Outside-in hypothesis revisited

Sugita, Kazunari; Soyka, Michael; Rinaldi, Arturo; Mitamura, Yasutaka; Akdiş, Mübeccel; Akdiş, Cezmi A.

doi:10.1016/j.anai.2020.05.016

Cited by 21 publications

(10 citation statements)

References 187 publications

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“…15 A disruption in the epithelial barrier could be a common pathway in the development of multiple allergic conditions. 365,366 The interaction between the epithelium and immune cells in addition to crosstalk with microbiota and environmental factors enroll in the pathogenesis of atopic disorders, including AD, AR, asthma, CRS as well as eosinophilic esophagitis and FA 367,368 (Table 2). Dysbiosis in the gut microbiota has effects on the immunity of distal organs, such as the lungs, in addition to modulating the immune responses of the gastrointestinal tract itself.…”

Section: Epithelial Barrier Damag E and The Link B E T Ween Allerg I ...mentioning

confidence: 99%

Epithelial barrier hypothesis: Effect of the external exposome on the microbiome and epithelial barriers in allergic disease

Sözener

Öztürk

Çerçi

et al. 2022

Allergy

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188

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Environmental exposure plays a major role in the development of allergic diseases.The exposome can be classified into internal (e.g., aging, hormones, and metabolic processes), specific external (e.g., chemical pollutants or lifestyle factors), and general external (e.g., broader socioeconomic and psychological contexts) domains, all of which are interrelated. All the factors we are exposed to, from the moment of conception to death, are part of the external exposome. Several hundreds of thousands of new chemicals have been introduced in modern life without our having a full understanding of their toxic health effects and ways to mitigate these effects.Climate change, air pollution, microplastics, tobacco smoke, changes and loss of biodiversity, alterations in dietary habits, and the microbiome due to modernization, urbanization, and globalization constitute our surrounding environment and external exposome. Some of these factors disrupt the epithelial barriers of the skin and mucosal surfaces, and these disruptions have been linked in the last few decades to the increasing prevalence and severity of allergic and inflammatory diseases such as atopic dermatitis, food allergy, allergic rhinitis, chronic rhinosinusitis, eosinophilic

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Section: Epithelial Barrier Damag E and The Link B E T Ween Allerg I ...mentioning

confidence: 99%

Epithelial barrier hypothesis: Effect of the external exposome on the microbiome and epithelial barriers in allergic disease

Sözener

Öztürk

Çerçi

et al. 2022

Allergy

Self Cite

188

166

View full text Add to dashboard Cite

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“…14 The "outside-in" hypotheses suggests that there is a complex interplay between epithelial barriers, environmental factors and the immune system in the development of systemic allergic diseases such as AD. 15 Food sensitization may be initiated through an impaired skin barrier, especially in those with AD, so prevention of AD may also prevent the development of subsequent food allergy 16,17 .…”

Section: Funding Informationmentioning

confidence: 99%

“…Dysfunction in the skin barrier starts soon after birth, making enhancement of the skin barrier a possible target for AD prevention by reducing inflammation from irritants and sensitization through the skin 14 . The “outside‐in” hypotheses suggests that there is a complex interplay between epithelial barriers, environmental factors and the immune system in the development of systemic allergic diseases such as AD 15 …”

Section: Introductionmentioning

confidence: 99%

Emollients for prevention of atopic dermatitis: 5‐year findings from the BEEP randomized trial

Bradshaw

Brown

Haines

et al. 2022

Allergy

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Background:The effectiveness of emollients for preventing atopic dermatitis/eczema is controversial. The Barrier Enhancement for Eczema Prevention trial evaluated the effects of daily emollients during the first year of life on atopic dermatitis and atopic conditions to age 5 years.Methods: 1394 term infants with a family history of atopic disease were randomized (1:1) to daily emollient plus standard skin-care advice (693 emollient group) or standard skin-care advice alone (701 controls). Long-term follow-up at ages 3, 4 and 5 years

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“…[17,32] It discusses whether the immune responses to dysbiotic microbiota that cross the damaged barrier are involved in the development of these diseases. [33] Almost two billion patients are affected with diseases which can be initiated or exacerbated with the exposure to epithelial barrier damaging agents. [34] The development of leaky epithelial barriers then leads to microbial dysbiosis and the translocation of bacteria to interepithelial and subepithelial areas and the development of tissue microinflammation [Figure 2].…”

Section: Type 2 Inflammation and Its Role In Asthmamentioning

confidence: 99%

“…The “Epithelial Barrier Hypothesis” proposes that increased exposure to epithelial barrier damaging agents linked to industrialization, urbanization, and modern life underlies the rise in allergic, autoimmune, and other chronic conditions [17,32] . It discusses whether the immune responses to dysbiotic microbiota that cross the damaged barrier are involved in the development of these diseases [33] . Almost two billion patients are affected with diseases which can be initiated or exacerbated with the exposure to epithelial barrier damaging agents [34] .…”

Section: Epithelial Barrier Dysfunction and Allergic Diseasesmentioning

confidence: 99%

Involvement and therapeutic implications of airway epithelial barrier dysfunction in type 2 inflammation of asthma

Ding

Zhang

Öğülür

et al. 2022

Chinese Medical Journal

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Type 2 inflammation is a complex immune response and primary mechanism for several common allergic diseases including allergic rhinitis, allergic asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps. It is the predominant type of immune response against helminths to prevent their tissue infiltration and induce their expulsion. Recent studies suggest that epithelial barrier dysfunction contributes to the development of type 2 inflammation in asthma, which may partly explain the increasing prevalence of asthma in China and around the globe. The epithelial barrier hypothesis has recently been proposed and has received great interest from the scientific community. The development of leaky epithelial barriers leads to microbial dysbiosis and the translocation of bacteria to inter- and sub-epithelial areas and the development of epithelial tissue inflammation. Accordingly, preventing the impairment and promoting the restoration of a deteriorated airway epithelial barrier represents a promising strategy for the treatment of asthma. This review introduces the interaction between type 2 inflammation and the airway epithelial barrier in asthma, the structure and molecular composition of the airway epithelial barrier, and the assessment of epithelial barrier integrity. The role of airway epithelial barrier disruption in the pathogenesis of asthma will be discussed. In addition, the possible mechanisms underlying the airway epithelial barrier dysfunction induced by allergens and environmental pollutants, and current treatments to restore the airway epithelial barrier are reviewed.

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Outside-in hypothesis revisited

Cited by 21 publications

References 187 publications

Epithelial barrier hypothesis: Effect of the external exposome on the microbiome and epithelial barriers in allergic disease

Epithelial barrier hypothesis: Effect of the external exposome on the microbiome and epithelial barriers in allergic disease

Emollients for prevention of atopic dermatitis: 5‐year findings from the BEEP randomized trial

Involvement and therapeutic implications of airway epithelial barrier dysfunction in type 2 inflammation of asthma

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