Ann Dermatol.  2016 Jun;28(3):344-351. 10.5021/ad.2016.28.3.344.

CSP0510 Lotion as a Novel Moisturizer Containing Citric Acid and Trisodium Phosphate Relieves Objective and Subjective Symptoms of Atopic Dermatitis

• Lee HJ
• Yang NW
• Choi JY
• Lee JB
• Lee SC

• KMID: 2164642
• DOI: http://doi.org/10.5021/ad.2016.28.3.344

Abstract

BACKGROUND
Moisturizers with anti-inflammatory or anti-itch activity should be developed for the safe and effective management of atopic dermatitis (AD).
OBJECTIVE
This study evaluated the efficacy of a newly developed moisturizer, CSP0510 lotion (Twolines Inc., Korea), containing citric acid (CA) and trisodium phosphate (TSP) as active ingredients, in mild to moderate AD.
METHODS AND RESULTS
CSP0510 lotion applied twice daily for 4 weeks to eczematous lesions improved objective and subjective (itch) symptoms of AD. The physician's global assessment (PGA) score for objective symptoms decreased from 2.5±0.6 before application to 1.3±0.5 after application in the CSP0510-treated group (n=42, p<0.001). Also, the PGA score decreased from 2.3±0.6 to 1.9±0.5 by vehicle-treated (without CA and TSP) control group (p=0.001), but there was no statistical difference between CSP0510-treated and vehicle-treated groups (p=0.089). The visual analogue scale score for itch decreased from 4.8±1.3 to 2.0±0.9 in the CSP0510-treated group (p<0.001), and from 4.6±1.1 to 3.5±0.9 in the control group (p=0.075), showing a statistical significance between two groups (p=0.002). Our results in humans were further supported by in vitro and animal experiments. In HaCaT cells treated with compound 48/80 (7.5 µg/ml), CA:TSP (1:1, vol:vol) synergistically suppressed the compound 48/80-induced upregulation of thymic stromal lymphopoietin, nerve grow factor, and calcitonin gene-related peptide. Application of CSP0510 to the dorsal skin of hairless mice for 3 weeks suppressed the oxazolone-induced allergic skin inflammation.
CONCLUSION
In conclusion, CSP0510 lotion has anti-itch and anti-inflammatory activity in the skin, which improves both objective and subjective symptoms of AD.

Keyword

Anti-inflammatory agents; Atopic dermatitis; Citric acid; CSP0510 lotion; Trisodium phosphate

MeSH Terms

Animal Experimentation
Animals
Anti-Inflammatory Agents
Calcitonin Gene-Related Peptide
Citric Acid*
Dermatitis, Atopic*
Humans
In Vitro Techniques
Inflammation
Mice
Mice, Hairless
Skin
Up-Regulation
Anti-Inflammatory Agents
Calcitonin Gene-Related Peptide
Citric Acid

Figure

• 

  Fig. 1 The Consolidated Standards of Reporting Trials (CONSORT)-type flow chart of study population. AD: atopic dermatitis, CSP0510 lotion: Twolines Inc., Gwangju, Korea.

• 

  Fig. 2 Efficacy of CSP0510 lotion (Twolines Inc., Gwangju, Korea) for treating objective and subjective symptoms in atopic dermatitis (AD) patients. AD patients were randomized into test (n=42) and control (n=42) groups, and skin inflammation (an objective symptom) and itch (a subjective symptom) were scored using the physician's global assessment (PGA) and visual analog scale (VAS), respectively, at the first visit (before application), second visit (after 2 weeks of application), and third visit (after 4 weeks of application). (A) Time-course changes of PGA score in the CSP0510- and vehicle-treated (control) groups. (B) Time-course changes of VAS score in the CSP0510- and vehicle-treated (control) groups. Data represent the mean±standard deviation. NS: not significant.

• 

  Fig. 3 MTT assay for cell viability. The MTT assay was conducted in order to assess the cytotoxic activity of (A) compound 48/80 (0.1~100 µg/ml), (B) trisodium phosphate (TSP) (0.25~5.0 mM), and (C) citric acid (CA) (0.25~5.0 mM), respectively.

• 

  Fig. 4 Determination of the optimal dose of compound 48/80 in studying biomarkers for cutaneous neurogenic inflammation (CNI). (A) Reverse transcriptase- polymerase chain reaction (RT-PCR) experiments for thymic stromal lymphopoietin (TSLP), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP), biomarkers for CNI, were performed as described in the MATERIALS AND METHODS. HaCaT cells were treated with different doses of compound 48/80 (1~10 µg/ml) to find out the optimal dose of compound 48/80 in following experiments. (B) Densitometric analysis on the relative density of tested biomarkers are depicted. This picture represents three repetitive experiments of RT-PCR.

• 

  Fig. 5 Effect of citric acid (CA) and trisodium phosphate (TSP) on expression levels of thymic stromal lymphopoietin (TSLP), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) in compound 48/80-treated HaCaT cells. (A) HaCaT cells were treated with TSP or CA or CA:TSP (1:1, vol:vol), and cells were harvested at designated time-points after treatment for reverse transcriptase- polymerase chain reaction (RT-PCR) experiments. Expression levels of TSLP were checked at 6 hours after compound 48/80 treatment, and those of NGF and CGRP were checked at 24 hours after compound 48/80 treatment. First lane represents the negative control samples, which were not treated with compound 48/80 and CA or TSP. Second land represents the positive control samples, which were treated only with compound 48/80 (7.5 µg/ml). (B) Data represent the mean±standard deviation of three independent experiments after densitometric analysis for positive bands of (A). *p<0.01 between the compound 48/80, TSP-treated and the compound 48/80, CA:TSP-treated samples. *p<0.01 between the compound 48/80, CA-treated and the compound 48/80, CA:TSP-treated samples.

• 

  Fig. 6 Effect of CSP0510 lotion (Twolines Inc., Gwangju, Korea) on oxazolone-induced skin inflammation in hairless mice. (A) Nontreated mouse, (B) oxazolone (OX)-treated mouse, (C) OX-treated, vehicle-applied mouse (control) and (D) OX-treated, CSP0510-applied mouse. The results shown are representative of five mice in each group.

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