title: Immunomodulatory Effects of Deokgu Thermomineral Water Balneotherapy on Oxazolone-Induced Atopic Dermatitis Murine Model.
abstract: BACKGROUND
  Although the therapeutic mechanism of balneotherapy for atopic dermatitis has not been clarified, many atopic patients who visit thermomineral springs have shown clinical improvements.
  
  
  OBJECTIVE
  This study was aimed to evaluate the immunomodulatory effect of thermomineral water balneotherapy on the atopic dermatitis murine model.
  
  
  METHODS
  The oxazolone-induced atopic dermatitis murine model was used to evaluate the therapeutic effect of balneotherapy with Deokgu thermomineral water compared with distilled water. Histologic evaluation and confocal microscopic imaging were performed to analyze the lesional expression of cluster-of-differentiation (CD)4 and forkhead box p3 (Foxp3). Lesional mRNA expression of interleukin (IL) 33, thymic stromal lymphopoietin (TSLP), and Foxp3 was evaluated by real-time reverse transcription polymerase chain reaction.
  
  
  RESULTS
  Compared with the distilled water bath group, confocal microscopic evaluation of CD4 and Foxp3 merged images showed increased expression of regulatory T cells in the thermomineral balneotherapy group. The lesional mRNA level of IL-33 showed a reduced trend in the thermomineral balneotherapy group, whereas the level of mRNA of Foxp3 was increased. TSLP showed a decreased trend in both distilled water and thermomineral water bath groups. There was a trend of reduced expression in lesional IL-33 mRNA but increased cell count of CD4(+) Foxp3(+) regulatory T cells in thermomineral balneotherapy compared with distilled water bath.
  
  
  CONCLUSIONS
  Therefore, thermomineral balneotherapy can be an effective and safe adjuvant therapeutic option for atopic dermatitis.
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Bok
authors.initials: YB
authors.lastname: Lee
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sae Mi
authors.initials: SM
authors.lastname: Park
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Han
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Yu
authors.affiliation: Department of Microbiology, Ewha Woman's University School of Medicine, Seoul, Korea.
authors.forename: So Youn
authors.initials: SY
authors.lastname: Woo
authors.affiliation: Department of Earth and Environmental Sciences, Korea University, Seoul, Korea.
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Yun
authors.affiliation: Division of Earth Environmental System, Pusan National University, Pusan, Korea.
authors.forename: Se-Yeong
authors.initials: SY
authors.lastname: Hamm
authors.affiliation: Oh&Kim's Aesthetic Clinic, Seoul, Korea.
authors.forename: Hong Jig
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jin-Wou
authors.initials: JW
authors.lastname: Kim
keywords: Atopic dermatitis; Balneotherapy; Dermatitis; Immunomodulation