SEARCH · Search PubMed

Results for “Vernix Caseosa”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed2006

Proteome analysis of vernix caseosa.

Vernix caseosa (vernix) is a white creamy substance covering the skin of the fetus during the last trimester of pregnancy. The function of vernix has long been debated but no consensus has been reached. We here report a proteome analysis of vernix using two-dimensional gel electrophoresis, matrix-assisted laser desorption/ionization mass spectrometry and liquid chromatography coupled to tandem mass spectrometry. We have identified 41 proteins, of which 25 are novel to vernix. Notably, 39% of the identified vernix proteins are components of innate immunity, and 29% have direct antimicrobial properties. These results form a substantial contribution to the knowledge of vernix composition and demonstrate that antimicrobial protection of the fetus and the newborn child is a major and important function of vernix.

Chromatography, Liquid↗

PubMedDate not supplied

Subamnionic vernix caseosa.

Vernix caseosa occasionally dissects underneath the amnion, presumably following rupture of the amnion prior to rupture of the chorion laeve. We describe the clinicopathological features of 18 cases in which large quantities of vernix caseosa were present beneath the amnion of the parietal membranes or the chorionic plate. The subamnionic vernix caseosa was an unexpected microscopic finding in each case and was not associated with any inflammation, giant cell reaction, or other chronic change in the adjacent membranes. The gestational age ranged from 29 to 42 weeks (mean, 37). Five (28%) of the 18 were twin pregnancies. Five (28%) were delivered by cesarean section. In no case was there a history of amniocentesis, prolonged rupture of membranes, or amnionic fluid leakage. None of the mothers had signs of amnionic fluid embolism. The absence of tissue response around the vernix caseosa suggests rupture of the amnion close to the time of delivery.

Adult↗

PubMed2002

Epidermal barrier lipids in human vernix caseosa: corresponding ceramide pattern in vernix and fetal skin.

BACKGROUND: Vernix caseosa is a protective biofilm covering the fetus during the last trimester. Vernix and epidermal barrier lipids (i.e. cholesterol, free fatty acids and ceramides) appear to share protective functions for fetal and neonatal skin. OBJECTIVES: To analyse vernix samples for epidermal barrier lipid content, and to compare lipid profiles of vernix with those of fetal and postnatal epidermis. METHODS: Vernix samples were collected from 21 healthy term neonates. Skin samples were collected from 10 fetuses aborted between gestational week (GW) 16 and 25, nine infants and 11 older children. Lipids were extracted according to standard protocols and analysed by high-performance thin-layer chromatography. RESULTS: Vernix contained 196.5 +/- 70.1 microg barrier lipids mg-1 protein (mean +/- SD). Cholesterol formed the major barrier lipid fraction (52.8%), followed by free fatty acids (27.7%) and ceramides (20.1%). The ceramide composition of vernix resembled that of mid-gestational (GW 23-25) fetal epidermis both qualitatively and quantitatively, while there were major differences from postnatal epidermis. The total epidermal ceramide concentration increased significantly between prenatal and postnatal samples. CONCLUSIONS: The composition pattern of ceramides mirrors that of mid-gestational fetal epidermis. Vernix thus represents a 'homologous' substitute for the immature epidermal barrier in fetal skin. The differential role of individual ceramides in this process remains to be established.

Aging↗

PubMed1986

[Identification of vernix caseosa].

Identification of vernix caseosa is relatively rare. As a rule it is examined only by morphological methods. The authors proved also the species and group. The authors draw attention to the possible erroneous assessment of the group (if the vernix is mixed with amniotic fluid, maternal blood).

Forensic Medicine↗

PubMedDate not supplied

Management for neonatal aspiration syndrome caused by vernix caseosa.

OBJECTIVE: To clarify resuscitation methods against the lethal vernix caseosa aspiration syndrome. METHOD: A single case report with a literature review. RESULTS: Our case report was associated with aspiration syndrome caused by an airway obstruction of vernix caseosa: a proteolipid biofilm synthesized by the fetus. A 23-year-old woman normally delivered a mature infant at term. The infantile oral cavity was filled with numerous aggregates of vernix caseosa. Two hours after his birth, the infant died from respiratory insufficiency. We discuss the difference between management of our case and the previously reported case. CONCLUSION: Pregnant women with a diffuse pattern of high-level echoes in prenatal ultrasonography, suggesting the presence of massive vernix caseosa, should be transferred to a well-equipped institution that can administer inhaled nitric oxide and extracorporeal membrane oxygenation.

Adult↗

PubMed2003

Antimicrobial polypeptides of human vernix caseosa and amniotic fluid: implications for newborn innate defense.

Antimicrobial peptides/proteins are widespread in nature and play a critical role in host defense. To investigate whether these components contribute to surface protection of newborns at birth, we have characterized antimicrobial polypeptides in vernix caseosa (vernix) and amniotic fluid (AF). Concentrated peptide/protein extracts were obtained from 11 samples of vernix and six samples of AF and analyzed for antimicrobial activity using an inhibition zone assay. Proteins/peptides in all vernix extracts exhibited strong antibacterial activity against Bacillus megaterium (strain Bm11), in addition to antifungal activity against Candida albicans, whereas AF-derived proteins/peptides showed only the former activity. Fractions obtained after separation by reverse-phase HPLC exhibited antibacterial activity, with the most pronounced activity in a fraction containing alpha-defensins (HNP1-3). The presence of HNP1-3 was proved by dot blot analysis and confirmed by mass spectrometry. Lysozyme and ubiquitin were identified by sequence analysis in two fractions with antibacterial activity. Fractions of vernix and AF were also positive for LL-37 with dot blot and Western blot analyses, and one fraction apparently contained an extended form of LL-37. Interestingly, psoriasin, a calcium-binding protein that is up-regulated in psoriatic skin and was found recently to exhibit antimicrobial activity, was characterized in the vernix extract. The presence of all of these antimicrobial polypeptides in vernix suggests that they are important for surface defense and may have an active biologic role against microbial invasion at birth.

Amniotic Fluid↗

PubMed2001

Surface free energy characterization of vernix caseosa. Potential role in waterproofing the newborn infant.

BACKGROUND/AIMS: Vernix caseosa is a proteolipid biofilm synthesized by the human fetus, which progressively covers the fetal skin surface during the last trimester of pregnancy. The exact physiological functions of vernix are unclear. Hypothetically, it serves a role in "waterproofing" the fetus during the critical period of epidermal barrier development before birth. Vernix may also play a role in adaptation of the fetal skin surface to the dry, cool extrauterine environment after birth. Given the strategic position of vernix on the fetal skin surface and the rapidly changing environment encountered by the skin at birth, we proposed that investigation of vernix surface characteristics would facilitate understanding its putative physiological roles. METHODS: In this paper, we focused on the determination of the surface free energy (SFE) of vernix caseosa. Different approaches were used to calculate the SFE of vernix from contact angle (theta) measurements between vernix and various liquids (benzyl alcohol, diiodomethane, glycerol, and water). The critical surface tension (CST) of vernix was calculated using Zisman plots. The dispersive and the polar components of vernix SFE were calculated using the Owens-Wendt geometric mean method. Vernix was contrasted with petrolatum, a commonly used skin protectant. RESULTS: CST of fresh vernix was 40.5 dyne/cm while that of petrolatum was 35.8 dyne/cm. Fresh vernix polar SFE was 1.5 dyne/cm while petrolatum had almost no polar SFE component (0.03 dyne/cm). For all liquids (except the nonpolar diiodomethane) there was a significant decrease in contact angle with time. CONCLUSIONS: The CST and the total SFE values suggest that vernix has very low surface energy and is highly unwettable. These findings are significant insofar as the main component in vernix is water, which is highly energetic. Although vernix has a very high water content, the major part of its SFE is hydrophobic (dispersive). The limited interaction between vernix and hydrophilic liquids supports the hypothesis that vernix acts as a natural protectant cream to "waterproof" the fetus in utero while submerged in the amniotic fluid.

Female↗

PubMed2000

Biased distribution of the branched-chain fatty acids in ceramides of vernix caseosa.

The compositions of ester- and amide-linked fatty acids from ceramides of human vernix caseosa were described with emphasis on the distribution of the branched-chain fatty acid (BCFA). Two novel ceramides were isolated from vernix caseosa in the course of this study: the acylated type of esterified alpha-OH-hydroxyacid/sphingosine ceramide (Cer[EAS]) and nonacylated type of non-OH fatty acid/hydroxysphingosine ceramide (Cer[NH]). Their chemical structures were identified by nuclear magnetic resonance and chemical procedure. The Cer[EAS] was an acylceramide and consisted of the highest concentrations of ester- and amide-linked BCFA (62 and 67%, respectively). The iso- or anteiso-branching structures of the aliphatic chains were confirmed by the mass spectra of their picolinyl or pyrrolidide derivatives. As a whole, amide-linked fatty acids of ceramides 1-7 and Cer[NH] were normal types of straight-chain fatty acids with or without alpha- or omega-hydroxylation. The BCFA concentrations of amide-linked fatty acids in these ceramides (ceramides 1-7 and Cer[NH]) were low and less than 10%. The BCFA thus occurred exclusively in a novel acylceramide of Cer[EAS] in the vernix caseosa.

Ceramides↗

PubMed1996

Fetal cocaine exposure: analysis of vernix caseosa.

Preliminary data regarding the use of vernix caseosa (VC) as an alternative to other biological specimens for the determination of fetal cocaine exposure are presented. Advantages of VC analysis include its presence on all newborn babies, historical record of drug exposure, and ease of collection and storage. Fifteen samples of vernix caseosa-five from babies known to be cocaine-exposed because of a positive benzoylecgonine result from the urine and umbilical cord blood and ten from nonexposed neonates-were analyzed for the presence of cocaine and metabolites. VC samples from three of the five neonates known to be cocaine-exposed were positive for cocaine or its metabolites, the other two had little or no remaining specimen. The remaining ten were negative.

Chromatography, Gas↗

PubMed2005

Vernix caseosa in neonatal adaptation.

OBJECTIVES: To characterize vernix caseosa in newborn infants with respect to factors that influence vernix distribution on the skin surface, vernix effects on thermal stability, skin hydration, acid mantle development, and vernix antioxidant properties. STUDY DESIGN: Vernix distribution was determined for 430 infants. Thermal stability was assessed in parallel groups following vernix retention (n=66) and removal (n=64). The effects of vernix retention on skin hydration, pH, erythema, and dryness/scaling were determined. Samples were analyzed for vitamin E before and after UV exposure. RESULTS: Vernix distribution depended upon gestational age, delivery mode, gender, race, and meconium exposure. Retention had no effect on axillary temperatures. Skin hydration was significantly higher for vernix-retained skin. Skin pH and erythema were significantly lower with retention. Vitamin E levels were decreased by ultraviolet radiation. CONCLUSIONS: Vernix is a naturally occurring barrier cream with multiple salubrious effects, which support its retention on the skin surface at birth.

Acclimatization↗

PubMed1980

Barrier properties of vernix caseosa.

Experiments are described which show that vernix caseosa has a mechanical barrier effect if it is deposited in an unbroken layer. Specific antibacterial properties were not detected in vernix. It is suggested that vernix is best left on a newborn infant because of its mechanical obstruction to bacterial passage.

Escherichia coli↗

PubMed1998

Vernix caseosa peritonitis as a rare complication of cesarean section. A case report.

BACKGROUND: Vernix caseosa peritonitis is a rare complication of cesarean section with distinctive histopathologic findings. CASE: Vernix caseosa peritonitis occurred in a 28-year-old, pregnant woman following emergency cesarean section. Exploratory laparotomy revealed right subphrenic and perihepatic fluid collections with multiple small abdominal abscesses. Cytopathologic examination of the peritoneal lavage specimen showed a purulent inflammatory exudate admixed with occasional squamous debris, portions of hair shafts, meconium pigment, and foamy and multinucleated giant cells. During hospitalization the patient had developed Clostridium perfringens acute endometritis, presumably due to aggressive treatment with broad-spectrum antibiotics. CONCLUSION: Pathologists are in a unique position to make the correct diagnosis in an otherwise-ambiguous clinical presentation because of the distinctive histopathologic and cytopathologic findings of this entity. Computed tomography-guided fine needle aspiration cytologic evaluation can be diagnostic in such cases.

Adult↗

PubMed2004

A novel role for vernix caseosa as a skin cleanser.

OBJECTIVES: Skin cleansing is a complex process involving endogenous and exogenous mechanisms. This study examines the role of vernix caseosa in the process of skin cleansing in the perinatal period. METHODS: Vernix was evaluated as an exogenously applied skin cleanser using digitized image analysis which quantified residual carbon particles following a standardized cleansing assay. In addition, the detachment of vernix from human cadaveric skin and Gore-Tex supports was investigated following timed exposures to a variety of commonly used commercial surfactants. Detachment was quantified spectrophotometrically as increased turbidity at 650 nm. RESULTS: Image analysis showed that exogenous application of vernix exhibited a cleansing capability comparable or superior to standard skin cleansers. Dose-dependent increases in solution turbidity (vernix detachment) were seen following exposure of vernix-covered Gore-Tex vehicles to sodium laureth sulfate, sodium lauryl sulfate, and cocamidopropyl betaine solutions. Similar results were seen with cadaveric skin. CONCLUSIONS: These results demonstrate a role for vernix caseosa as a skin cleanser. Previous views of vernix as a soil or skin contaminant at birth need to be reevaluated.

Cadaver↗

PubMed1995

Vernix caseosa peritonitis. An infrequent complication of cesarean section with distinctive histopathologic features.

The authors report two cases of vernix caseosa peritonitis, an infrequent complication of cesarean section with distinctive histopathologic findings. Both patients underwent exploratory laparotomy for unexplained abdominal pain after cesarean section. Histopathologic evaluation of surgically removed tissue revealed an organizing peritonitis, which included prominent collections of anucleate squamous cells in association with a foreign body-type granulomatous response. In both cases, the surgical pathologist suggested that the abdominal pain was likely a result of peritoneal reaction to spillage of keratinous material (vernix caseosa) derived from amniotic fluid contents during cesarean section. Surgical pathologists should be aware of this entity and include it in the differential diagnosis of acute abdominal pain.

Abdominal Pain↗

PubMed1982

Variability in the fatty acid composition of wax esters from vernix caseosa and its possible relation to sebaceous gland activity.

Wax ester/sterol ester (WE/SE) ratios were measured in samples of vernix caseosa lipid obtained from 21 full-term infants. The mean WE/SE ratio was twice as high in males as in females, suggesting higher average fetal sebum production rates in males, but individual values varied widely and there was considerable overlap between the sexes. Wax esters (a class of lipid produced only by the sebaceous glands) were isolated from 6 of the 21 samples of vernix caseosa lipid and analyzed for fatty acid composition. The percentages of iso and anteiso branched saturated fatty acids and of delta 9-type monounsaturated fatty acids were found to be correlated negatively with the WE/SE ratios of the original lipid samples. Values for the percentages of the major delta 9-type monounsaturates, plotted as a function of WE/SE ratios, fell near a curve of the shape which would be expected if a limited quantity of delta 9-type monounsaturates were available for sebum synthesis, and were diluted with varying amounts of delta 6-type monounsaturates, the amount of the delta 6-type monounsaturates being proportional to the amount of wax esters synthesized by the sebaceous glands. The results suggested that the rate of sebum production may be the sole determinant of the percentage of delta 9-type monounsaturates in sebaceous wax esters and a partial determinant of the percentage of iso and anteiso branched saturates.

Esters↗

PubMed2002

The newborn infant is protected by an innate antimicrobial barrier: peptide antibiotics are present in the skin and vernix caseosa.

BACKGROUND: Peptide antibiotics are part of the surface defences against microbial intruders. However, the presence and significance of these innate immune effectors in the skin barrier of the newborn infant have not yet been appreciated. Erythema toxicum neonatorum is an inflammatory skin reaction of unknown aetiology and significance, commonly present in the healthy newborn infant. OBJECTIVES: As peptide antibiotics are upregulated in inflammatory skin disorders, we hypothesized that this also could be the case in erythema toxicum. We also investigated if the vernix caseosa, a cream-like white substance present on the skin of the infant at birth, might contribute to host defences. METHODS: The presence of the human antibacterial peptide LL-37 was investigated by immunohistochemistry and confocal imaging of skin biopsies from four 1-day-old infants with an erythema toxicum rash and four matched newborns without the rash. In addition, we analysed the expression of LL-37 and human beta defensin-1, an antibacterial peptide of epithelial origin, by reverse transcriptase-polymerase chain reaction. Finally, we screened for antibacterial components in vernix material obtained from six healthy newborns by inhibition zone assays. RESULTS: All biopsies from the lesions of erythema toxicum showed a dense, nodular infiltrate with numerous LL-37-expressing cells located in the dermal layer and a clear localization of the peptide within CD15-expressing neutrophils, EG2-expressing eosinophils and CD1a-expressing dendritic cells. LL-37 was also found to be located in CD1a-expressing Langerhans cells and a positive staining for the peptide was seen throughout the whole epidermal layer, both in infants with and without the rash. Skin samples from infants with the rash of erythema toxicum showed a constitutive expression of human beta defensin-1, while the expression of LL-37 seemed to be induced. Furthermore, LL-37 and lysozyme were detected in the protein fractions derived from the vernix caseosa, and these fractions exhibited a clear antibacterial activity. CONCLUSIONS: Peptide antibiotics are present in the vernix caseosa and in the skin of the healthy newborn infant, indicating effective innate immune protection already during fetal and neonatal life.

Anti-Bacterial Agents↗

PubMed2003

Role of Vernix caseosa in the neonate: potential application in the adult population.

Vernix caseosa is a naturally occurring fetal barrier film produced in late pregnancy as a result of sebaceous and epidermal lipids combined with desquamation of maturing fetal corneocytes. Vernix lacks desmosomal interconnections between corneocytes as demonstrated in adult stratum corneum and is, therefore, referred to as a "mobile phase" stratum corneum. Vernix is proposed to have multiple fetal/newborn overlapping biological functions: moisturization, anti-infective, antioxidant, wound healing, and waterproofing. Patients with altered skin integrity due to burn injuries lack the protective qualities necessary for wound healing. Emerging research suggests that Vernix applied to skin cultures may enhance wound healing. Application of the fetal/neonatal skin science findings to the adult burn population offers the potential for a clinically relevant homologous substitute for impaired tissue integrity.

Adult↗

PubMed1985

Neonatal aspiration syndrome due to vernix caseosa.

Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseosa causes a similar syndrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as in aspiration of meconium.

Humans↗