Buske-Kirschbaum A, Jobst S, Hellhammer D H
Center of Psychobiology and Psychosomatic Research, University of Trier, Germany.
Ann N Y Acad Sci. 1998 May 1;840:747-54. doi: 10.1111/j.1749-6632.1998.tb09613.x.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with the principal symptoms of dry skin, lichnification, eczematous inflammation, and an intense pruritus. Despite general acceptance that AD is a multifactorial skin disorder, dysregulation of immune functions (e.g., hypersecretion of immunoglobulin-E, altered cytokine profiles) is considered to be mainly involved in AD pathogenesis. Considerable evidence points to an immunoregulatory function for the hypothalamus-pituitary-adrenal (HPA) axis, suggesting that appropriate reactivity of the HPA axis is necessary to prevent the immune system from reaching a level that may be damaging for the host. It is further hypothesized that dysfunctional reactivity of the HPA axis may increase the vulnerability of the organism to immune-related disorders such as inflammatory diseases. In the present paper the role of the HPA axis for the development and chronification of allergic inflammation will be summarized and the potential pathological significance of a dysfunctional HPA axis in AD pathogenesis will be discussed.
特应性皮炎（AD）是一种慢性炎症性皮肤病，主要症状包括皮肤干燥、苔藓化、湿疹样炎症和剧烈瘙痒。尽管人们普遍认为AD是一种多因素的皮肤疾病，但免疫功能失调（如免疫球蛋白-E分泌过多、细胞因子谱改变）被认为主要参与了AD的发病机制。大量证据表明下丘脑-垂体-肾上腺（HPA）轴具有免疫调节功能，这表明HPA轴的适当反应对于防止免疫系统达到可能对宿主造成损害的水平是必要的。进一步推测，HPA轴的功能失调反应可能会增加机体对免疫相关疾病（如炎症性疾病）的易感性。在本文中，将总结HPA轴在过敏性炎症发生和慢性化中的作用，并讨论功能失调的HPA轴在AD发病机制中的潜在病理意义。
