"Outside-to-inside" (and now back to "outside") pathogenic mechanisms in atopic dermatitis
Peter M Elias, Martin Steinhoff, Peter M Elias, Martin Steinhoff
Abstract
The pathogenesis of atopic dermatitis (AD) has been attributed largely to abnormalities in the adaptive immune system, with key roles played by T-helper 1(Th1)/Th2 cell dysregulation, IgE production, dendritic cell signaling, and mast-cell hyperactivity, resulting in the pruritic, inflammatory dermatosis that characterizes AD (Leung et al., 2004). Accordingly, therapy has been focused on ameliorating Th2-mediated inflammation and pruritus (eg, Leung, 2000). Indeed, there is emerging evidence that inflammation in AD results first from inherited and acquired insults that converge to alter epidermal structure and function, followed by immune system activation, which in turn has negative consequences for skin-barrier homeostasis. This cycle comprises an "outside-inside-outside" model of AD pathogenesis (Elias et al., in press).
Conflict of interest statement
CONFLICT OF INTEREST
Dr Elias is a co-inventor of Cer-dominant formulation (TriCeram, Osmotics Corp.), a patented technology, and an officer of Ceragenix Pharmaceuticals, the licensee of this technology. Dr Steinhoff states no conflict of interest.
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Source: PubMed