DERMATITE ATOPICA: MECCANISMI

IMMUNOLOGICI

Università degli studi di Messina

Dip. di Scienze Pediatriche Mediche e Chirurgiche

U.O. C. di Genetica ed Immunologia Pediatrica

Centro di Riferimento Regionale per la Prevenzione, Diagnosi

e Cura delle Malattie Genetiche

Direttore Prof. Carmelo Salpietro

Katia Cuppari

DERMATITE ATOPICA

LE BARRIERE DELLA CUTE

stratum corneum

stratum granulosum

LE BARRIERE DELLA CUTE

stratum corneum

stratum granulosum

PROTEINE CUTANEE

multiple transmembrane proteins (occludin, claudins, junctional adhesion molecules [JAMs] and E-cadherin) adapter proteins (catenin, ZO 1-3) to the cytoskeleton (actin and cingulin).

LE BARRIERE DELLA CUTE BARRIERIA FISICA

LE BARRIERE DELLA CUTE

stratum corneum

stratum granulosum

Peptidi antimicrobici

MICROBIOMA CUTANEO

MICROBIOMA CUTANEO

AFFETTI

NON

AFFETTI

LE BARRIERE DELLA CUTE

stratum corneum

stratum granulosum

80%

IL-4, IL-5 ,IL-13 eosinophil counts

elevation of total serum IgE

EAACI Nomenclature

ATOPIC ECZEMA/DERMATITIS SYNDROME

the intrinsic type is

termed non-allergic AEDS,

which shows

•normal IgE levels,

•No specific IgE,

•no association with respiratory

diseases (bronchial

•asthma or allergic rhinitis),

•negative skin-prick tests to

common aeroallergens or food

allergens

Interleukin-17, interleukin-23, and interleukin-10 serum levels in children with

AEDSand their relationship with clinical severity Leonardi Salvatore, Cuppari Caterina, Manti Sara, Filippelli Martina, Borgia Francesco, Briuglia Silvana, Cannavò

Patrizia, Salpietro Annamaria, Arrigo Teresa, SalpietroCarmelo

Allergy and Asthma Proceedings in press

IL-23

PROFILI GENETICI ED IMMUNOLOGICI E FENOTIPI DI DA

HMGB1

HMGB1 e SCORAD HMGB1 e IL-17/IL-23/IL-10

C. Cuppari, S. Manti, A. Salpietro, S. Valenti, A. Capizzi, T. Arrigo, C.

Salpietro, S. Leonardi.

LE BARRIERE DELLA CUTE

stratum corneum

stratum granulosum

CELLULE LINFOIDI INNATE

Regulation and function of human skin ILC responses

CELLULE LINFOIDI INNATE (ILC)

A model of barrier disruption and

consequences of percutaneous

sensitization. SC barrier

damages induce danger signals

in the epidermis. After SC barrier

abrogation, protease-active

allergens and uncontrolled

intrinsic proteases, as well as

bacterial molecules such as

lipoteichoic acid of gram-positive

bacteria, might agonize Par2 and

TLRs on keratinocytes,

respectively Keratinocytes then

produce TNF-α, IL-1, and thymic

stromal lymphopoietin (TSLP) in

response to which LCs become

activated . Alternatively,

protease-active

allergens might directly obscure

the TJ barrier and then penetrate

the epidermis, where they

directly or indirectly activate LCs.

Upon SC perturbation, dendrites

of activated LCs penetrate the

TJs to take up protease-active or

-inactive antigens from the extra-

TJ environment.

MALT: TESSUTO LINFOIDE

ASSOCIATO A MUCOSE E CUTE

PREDISPOSIZIONE GENETICA

ANOMALIE DELLA BARRIERA CUTANEA

FATTORI AMBIENTALI

ANOMALIE DEL SISTEMA IMMUNITARIO

ANOMALIE DEL SISTEMA NEUROVEGETATIVO

DERMATITE ATOPICA: TRA GENI ED AMBIENTE

IPEREATTITA’ CUTANEA

ALIMENTI ALLERGENI

TERAPIA PERSONALIZZATA

COSTITUZIONE IMMUNOGENETICA

FENOTIPO

Diagnosis and treatment of atopic dermatitisin children and adults: European Academy of Allergology and Clinical

Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus ReportJ Allergy Clin Immunol

2006;118:152-69

STRATEGIE TERAPEUTICHE STEPWISE MANAGEMENT OF PATIENT WITH DA

SISTEMA IMMUNITARIO

E

VITAMINA D

TERAPIA PERSONALIZZATA

http://www.google.it/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjZ2oqu7q3KAhUjvnIKHb0MCb0QjRwIBw&url=http%3A%2F%2Fwww.the-dermatologist.com%2Fcontent%2Fchoosing-best-biologic-therapy-patients-psoriasis&psig=AFQjCNFzj7mW7droYZObE5V1nBt1qtUvkg&ust=1453017473301433

J Clin Med. 2015 Apr; 4(4): 593–613.

TERAPIA PERSONALIZZATA

COSTITUZIONE IMMUNOGENETICA

FENOTIPO