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Updated: May 20, 2026
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Isolation and Culture of Primary Mouse Keratinocytes from Neonatal and Adult Mouse Skin
Published on: July 14, 2017
Topical Calcineurin Inhibitors and the Epidermal Barrier in Atopic Dermatitis
Joachim W Fluhr1,2, Matthias M Bräutigam3, Ehrhardt Proksch4
1Institute of Allergology, Charite - Universitätsmedizin Berlin, Berlin, Germany, joachim.fluhr@charite.de.
Dermatology (Basel, Switzerland)
|May 18, 2026
Summary
Topical calcineurin inhibitors (TCIs) improve skin barrier function in atopic dermatitis (AD) by enhancing hydration and normalizing proteins. Unlike steroids, TCIs do not cause skin thinning and may positively impact the skin microbiome.
Area of Science:
- Dermatology
- Immunology
- Skin Barrier Research
Background:
- Topical calcineurin inhibitors (TCIs) like pimecrolimus and tacrolimus are non-steroidal treatments for atopic dermatitis (AD).
- Existing research on TCIs and skin barrier function is fragmented, necessitating a comprehensive review.
Purpose of the Study:
- To review the impact of TCIs on epidermal barrier structure and function in AD patients.
- To compare TCI effects on skin barrier with topical corticosteroids (TCS).
Main Methods:
- Systematic review of clinical studies on TCIs in atopic dermatitis.
- Analysis of data on transepidermal water loss (TEWL), stratum corneum (SC) hydration, and protein normalization.
- Evaluation of effects on antimicrobial peptides (AMPs), lipid organization, and natural moisturizing factor (NMF).
Main Results:
- TCIs improve TEWL, SC hydration, and normalize structural proteins (filaggrin, loricrin) in AD.
- TCIs do not cause skin atrophy, unlike TCS, and may reverse steroid-induced thinning.
- TCIs preserve AMP expression, potentially reducing Staphylococcus aureus colonization and supporting microbial diversity.
- Positive effects on lipid lamellar organization and NMF levels indicate barrier restoration.
Conclusions:
- TCIs improve skin barrier function in AD through T-cell modulation without harming keratinocytes or dermal components.
- Unlike TCS, TCIs lack intrinsic barrier-damaging mechanisms, offering a safer long-term profile.
- Further research is needed on long-term effects, microbiome stability, and integration with biologic therapies.
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