特应性皮炎与2型炎症反应

doi:10.35541/cjd.20201030

中华皮肤科杂志 ›› 2021, Vol. 54 ›› Issue (1): 84-88.doi: 10.35541/cjd.20201030

特应性皮炎与2型炎症反应

梁云生刘钊

南方医科大学皮肤病医院皮肤科，广州 510091

收稿日期:2020-10-22 修回日期:2020-12-09 发布日期:2021-01-05
通讯作者: 梁云生 E-mail:yunshengliang@aliyun.com
基金资助:
国家自然科学基金（81972941）

Type 2 inflammatory responses in atopic dermatitis

Liang Yunsheng, Liu Zhao

Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China

Received:2020-10-22 Revised:2020-12-09 Published:2021-01-05
Contact: Liang Yunsheng E-mail:yunshengliang@aliyun.com
Supported by:
National Natural Science Foundation of China （81972941）

摘要/Abstract

摘要： 【摘要】研究显示，2型炎症及其相关细胞因子白细胞介素4、13等在特应性皮炎（AD）中起关键作用。Th2细胞及2型细胞因子是2型炎症反应的核心驱动因素，主要通过3条路径参与AD发病：加重皮肤屏障缺陷；激活和强化瘙痒反应；调节性T细胞（Treg）病理性重编程为Th2样Treg细胞，从而放大2型炎症反应。本综述探讨2型炎症与AD的关系，希望有助于优化治疗方案，为AD患者提供新的治疗选择。

关键词: 特应性皮炎, 哮喘, 2型炎症, 调节性T细胞, 生物制剂

Abstract: 【Abstract】 Studies have shown that the type 2 inflammatory response and related cytokines such as interleukin-4 and -13, play a key role in atopic dermatitis （AD）. Th2 cells and type 2 cytokines are the core factors in the type 2 inflammatory response, which is mainly involved in the pathogenesis of AD through 3 pathways: aggravating skin barrier defects; activating and strengthening the itching response; pathologically reprograming regulatory T cells into Th2-like regulatory T cells to amplify the type 2 inflammatory response. This review explores the relationship between the type 2 inflammatory response and AD, aiming to help optimize treatment regimens and provide new treatment options for patients with AD.

Key words: Atopic dermatitis, Asthma, Type 2 inflammatory responses, Treg cell, Biologics

梁云生刘钊. 特应性皮炎与2型炎症反应[J]. 中华皮肤科杂志, 2021,54(1):84-88. doi:10.35541/cjd.20201030

Liang Yunsheng, Liu Zhao . Type 2 inflammatory responses in atopic dermatitis[J]. Chinese Journal of Dermatology, 2021, 54(1): 84-88.doi:10.35541/cjd.20201030

参考文献 28

［1］	中华医学会皮肤性病学分会免疫学组, 特应性皮炎协作研究中心. 中国特应性皮炎诊疗指南（2020版）［J］. 中华皮肤科杂志, 2020,53（2）:81⁃88. doi: 10.35541/cjd.20191000.
［2］	Annunziato F, Romagnani C, Romagnani S. The 3 major types of innate and adaptive cell⁃mediated effector immunity［J］. J Allergy Clin Immunol, 2015,135（3）:626⁃635. doi: 10.1016/j.jaci. 2014.11.001.
［3］	Cavani A, Pennino D, Eyerich K. Th17 and Th22 in skin allergy［J］. Chem Immunol Allergy, 2012,96:39⁃44. doi: 10.1159/000 331870.
［4］	Jiao Q, Qian Q, Liu C, et al. T helper 22 cells from Han Chinese patients with atopic dermatitis exhibit high expression of inducible T⁃cell costimulator［J］. Br J Dermatol, 2020,182（3）:648⁃657. doi: 10.1111/bjd.18040.
［5］	Leyva⁃Castillo JM, Yoon J, Geha RS. IL⁃22 promotes allergic airway inflammation in epicutaneously sensitized mice［J］. J Allergy Clin Immunol, 2019,143（2）:619⁃630.e7. doi: 10.1016/j.jaci.2018.05.032.
［6］	Taube C, Tertilt C, Gyülveszi G, et al. IL⁃22 is produced by innate lymphoid cells and limits inflammation in allergic airway disease［J/OL］. PLoS One, 2011,6（7）:e21799［2020⁃10⁃15］. https://journals.plos.org/plosone/article?id=10.1371/journal.pone. 0021799. doi: 10.1371/journal.pone.0021799.
［7］	Akdis CA, Arkwright PD, Brüggen MC, et al. Type 2 immunity in the skin and lungs［J］. Allergy, 2020,75（7）:1582⁃1605. doi: 10.1111/all.14318.
［8］	Sugita K, Akdis CA. Recent developments and advances in atopic dermatitis and food allergy［J］. Allergol Int, 2020,69（2）:204⁃214. doi: 10.1016/j.alit.2019.08.013.
［9］	Oetjen LK, Mack MR, Feng J, et al. Sensory neurons co⁃opt classical immune signaling pathways to mediate chronic itch［J］. Cell, 2017,171（1）:217⁃228.e13. doi: 10.1016/j.cell.2017.08.006.
［10］	Ko E, Chehade M. Biological therapies for eosinophilic esophagitis: where do we stand?［J］. Clin Rev Allergy Immunol, 2018,55（2）:205⁃216. doi: 10.1007/s12016⁃018⁃8674⁃3.
［11］	Kim BE, Leung D. Significance of skin barrier dysfunction in atopic dermatitis［J］. Allergy Asthma Immunol Res, 2018,10（3）:207⁃215. doi: 10.4168/aair.2018.10.3.207.
［12］	Man MQ, Hatano Y, Lee SH, et al. Characterization of a hapten⁃induced, murine model with multiple features of atopic dermatitis: structural, immunologic, and biochemical changes following single versus multiple oxazolone challenges［J］. J Invest Dermatol, 2008,128（1）:79⁃86. doi: 10.1038/sj.jid.5701 011.
［13］	Elias PM, Wakefield JS. Mechanisms of abnormal lamellar body secretion and the dysfunctional skin barrier in patients with atopic dermatitis［J］. J Allergy Clin Immunol, 2014,134（4）:781⁃791.e1. doi: 10.1016/j.jaci.2014.05.048.
［14］	Berdyshev E, Goleva E, Bronova I, et al. Lipid abnormalities in atopic skin are driven by type 2 cytokines［J/OL］. JCI Insight, 2018,3（4）［2020⁃10⁃15］. https://insight.jci.org/articles/view/98006. doi: 10.1172/jci.insight.98006.
［15］	Brauweiler AM, Goleva E, Leung D. Interferon⁃γ protects from staphylococcal alpha toxin⁃induced keratinocyte death through apolipoprotein L1［J］. J Invest Dermatol, 2016,136（3）:658⁃664. doi: 10.1016/j.jid.2015.12.006.
［16］	Howell MD, Gallo RL, Boguniewicz M, et al. Cytokine milieu of atopic dermatitis skin subverts the innate immune response to vaccinia virus［J］. Immunity, 2006,24（3）:341⁃348. doi: 10.1016/j.immuni.2006.02.006.
［17］	Wilson SR, Thé L, Batia LM, et al. The epithelial cell⁃derived atopic dermatitis cytokine TSLP activates neurons to induce itch［J］. Cell, 2013,155（2）:285⁃295. doi: 10.1016/j.cell.2013.08.057.
［18］	Andersen HH, Elberling J, Sølvsten H, et al. Nonhistaminergic and mechanical itch sensitization in atopic dermatitis［J］. Pain, 2017,158（9）:1780⁃1791. doi: 10.1097/j.pain.0000000000000980.
［19］	Akdis M, Akdis CA. Therapeutic manipulation of immune tolerance in allergic disease［J］. Nat Rev Drug Discov, 2009,8（8）:645⁃660. doi: 10.1038/nrd2653.
［20］	Noval Rivas M, Burton OT, Wise P, et al. Regulatory T cell reprogramming toward a Th2⁃cell⁃like lineage impairs oral tolerance and promotes food allergy［J］. Immunity, 2015,42（3）:512⁃523. doi: 10.1016/j.immuni.2015.02.004.
［21］	Massoud AH, Charbonnier LM, Lopez D, et al. An asthma⁃associated IL4R variant exacerbates airway inflammation by promoting conversion of regulatory T cells to TH17⁃like cells［J］. Nat Med, 2016,22（9）:1013⁃1022. doi: 10.1038/nm.4147.
［22］	Durham AL, Caramori G, Chung KF, et al. Targeted anti⁃inflammatory therapeutics in asthma and chronic obstructive lung disease［J］. Transl Res, 2016,167（1）:192⁃203. doi: 10. 1016/j.trsl.2015.08.004.
［23］	中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南（2018）［J］. 中华耳鼻咽喉头颈外科杂志, 2019,54（2）:81⁃100. doi: 10.3760/cma.j.issn.1673⁃0860.2019.02.001.
［24］	Silverberg JI, Yosipovitch G, Simpson EL, et al. Dupilumab treatment results in early and sustained improvements in itch in adolescents and adults with moderate to severe atopic dermatitis: analysis of the randomized phase 3 studies SOLO 1 and SOLO 2, AD ADOL, and CHRONOS［J］. J Am Acad Dermatol, 2020,82（6）:1328⁃1336. doi: 10.1016/j.jaad.2020.02.060.
［25］	Simpson EL, Flohr C, Eichenfield LF, et al. Efficacy and safety of lebrikizumab （an anti⁃IL⁃13 monoclonal antibody） in adults with moderate⁃to⁃severe atopic dermatitis inadequately controlled by topical corticosteroids: a randomized, placebo⁃controlled phase II trial （TREBLE）［J］. J Am Acad Dermatol, 2018,78（5）:863⁃871.e11. doi: 10.1016/j.jaad.2018.01.017.
［26］	Wollenberg A, Howell MD, Guttman⁃Yassky E, et al. Treatment of atopic dermatitis with tralokinumab, an anti⁃IL⁃13 mAb［J］. J Allergy Clin Immunol, 2019,143（1）:135⁃141. doi: 10.1016/j.jaci.2018.05.029.
［27］	Kabashima K, Furue M, Hanifin JM, et al. Nemolizumab in patients with moderate⁃to⁃severe atopic dermatitis: randomized, phase II, long⁃term extension study［J］. J Allergy Clin Immunol, 2018,142（4）:1121⁃1130.e7. doi: 10.1016/j.jaci.2018.03.018.
［28］	Chan S, Cornelius V, Cro S, et al. Treatment effect of omalizumab on severe pediatric atopic dermatitis: the ADAPT randomized clinical trial［J］. JAMA Pediatr, 2019,174（1）:29⁃37. doi: 10.1001/jamapediatrics.2019.4476.

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特应性皮炎与2型炎症反应

Type 2 inflammatory responses in atopic dermatitis

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