TiO2 and ZnO nanoparticles are commonly used in sunscreen products; however, there remains a concern regarding their safety. The aim of this study was to evaluate in human skin the effects of TiO2 and ZnO nanoparticles on a panel of cytokines under different UVB exposure scenarios. Although previous studies have assessed these nanoparticles, those relevant to dermal exposure and human models have primarily focused on penetration through the skin or in vitro toxicity studies using keratinocytes; few studies have evaluated cytokine production (reviewed by [22–27]). The current study utilized human skin explants, which allows for an assessment of the dermal cytokine reaction in the absence of infiltrating white blood cells.
Inflammatory cytokines play an important role in the body’s first line innate response to foreign bodies and environmental insults by regulating and coordinating the functions of immune cells. Keratinocytes have been shown to secrete a number of cytokines including IL-1β, IL-6, IL-8, GM-CSF, and TNFα. Cytokine expression can be induced and modulated by both intrinsic and extrinsic factors [33–37]. Our study evaluated 27 human cytokines using a multiplex cytokine panel and similar to previous studies using skin wound models or UV exposure, we observed detectable basal levels for all cytokines measured [33, 36, 38]. Compared to the no treatment control, cytokine levels were not significantly increased at 24 hr following a UVB exposure of 1000 J/m2 (10 J/cm2). Other studies using human volunteers and skin biopsies demonstrated increased cytokine expression and levels at 24 hr following approximately 4.2 to 16.8 J/cm2 of solar simulated UV radiation, which includes both UVA and UVB radiation [39, 40]. However, Barr et al [39] identified the maximal increase in IL-1β, TNFα, and IL-10 protein levels following skin exposure to solar simulated UV radiation at 15 hrs with a reduction at 24 hrs. Similar to our results showing an increase in IL-1RA at 24 hr in two of the three donor explants, solar simulated UV radiation increased IL-1RA in the majority of the biopsies by 15 hr, which was sustained through 72 hrs [39]. In vitro studies using human keratinocytes demonstrated an increase in cytokine expression and secretion at 24 hr following 20 to 1000 mJ/cm2 UVB exposure [38, 41–43]. Compared to these studies, our skin explants demonstrated a minimal cytokine response following UVB exposure. This could be due to several reasons including the use of only UVB and not solar simulated UV radiation. Solar simulated UV radiation has both UVA and UVB and has deeper penetration into the epidermis because of the longer UVA wavelengths [39, 40, 44]. Additionally, unlike skin biopsies, our explant model lacks infiltrating lymphocytes, which would likely lead to lower overall cytokine levels, but does allow for an acute assessment of the dermal response.
The aim of the current study was to directly assess the dermal response to the sunscreen-relevant nanoparticles ZnO and TiO2 in the context of pre- and post-exposure to UVB. Strikingly, nearly all the cytokines assessed were increased when TiO2 nanoparticles were applied after UVB exposure, simulating a realistic use case of applying sunscreen after already being exposed to the sun. This increase in cytokine levels was not observed with post-UVB exposure of ZnO or the combined application of TiO2 and ZnO suggesting that ZnO is more bioinert or induces a response that resolves within 24 hrs as compared to TiO2. Additionally, ZnO may provide a protective effect against the induction of cytokines induced by TiO2 after UVB exposure. Previous in vitro and in vivo studies have demonstrated the potential for TiO2 and ZnO nanoparticles to induce oxidative stress, inflammation, and cytotoxicity [25, 45–48]. However, when applied dermally, the majority of studies support their general safety and limited dermal absorption; none have specifically evaluated cytokine levels when nanoparticles are applied post-UVB [16, 22–27].
Using an in vitro porcine model, Monteiro-Riviere et al [49] identified no dermal penetration of ZnO but TiO2 penetrated seven layers, which was enhanced in UV-damaged skin. In human subjects, TiO2 has been identified in the epidermis and dermis of human subjects who applied TiO2 containing sunscreen for 2–6 weeks prior to skin surgery [50]. Additionally, the possibility of some systemic absorption of TiO2 and ZnO from dermal application of sunscreen has been suggested through human studies and evaluation of blood and urine [16, 51]. Although minimal, these studies do support some dermal penetration of TiO2 that may be increased with prior UV exposure corresponding to the increase in cytokines seen in the current study. Furthermore, opposite of the protective effect we observed with a combination of ZnO with TiO2 after UVB exposure, a previous study demonstrated a protective effect of TiO2 on ZnO-induced toxicity by binding free Zn2+ ions [52]. An additional consideration is the potential for inhalation toxicity if spray sunscreens contain nanoparticles. ZnO has been shown to induce acute lung toxicity in animal models and metal fume fever in occupational settings [28, 29]. TiO2 has also been associated with abnormal pulmonary function when inhaled [53 {Otani, 2008 #83]. Additionally, it is important to consider the potential environmental impact of nanoparticles in sunscreens as they wash off into the environment through regular use. Previous studies suggest a detrimental impact of engineered nanoparticles environmental processes and organisms [54, 55]. For example, TiO2 and ZnO nanoparticles have been found to reduce microbial biomass and diversity in the environment by changing the composition of the soil bacterial community [54]. Plants also appear to be sensitive to engineered nanomaterials including TiO2 and ZnO nanoparticles and exhibit many adverse effects [55].
It is noteworthy that the concentrations of TiO2 and ZnO used in the current study (i.e. 0.25 mg or 0.01 mg/cm2) are much lower than the concentration of these nanoparticles in sunscreen when approximated to potential dose per surface area. The maximum allowable nanoparticle concentration in sunscreen is less than 25% [56]; however, Bocca et al [57] analyzed four different sunscreens and identified between 2.6–18.3% TiO2 and 0.05–0.22% ZnO. Based on these concentrations and the recommendation of the American Academy of Dermatology to use 1 oz (28.3 g) of sunscreen to adequately cover the adult body, the potential exposure to TiO2 and ZnO would be 4.6 to 43.2 mg/cm2 and 88 to 519 µg/cm2, respectively, assuming coverage of 80% of the body and a body surface area of 1.5 to 2 m2 [58]. Therefore, the marked increase in cytokines when TiO2 is applied after UVB occurs at concentrations estimated to be more than ~ 400 fold lower than that found in some sunscreens.
Overall, our results suggest the potential for a direct inflammatory response of the skin to UVB and sunscreen containing TiO2 depending on the sunscreen formulation and timing of application. Since sunscreens typically contain at least two organic active ingredients to offer broad protection [19] further studies are necessary to determine if current formulations of TiO2-containing sunscreens produce a similar effect on cytokine production when applied after UVB exposure and if altering the composition could mitigate this effect, such as a combined TiO2 and ZnO formulation. A combination of TiO2 and ZnO applied after UVB did not show an increase in cytokine levels as seen with application of TiO2 alone. Additionally, a combined application of TiO2 and ZnO pre- and post-UVB exposure decreased the level of some cytokines, potentially protecting against an inflammatory response.
4.1 Limitations of the study
The small sample size (N = 3) and lack of diversity in sex and types of skin (i.e. types I – VI) is a clear limitation of this study. However, considering that the exposures were conducted when the skin was received, which was approximately two weeks apart for each donor, the remarkable consistency in the cytokine response to TiO2 post-UVB exposure supports a biologically relevant response. An additional consideration is a potential inflammatory response induced by the excision of the skin and the further cutting required to prepare the samples for the different treatment groups. In comparison to previous studies evaluating cytokine levels associated with dermal wounds and wound age, our cytokine levels at 1 hr are consistent with a response to a dermal wound, i.e. surgical excision [33, 59], and thus suggests a higher basal cytokine level than might be found in intact skin. A higher basal cytokine profile could impact the response to test treatments and highlighting the importance of time-matched no treatment controls. A final consideration is the nanoparticle formulation. The current study used nanoparticles suspended in media, which was previously shown to increase the mean diameter (i.e. 1307 ± 313.7 nm for 40 nm TiO2 and 188.9 ± 37.2 nm for 85 nm ZnO [32]). Whereas previous analysis of TiO2 and ZnO in four commercially available sunscreens identified a smaller particle mean diameter for both TiO2 (89 ± 18 to 107 ± 14) and ZnO (74 ± 8 to 98 ± 22), which is likely due to the nanoparticle protein corona formed by the more hydrophobic composition of the sunscreen [57]. Future experiments are needed to evaluate the effect of post-UVB application of commercially available TiO2 containing sunscreen on cytokine levels.