Multifactorial skin barrier deficiency and atopic dermatitis: Essential topics to prevent the atopic march Gyohei Egawa, MD, PhD, Kenji Kabashima, MD,

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Presentation transcript:

Multifactorial skin barrier deficiency and atopic dermatitis: Essential topics to prevent the atopic march Gyohei Egawa, MD, PhD, Kenji Kabashima, MD, PhD Journal of Allergy and Clinical Immunology Volume 138, Issue 2, Pages 350-358.e1 (August 2016) DOI: 10.1016/j.jaci.2016.06.002 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Barrier structures of the skin. A, Structure of the epidermis. B, Structure of the SC and TJ (red line). C, “Brick and mortar” structure of the SC. D, Structures of the CE and corneodesmosome. Journal of Allergy and Clinical Immunology 2016 138, 350-358.e1DOI: (10.1016/j.jaci.2016.06.002) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Schema of the FLG metabolic process. In the SG profilaggrins are stored in keratohyalin granules and then cleaved into FLG monomers. FLG monomers bind to keratin filaments in corneocytes. At the upper layer of the SC, FLG monomers are released from keratins and cleaved into free amino acids, followed by conversion into PCA and UCA. Asterisks denote genes with mutations that have been linked to AD pathogenesis. Journal of Allergy and Clinical Immunology 2016 138, 350-358.e1DOI: (10.1016/j.jaci.2016.06.002) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 KLK function in the SC. 1, KLKs cleave corneodesmosomal cadherins to promote desquamation. 2, KLKs activate PAR2 to regulate lipid synthesis and immune responses. 3, KLK cleavage of IL-1 preforms. IL-1 preforms are stored in the cytosol of corneocytes and escape into the intercellular space upon damage. Asterisks denote genes whose mutations have been linked to the AD pathogenesis. Journal of Allergy and Clinical Immunology 2016 138, 350-358.e1DOI: (10.1016/j.jaci.2016.06.002) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions