Freudenberg M A, Esser P R, Jakob T, Galanos C, Martin S F
Max-Planck-Institute for Immunobiology, Freiburg, Germany.
G Ital Dermatol Venereol. 2009 Apr;144(2):173-85.
Allergic contact dermatitis (ACD) is an inflammatory skin disease of great and steadily increasing importance as an occupational health problem. The disease is induced by chemicals and metal ions which penetrate the skin and form complexes with host proteins. This process is accompanied by a strong, allergen-induced inflammatory reaction and leads to the migration of allergen-carrying dendritic cells (DC) from the skin to regional lymph nodes, where they promote generation of allergen-specific T cells. The latter are the ultimate effector cells of the disease. Re-exposure to the causative agent leads to the recruitment of the T effector cells, which then elicit the typical skin inflammatory reaction at the site of contact. Although DC and effector T cells play a protagonistic role in the sensitization and elicitation phase of ACD, respectively, other cell types including keratinocytes, NK cells, mast cells and B cells contribute to the pathogenesis of the disease. In this review the authors summarize recent findings that identify stress responses and innate immune pathways triggered by contact allergens and review recent data regarding the adaptive T cell response. The new data were collected mainly from studies on contact hypersensitivity (CHS), the corresponding experimental mouse model of human ACD. The elucidation of the molecular events involved in contact allergen-induced innate responses will help to design new treatment strategies and may allow to develop predictive in vitro assays for the identification of contact allergens.
过敏性接触性皮炎（ACD）作为一种职业健康问题，是一种重要性不断增加的炎症性皮肤病。该疾病由穿透皮肤并与宿主蛋白形成复合物的化学物质和金属离子诱发。此过程伴随着强烈的、过敏原诱导的炎症反应，并导致携带过敏原的树突状细胞（DC）从皮肤迁移至局部淋巴结，在那里它们促进过敏原特异性T细胞的生成。后者是该疾病的最终效应细胞。再次接触致病因子会导致效应T细胞的募集，随后在接触部位引发典型的皮肤炎症反应。尽管DC和效应T细胞分别在ACD的致敏和激发阶段起主要作用，但包括角质形成细胞、NK细胞、肥大细胞和B细胞在内的其他细胞类型也参与了该疾病的发病机制。在这篇综述中，作者总结了近期发现，这些发现确定了接触过敏原引发的应激反应和固有免疫途径，并回顾了有关适应性T细胞反应的最新数据。这些新数据主要来自对接触性超敏反应（CHS）的研究，即人类ACD相应的实验小鼠模型。对接触过敏原诱导的固有反应所涉及分子事件的阐明，将有助于设计新的治疗策略，并可能开发出用于识别接触过敏原的预测性体外检测方法。
