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Atopic Dermatitis

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Principles of Molecular Medicine

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Abstract

Atopic dermatitis, also known as atopic eczema, is a chronic inflammatory skin disease frequently seen in patients with a personal or family history of asthma and allergic rhinitis. There have been extraordinary strides made in the understanding of the immunopathogenesis of allergic diseases. In particular, this constellation of inherited illnesses is associated with activation of a specific group of cytokine genes encompassing IL-3, IL-4, IL-5, IL-13, and granulocyte-macrophage colony-stimulating factor The molecular basis for selective activation of this cytokine gene cluster and their immunological consequences are being investigated However, it is clear that allergic diseases result from a poly-genic inheritance pattern that involves cytokine-gene activation and other less-well-defined gene products as well. In addition, the clinical expression of allergic diseases is highly dependent on a complex interaction between the host and its environment, for example, allergen exposure. This chapter reviews some of these developments and their clinical implications

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Selected references

  • Abemathy-Carver KJ, Sampson HA, Picker LJ, Leung DYM. Milk-induced eczema is associated with the expansion of T cells expressing cutaneous lymphocyte antigen. J Clin Invest 1995;95:913–918.

    Google Scholar 

  • Akdis M, Trautmann A, Klunker S, et al. T helper (Th) 2 predominance in atopic diseases is due to preferential apoptosis of circulating memory/effector Th1 cells. FASEB J 2003;17:1026–1035.

    Article  CAS  Google Scholar 

  • Al-Daraji WI, Grant KR, Ryan K, Saxton A, Reynolds NJ. Localization of calcineurin/NFAT in human skin and psoriasis and inhibition of cal-cineurin/NFAT activation in human keratinocytes by cyclosporin A. J Invest Dermatol 2002;1 18:779–788.

    Article  Google Scholar 

  • Babi LFS, Picker U, Soler MTP. Circulating allergen-reactive T cells from patients with atopic dermatitis and allergic contact dermatitis express the skin-selective homing receptor the cutaneous lymphocyte-associated antigen (CLA). J Exp Med 1995;181:1935–1940.

    Article  Google Scholar 

  • Barton D, HogenEsch H, Weih F. Mice lacking the transcription factor RelB develop T cell-dependent skin lesions similar to human atopic dermatitis. Eur J Immunol 2000;30(8):2323–2332.

    Article  PubMed  CAS  Google Scholar 

  • Bieber T, de la Salle H, Wollenberg A, et al. Human epidermal Langerhans cells express the high affinity receptor for immunoglobulin E (FceRI). J Exp Med 1992;175:1285–1290.

    Article  PubMed  CAS  Google Scholar 

  • Bochner BS, Klunk DA, Sterbinsky SA, Coffinan RL, Schleimer RP. IL-13 selectively induces vascular cell adhesion molecule-I expression in human endothelial cells. J Immunol 1995;154:799–803.

    PubMed  CAS  Google Scholar 

  • Chan LS, Robinson N, Xu L. Expression of interleukin-4 in the epidermis of transgenic mice results in a pruritic inflammatory skin disease: an experimental animal model to study atopic dermatitis. J Invest Dermatol 2001;117(4):977–983.

    Article  PubMed  CAS  Google Scholar 

  • Chan SC, Hanifin JM. Immunopharmacologic aspects of atopic dermatitis. Clin Rev Allergy Immunol 1993;11:523–542.

    CAS  Google Scholar 

  • Chandrasekharappa SC, Rebelsky MS, Fiiak TA, LeBeau MM, Westbrook CA. A long-range restriction map of the interleukin-4 and interleukin 5 linkage group on chromosome 5. Genomics 1990;6:94–99.

    Article  PubMed  CAS  Google Scholar 

  • Cooke RA, van der Veer A. Human sensitization. J Immunol 1916;1: 201–305.

    CAS  Google Scholar 

  • Cookson WOCM, Hopkin JM. Dominant inheritance of atopic immuno-globulin E responsiveness. Lancet 1988;1:86–88.

    Article  PubMed  CAS  Google Scholar 

  • Cooper KD. New therapeutic approaches in atopic dermatitis. Clin Rev Allergy Immunol 1993;11(4):543–559.

    CAS  Google Scholar 

  • Giannetti A. Neuropeptides in atopic dermatitis. Curr Probl Dermatol 1999;28:51–55.

    PubMed  CAS  Google Scholar 

  • Grewe M, Czech W, Morita A, et al. Human eosinophils produce biologically active IL-12: implications for control of T cell responses. J Immunol 1998;161(1):415–420.

    PubMed  CAS  Google Scholar 

  • Hamid Q, Boguniewicz M, Leung DYM. Differential in situ cytokine gene expression in acute vs. chronic atopic dermatitis. J Clin Invest 1994; 94:870–876.

    PubMed  CAS  Google Scholar 

  • Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol 1980;92:44–47.

    Google Scholar 

  • Hara J, Higuchi K, Okamoto R, Kawashima M, Imokawa G. High-expression of sphingomyelin deacylase is an important determinant of ceramide deficiency leading to barrier disruption in atopic dermatitis. J Invest Dermatol 2000;115(3):406–413.

    Article  PubMed  CAS  Google Scholar 

  • Hill LW, Sulzberger MB. Yearbook of Dermatology and Syphilology. Chicago: Year Book Medical Publisher, 1933; pp. 1–70.

    Google Scholar 

  • Hopp RJ, Bewtra AK, Watt GD, Nair NM, Townley RG. Genetic analysis of allergic disease in twins. J Allergy Clin Immunol 1984;73:265–270.

    PubMed  CAS  Google Scholar 

  • Jones SM, Sampson HA. The role of allergens in atopic dermatitis. Clin Rev Allergy Immunol 1993;11:471–490.

    CAS  Google Scholar 

  • Kang KF, Tian RM. Atopic dermatitis. An evaluation of clinical and laboratory findings. Int J Dermatol 1987;26:27–32.

    Article  PubMed  CAS  Google Scholar 

  • Kay AM, Ying S, Vamey V, et al. Messenger RNA expression of cytokine gene cluster, interleulan 3 (IL-3), IL-5, and granulocyte/macrophage colony-stimulating factor, in allergen-induced late-phase cutaneous reactions in atopic subjects. J Exp Med 1991;173:775–778.

    Article  PubMed  CAS  Google Scholar 

  • Klunker S, Trautmann A, Akdis M, et al. A second step of chemotaxis after transendothelial migration: keratinocytes undergoing apoptosis release IFN-gamma-inducible protein 10, monokine induced by IFN-gamma, and IFN-gamma-inducible alpha-chemoattractant for T cell chemotaxis toward epidermis in atopic dermatitis. J Immunol 2003; 171:1078–1084.

    PubMed  CAS  Google Scholar 

  • Kondo H, Ichikawa Y, Imokawa G. Percutaneous sensitization with allergens through barrier-disrupted skin elicits a Th2-dominant cytokine response. Eur J Immunol 1998;28:769–779.

    Article  PubMed  CAS  Google Scholar 

  • Koomen CAFM. Allergen presentation by epidermal Langerhans cells from patients with atopic dermatitis is mediated by IgE. Immunology 1990;69:335–341.

    Google Scholar 

  • Kraft S, Wessendorf JH, Haberstok J, Novak N, Wollenberg A, Bieber T. Enhanced expression and activity of protein-tyrosine kinases establishes a functional signaling pathway only in FcepsilonRIhigh Langerhans cells from atopic individuals. J Invest Dermatol 2002; 119:804–811.

    Article  PubMed  CAS  Google Scholar 

  • Lacour M, Hauser C. The role of microorganisms in atopic dermatitis. Clin Rev Allergy Immunol 1993;11:491–522.

    CAS  Google Scholar 

  • Lee YA, Wahn U, Kehrt R, et al. A major susceptibility locus for atopic dermatitis maps to chromosome 3q21. Nat Genet 2000;26(4): 470–473.

    Article  PubMed  CAS  Google Scholar 

  • Leiferman KM. A role for eosinophils in atopic dermatitis. J Am Acad Dermatol 2001;45(1 Pt 2):S21–S24.

    Article  Google Scholar 

  • Leung DY, Bieber T. Atopic dermatitis. Lancet 2003;361(9352):151–160.

    Article  Google Scholar 

  • Leung DYM. Atopic dermatitis: the skin as a window into the pathogene-sis of chronic allergic diseases. J Allergy Clin Immunol 1995;96: 302–319.

    Article  PubMed  CAS  Google Scholar 

  • Leung DYM, Geha RS. Clinical and immunologic aspects of the hyper IgE syndrome. In: Hematology Oncology Clinics of North America. Philadelphia: Saunders, 1988; pp. 81–100.

    Google Scholar 

  • Leung DYM, Travers JB, Norris DA. Superantigens in skin disease. J Invest Dermatol 1995;105:37S–42S.

    Article  PubMed  CAS  Google Scholar 

  • Leung DYM, Harbeck R, Bina P, Hanifin JM, Reiser RF, Sampson HA. Presence of IgE antibodies to staphylococcal exotoxins on the skin of patients with atopic dermatitis: evidence for a new group of allergens. J Clin Invest 1993;92:1374–1380.

    PubMed  CAS  Google Scholar 

  • Marsh DG, Neely JD, Breazeale DR, et al. Linkage analysis of lL-4 and other chromosome 5q31.1 markers and total serum immunoglobulin E concentrations. Science 1994 264:1152–1156.

    Article  PubMed  CAS  Google Scholar 

  • Matsumoto M, Ra C, Kawamoto K, et al. IgE hyperproduction through enhanced tyrosine phosphorylation of Janus kinase 3 in NC/Nga mice, a model for human atopic dermatitis. J Immunol 1999;162(2): 1056–1063.

    PubMed  CAS  Google Scholar 

  • May CE. Objective clinical laboratory studies of immediate hypersensitiv-ity reactions to foods in asthmatic children. J Allergy Clin Immunol 1976;58:500–515.

    Article  PubMed  CAS  Google Scholar 

  • Meyers D, Marsh D. Report on a national institute of allergy and infectious diseases sponsored workshop on the genetics of total immunoglobulin E levels in humans. J Allergy Clin Immunol 1981;67:167–170.

    Article  PubMed  CAS  Google Scholar 

  • Mosmann TR, Cherwinski H, Bond MW, Giedlin MH, Coffinan R. Two types of murine helper T cell clones. 1. Definition according to profiles of lymphokine activities and secretory proteins. J Immunol 1986;136:2348–2357.

    PubMed  CAS  Google Scholar 

  • Mudde GC, Van Reijsen PC, Boland GJ, et al. Engagement of Fc epsilon RI on human monocytes induces the production of IL-10 and prevents their differentiation in dendritic cells. J Immunol 2001;167:797–804.

    Google Scholar 

  • Nghiem P, Pearson G, Langley RG. Tacrolimus and pimecrolimus: from clever prokaryotes to inhibiting calcineurin and treating atopic dermatitis. J Am Acad Dermatol 2002;46(2 Pt 1):228–241.

    Article  Google Scholar 

  • Nomura I, Gao B, Boguniewicz M, Darst MD, Travers JB, Leung DYM. Distinct patterns of gene expression in the skin lesions of atopic dermatitis and psoriasis: a gene microarray analysis. J Allergy Clin Immunol 2003;112:1195–1202.

    Article  PubMed  CAS  Google Scholar 

  • Nomura I, Goleva E, Howell MD, et al. Cytokine milieu of atopic dermatitis, as compared to psoriasis, skin prevents induction of innate immune response genes. J Immunol 2003;171:3262–3269.

    PubMed  CAS  Google Scholar 

  • Novak N, Kruse S, Kraft S, et al. Dichotomic nature of atopic dermatitis reflected by combined analysis of monocyte immunophenotyping and single nucleotide polymorphisms of the interleukin-4/interleukin-13 receptor gene: the dichotomy of extrinsic and intrinsic atopic dermatitis. J Invest Dermatol 2002;119:870–875.

    Article  PubMed  CAS  Google Scholar 

  • Ong PY, Ohtake T, Brandt C, et al. Endogenous antimicrobial peptides and skin infections in atopic dermatitis. N Engl J Med 2002; 347(15): 1151–1160.

    Article  PubMed  CAS  Google Scholar 

  • Pastore S, Fanales-Belasio E, Albanesi C, Chinni LM, Giannetti A, Girolomoni G. Granulocyte macrophage colony-stimulating factor is overproduced by keratinocytes in atopic dermatitis. Implications for sustained dendritic cell activation in the skin. J Clin Invest 1997;99: 3009–3017.

    Article  PubMed  CAS  Google Scholar 

  • Schnyder UW. Neurodermititis-asthma-rhintis. Eine genetischallergol-ogisch studie. Acta Genet Stat Med 1960;10(Suppl 18):1–106.

    Google Scholar 

  • Schultz Larsen F, Holm NV, Henningsen K. Atopic dermatitis. A genetic-epidemiologic study in a population-based twin sample. J Am Acad Dermatol 1986;15:487–494.

    Article  Google Scholar 

  • Shibaki A, Ohkawara A, Shimada S, Ra C, Aiba S, Cooper KD. Expression, but lack of calcium mobilization by high-affinity IgE Fc epsilon receptor I on human epidermal and dermal Langerhans cells. Exp Dermatol 1996;5:272–278.

    Article  PubMed  CAS  Google Scholar 

  • Shirakawa TS, Li A, Dubowitz M, et al. Association between atopy and variants of the P-subunit of the high affinity Immunoglobulin E receptor. Nat Genet 1994;7:124–129.

    Article  Google Scholar 

  • Taylor RS, Baadsgaard O, Hammerberg C, Cooper KD. Hyperstimulatory CD1a+CD1b+CD36+Langerhans cells are responsible for increased autologous T lymphocyte reactivity to lesional epidermal cells of patients with atopic dermatitis. J Immunol 1991;147:3794–3802.

    PubMed  CAS  Google Scholar 

  • Tsicopoulous A, Hamid Q, Vamey V, et al. Preferential messenger RNA expression of Thl-type cells (IFN-Îł+, IL-2+) in classical delayed-type (tuberculin) hypersensitivity reactions in human skin. J Immunol 1992;148:2058–2061.

    Google Scholar 

  • Vercelli D, Jabara HH, Lee B, Woodland N, Geha RS, Leung DYM. Human recombinant interleukin-4 induces FcεR2/CD23 on normal human monocytes. J Exp Med 1988;167:1406–1416.

    Article  PubMed  CAS  Google Scholar 

  • Vestergaard C, Bang K, Gesser B, Yoneyama H, Matsushima K, Larsen CG. A Th2 chemokine, TARC, produced by keratinocytes may recruit CLA+CCR4+lymphocytes into lesional atopic dermatitis skin. J Invest Dermatol 2000;115(4):640–646.

    Article  PubMed  CAS  Google Scholar 

  • Walley AJ, Chavanas S, Moffatt MF el al. Gene polymorphism in Netherton and common atopic disease. Nat Genet 2001;29(2):175–178.

    Article  PubMed  CAS  Google Scholar 

  • Williams HC, Burney PGJ, Pembroke AC, et al. The UK Working Party’s diagnostic criteria for atopic dermatitis III. Independent hospital validation. Br J Dermatol 1994;131:406–416.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Kefei Kang
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  2. Donald Y. M. Leung
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  3. Kevin D. Cooper
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Editors and Affiliations

  1. Department of Medicine, Division of Cardiology Carolina Cardiovascular Biology Center, University of North Carolina School of Medicine, Chapel Hill, NC

    Marschall S. Runge MD, PhD  & Cam Patterson MD  & 

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© 2006 Humana Press Inc.

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Kang, K., Leung, D.Y.M., Cooper, K.D. (2006). Atopic Dermatitis. In: Runge, M.S., Patterson, C. (eds) Principles of Molecular Medicine. Humana Press. https://doi.org/10.1007/978-1-59259-963-9_97

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  • DOI: https://doi.org/10.1007/978-1-59259-963-9_97

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-202-5

  • Online ISBN: 978-1-59259-963-9

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