Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria; Institute for Pediatric Dermatology and Rare Diseases, Karl Landsteiner Society, Innsbruck, Austria.
Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria.
J Invest Dermatol. 2024 May;144(5):989-1000.e1. doi: 10.1016/j.jid.2024.03.006.
A compromised permeability barrier is a hallmark of atopic dermatitis (AD). Localized to the outermost skin layer, the stratum corneum (SC) is critically dependent on terminal differentiation of epidermal keratinocytes, which transform into protein-rich corneocytes surrounded by extracellular lamellae of unique epidermal lipids, conferring permeability barrier function. These structures are disrupted in AD. A leaky barrier is prone to environmental insult, which in AD elicits type 2-dominant inflammation, in turn resulting in a vicious cycle further impairing the SC structure. Therapies directed at enforcing SC structure and anti-inflammatory strategies administered by topical and systemic route as well as UV therapy have differential effects on the permeability barrier. The expanding armamentarium of therapeutic modalities for AD treatment warrants optimization of their effects on permeability barrier function.
通透性屏障受损是特应性皮炎（AD）的一个标志。位于皮肤最外层的角质层（SC）严重依赖于表皮角质形成细胞的终末分化，这些细胞转化为富含蛋白质的角蛋白细胞，周围是独特的表皮脂质的细胞外薄片，赋予其通透性屏障功能。这些结构在 AD 中被破坏。渗漏的屏障容易受到环境的影响，在 AD 中会引发 2 型主导的炎症，反过来又会导致进一步损害 SC 结构的恶性循环。通过局部和全身途径以及紫外线治疗来强化 SC 结构和抗炎策略的治疗方法对通透性屏障有不同的影响。AD 治疗的治疗方法不断增加，需要优化它们对通透性屏障功能的影响。
