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特应性皮炎与感染之间的相互作用:临床意义

Interactions Between Atopic Dermatitis and Infection: Clinical Implications.

作者信息

Kim Jihyun, Kim Byung Eui, Ahn Kangmo, Leung Donald Y M

机构信息

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.

出版信息

Allergy Asthma Immunol Res. 2019 Sep;11(5):593-603. doi: 10.4168/aair.2019.11.5.593.

Abstract

commonly colonizes the skin of atopic dermatitis (AD) patients and contributes to the development and exacerbation of AD. Multiple factors are associated with colonization of AD skin by , including the strength of -corneocyte adhesion, deficiency of antimicrobial peptides, decreased levels of filaggrin and filaggrin degradation products, overexpressed Th2/Th17 cytokines, microbial dysbiosis and altered lipid profiles. colonization on AD skin causes skin barrier dysfunction through virulence factors such as superantigens (toxins), enzymes and other proteins. Furthermore, colonization of AD skin by exacerbates AD and may contribute to microbial dysbiosis, allergen sensitization, Th2/Th17 polarization, development of atopic march and food allergy in AD patients. Skin colonization of , particularly methicillin-resistant (MRSA), is one of the major challenges commonly encountered in the management of AD. Bleach bath, and topical or systemic antibiotics could be used to control infection on AD skin. However, careful use of antibiotics is required to control the occurence of MRSA. Recently, various strategies, including microbiome transplant, monoclonal antibodies against virulent toxins, vaccines and recombinant phage endolysin, have been studied to control infection on AD skin. Further advances in our understanding of could provide us with ways to manage colonization more effectively in AD patients.

摘要

通常定植于特应性皮炎(AD)患者的皮肤,并促进AD的发生和加重。多种因素与AD皮肤被[具体微生物名称未给出]定植有关,包括[具体微生物名称未给出]与角质形成细胞的黏附强度、抗菌肽缺乏、丝聚合蛋白和丝聚合蛋白降解产物水平降低、Th2/Th17细胞因子过度表达、微生物群落失调和脂质谱改变。[具体微生物名称未给出]在AD皮肤上的定植通过超抗原(毒素)、酶和其他蛋白质等毒力因子导致皮肤屏障功能障碍。此外,[具体微生物名称未给出]在AD皮肤上的定植会加重AD,并可能导致微生物群落失调、过敏原致敏、Th2/Th17极化、AD患者特应性进程的发展和食物过敏。[具体微生物名称未给出]的皮肤定植,尤其是耐甲氧西林金黄色葡萄球菌(MRSA),是AD管理中常见的主要挑战之一。漂白浴以及局部或全身使用抗生素可用于控制AD皮肤上的[具体微生物名称未给出]感染。然而,需要谨慎使用抗生素以控制MRSA的发生。最近,包括微生物群移植、抗毒力毒素单克隆抗体、疫苗和重组噬菌体溶菌酶在内的各种策略已被研究用于控制AD皮肤上的[具体微生物名称未给出]感染。我们对[具体微生物名称未给出]的进一步了解可能会为我们提供更有效地管理AD患者[具体微生物名称未给出]定植的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0905/6658404/fb0346773925/aair-11-593-g001.jpg

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