13.18 Conclusions
Increasing evidence suggests that keratinocytes not only participate in cutaneous immune responses against pathogens but may in fact play key initiation roles. Keratinocytes are able to recognize a wide variety of microorganisms through their TLRs and have evolved mechanisms to distinguish between skin commensals and pathogens. Signaling through specific TLR combinations provides selectivity and specificity to keratinocyte immune responses.
In epidermal keratinocytes, TLR-mediated signaling pathways induce the production of antimicrobial and antiviral peptides, cytokines/chemokines, and inducible enzymes. A major factor in epidermal host defense mechanisms of the epidermis is the secretion of antimicrobial peptides, as lesions of the skin characterized by low levels of antimicrobial peptides have raised susceptibility to infections. Keratinocyte-derived cytokines and chemokines are critical in the recruitment of dendritic cells, T cells, and neutrophils into sites of infection. In addition to having microbicidal functions, antimicrobial peptides can act as chemoattractants, thus providing an improved immune response against pathogens.
Taking all this into account, the epidermal keratinocytes can be regarded as potent immune cells, as they fulfill the requirements for the induction of both an innate and an adaptive immune response. These exciting discoveries extend our current understanding of the skin’s innate immune functions and may give rise to future perspectives of the treatment of skin disorders such as hidradenitis suppurativa.
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Nagy, I., Kemény, L. (2006). Immunity. In: Jemec, G.B.E., Revuz, J., Leyden, J.J. (eds) Hidradenitis Suppurativa. Springer, Berlin, Heidelberg . https://doi.org/10.1007/978-3-540-33101-8_13
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