Dysregulation of the epithelial barrier by environmental and other exogenous factors

Contact Dermatitis - Tập 85 Số 6 - Trang 615-626 - 2021
Yasutaka Mitamura1,2, İsmail Öğülür3,1,2, Yağız Pat4,1, Arturo Rinaldi1, Özge Ardıçlı5,1, Lacin Cevhertas6,1, Marie‐Charlotte Brüggen7,8,9, Claudia Traidl‐Hoffmann7,10, Mübeccel Akdiş1, Cezmi A. Akdiş7,1
1Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos
2Yasutaka Mitamura and Ismail Ogulur Contributed equally to this work.
3Division of Pediatric Allergy and Immunology School of Medicine, Marmara University, Istanbul, Turkey
4Department of Medical Microbiology, Faculty of Medicine, Aydin Menderes University, Aydin, Turkey
5Department of Microbiology, Faculty of Veterinary Medicine, Bursa Uludag University, Bursa, Turkey
6Department of Medical Immunology, Institute of Health Sciences, Bursa Uludag University, Bursa, Turkey
7Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
8Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
9Faculty of Medicine, University of Zurich, Zurich, Switzerland
10Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany

Tóm tắt

AbstractThe “epithelial barrier hypothesis” proposes that the exposure to various epithelial barrier–damaging agents linked to industrialization and urbanization underlies the increase in allergic diseases. The epithelial barrier constitutes the first line of physical, chemical, and immunological defense against environmental factors. Recent reports have shown that industrial products disrupt the epithelial barriers. Innate and adaptive immune responses play an important role in epithelial barrier damage. In addition, recent studies suggest that epithelial barrier dysfunction plays an essential role in the pathogenesis of the atopic march by allergen sensitization through the transcutaneous route. It is evident that external factors interact with the immune system, triggering a cascade of complex reactions that damage the epithelial barrier. Epigenetic and microbiome changes modulate the integrity of the epithelial barrier. Robust and simple measurements of the skin barrier dysfunction at the point‐of‐care are of significant value as a biomarker, as recently reported using electrical impedance spectroscopy to directly measure barrier defects. Understanding epithelial barrier dysfunction and its mechanism is key to developing novel strategies for the prevention and treatment of allergic diseases. The aim of this review is to summarize recent studies on the pathophysiological mechanisms triggered by environmental factors that contribute to the dysregulation of epithelial barrier function.

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