title: [Allergic contact dermatitis: how to re-induce tolerance?].
abstract: Allergic contact dermatitis (ACD) is a skin inflammatory disease mediated by activation of CD8+ cytotoxic T cells specific for haptens in contact with the skin. CD4+ T cells behave as both regulatory and tolerogenic cells since they down-regulate the skin inflammation in patients with ACD (regulation) and prevent the development of eczema (tolerance) in normal individuals. Thus, ACD corresponds to a breakdown of immune tolerance to haptens in contact with the skin. Several regulatory CD4+ T cell subsets (Treg), especially CD4+CD25+ natural Treg cells, are involved in immunological tolerance and regulation to haptens through the production of the immunosuppressive cytokines IL-10 and TGF-beta. Ongoing strategies to re-induce immune tolerance to haptens in patients with eczema include improvement of existing methods of tolerance induction (oral tolerance, low dose tolerance, allergen-specific immunotherapy, UV-induced tolerance) as well as development of new drugs able to activate IL-10 producing Treg cells in vivo. Ongoing and future progress in this area will open up new avenues for treatment of eczema and more generally autoimmune and allergic diseases resulting from a breakdown of tolerance to autoantigens and allergens, respectively.
authors.affiliation: Inserm U.503 et U.404, IFR 128 BioSciences Lyon-Gerland, 21, avenue Tony Garnier, 69375 Lyon Cedex 7, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Vocanson
authors.forename: Anca
authors.initials: A
authors.lastname: Hennino
authors.forename: Cyril
authors.initials: C
authors.lastname: Chavagnac
authors.forename: Aurore
authors.initials: A
authors.lastname: Rozières
authors.forename: Pierre
authors.initials: P
authors.lastname: Saint-Mezard
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Akiba
authors.forename: Masataka
authors.initials: M
authors.lastname: Satoh
authors.forename: Dominique
authors.initials: D
authors.lastname: Kaiserlian
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Nicolas
mesh_terms: D000485:Allergens / Q000009:adverse effects / Q000627:therapeutic use; D000818:Animals; D016207:Cytokines / Q000502:physiology; D017449:Dermatitis, Allergic Contact / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D003888:Desensitization, Immunologic; D006241:Haptens / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D007108:Immune Tolerance; D007165:Immunosuppression Therapy / Q000379:methods*; D016753:Interleukin-10 / Q000502:physiology; D007376:Interleukin-2 / Q000627:therapeutic use; D023421:Models, Animal; D008954:Models, Biological; D011701:PUVA Therapy; D016176:T-Lymphocyte Subsets / Q000276:immunology; D016212:Transforming Growth Factor beta / Q000502:physiology
chemical_list: D000485:Allergens; D016207:Cytokines; D006241:Haptens; D007376:Interleukin-2; D016212:Transforming Growth Factor beta; D016753:Interleukin-10