Abstract

At birth, human infants are poised to survive in harsh, hostile conditions. An understanding of the state of newborn skin development and maturation is key to the maintenance of health, optimum response to injury, healing and disease. The observational study collected full-thickness newborn skin samples from 27 infants at surgery and compared them to skin samples from 43 adult sites protected from ultraviolet radiation exposure, as the standard for stable, mature skin. Transcriptomics profiling and gene set enrichment analysis were performed. Statistical analysis established over 25,000 differentially regulated probe sets, representing 10,647 distinct genes, in infant skin compared to adult skin. Gene set enrichment analysis showed a significant increase in 143 biological processes (adjusted p < 0.01) in infant skin, versus adult skin samples, including extracellular matrix (ECM) organization, cell adhesion, collagen fibril organization and fatty acid metabolic process. ECM organization and ECM structure organization were the biological processes in infant skin with the lowest adjusted P-value. Genes involving epidermal development, immune function, cell differentiation, and hair cycle were overexpressed in adults, representing 101 significantly enriched biological processes (adjusted p < 0.01). The processes with the highest significant difference were skin and epidermal development, e.g., keratinocyte differentiation, keratinization and cornification intermediate filament cytoskeleton organization and hair cycle. Enriched Gene Ontology (GO) biological processes also involved immune function, including antigen processing and presentation. When compared to ultraviolet radiation-protected adult skin, our results provide essential insight into infant skin and its ability to support the newborn’s preparedness to survive and flourish, despite the infant’s new environment laden with microbes, high oxygen tension and potential irritants. This fundamental knowledge is expected to guide strategies to protect and preserve the features of unperturbed, young skin.

Highlights

  • Newborn infant skin is truly remarkable, characterized by its notable softness, smoothness and uniformity, yet poised to survive in harsh, hostile conditions following birth [1]

  • Adult skin reflects the accumulation of years of assault from its environment, including ultraviolet radiation [2], endogenous aging, changes in temperature and humidity, exposure to irritants [3] and disease, to name a few

  • Full-term newborn skin is well-formed at birth with low transepidermal water loss (TEWL), equal to, or lower, than that of adults [4, 5]

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Summary

Introduction

Newborn infant skin is truly remarkable, characterized by its notable softness, smoothness and uniformity, yet poised to survive in harsh, hostile conditions following birth [1]. An understanding of this pristine infant skin is key to the maintenance of health, optimum response to insults and restoration of barrier damage and avoidance of disease, e.g., atopic dermatitis. Provision of innate immunity is an essential skin function, at birth. Innate immunity is conferred through a complex balance of structural proteins, lipids, Langerhans cells, pro- and anti-inflammatory cytokines and the physical stratum corneum (SC) barrier

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