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[The skin as an immunological organ]
1Hudavdelingen Ullevål universitetssykehus 0407 Oslo.
Background:
The skin is our largest organ. Its physico-chemical properties are adapted to its function as a non-specific general defense line against infections and injury from the environment. Through evolution the skin has developed a second line of highly specific immune defense comprising epidermal Langerhans cells, T lymphocytes and keratinocytes as the most distinct cellular elements.
Material And Methods:
On the basis of available research data and reviews, an overview on the skin as an immunological organ is presented.
Results And Interpretation:
Antigens penetrating into the epidermis are bound to dendritic Langerhans cells, processed and presented to T lymphocytes. Certain memory T cells are able to remember where they first encountered antigen. Skin homing T cells are CLA+ and circulate between the skin, peripheral blood and skin draining lymph nodes. Keratinocytes produce a wide spectre of cytokines, in particular interleukin-1, which has a key role in the skin immune function. The most common inflammatory skin disorders are mediated by T lymphocytes, usually Th1 cells, as in psoriasis, or Th2 cells, as in atopic dermatitis. Systemic treatment with T cell specific suppressive drugs, such as cyclosporine, has been successful in certain dermatoses. Promising cyclosporine analogues for topical treatment (tacrolimus and pimecrolimus) have been developed and may soon be introduced.