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The Skin as a Route of Allergen Exposure: Part II. Allergens and Role of the Microbiome and Environmental Exposures

  • Allergens (RK Bush and JA Woodfolk, Section Editors)
  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This second part of the article aims to highlight recent contributions in the literature that enhance our understanding of the cutaneous immune response to allergen.

Recent Findings

Several properties of allergens facilitate barrier disruption and cutaneous sensitization. There is a strong epidemiologic relationship between the microbiome, both the gut and skin, and atopic dermatitis (AD). The mechanisms connecting these two entities remain enigmatic; however, recent murine models show that commensal skin bacteria play an active role in supporting skin barrier homeostasis and defense against microbial penetration. Likewise, the association between the lack of colonization with Staph species and AD development suggests a potentially functional role for these organisms in regulating the skin barrier and response to environmental allergens. In undisrupted skin, evidence suggests that the cutaneous route may promote allergen tolerance.

Summary

Properties of environmental allergens and commensal bacteria add to the complex landscape of skin immunity. Further investigation is needed to elucidate how these properties regulate the cutaneous immune response to allergen.

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Abbreviations

AD:

Atopic dermatitis

AMP:

Antimicrobial peptide

CGN:

Culture gram-negative bacteria

DC:

Dendritic cell

DC-SIGN:

Dendritic cell-specific ICAM-grabbing nonintegrin

TLR:

Toll-like receptor

Treg:

T regulatory cell

EDC:

Endocrine-disrupting compound

EPIT:

Epicutaneous immunotherapy

PRR:

Pattern recognition receptor

PAR-2:

Protease-activated receptor-2

DNTB:

2,4-Dinitrothiocyanobenzene

LC:

Langerhans cell

LPS:

Lipopolysaccharide

MC:

Mast cell

MDDC:

Monocyte-derived DC

PAMP:

Pathogen-associated molecular pattern

TER:

Transepithelial resistance

UV:

Ultraviolet

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Acknowledgements

This work was supported by the UVA Child Health Research Grant (J.W.).

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    Authors and Affiliations

    1. Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA

      George Knaysi

    2. Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Road, Hanover, NH, 03755, USA

      George Knaysi

    3. Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA

      Anna R. Smith, Jeffrey M. Wilson & Julia A. Wisniewski

    4. Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA

      Julia A. Wisniewski

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    Correspondence to Julia A. Wisniewski.

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    This article is part of the Topical Collection on Allergens

    George Knaysi and Anna R. Smith contributed equally to this work.

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    Knaysi, G., Smith, A.R., Wilson, J.M. et al. The Skin as a Route of Allergen Exposure: Part II. Allergens and Role of the Microbiome and Environmental Exposures. Curr Allergy Asthma Rep 17, 7 (2017). https://doi.org/10.1007/s11882-017-0675-4

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