PathogenesisofAtopicDermatitisJuHui-Wang1.PathogenesisofEpidermal BarrierDysfunctioninAtopicDermatitisSystemicAllergicInflam mation(“outside-in”hypothesis)Epidermal?structural?proteinreduct ion/structuralfunctionalchangeScratchtissuedamageEpidermalba rrierdysfunctionEpidermalbarriergenedefectMicroorganismcolon izationAllergenAbnormalofspecificcytokinepathwaysInnateorsp ecificimmuneresponse-relatedgenemutationADacutephaseADChro nicphaseIL-17Th2immuneresponseTh1immuneresponseIL-22Systemic orlocalinflammatoryresponsePathogenesisofMicroorganismCol onizationinAtopicDermatitisStaphylococcus?AureusColonizationS ecreteSerine?ProteaseSecreteExotoxin(assuper-antigen)Accelerat etheexfoliationofkeratinocytesActivateInflammatoryCellCutic leAttenuatedPromotesCellProliferationTheinvadeofExternalS timulusandAllergenReleasepro-inflammatoryfactor(asIL-22、IL-3 1et.al)Releasepro-inflammatoryfactor(asIL-22、IL-31et.al)Epid ermalbarrierDysfunctionTheInflammateandTissuedamage1.Pathog enesisofEpidermalBarrierDysfunctioninAtopicDermatitisTradi tionalKnowledge:BidirectionalImmuneSchemainOccurofAtopicD ematitisAbnormalofspecificcytokinepathwaysADacutephaseADCh ronicphaseTh2ImmuneResponseTh1ImmuneResponseTh2Cytokines(IL -4/IL-5/IL-6/IL-9/IL-10/IL-13,et.al)Th1Cytokines(INF-γ/TNF-α/IL- 2/IL-12/IL-18,et.al)TCellImmuneResponseBCellReleaseExcessI gEAnaphylaxisandHumoralImmuneResponse1.PathogenesisofEpider malBarrierDysfunctioninAtopicDermatitis1.PathogenesisofEpi dermalBarrierDysfunctioninAtopicDermatitisReference【Elias?PM ,?WoodLC,?FeingoldKR.Epidermal?pathogenesis?ofinflammatory?de rmatoses.AmJContactDermat.?1999Sep;10(3):119-26.】2.Pathogene sisofImmuneDysfunctioninAtopicDermatitisImpairmentofSkin Barrier(“inside-out”hypothesis)Genetic?factors(Genedefectrelate withInnateorSpecificImmuneResponse)Environmentalfactors(Al lergen/Scratch/MicroorganismColonization)EpidermalbarrierDysf unctionActivatedCertainSpecificCytokinesPathwayinVivoInd ucingSystemicAllergicInflammationWhethertheimmunedysfunctio nplaysaleadingroleintheprogressofatopicdermatitis?Defec tinKeratinocyteDifferentiation2.PathogenesisofImmuneDysfunctioninAtopicDermatitisReference |
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