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The adaptive immune system in atopic dermatitis and implications on therapy
Lennart M Roesner1, Thomas Werfel1, Annice Heratizadeh1
1a Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy , Hannover Medical School , Hannover , Germany.
Expert Review of Clinical Immunology
|March 12, 2016
Summary
Atopic dermatitis involves immune reactions and skin barrier issues. Research highlights aeroallergen exposure worsening symptoms and explores T-cell responses, microbiome alterations, and new itch treatments.
Area of Science:
- Immunology
- Dermatology
- Allergology
Background:
- Atopic dermatitis (AD) pathogenesis involves immune dysregulation and skin barrier defects.
- Aeroallergen exposure exacerbates AD symptoms, with Th2 cytokines (IL-4, IL-13) playing a key role.
- The skin microbiome and sensitization to microbial/self-antigens are critical factors in AD.
Purpose of the Study:
- To investigate the complex immune responses in atopic dermatitis.
- To explore the role of T-cell polarization beyond Th2.
- To highlight therapeutic targets for AD, including itch management.
Main Methods:
- Clinical observation of aeroallergen exposure effects.
- Analysis of cytokine profiles (Th2, IFN-γ, IL-17) in AD lesions.
- Investigation of T-cell populations (Foxp3, Tr1) and skin microbiome alterations.
Main Results:
- Aeroallergen exposure worsens AD symptoms.
- T-cell responses in AD are heterogeneous, involving multiple cytokines.
- Altered skin microbiome and increased S. aureus colonization are observed.
- IL-4, IL-13, histamine H4 receptor, IL-31, and TSLP are implicated in AD.
Conclusions:
- Atopic dermatitis involves complex immune and microbial interactions.
- Targeting specific cytokines and receptors offers potential therapeutic strategies.
- Further research into T-cell heterogeneity and microbiome modulation is warranted.
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