Peter M. Elias, MD, Yutaka Hatano, MD, PhD, Mary L. Williams, MD

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Presentation transcript:

Basis for the barrier abnormality in atopic dermatitis: Outside-inside-outside pathogenic mechanisms Peter M. Elias, MD, Yutaka Hatano, MD, PhD, Mary L. Williams, MD Journal of Allergy and Clinical Immunology Volume 121, Issue 6, Pages 1337-1343 (June 2008) DOI: 10.1016/j.jaci.2008.01.022 Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Inherited and acquired activation of serine proteases converge to affect multiple SC functions but by divergent mechanisms. SPI, Serine protease inhibitor; DSG1, desmoglein 1; CD, corneodesmosome; LEKTI, lymphoepithelial Kazal-type trypsin inhibitor; PAR2, plasminogen activator type 2 receptor; KLK7, kallikrein 7. Journal of Allergy and Clinical Immunology 2008 121, 1337-1343DOI: (10.1016/j.jaci.2008.01.022) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 FLG proteolytic pathway affects multiple SC functions: potential implications for pathogenesis of AD. R.H., Relative humidity; trans-UCA, trans-urocanic acid. Journal of Allergy and Clinical Immunology 2008 121, 1337-1343DOI: (10.1016/j.jaci.2008.01.022) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Outside-inside initial provocation of AD eventually can lead to an outside-inside-outside vicious cycle. hBD2, Human β-defensin; AR, amphiregulin; NGF, nerve growth factor. Journal of Allergy and Clinical Immunology 2008 121, 1337-1343DOI: (10.1016/j.jaci.2008.01.022) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Role of secondary infections in further aggravation of AD. AMP, Antimicrobial peptides; FFA, free fatty acids. Journal of Allergy and Clinical Immunology 2008 121, 1337-1343DOI: (10.1016/j.jaci.2008.01.022) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions