title: Humoral and Cellular Autoreactivity to Epidermal Proteins in Atopic Dermatitis.
abstract: Atopic dermatitis (AD), a chronic relapsing inflammatory disease of the skin, is an important public health concern affecting 10-20 % of children worldwide. The etiology and pathogenesis of AD involve the interplay of genetic and environmental factors, including abnormalities in skin integrity and a skewed immune system usually driven by a Th2 phenotype in childhood with a switch to Th1 in the chronic phase of disease. Children and adults with AD commonly have elevated IgE levels directed to multiple different antigens, including aeroallergens, food allergens, and microbial proteins. IgE targeting self-antigens from epidermal proteins have been detected in up to 91 % of patients, particularly in severe persistent AD. It has been suggested that the occurrence of autoreactivity develops in early childhood. However, it is not clear yet if autoreactive IgEs in patients with AD are pathogenic or just an epiphenomenon. The fact that these autoantibodies are associated with severity and are not present in other allergic or skin diseases favors the pathogenicity of IgE-mediated autoreactivity in AD. In this review, we evaluate the pathogenesis of AD and the emerging role of autoreactivity to various keratinocyte antigens involving both the humoral and cellular components of the immune system.
authors.affiliation: Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Cristián
authors.initials: C
authors.lastname: Navarrete-Dechent
authors.affiliation: Department of Pediatric Infectious Diseases and Immunology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Portugal 61, Santiago, 8330034, Chile.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pérez-Mateluna
authors.affiliation: Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Silva-Valenzuela
authors.affiliation: Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Cristián
authors.initials: C
authors.lastname: Vera-Kellet
authors.affiliation: Department of Pediatric Infectious Diseases and Immunology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Portugal 61, Santiago, 8330034, Chile. arturobor@med.puc.cl.|Millennium Institute on Immunology and Immunotherapy, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. arturobor@med.puc.cl.
authors.forename: Arturo
authors.identifier: http://orcid.org/0000-0002-7904-262X
authors.initials: A
authors.lastname: Borzutzky
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology; D002648:Child; D003876:Dermatitis, Atopic / Q000276:immunology* / Q000503:physiopathology; D004817:Epidermis / Q000276:immunology*; D005512:Food Hypersensitivity; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology*; D056724:Immunity, Humoral / Q000276:immunology*; D007073:Immunoglobulin E / Q000276:immunology; D010641:Phenotype; D012867:Skin / Q000276:immunology; D018417:Th1 Cells / Q000166:cytology; D018418:Th2 Cells / Q000166:cytology; D055815:Young Adult
chemical_list: D000485:Allergens; D001323:Autoantibodies; D001324:Autoantigens; D007073:Immunoglobulin E
keywords: Autoimmunity; Epidermis; Immunoglobulin E; Malassezia