Immune mechanisms leading to atopic dermatitis (original) (raw)
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Cellular and molecular immunologic mechanisms in patients with atopic dermatitis
The Journal of allergy and clinical immunology, 2016
Atopic dermatitis (AD) is a complex skin disease frequently associated with other diseases of the atopic diathesis. Recent evidence supports the concept that AD can also recognize other comorbidities, such as chronic inflammatory bowel or cardiovascular diseases. These comorbidities might result from chronic cutaneous inflammation or from a common, yet-to-be-defined immunologic background leading to immune deviations. The activation of immune cells and their migration to the skin play an essential role in the pathogenesis of AD. In patients with AD, an underlying immune deviation might result in higher susceptibility of the skin to environmental factors. There is a high unmet medical need to define immunologic endotypes of AD because it has significant implications on upcoming stratification of the phenotype of AD and the resulting targeted therapies in the development of precision medicine. This review article emphasizes studies on environmental factors affecting AD development and...
Insights Into Atopic Dermatitis – From Pathogenesis to Therapy
Acta Medica Bulgarica
Atopic dermatitis (AD), or eczema, is a common skin disease that is often associated with other atopic disorders, such as allergic rhinitis and asthma. The disease can develop both in infancy and adulthood, and characterizes with recurrent episodes impairing the quality of life. The review аnalyzes the genetical, immunological, and environmental factors in the pathogenesis of AD. The role of the skin barrier function is also considered in regard of the main hypotheses for AD development. Further elucidation of the mechanisms involved in the pathogenesis of AD could give interesting and useful clues for therapeutic protocols and prophylactic approaches.
Clinical correlations of recent developments in the pathogenesis of atopic dermatitis
Anais Brasileiros de Dermatologia, 2008
Atopic dermatitis is a chronic inflammatory skin disease with a steadily increasing prevalence affecting 10-20 % of infants and 1-3% of adults globally. It is often the first clinical manifestation of atopic disease preceding asthma and allergic rhinitis. Probably half of the children with atopic dermatitis develop some other form of atopic disease later in life. The pathogenesis involves a complex interplay of factors including genetic predisposition due to altered immune or skin barrier function, interactions with the environment such as food and allergen exposures, and infectious triggers of inflammation. In this review, we summarize the recent advances in understanding the contribution of different factors in the pathophysiology of atopic dermatitis and how insights provide new therapeutic potential for its treatment.
Pathogenetic Mechanisms of Atopic Dermatitis
Inflammation, 2001
Atopic dermatitis (AD) is a chronic inflammatory disease which results from complex interac § tions b etween genetic and environmental mechanisms. An altered lipid composition of the stratum © corneum is responsible for the xerotic aspect of the skin and determines a higher permeability to allergens and irritants. Keratinoc § § hemokines contributes to establishing a local milieu that favors the permanence of inflamma tion in AD skin.
Immune dysregulation in atopic dermatitis
Allergy and Asthma Proceedings, 2006
Atopic dermatitis is a chronic inflammatory skin disease that causes significant morbidity in affected individuals. It is characterized by dysregulated immune responses that consist of an increased systemic Th2 response and a combination of Th2 and Th1 responses in the skin lesions. In this article, we review factors that contribute to these abnormal responses, including key effector cells of the immune system, chemokines, defective skin barrier, genetic predisposition, and environmental triggers. Understanding these pathomechanisms may improve our current therapies for atopic dermatitis.
International Journal of Molecular Sciences
Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, which generally presents with intense itching and recurrent eczematous lesions. AD affects up to 20% of children and 10% of adults in high-income countries. The prevalence and incidence of AD have increased in recent years. The onset of AD mostly occurs in childhood, although in some cases AD may persist in adult life or even manifest in middle age (adult-onset AD). AD pathophysiology is made of a complex net, in which genetic background, skin barrier dysfunction, innate and adaptive immune responses, as well as itch contribute to disease development, progression, and chronicization. One of the most important features of AD is skin dehydration, which is mainly caused by filaggrin mutations that determine trans-epidermal water loss, pH alterations, and antigen penetration. In accordance with the “outside-inside” theory of AD pathogenesis, in a context of an altered epidermal barrier, antigens encount...
Cellular and molecular mechanisms in atopic dermatitis
Advances in immunology, 2009
Atopic dermatitis (AD) is a pruritic inflammatory skin disease associated with a personal or family history of allergy. The prevalence of AD is on the rise and estimated at approximately 17% in the USA. The fundamental lesion in AD is a defective skin barrier that results in dry itchy skin, and is aggravated by mechanical injury inflicted by scratching. This allows entry of antigens via the skin and creates a milieu that shapes the immune response to these antigens. This review discusses recent advances in our understanding of the abnormal skin barrier in AD, namely abnormalities in epidermal structural proteins, such as filaggrin, mutated in approximately 15% of patients with AD, epidermal lipids, and epidermal proteases and protease inhibitors. The review also dissects, based on information from mouse models of AD, the contributions of the innate and adaptive immune system to the pathogenesis of AD, including the effect of mechanical skin injury on the polarization of skin dendrit...
Immunological Implications in Atopic Dermatitis
International Journal of Celiac Disease, 2021
Both the inborn and acquired immune system plays an important role in the pathogenicity of atopic dermatitis (AD). The skin lesions are mostly due to the complex interaction of the cytokines, above all the ones secreted by the T helper 2 lymphocytes (Th2). In the acute phase of the disease, the most important cytokines are IL-4, IL-5 and IL-13, and also the subsequent activation of mastocytes and eosinophiles. The next step is the production of antigen-specific antibodies. The Th2 immune response is initiated by IL-1, IL-25, IL-17, IL-33 and by thymic stromal lymphopoietin (TSLP). Th2 cytokines block the expression of differentiation of certain proteins, like locrine, filaggrin, involucrin, and at the same time, they reduce the beta-antimicrobial peptide levels, disturbing the skin barrier in the process. In the chronic phase of the illness, the Th2 cytokines are predominant, with varying levels of T helper 17 cytokines.
Cellular Aspects of Atopic Dermatitis
Clinical Reviews in Allergy & Immunology, 2007
Atopic dermatitis (AD) is a highly pruritic, chronic, and relapsing inflammatory skin disease. Recent interest in AD has been sparked by reports of its increasing prevalence and its contribution to increasing health care costs. A precise understanding of immunologic mechanisms is crucial for the development of effective treatment strategies for AD. Various studies reveal that AD has a multifactorial cause with the activation of complex immunologic and inflammatory pathways. This review will discuss cellular-mediated immunological pathomechanisms of AD. Emphasis will be given to the role played by T cells, antigen-presenting cells, eosinophils, and keratinocytes. We also examine the immunological effect of superantigens on various inflammatory cells including T regulatory cells.