TY - JOUR
T1 - Atopic Dermatitis and Type 2 Immune Deviation
AU - Furue, Masutaka
AU - Ulzii, Dugarmaa
AU - Vu, Yen Hai
AU - Tsuji, Gaku
AU - Kido-Nakahara, Makiko
AU - Nakahara, Takeshi
N1 - Publisher Copyright:
© 2019, Springer Nature Switzerland AG.
PY - 2019/9
Y1 - 2019/9
N2 - Purpose of the review: To summarize recent topics on type 2 signatures in atopic dermatitis (AD). Recent findings: Therapeutic success of anti-IL-4 receptor antibody dupilumab does suggest that type 2 cytokines IL-4 and IL-13 have pivotal roles in the pathogenesis of AD. Lesional skin of AD expresses increased levels of IL-4 and IL-13. In parallel, type 2 chemokines such as CCL17, CCL22, and CCL26 are overexpressed in AD, and these chemokines recruit type 2 T cells and eosinophils. IL-4 and IL-13 downregulate the expression of filaggrin and exacerbate epidermal barrier dysfunction. Keratinocytes in barrier-disrupted epidermis produce thymic stromal lymphopoietin, IL-25 and IL-33, which enhance the type 2 immune response. IL-31, released from type 2 T cells, is an essential pruritogenic cytokine. IL-4 and IL-13 amplify the IL-31-mediated neuronal signal. Summary: Type 2 cytokines IL-4 and IL-13 are profoundly associated with three cardinal features of AD: barrier dysfunction, skin inflammation, and chronic pruritus. These findings explain the high efficacy of dupilumab in the treatment of AD.
AB - Purpose of the review: To summarize recent topics on type 2 signatures in atopic dermatitis (AD). Recent findings: Therapeutic success of anti-IL-4 receptor antibody dupilumab does suggest that type 2 cytokines IL-4 and IL-13 have pivotal roles in the pathogenesis of AD. Lesional skin of AD expresses increased levels of IL-4 and IL-13. In parallel, type 2 chemokines such as CCL17, CCL22, and CCL26 are overexpressed in AD, and these chemokines recruit type 2 T cells and eosinophils. IL-4 and IL-13 downregulate the expression of filaggrin and exacerbate epidermal barrier dysfunction. Keratinocytes in barrier-disrupted epidermis produce thymic stromal lymphopoietin, IL-25 and IL-33, which enhance the type 2 immune response. IL-31, released from type 2 T cells, is an essential pruritogenic cytokine. IL-4 and IL-13 amplify the IL-31-mediated neuronal signal. Summary: Type 2 cytokines IL-4 and IL-13 are profoundly associated with three cardinal features of AD: barrier dysfunction, skin inflammation, and chronic pruritus. These findings explain the high efficacy of dupilumab in the treatment of AD.
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U2 - 10.1007/s40521-019-00219-w
DO - 10.1007/s40521-019-00219-w
M3 - Review article
AN - SCOPUS:85097759235
SN - 2196-3053
VL - 6
SP - 200
EP - 210
JO - Current Treatment Options in Allergy
JF - Current Treatment Options in Allergy
IS - 3
ER -