Bjerke Jens Roar
Hudavdelingen Ullevål universitetssykehus 0407 Oslo.
Tidsskr Nor Laegeforen. 2002 Mar 20;122(8):793-6.
The skin is our largest organ. Its physico-chemical properties are adapted to its function as a non-specific general defense line against infections and injury from the environment. Through evolution the skin has developed a second line of highly specific immune defense comprising epidermal Langerhans cells, T lymphocytes and keratinocytes as the most distinct cellular elements.
On the basis of available research data and reviews, an overview on the skin as an immunological organ is presented.
Antigens penetrating into the epidermis are bound to dendritic Langerhans cells, processed and presented to T lymphocytes. Certain memory T cells are able to remember where they first encountered antigen. Skin homing T cells are CLA+ and circulate between the skin, peripheral blood and skin draining lymph nodes. Keratinocytes produce a wide spectre of cytokines, in particular interleukin-1, which has a key role in the skin immune function. The most common inflammatory skin disorders are mediated by T lymphocytes, usually Th1 cells, as in psoriasis, or Th2 cells, as in atopic dermatitis. Systemic treatment with T cell specific suppressive drugs, such as cyclosporine, has been successful in certain dermatoses. Promising cyclosporine analogues for topical treatment (tacrolimus and pimecrolimus) have been developed and may soon be introduced.
皮肤是我们最大的器官。其物理化学特性与其作为抵御感染和外界环境伤害的非特异性一般防线的功能相适应。在进化过程中，皮肤形成了第二条高度特异性的免疫防线，包括表皮朗格汉斯细胞、T淋巴细胞和角质形成细胞，这些是最显著的细胞成分。
基于现有研究数据和综述，对皮肤作为免疫器官进行概述。
穿透表皮的抗原与树突状朗格汉斯细胞结合，被加工处理后呈递给T淋巴细胞。某些记忆T细胞能够记住它们首次遇到抗原的位置。皮肤归巢T细胞为CLA+，在皮肤、外周血和引流皮肤的淋巴结之间循环。角质形成细胞产生多种细胞因子，特别是白细胞介素-1，其在皮肤免疫功能中起关键作用。最常见的炎症性皮肤病由T淋巴细胞介导，通常在银屑病中由Th1细胞介导，在特应性皮炎中由Th2细胞介导。用T细胞特异性抑制药物如环孢素进行全身治疗在某些皮肤病中取得了成功。已开发出有望用于局部治疗的环孢素类似物（他克莫司和吡美莫司），可能很快会投入使用。
