Inflammatory Loops in the Epithelial-Immune Microenvironment of the Skin and Skin Appendages in Chronic Inflammatory Diseases

    September 2023 in “ Frontiers in immunology
    Teruki Dainichi, Masashi Iwata
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    TLDR Chronic inflammatory skin diseases are caused by disrupted interactions between skin cells and immune cells.
    The paper discusses the epithelial-immune microenvironment (EIME) in chronic inflammatory skin diseases, focusing on atopic dermatitis (AD), psoriasis, systemic lupus erythematosus (SLE), alopecia areata (AA), and acne vulgaris. Dysregulation of interactions within the EIME can lead to inflammatory loops characteristic of these diseases. For example, AD involves type 2 inflammation with feedback loops between keratinocytes and immune cells, while psoriasis features a type 17 inflammatory loop driven by the IL-23-IL-17 axis. In AA, an inflammatory loop involving IFN-γ and IL-15 disrupts hair follicle immune privilege, leading to hair loss. The study highlights current treatments targeting these loops and suggests future therapeutic strategies.
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