Immunological findings in atopic dermatitis

Atopic dermatitis/neurodermatitis is a common skin disorder with increasing incidence. The skin disease can be compared to asthma bronchiale since an intrinsic (= neurodermatitis) and an extrinsic (= atopic dermatitis) variant is known. It is suggested that environmental factors trigger the manifestation of the disease in genetically susceptible individuals. This allergen-specific immune response is mediated via Langerhans cells, expressing the high affinity Fc-receptor for specific IgE. In acute skin lesions activation results in the generation of atopen-specific T cells, expressing a type 2 cytokine pattern mainly defined by the secretion of IL-4 and IL-5. IL-5 is capable of stimulating eosinophiles as important effector cells in AD. Toxic proteins from eosinophiles and secretory products from other cells playing a role in AD correlate with disease activity. During chronification of the disease, the cytokine pattern of skin-infiltrating T-cells changes and the "type 1" cytokine interferon-gamma is found in lesional skin.