Fölster-Holst Regina, Reimer Rahel, Neumann Claudia, Proksch Erhardt, Rodriguez Elke, Weidinger Stephan, Goldust Mohamad, Hanisch Eckhard, Dähnhardt-Pfeiffer Stephan, Freitag-Wolf Sandra
Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
Department of Dermatology, University Medical Center Mainz, 55101 Mainz, Germany.
Biology (Basel). 2021 Oct 7;10(10):1008. doi: 10.3390/biology10101008.
A deficient epidermal barrier is a key feature of atopic dermatitis (AD) and comprises altered lipid and protein content and composition of the stratum corneum resulting in disturbed water balance. Clinically, eczematous lesions on dry skin and pruritus develop. Pruritic nodules occur in prurigo nodularis (PN), another chronic skin disease, which can be associated with atopy. We aimed at comparing the three clinical pictures, classic AD, atopic prurigo (AP), and non-atopic PN, to healthy controls regarding the epidermal barrier. We determined clinical parameters and performed biophysical measurements, histology/immunohistochemistry, electron microscopy, and molecular biological analysis. We found distinctively elevated clinical scores, reduced hydration and increased transepidermal water loss, epidermal hyperplasia and inflammation reduced filaggrin and increased loricrin and involucrin expression, as well as reduced intercellular lipid lamellae in all three disease groups. These findings show a severe disruption in epidermal barrier structure and function in all three disorders so that epidermal barrier impairment is now proven not only for AD but also for PN.
表皮屏障功能缺陷是特应性皮炎（AD）的一个关键特征，包括角质层脂质和蛋白质含量及组成的改变，从而导致水平衡紊乱。临床上，干性皮肤会出现湿疹样病变并伴有瘙痒。瘙痒性结节见于结节性痒疹（PN），这是另一种慢性皮肤病，可能与特应性有关。我们旨在比较三种临床情况，即经典AD、特应性瘙痒症（AP）和非特应性PN与健康对照在表皮屏障方面的差异。我们测定了临床参数，并进行了生物物理测量、组织学/免疫组织化学、电子显微镜检查和分子生物学分析。我们发现，在所有三个疾病组中，临床评分显著升高、皮肤水合作用降低、经表皮水分流失增加、表皮增生和炎症、丝聚合蛋白减少、兜甲蛋白和内披蛋白表达增加，以及细胞间脂质层减少。这些发现表明，在所有这三种疾病中，表皮屏障结构和功能均受到严重破坏，因此现在已证实表皮屏障受损不仅存在于AD，也存在于PN。
