Department of Dermatology and Allergology, Philipps University, Baldinger Str., D-35043, Marburg, Germany.
Br J Dermatol. 2014 Aug;171(2):212-9. doi: 10.1111/bjd.12936. Epub 2014 Aug 5.
Pruritus increasingly occurs in the elderly population and is associated with a variety of dermatoses of mixed aetiology. Clinical and experimental evidence suggests that senile pruritus may be linked to autoimmune events initiated by loss of self-tolerance against cutaneous autoantigens, which is facilitated by immune ageing processes. T-cell immunity, which underpins the production of pathogenic autoantibodies in autoimmune diseases, is deregulated by immune senescence thereby leading to autoimmune disorders such as bullous pemphigoid (BP). High mortality rates of BP combined with steadily increasing incidence emphasize the need for an effective diagnostic strategy at an early stage. We summarize here the current understanding of immunological alterations during the ageing process, thereby focusing on aberrant T-cell responses against the basement membrane antigens BP180 and BP230, which may eventually lead to the clinical outcome of BP.
瘙痒症在老年人群中越来越常见，与多种病因混合的皮肤病有关。临床和实验证据表明，老年瘙痒症可能与自身免疫事件有关，这些事件是由对皮肤自身抗原的自身耐受性丧失引发的，而免疫衰老过程则促进了这些事件的发生。细胞免疫是自身免疫性疾病中产生致病性自身抗体的基础，免疫衰老会导致其失调，从而导致自身免疫性疾病，如大疱性类天疱疮 (BP)。BP 的高死亡率加上发病率的稳步上升，强调了在早期阶段需要采取有效的诊断策略。在这里，我们总结了衰老过程中免疫变化的现有认识，重点介绍了针对基底膜抗原 BP180 和 BP230 的异常 T 细胞反应，这些反应最终可能导致 BP 的临床结果。
