Inflammation-Induced Alterations in the Skin Barrier Function: Implications in Atopic Dermatitis
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Allergy and allergic diseases have increased in prevalence worldwide during the last decade. Relevant determinants influencing the development of allergic inflammation come from the environment and are either enhancing (e.g. environmental pollutants both indoors and outdoors) or protective (e.g. parasite infestations causing early stimulation of the immune system). In spite of considerable progress in experimental allergology and immunology, there is still a great discrepancy between theoretical knowledge and practical performance in the routine treatment of patients with allergies. The development of new therapeutic and preventive strategies for the future management of allergy is dependent on a better understanding of the pathomechanisms and molecular pathways involved. Based on an international symposium, this volume summarizes the latest findings in epidemiology, pathophysiology, and clinical aspects of allergic diseases such as asthma, food allergy, and, especially, atopic eczema. Risk factors for the development of allergies and novel treatment strategies are carefully evaluated. This update is essential reading for anyone interested in allergy: doctors working in the clinical fields of dermatology, pneumology, internal medicine, pediatrics, ENT, epidemiology and public health, as well as researchers in molecular genetics, immunobiology, food and nutrition sciences, and pharmacology.Keywords:
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Despite age-related changes in skin appearance are well documented, less is known about changes of the skin barrier function during aging. Several markers of skin barrier function such as transepidermal water loss, stratum corneum hydration, sebum secretion and pH value were used to reveal these changes, but the influence aging on skin barrier function is still controversial. Some studies present an impairment of the skin barrier function with aging, while others show no significant changes. In this review, we discuss an age-related alteration and associating factors of barrier function.
Transepidermal water loss
Barrier function
Skin Barrier
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The skin provides a semipermeable barrier, an antimicrobial barrier and an immunological barrier. The current view on the pathogenesis of atopic dermatitis (AD) suggests the 'outside-inside-outside' model, which emphasises that barrier disruption due to environmental or genetic insults drives the disease process in AD, thereby stimulating the immune system which then further disrupts the skin barrier. This article summarises the different aspects of normal skin barrier function. It describes how they are affected in AD and the clinical implications for the management of AD.
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Multiple research studies have examined the role of specific dietary interventions and their effects on skin barrier function. The skin barrier is one of the body's first lines of protection against environmental insults, and disruption of this natural line of defense can result in xerosis, irritation, chronic dermatitis, and other cutaneous effects. Multiple laboratory, animal, and human studies have demonstrated that certain dietary interventions have the potential to impact skin barrier function. Measurements of skin barrier function include stratum corneum hydration and transepidermal water loss. In this review, we examine this research and provide an overview of the effects of prebiotics, probiotics, fatty acids, and emerging research on other substances.
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A better understanding of the structure and function of the human skin barrier is a prerequisite for a more rational design of transdermal drug administration systems. The study of biological structural organisation is, however, confronted with many difficulties, and interpretations of skin barrier-related data should therefore be done with caution. The recently developed ‘single gel-phase model’ constitutes an attempt to interpret structural and functional skin barrier data from a biophysical standpoint.
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