Cohesion and desquamation of epidermal stratum corneum

This article attempts to provide a comprehensive review on the roles of various classes of molecules in the cohesion and desquamation of the stratum corneum. In the first part of this monograph we review the field of epidermal differentiation in vivo and vitro, describing the expression and functions of a number of key structural molecules that characterize the process. In the second part we emphasize terminal differentiation and the biogenesis of the stratum corneum. The stratum corneum is a cell layer unique to fully differentiated squamous epithelia such as skin. While it is a dead stratum, it nevertheless is in a homeostatic process of continual shedding and renewal in synchrony with basal cell replication. It is also a degradative layer containing many proteinases and glycosidases in which a variety of intracellular and intercellular macromolecules are degraded. We highlight the molecules localized within the intercorneal matrix that are most likely to play a role in cohesion and desquamation, including: glycoproteins, lipids and enzymes. Because it is difficult to study the stratum corneum and desquamation in the native tissue, we discuss a number of model systems that have been used. The stratum corneum can be dispersed into single squames in different ways; these include mechanical dispersion as well as agents such as detergents and enzymes. The solubilized molecules and the structures remaining can then be studied as to their specific roles in desquamation. Using this approach it is possible to reconstitute multilayered structures that resemble a real stratum corneum. We have shown that glycoproteins play a key role in squame reaggregation and that this process can be modulated with amino sugars in a lectin-like fashion. Cohesion and desquamation can also be studied in tissue culture. Depending on the culture system, the extent of terminal differentiation and squame accumulation varies. Yet desquamation does not normally occur. It can be induced however by the inclusion of exogenous agents such as IFN-gamma which are found in the native epidermis but are absent in vitro. Modulation of desquamation by other exogenous agents is likely to yield further knowledge of how shedding occurs in vivo. Insight has also come from studies of scaling skin disorders. The glycoprotein and lipid profiles are altered in the stratum corneum in many diseases of aberrant terminal differentiation. A number of abnormalities in the levels of cytokines and growth factors have also been reported in the lesional tissue of such diseases.(ABSTRACT TRUNCATED AT 400 WORDS)