRuffa AA, Robinson M, Wickett RR, Narendran V & Hoath SB. (2011). Neonatal skin maturation--vernix caseosa and free amino acids. Pediatr Dermatol , 28, 122-32. PMID: 21504444 DOI.
Tollin M, Jägerbrink T, Haraldsson A, Agerberth B & Jörnvall H. (2006). Proteome analysis of vernix caseosa. Pediatr. Res. , 60, 430-4. PMID: 16940245 DOI.
Rissmann R, Groenink HW, Weerheim AM, Hoath SB, Ponec M & Bouwstra JA. (2006). New insights into ultrastructure, lipid composition and organization of vernix caseosa. J. Invest. Dermatol. , 126, 1823-33. PMID: 16628195 DOI.
Tollin M, Bergsson G, Kai-Larsen Y, Lengqvist J, Sjövall J, Griffiths W, Skúladóttir GV, Haraldsson A, Jörnvall H, Gudmundsson GH & Agerberth B. (2005). Vernix caseosa as a multi-component defence system based on polypeptides, lipids and their interactions. Cell. Mol. Life Sci. , 62, 2390-9. PMID: 16179970 DOI.
Akinbi HT, Narendran V, Pass AK, Markart P & Hoath SB. (2004). Host defense proteins in vernix caseosa and amniotic fluid. Am. J. Obstet. Gynecol. , 191, 2090-6. PMID: 15592296 DOI.
Yoshio H, Tollin M, Gudmundsson GH, Lagercrantz H, Jornvall H, Marchini G & Agerberth B. (2003). Antimicrobial polypeptides of human vernix caseosa and amniotic fluid: implications for newborn innate defense. Pediatr. Res. , 53, 211-6. PMID: 12538777 DOI.
Hoeger PH, Schreiner V, Klaassen IA, Enzmann CC, Friedrichs K & Bleck O. (2002). Epidermal barrier lipids in human vernix caseosa: corresponding ceramide pattern in vernix and fetal skin. Br. J. Dermatol. , 146, 194-201. PMID: 11903227
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