New perspectives on epidermal barrier dysfunction in atopic dermatitis: Gene–environment interactions

摘要: Atopic dermatitis (AD) is a multifactorial, chronic inflammatory skin disorder in which genetic mutations and cutaneous hyperreactivity to environmental stimuli play causative role. Genetic alone might not be enough cause clinical manifestations of AD, this review will propose new perspective on the importance epidermal barrier dysfunction genetically predisposed individuals, predisposing them harmful effects agents. The known damaged patients with both acute eczematous lesions also clinically unaffected skin. Skin function can impaired first by predisposition produce increased levels stratum corneum chymotryptic enzyme. This protease enzyme causes premature breakdown corneodesmosomes, leading impairment barrier. addition interactions, such as washing soap detergents, or long-term application topical corticosteroids further increase production impair function. exogenous proteases from house dust mites Staphylococcus aureus. One more these factors combination lead defective barrier, thereby increasing risk allergen penetration succeeding reaction, thus contributing exacerbations disease.