Allergy and Asthma in Modern Society: A Scientific Approach Allergic Manifestations of Skin Diseases – Atopic Dermatitis Breuer K, Werfel T, Kapp A Crameri R (ed): Allergy and Asthma in Modern Society: A Scientific Approach. Chem Immunol Allergy. Basel, Karger, 2006, vol 91, pp 76-86 (DOI: 10.1159/000090231)
Abstract: Atopic dermatitis (AD) is a chronic inflammatory skin disease which often becomes manifest in early infancy and is characterized by itchy eczematous lesions with characteristic localization. The cellular infiltrate of allergic eczematous skin diseases (i.e. AD, allergic contact dermatitis) is mainly composed of mononuclear cells. Whereas allergic contact dermatitis is always triggered by allergen-specific T cells, a number of allergic and nonallergic trigger factors appear to be relevant in AD. This article discusses data coming from immunological studies focusing on T-cell responses in AD. The concept of a switch from a T helper type 1 (Th1) to a Th2 cytokine profile in lesional skin of AD is well accepted. Besides CD4+ T lymphocytes, CD8+ cells are likely to play an important role in the pathogenesis of AD. Recent studies point to the induction of apoptosis in keratinocytes by interferon-  derived
from skin-homing T cells as a further important mechanism for the induction and maintenance
of the eczema. Recent clinical studies have confirmed the major role of food allergy
and infectious microorganisms as trigger factors of AD. New therapeutic strategies for AD
include topical calcineurin inhibitors which were introduced as a new therapeutic principle at
the beginning of this decade. |
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