Atopic dermatitis pathophysiology

Sicherer, S.H. and Sampson, H.A. 1999. Food hypersensitivity and atopic dermatitis pathophysiology, epidemiology, diagnosis and management. J Allergy Clin Immunol 104 114-122. 

Novak N, Bieber T The role of dendritic cell sub-types in the pathophysiology of atopic dermatitis. J Am Acad Dermatol 2005 53 S171-S176. 

Billow JA. Acne. In Berardi RR, McDermott JH, Newton GD, et al, eds. The Handbook of Nonprescription Drugs. 14th ed. Washington, DC American Pharmaceutical Association, 2004 913-928. Cheigh NH. Atopic dermatitis. In DiPiro JT, Talbert RL, Yee GC, et al, eds. Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York City McGraw-Hill, 2005 1785-1792. 

Are T Cells Involved in Specific Immune Responses to Autoantigens in Atopic Dermatitis Autoimmune phenomena to human self-proteins may also contribute to the pathophysiology of atopic dermatitis. IgE against autoantigens such as Horn SI-4 have been shown to stimulate type 1 hypersensitivity reactions which in turn may contribute to the clinical cutaneous reactions in atopic dermatitis [15]. Autoallergens induce the proliferation of CLA+ autoreactive T cells derived... 

Atopy denotes a hereditary predisposition for IgE-mediated allergic reactions. Clinical pictures include allergic rhinoconjunctivitis ( hay fever ), bronchial asthma, atopic dermatitis (neurodermatitis, atopic eczema) and urticaria. Evidently, differentiation ofT-helper (TH) lymphocytes toward the TH2 phenotype is the common denominator. Therapeutic interventions are aimed at different levels to influence pathophysiological events (A). 

MDC is chemotactic for a number of cell types, including thymocytes, monocytes, IL-2-activated NK cells, dendritic cells, and both TH2 and CLA-t-T cells. In the context of pathophysiology the latter two activities are the most relevant. TH2 T cells are important mediators of allergic inflammation and MDC appears to play a role in the migration of this cell type in disease settings. MDC levels are elevated in the affected tissues in murine models of asthma (Gonzalo et al, 1999) and atopic dermatitis... 

Kang K, Stevens SR. Pathophysiology of atopic dermatitis. Clin Dermatol 2003 21 116-121. 

Stander S, Steinhoff M Pathophysiology of pruritus in atopic dermatitis an overview. Exp Dermatol 2002 11 12-24. 

It is generally believed that these four canonical mechanisms of IgE-mediated activation of human FceRI + cells are responsible for the pathophysiologic involvement of these cells in allergic disorders [7], However, a significant percentage of allergic diseases (e.g. certain cases of asthma, chronic idiopathic urticaria, and atopic dermatitis) cannot be explained by the four classical mechanisms of FceRI + cell activation. 

Although there are five types of hypersensitivity responses, two of these, types 1 and 1 play a significant role in the pathophysiology of allergic eye disease. The ocular manifestations include seasonal allergic conjunctivitis (SAC), giant papillary conjunctivitis (GPC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis, contact dermatitis, and urticaria. These are discussed in Chapter 27. 

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