Clinical Reviews in Allergy & Immunology

, Volume 33, Issue 1–2, pp 35–44

Current Aspects of Innate and Adaptive Immunity in Atopic Dermatitis

Article

Abstract

Atopic dermatitis (AD) is a highly pruritic, chronic, multifactorial skin disease predisposing to bacterial and viral infections based on abnormalities of the innate and acquired immune system. The innate system quickly mobilizes an inflexible, standardized first-line response against different pathogens. Epidermal barrier dysfunction results in increased protein allergen penetration through the epidermis and predisposes to secondary skin infections. Two loss-of-function mutations in the epidermal filaggrin gene are associated with AD. Langerhans cells and inflammatory dendritic epidermal cells (IDEC) express high affinity IgE receptors, which are functional in IgE-mediated antigen presentation. Inducible antimicrobial peptides including the antiviral cathelicidin and the antibacterial beta-defensins show defective upregulation in lesional AD skin. The desmosomal protein nectin-1 is unmasked in AD lesions, thus becoming a relevant herpes simplex virus (HSV) entry receptor. Type I IFN-producing plasmacytoid dendritic cells are decreased and dysfunctional in AD skin, predisposing the patients to viral skin infections. Molluscum contagiosum virus produces a unique IL-18 binding protein to evade antiviral defense mechanisms. Innate and adaptive immunity do not simply coexist but are linked to one another in a complex network of skin immunobiology.

Keywords

Innate immunity Secondary infections Atopic dermatitis 

Abbreviations

AD

atopic dermatitis

AMP

antimicrobial peptides

APC

antigen presenting cell

DC

dendritic cell

EH

eczema herpeticum

EM

eczema molluscatum

FcɛRI

high affinity IgE receptor

FPR-1

formyl peptide receptor

HBD

human beta-defensin

HSV

herpes simplex virus

IDEC

inflammatory dendritic epidermal cell

IFN

interferon

IL18-BP

interleukin-18 binding protein

iNOS

inducible NO synthetase

KVE

Kaposi’s varicelliform eruption

LC

Langerhans cell

MCV

molluscum contagiosum virus

NK cell

natural killer cell

PAMP

pathogen-associated molecular pattern

PDC

plasmacytoid dendritic cell

PRR

pathogen recognition receptor

S. aureus

Staphylococcus aureus

TLR

toll-like receptor

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Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  1. 1.Department of Dermatology and AllergyLudwig-Maximilian-University of MunichMunichGermany
  2. 2.Department of DermatologyFriedrich-Wilhelm-UniversityBonnGermany

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