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Innate immunity, allergy and atopic dermatitis

Niebuhr, Margarete; Werfel, Thomas

Current Opinion in Allergy and Clinical Immunology: October 2010 - Volume 10 - Issue 5 - p 463–468
doi: 10.1097/ACI.0b013e32833e3163
Skin allergy: Edited by Torsten Zuberbier and Thomas Werfel
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Purpose of review We review here the recent discoveries in innate immunity that shed light on the pathophysiology of atopic dermatitis.

Recent findings The mechanisms that promote the enhanced susceptibility to cutaneous infections in atopic dermatitis are complex interactions among several factors. They include skin barrier dysfunction, reduced skin lipid content, and abnormalities of the innate immune response. Some of the innate immune defects observed in atopic dermatitis are primary defects, such as epithelial barrier defects and defects in signaling or expression of innate receptors. Others may be secondary to the effects of the adaptive immune response. For example, deficiencies in antimicrobial peptides may be due to the overexpression of T helper 2 cytokines such as interleukin-4 and interleukin-13. However, how all components interact with each other remains to be fully investigated.

Summary To break this vicious circle, a multiprolonged approach directed at healing or protecting the skin barrier and addressing the immune dysregulation is necessary to improve and control the disease.

Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany

Correspondence to Dr Margarete Niebuhr, MD, Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Ricklinger Strasse #5, Hannover D-30449, Germany Tel: +49 511 9246 450; fax: +49 511 9246 440; e-mail: niebuhr.margarete@mh-hannover.de

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