2002
DOI: 10.1046/j.1365-2230.2002.00997.x
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Irritant dermatitis, irritancy and its role in allergic contact dermatitis

Abstract: Irritant contact dermatitis is the clinical result of sufficient inflammation arising from release of pro-inflammatory cytokines from skin cells (principally keratinocytes) in response to (usually) chemical stimuli. Different clinical forms may arise. The three main pathophysiological changes seen are skin barrier disruption, epidermal cellular changes and cytokine release. An important role of irritancy in allergic contact dermatitis (ACD) comes from earlier animal and human studies. Evidence is outlined whic… Show more

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Cited by 138 publications
(101 citation statements)
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“…Damaged cells are known to release ATP into the extracellular environment (10), and we hypothesize that the release of ATP from keratinocytes after injury or irritation of the skin leads to ATP-induced up-regulation of LC function as a homeostatic protective mechanism. This observation may also explain why contact allergens are invariably also contact irritants; irritation may be necessary for up-regulation of APC function and subsequent induction of immunity to the allergen (20). In this regard, purinergic agonists may represent a class of danger signals that alert the immune system to dying cells in a manner analogous to that recently proposed for uric acid (21).…”
Section: Discussionmentioning
confidence: 86%
“…Damaged cells are known to release ATP into the extracellular environment (10), and we hypothesize that the release of ATP from keratinocytes after injury or irritation of the skin leads to ATP-induced up-regulation of LC function as a homeostatic protective mechanism. This observation may also explain why contact allergens are invariably also contact irritants; irritation may be necessary for up-regulation of APC function and subsequent induction of immunity to the allergen (20). In this regard, purinergic agonists may represent a class of danger signals that alert the immune system to dying cells in a manner analogous to that recently proposed for uric acid (21).…”
Section: Discussionmentioning
confidence: 86%
“…The release of TNF-a by KC is induced during allergic contact dermatitis [19,[38][39][40]. Exposure to contact allergens results in secretion of IL-1b by LC which in turn stimulates epidermal KC to secrete TNF-a, and also IL-18 [41][42][43].…”
Section: Discussionmentioning
confidence: 99%
“…We propose that dermis-derived cells play a role in creating a directional chemotactic gradient between the epidermis and the dermis, by secreting chemokines in response to epidermis-derived cytokines (e.g. TNF-a).The release of TNF-a by KC is induced during allergic contact dermatitis [19,[38][39][40]. Exposure to contact allergens results in secretion of IL-1b by LC which in turn stimulates epidermal KC to secrete TNF-a, and also .…”
mentioning
confidence: 99%
“…These pathological changes may be associated with the release of danger signals, including MSU. Smith et al [24] proposed that irritancy plays a crucial role in the development of allergic contact dermatitis. Consistent with this hypothesis, we propose that skin damage could play a crucial role in the development and deterioration of allergic skin diseases.…”
Section: Discussionmentioning
confidence: 99%