Atopic dermatitis: allergic dermatitis or neuroimmune dermatitis?

Abstract

Advances in knowledge of neurocellulars relations have provided new directions in the understanding and treatment of numerous conditions, including atopic dermatitis. It is known that emotional, physical, chemical or biological stimuli can generate more accentuated responses in atopic patients than in non-atopic individuals; however, the complex network of control covered by these influences, especially by neuropeptides and neurotrophins, and their genetic relations, still keep secrets to be revealed. Itching and airway hyperresponsiveness, the main aspects of atopy, are associated with disruption of the neurosensory network activity. Increased epidermal innervation and production of neurotrophins, neuropeptides, cytokines and proteases, in addition to their relations with the sensory receptors in an epidermis with poor lipid mantle, are the aspects currently covered for understanding atopic dermatitis.

Concentration of substance P in patients with atopic dermatitis with and without past history of treatment

“…Stress has the adjunct effect with the increase of substance P, which can increase the production of vascular cell adhesion, skin thickness and vascular eosinophilic infiltration parameters. 8 Although there is no significant relationship between the treatment history and the substance P levels in our study, the median level of substance P levels was lower in subjects with a history of atopic dermatitis treatment and higher in subjects without atopic dermatitis treatment.…”

Candidate Genes of Allergic Dermatitis Are Associated with Immune Response

“…In recent years, the incidence rate has increased by 2-3 times [ 2 ]. Common symptoms of AD patients are erythema, edema, papules, blisters, bullae, and even necrosis, accompanied by varying degrees of itching, pain, or burning [ 3 , 4 ]. Children are common on the cheeks, and adult patients are common on the folds of the joints and on the back of the hands or on the scalp [ 5 , 6 ].…”

Neuritin, unmasked as a checkpoint for the pathogenesis of allergy and autoimmunity

“…To date, nothing is known about the role of neuritin in the development of AD. However, there is clear evidence of the influence of the peripheral nervous system on AD, 15 with interactions likely between nerve fibres and mast cells 16 . It is plausible that neuritin may be part of the normal homeostatic regulation of the skin and its reduced expression either in the germinal centre, driving an atopic phenotype, or in the skin, might affect epithelial cell biology.…”