Far from simply representing passive targets of environmental or immunological attack, epithelial cells play an active role in the generation and expression of protective immune responses. In response to physical, chemical or microbial perturbation of the epithelial barrier, these cells provide a valid defensive line by the expression of an array of soluble mediators with direct antimicrobial and/or chemotactic activities towards distinct immune cell populations and also towards cytokines and adhesion molecules that affect their functional activation. These epithelial cell‐driven molecular events are also involved in the pathogenesis of chronic inflammatory disorders, with the amplification of the inflammatory reactions because of a sustained crosstalk with infiltrating leucocytes. In particular, T‐cell‐derived cytokines have been identified as the most effective inducers of pro‐inflammatory signals in epithelial cells, in turn responsible for further recruitment and local activation of immune cells, leading to the eventual amplification of the inflammatory reaction.
Key Concepts
Epithelial cells organise the physical barriers of the body, the first defensive lines against environmental, physical, chemical and microbial insults.
In response to any damage to the physical barriers of the body, epithelial cells display their nature of resident components of the immune system and provide a second defensive line by the release of a plethora of active mediators.
In genetically predisposed individuals, a defective permeability of the skin early in life leads to the penetration of environmental allergens and to the initiation of the chronic inflammatory syndrome known as atopy.
Loss‐of‐function mutations in the filaggrin gene are the most significant and well‐replicated risk factor for the development of atopy.
To adequately defend against microbial colonisation and infection, epithelial cells are endowed with the complete armamentarium of innate immune defence.
The epidermal growth factor receptor and its endogenous ligands provide a formidable mechanism to enhance innate immunity, while they oppose activation of adaptive immunity in epithelial cells.
Patients with atopic dermatitis are more susceptible to cutaneous fungal, viral and bacterial pathogens because of an articulate defect in the innate immunity mechanisms of the epithelial cell.
Dysregulated expression of cytokines and chemokines in skin keratinocytes leads to sustained skin infiltration and local activation of a variety of immune cell populations in chronic skin inflammatory disorders including atopic dermatitis.
Epithelial cells possess a number of effective regulatory mechanisms to control intensity and duration of inflammatory events.