Allergen sensitization through the skin induces systemic allergic responses.
Allergen sensitization through the skin induces systemic allergic responses.
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DOI：
10.1067/mai.2000.110159
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发表时间：
2000-11
期刊：
影响因子：
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通讯作者：
Lisa A. Beck;Donald Y.M. Leung
中科院分区：
文献类型：
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作者：
Lisa A. Beck;Donald Y.M. Leung
皮肤是一种独特的免疫器官，作为外部环境和全身免疫反应之间的界面。因此，它可能直接与表皮应用的过敏原反应，从而影响全身过敏反应。众所周知，特应性皮炎（经常与食物过敏有关）比哮喘和过敏性鼻炎早几年发生。一些有趣的观察结果表明，特应性皮炎可能影响哮喘的病程。首先，过敏原皮试阳性的异位性皮炎患儿比无异位性皮炎的哮喘患儿哮喘更严重。第二，由于血清总IgE与哮喘的患病率密切相关，这就提出了一个有趣的问题，即过敏原通过皮肤致敏是否会因其对全身过敏反应的影响而导致更严重和持续的呼吸道疾病。事实上，小鼠对蛋白质抗原的表皮致敏诱导了局部过敏性皮炎和对乙酰甲胆碱的高反应性，这表明特应性皮炎中表皮暴露于抗原可能会增强哮喘的发展。最后，特应性皮炎的全身免疫激活得到了这些患者循环中活化T（H）2细胞、嗜酸性粒细胞、巨噬细胞和IgE数量增加的观察结果的支持。许多白细胞活化的标志物已被证明与特应性皮炎疾病的严重程度相关。这种全身性激活可能促进致敏T细胞、嗜酸性粒细胞和巨噬细胞在遗传易感宿主吸入过敏原后局部浸润到呼吸道粘膜中。特应性皮炎的系统方面，重点是呼吸系统的影响，进行了总结。
The skin is a unique immunologic organ that acts as an interface between the external environment and the systemic immune response. As such, it may react directly with allergens that are applied epicutaneously, thereby influencing the systemic allergic response. It is well known that atopic dermatitis (frequently in association with food allergy) predates the development of asthma and allergic rhinitis by several years. The possibility that atopic dermatitis may influence the course of asthma is suggested by several interesting observations. First, children with atopic dermatitis and positive skin tests to allergens frequently have more severe asthma than asthmatic children without atopic dermatitis. Second, because total serum IgE is strongly associated with the prevalence of asthma, it raises the interesting question of whether allergen sensitization through the skin predisposes to more severe and persistent respiratory disease because of its effects on the systemic allergic response. Indeed, epicutaneous sensitization of mice to a protein antigen induces both a localized allergic dermatitis and hyperresponsiveness to methacholine, which suggests that epicutaneous exposure to antigen in atopic dermatitis may enhance the development of asthma. Finally, systemic immune activation in atopic dermatitis is supported by the observation that these patients have increased numbers of circulating activated T(H)2 cells, eosinophils, macrophages, and IgE. Many of the markers of leukocyte activation have been shown to correlate with the severity of atopic dermatitis disease. This systemic activation might facilitate local infiltration of primed T cells, eosinophils, and macrophages into the respiratory mucosa after inhalation of allergen in genetically predisposed hosts. The systemic aspects of atopic dermatitis, with an emphasis on respiratory effects, are summarized.