Atopik Dermatit Patogenezinde Son Gelişmeler

Year 2015, Volume: 13 Issue: 3, 194 - 200, 01.12.2015

Ayşegül Akan Emine Dibek Mısırlıoğlu Can Naci Kocabaş

https://doi.org/10.4274/jcp.53215

Abstract

Atopik dermatit AD , yatkınlık oluşturan genler, konağın içinde bulunduğu çevre ve immünolojik faktörlerin etkileşimiyle ortaya çıkan multifaktöriyel bir deri hastalığıdır. Hastaların ve ailelerinin yaşam kalitesini önemli ölçüde etkileyebilen bir hastalık olan AD’nin, çocuklarda prevelansı gelişmiş ülkelerde %10-20, ülkemizde ise %4,9 ile 8,1 arasında değişmekte olup sıklığı tüm dünyada giderek artmaktadır. Günümüzde hastalık patogenezini açıklamakta iki temel hastalık hipotezi kabul edilmektedir: İçeriden dışarıya ve dışarıdan içeriye hipotezleri, ancak bunlar da AD patogenezini tüm ayrıntıları ile açıklayabilmiş değildirler. Son yıllardaki genetik araştırmalar filaggrin geni ve AD patogenezi arasında önemli bir ilişki olduğunu göstermektedir. Epidermal bariyer fonksiyon bozukluğunun deride kuruluk ve kaşıntıya neden olarak AD patogenezine katkıda bulunabileceği, ek olarak bazı viral ve bakteriyel etkenlerle enfeksiyona yatkınlık oluşturabileceği gösterilmiştir. Bu derlemede AD patogenezinde etkili olduğu düşünülen genetik, immünolojik ve deri bariyer fonksiyonu ile ilgili mekanizmalar gözden geçirilecektir

Keywords

Atopik dermatit, patogenez, filaggrin, epidermal bariyer fonksiyonu, antimikrobiyal proteinler

Recent Improvements in the Pathogenesis of Atopic Dermatitis

Abstract

Atopic dermatitis AD is a multifactorial skin disease manifested by the interaction between environmental factors, immune system and the genes predisposing to the disease. It affects the quality of life of patients and their family considerably. The prevelance for children is 10-20% in developed countries, while frequency of AD is considered as rising all over the world. According to the studies conducted in our country, the frequency is about 4.9% to 8.1%. Currently, there are two main hypothesis accepted to explain disease pathogenesis; inside-outside and outsideinside hypotheses. However, these are even not able to define the pathogenetic mechanisms underlying AD in all details. In the recent years, genetic studies have revealed significant role of filaggrin gene in the pathogenesis of AD. Further, epidermal barier dysfunction is found to play an important role in the pathogenesis by causing dryness and pruritus in skin and cause predisposition to infections with some viruses and bacteria. In this review, recent data about genetic, immunologic mechanisms and the dysfunction of epidermal barier complex underlying the pathogenesis of AD will be discussed

Keywords

Atopic dermatitis, pathogenesis, filaggrin, epidermal barier complex, antimicrobial proteins

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