Novel immunologic aspects in the pathogenesis of atopic dermatitis

Research based on the newest medical technologies to understand thoroughly the pathogenesis of atopic dermatitis (AD) recently has allowed to develop several new effective medical substances in treatment of the disease. Presently in Latvia we are facing a problem of increasing numbers of severe disabling forms of atopic dermatitis, especially in young persons. Since the problem has become alarming, new effective methods to investigate the mechanisms of AD and find optimal treatments must be considered. We review here the novel immunologic findings of the pathogenesis of atopic skin that have been published in the scientific literature during the last decade. A statistically believable association of human leukocyte antigens (HLA) with the existence of atopic dermatitis has been found, which determines not only the development of this pathology, but also the severity of the disease, and HLA A24 in the genome is a risk factor for the development of the disease in the human population. In the case of AD expression is activated in genes encoding the production of inflammatory mediators. In the pathogenesis of AD, recently detected mechanisms of superantigens of Staphylococci, such as direct stimulation of antigen-presenting cells and keratinocytes, have been found to determine the progress of this skin pathology and decrease of apoptosis of skin-associated (CLA+) T-cells. Langerhans cells participating in the process of antigen presentation play an important role in the pathogenesis of AD by promoting connection with fixed IgE receptors, and by active production of inflammatory mediators.