Breuer Kristine, Werfel Thomas, Kapp Alexander
Nordseeklinik Norderney, Norderney, Hannover, Germany.
Chem Immunol Allergy. 2006;91:76-86. doi: 10.1159/000090231.
Atopic dermatitis (AD) is a chronic inflammatory skin disease which often becomes manifest in early infancy and is characterized by itchy eczematous lesions with characteristic localization. The cellular infiltrate of allergic eczematous skin diseases (i.e. AD, allergic contact dermatitis) is mainly composed of mononuclear cells. Whereas allergic contact dermatitis is always triggered by allergen-specific T cells, a number of allergic and nonallergic trigger factors appear to be relevant in AD. This article discusses data coming from immunological studies focusing on T-cell responses in AD. The concept of a switch from a T helper type 1 (Th1) to a Th2 cytokine profile in lesional skin of AD is well accepted. Besides CD4+ T lymphocytes, CD8+ cells are likely to play an important role in the pathogenesis of AD. Recent studies point to the induction of apoptosis in keratinocytes by interferon-gamma derived from skin-homing T cells as a further important mechanism for the induction and maintenance of the eczema. Recent clinical studies have confirmed the major role of food allergy and infectious microorganisms as trigger factors of AD. New therapeutic strategies for AD include topical calcineurin inhibitors which were introduced as a new therapeutic principle at the beginning of this decade.
特应性皮炎（AD）是一种慢性炎症性皮肤病，常在婴儿早期发病，其特征为瘙痒性湿疹样皮损且有特征性的分布部位。过敏性湿疹性皮肤病（如AD、过敏性接触性皮炎）的细胞浸润主要由单核细胞组成。过敏性接触性皮炎总是由过敏原特异性T细胞触发，而在AD中，一些过敏和非过敏触发因素似乎都与之相关。本文讨论了来自免疫学研究的数据，这些研究聚焦于AD中的T细胞反应。AD皮损皮肤中从1型辅助性T细胞（Th1）向2型辅助性T细胞（Th2）细胞因子谱转变的概念已被广泛接受。除了CD4+ T淋巴细胞外，CD8+细胞可能在AD的发病机制中起重要作用。最近的研究指出，皮肤归巢T细胞产生的干扰素-γ诱导角质形成细胞凋亡是湿疹发生和维持的另一个重要机制。最近的临床研究证实了食物过敏和感染性微生物作为AD触发因素的主要作用。AD的新治疗策略包括局部钙调神经磷酸酶抑制剂，这是在本十年初作为一种新的治疗原则引入的。
