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Inflammation of the Skin and Its Therapeutic Targets

  • Clinton B. MathiasEmail author
Chapter

Abstract

The skin is a formidable physical barrier that protects the body from infection and other foreign irritants. Immune cells in the skin play a critical role in host defense, and include a number of specialized cell types such as keratinocytes, Langerhans cells, dendritic cells, and various subsets of T cells, which aid the body in fighting pathogens. However, when immune function in the skin is compromised, either due to a hereditary defect in skin barrier function, or as a result of unwarranted immune sensitization, these same cells can drive the development of skin disease and induce chronic cutaneous inflammation. In this chapter, we will review the immunological functions of the skin and discuss the roles of various immune cells and cellular mediators in host defense. Next, we will examine in detail the immunological basis and pathophysiology of two widely prevalent skin diseases mediated by immune cells, namely atopic dermatitis and psoriasis. The immunopathogenesis of these diseases will be discussed in light of current evidence from the literature and the roles of various subsets of helper T cells, including TH2, TH17, and TH22 cells will be highlighted. Lastly, we will examine the pharmacology of various immunotherapeutic drugs used in the treatment of these diseases. These include glucocorticoids, anti-proliferative agents, phosphodiesterase inhibitors, and various biologics such as inhibitors of IL-4, IL-13, IL-17, and IL-12 and IL-23. In the From Bench to Bedside section, we will review the discovery and development of Dupilumab for the treatment of atopic dermatitis.

Keywords

Skin Atopic dermatitis Psoriasis Allergy Atopy TH2 cells TH17 cells TH22 cells Mast cells IgE antibodies Eosinophils IL-4 IL-13 IL-17 IL-23 Dupilumab Calcineurin inhibitors TNF inhibitors IL-17 antagonists IL-12/IL-23 antagonists 

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Pharmaceutical and Administrative Sciences, College of Pharmacy and Health SciencesWestern New England UniversitySpringfieldUSA

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