Atopic dermatitis: a disease of altered skin barrier and immune dysregulation

Immunol Rev. 2011 Jul;242(1):233-46. doi: 10.1111/j.1600-065X.2011.01027.x.

Abstract

Atopic dermatitis (AD) is an important chronic or relapsing inflammatory skin disease that often precedes asthma and allergic disorders. New insights into the genetics and pathophysiology of AD point to an important role of structural abnormalities in the epidermis as well as immune dysregulation not only for this skin disease but also for the development of asthma and allergies. Patients with AD have a unique predisposition to colonization or infection by microbial organisms, most notably Staphylococcus aureus and herpes simplex virus. Measures directed at healing and protecting the skin barrier and addressing the immune dysregulation are essential in the treatment of patients with AD, and early intervention may improve outcomes for both the skin disease as well as other target organs.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adaptive Immunity*
  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Asthma / complications
  • Asthma / immunology
  • Cytokines / immunology*
  • Dermatitis, Atopic / complications
  • Dermatitis, Atopic / genetics
  • Dermatitis, Atopic / immunology*
  • Dermatitis, Atopic / metabolism
  • Dermatitis, Atopic / physiopathology
  • Dermatitis, Atopic / therapy
  • Disease Models, Animal
  • Epidermis / immunology*
  • Epidermis / metabolism
  • Epidermis / physiopathology
  • Filaggrin Proteins
  • Gene Expression Regulation
  • Herpes Simplex / immunology
  • Herpes Simplex / virology
  • Humans
  • Immunity, Innate*
  • Intermediate Filament Proteins / genetics
  • Intermediate Filament Proteins / metabolism*
  • Keratinocytes / metabolism
  • Keratinocytes / pathology
  • Mice
  • Mice, Transgenic
  • Polymorphism, Genetic
  • Pruritus / complications
  • Pruritus / immunology*
  • Simplexvirus / immunology
  • Staphylococcal Skin Infections / immunology
  • Staphylococcal Skin Infections / microbiology
  • Staphylococcus aureus / immunology
  • T-Lymphocyte Subsets / immunology
  • Tight Junctions / metabolism
  • Tight Junctions / pathology
  • Vitamin D / metabolism

Substances

  • Anti-Inflammatory Agents
  • Cytokines
  • Filaggrin Proteins
  • Intermediate Filament Proteins
  • Vitamin D