2.2. Ex Vivo Experimentation
Experimentation was carried out on skin explants, a full-thickness skin biopsy embedded in a solid and nourishing matrix while its epidermal surface was left in contact with air. The aim of this investigation was to evaluate the effectiveness of TPSE at 0.5% (5 mg.ml-1) formulated in a vehicle on Calcitonin Gene-Related Peptide (CGRP), IL-10 release, Kappa Opioid Receptor (KOR) and Caspase 14 expression.
Nine explants of approximately 10 mm (± 1 mm) in diameter were prepared from an abdominoplasty procedure of a 36-year-old, phototype III, female donor. Explants were divided into batches and each experimental batch consisted of three replicates (n=3).
Three conditions were carried out as follows:
- -
Untreated skin explants
- -
Skin explant + vehicle 100%
- -
Skin explant + vehicle (99.5%) + TPSE at 0.5%
Composition of the product
The composition of the vehicle was: 100% Caprylic/Capric Triglycerides (Dullberg Konzentra, Hamburg, Germany).
Every day, 5μl of vehicle or vehicle + TPSE 0.5% were applied on human skin explant. Skins were growing for 7 days. The specific medium was removed every two days.
Quantification of protein amount by ELISA
After 7 days of treatment, the supernatants were collected. The quantity of total proteins on each supernatant was measured by BCA test. This quantity allowed us to standardize each sample. IL-10 and CGRP were quantified by ELISA (pg.ml-1 reported to 1 mg of protein). The average amount of protein (pg.mg-1 of protein) ± standard error (SEM) was presented (four measures per sample).
Quantification of protein expression by Immunofluorescence
After 7 days of treatment, the skins were fixed and included in paraffin. The samples were microtome sectioned before stained. Caspase 14 and KOR were detected by immunofluorescence. The staining was observed with Zeiss Axio green fluorescence microscope. The average of protein fluorescence intensity (AU) ± SEM was presented (10 measures per sample).
2.3. In Vivo Trials
This single center randomized double-blinded interventional face study controlled clinical trial adhered to the principles of Good Clinical Practices and the declaration of Helsinki. According to local and European regulatory guidelines (Official Journal of EU of 10 March 2010 paragraph 1.2.9), this type of trial testing marketed cosmetics does not require approval from local ethics committees.
Population
Thirty-five female subjects, all aged between 40 and 65 years, were recruited according to skin types I to IV. Subjects received information regarding the aim and procedures of the experiment, and they gave their written informed consent to their participation. All were healthy and declared that they were neither pregnant nor breastfeeding at the time of the study. They were separated into two groups: Group A and Group B. The major difference in the treatment was that Group A was treated with placebo, whereas the Group B was treated with TPSE. Subjects with any facial skin diseases (i.e., acne, allergic dermatitis, glucocorticoid-dependent dermatitis, rosacea, infections), systemic disorders and ongoing pharmacological treatment were excluded. Exclusion criteria also included acute and/or chronic inflammation or infection of facial skin, exposure to sunlight or artificial UV rays within 15 days of the experiment. Pregnant women and women having benefited from facial injection were advised to avoid the application of other similar products during the whole study, which lasted 28 days.
Stinging Test
To determine if the volunteer had sensitive skin, a stinging test as described by Frosch and Duhring [
27], was performed during the inclusion visit (D-7) by the dermatologist who recorded the subject’s sensations.
To induce a burning or stinging sensation, subjects were stimulated on both nasolabial folds with a 10% lactic acid aqueous solution for at least 2 min until a stinging sensation was triggered. The side of application of lactic acid was defined by randomization. The test was blinded for subjects. The intensity of the self-declared sensation of discomfort including stinging, tingling, itching, tightening, burning, or pain on the site of application was estimated using a 4-point scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe). The cumulative scores at 2.5 and 5 min on the lactic acid side ≥ 3 were considered positive to the test and included in the experimentation. The stinging test was carried out under a controlled temperature and relative humidity (temperature: 21 ± 1 °C, hygrometry: 45 ± 5%). At D28, the same procedure was administered.
Test formulations
A face cream containing 0.5% of TPSE and a face cream placebo, which the following components, have been used:
Aqua, cyclopentasiloxane, isopropyl miristate, cetyl alcohol, glyceryl stereate, PEG-100 stereate/phenoxyethanol, dimethiconol, chlophenesin carbomer, sodium hydroxide. In addition to these, the “active”cream also contains 0.5% of TPSE.
Both study formulas were identical in appearance and supplied with two identical pump dispensers.
Treatment and evaluation visits
The TPSE face cream or the placebo face cream was applied twice daily to the face for 28 days. Each dose applied was 0.4 g. Dermatological evaluations were conducted at D28.
Evaluation by clinical scoring of erythrosis/rosacea
Erythema was assessed using standardized three-dimensional images taken with the LifeViz® Micro stereophotogrammetric 3D imaging system (Quantificare, Sophia Antipolis, France), and analyzed using MySkin® software.
The redness obtained depends on the subcutaneous capillaries. A scoring of the intensity and extent of erythematous areas (0 to 4) was performed on the face as follow: 0: absence; 1: light; 2: moderate; 3: significant; 4: severe.
Clinical evaluation of skin homogeneity
To assess skin homogeneity, the dermatologist uses scores from 0 to 4 (score 0 corresponding to homogeneous skin and 4 corresponding to a very heterogeneous complexion with the presence of pigment spots).
Evaluation of dermatological tolerance of the 2 tested products
On D28, a clinical assessment of the condition of the skin in the treated area including erythema, edema, eczema (vesicles, edema, pruritus, desquamation) was carried out by indicating its nature, its intensity on a scale of 0 to 3 (0: absent; 1: mild; 2: moderate; 3: severe), the moment of its appearance in relation to the application of the product, its duration and the need for dermatological treatment. The medical examination made it possible to specify the possible occurrence of adverse events (AE) during the duration of the study. In the event of an undesirable event, a clinical investigation was carried out by the dermatologist.
Saliva sampling
The participants received the saliva sampling materials along with both spoken and written instructions. Saliva samples were collected in an adapted tube (Sarstedt, distributed by Salimetrics, Inc., State College, PA, USA) using a passive drool system. Briefly, participants were instructed to allow saliva to pool in the mouth and deposit it into 1.6 ml vials at three time points in the diurnal cycle at D0 and D28: at awakening, 40 min after waking, and at 19:00.
In between the two saliva collections (at awakening and 40 min after waking), participants were provided the opportunity to use the bathroom and may have gently moved around the room. To avoid contamination of saliva, participants were instructed to refrain from eating (particularly high protein foods), drinking beverages (other than water) containing alcohol, caffeine, or fruit juice, brushing teeth, flossing teeth, or engaging in activities that may involve placement of items in the mouth (i.e., smoking, chewing gum). It was also instructed not to be engaged in physical exercise during the post-awakening period (Stalder et al., 2016). Participants recorded the precise data and time of each saliva collection session on a Salivette® timesheet log.
The day after the last saliva collection, participants brought their samples to the laboratory in a small cooler bag. Samples were stored at -25°C until analysis.
The saliva volume was estimated by weighing to the nearest milligram, and the saliva density was assumed to be 1.0 ml
-1 [
28]. Each sample was frozen, thawed, and centrifuged at 1500g for 15 min to separate mucins. The supernatant was retrieved for measuring level of salivary cortisol (sCort), and sDHEA concentrations). Enzyme-linked immunosorbent assays (ELISA) were used for the saliva cortisol and DHEA analyses according to the manufacturer’s instruction (Salimetrics, Inc., State College, PA, USA) with a lower limit of sensitivity at 0.19 nmol.l
−1 and 17.4 pmol.l
−1, respectively.
All samples were tested in duplicate in the same series to avoid any variations between tests. The intra-assay maximum coefficient of variation was 2.6% for DHEA, and 2.6% for cortisol. The inter-assay maximum coefficient of variation was 2.7% for DHEA, and 7.4% for cortisol.
All samples were analysed according to a blind procedure and were decoded only after analyses were completed. All analyses were controlled for contraceptive use (“no” coded as “0” and “yes” coded as “1”).
Psychological parameter
Emotion and pleasure were characterized using the Brief Mood Introspection Scale (BMIS) originally developed by Mayer and Gaschke [
29] and translated into French by Niedenthal and Dalle [
30], which is widely used in psychological studies to assess pleasant emotions. This questionnaire is based on a set of sixteen emotional adjectives with four values ranging from "not at all" to "completely".