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Neurodermitis und Stress

Wie kommen Gefühle in die Haut?

Atopic dermatitis and stress?

How do emotions come into skin?

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Zusammenfassung

Es wird allgemein angenommen, dass Stress einen Einfluss auf die Entstehung oder zumindest Verschlimmerung der Neurodermitis hat. Die psychoimmunologischen Mechanismen, wie sich durch Stress eine Hautentzündung entwickelt, sind bisher nicht ganz klar. Dieses Thema wurde jedoch in den letzten Jahren intensiv erforscht, und die Studien beschäftigen sich mit verschiedenen Erklärungsaspekten: Neuroimmunologische, psychoendokrinologische Studien und Untersuchungen zur Integrität und Funktion der Hautbarriere bei Stress. Verschiedene Neuropeptide und Neurotrophine scheinen eine wichtige Rolle bei stressinduzierten neurogenen Entzündungsprozessen und der Verbindung von Nerven- und Immunsystem zu einzunehmen. Mastzellen spielen dabei eine Schlüsselrolle in der Entwicklung von entzündlichen Reaktionen infolge von Stress. Die Hautbarriere wird unter Stressbedingungen durch Steigerung des Kortisolspiegels zerstört. Dabei ist die Bildung von Lamellarkörperchen vermindert und die epidermale Expression von antimikrobiellen Peptiden (β-Defensin und Cathelicidin) gehemmt. In diesem Beitrag wird eine Übersicht über die aktuellen Forschungsaspekte gegeben.

Abstract

It is widely accepted, that stress can induce or exacerbate atopic dermatitis. The physiological mechanisms that mediate this negative influence of stress on atopic dermatitis are not clearly understood. This topic has been actively investigated in recent years focusing on neuroimmunological, psychoendocrinological studies and examination of integrity and function of skin barrier under stress. Different neuropeptides and neurotrophins seem to play an important role in stress-induced neurogenic inflammation and connection of nervous and immune system. Mast cells play a key role in the development of inflammatory reaction to stress. Skin barrier is altered by stress by means of increased cortisol level. Thereby lamellar body secretion is decreased and epidermal expression of antimicrobial peptides (β-defensin and cathelicidin) is down-regulated. We review recent investigations in this field.

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Literatur

  1. Aberg KM, Radek KA, Choi EH et al. (2007) Psychological stress downregulates epidermal antimicrobial peptide expression and increases severity of cutaneous infections in mice. J Clin Invest 117(11): 3339–3349

    Article  PubMed  CAS  Google Scholar 

  2. Arck P, Paus R (2006) From the brain-skin connection: the neuroendocrine-immune misalliance of stress and itch. Neuroimmunomodulation 13(5–6): 347–356

    Google Scholar 

  3. Botchkarev VA, Yaar M, Peters EM et al. (2006) Neurotrophins in skin biology and pathology J Invest Dermatol 126(8): 1719–1727

    Google Scholar 

  4. Braff MH, Di Nardo A, Gallo RL (2005) Keratinocytes store the antimicrobial peptide cathelicidin in lamellar bodies. J Invest Dermatol 124(2): 394–400

    Article  PubMed  CAS  Google Scholar 

  5. Brocq L, Jacquet L (1891) Notes pour servir a l’histoire des neurodermatitis. Annales Dermatol Venerol 97: 193–195

    Google Scholar 

  6. Buske-Kirschbaum A, Ebrecht M, Kern S, Hellhammer DH (2006) Endocrine stress responses in TH1-mediated chronic inflammatory skin disease (psoriasis vulgaris) – do they parallel stress-induced endocrine changes in TH2-mediated inflammatory dermatoses (atopic dermatitis)? Psychoneuroendocrinology 31(4): 439–446

    Article  PubMed  CAS  Google Scholar 

  7. Buschke-Kirschbaum A, Geiben A, Hollig H et al (2002) Altered responsiveness of the hypothalamus-pituitary-adrenal axis and the sympathetic adrenomedullary system to stress in patients with atopic dermatitis. J Clin Endocrinol Metab 87(9): 4245–4251

    Article  CAS  Google Scholar 

  8. Choi EH, Demerjian M, Crumrine D et al. (2006) Glucocorticoid blockade reverses psychological stress-induced abnormalities in epidermal structure and function. Am J Physiol Regul Integr Comp Physiol 291(6): R1657–1662

    PubMed  CAS  Google Scholar 

  9. Chowdury MMU, Hedges R, Lanigan SW (2000) Unilateral resolution of palmar eczema and hyperhidrosis complicated by Horner’s syndrome following ipsilateral endoscopic cervial sympathectomy. Br J Dermatol 143: 653–654

    Article  Google Scholar 

  10. Foster AP, Cunningham FM (2003) Substance P induces activation, adherence and migration of equine eosinophils. J Vet Pharmacol Ther 26: 131–138

    Article  PubMed  CAS  Google Scholar 

  11. Groneberg DA, Serowka F, Peckenschneider N et al. (2005) Gene expression and regulation of nerve growth factor in atopic dermatitis mast cells and the human mast cell line-1. J Neuroimmunol 161(1–2): 87–92

    Google Scholar 

  12. Harth W (2008) Psychosomatic dermatology (psychodermatology). J Dtsch Dermatol Ges 6(1): 67–76

    PubMed  Google Scholar 

  13. Hembold P, Gaisbauer G, Kupfer J, Haustein UF (2000) Longitudinal case analisis in atopic dermatitis. Acta Derm Venereol 80: 348–352

    Article  Google Scholar 

  14. Hinz T, Staudacher A, Bieber T (2006) Neues in der Pathophysiologie der atopischen Dermatitis. Hautarzt 57(7): 567–570, 572–575

    Article  PubMed  CAS  Google Scholar 

  15. Hon KL, Lam MC, Wong KY et al. (2007) Pathophysiology of nocturnal scratching in childhood atopic dermatitis: the role of brain-derived neurotrophic factor and substance P. Br J Dermatol 157(5): 922–925

    Article  PubMed  CAS  Google Scholar 

  16. Järvikallio A, Harvima IT, Naukkarinen A (2003) Mast cells, nerves and neuropeptides in atopic dermatitis and nummular eczema. Arch Dermatol Res 295(1): 2–7

    PubMed  Google Scholar 

  17. Kang H, Byun DG, Kim JW (2000) Effects of substance P and vasoactive intestinal peptide on interferon-gamma and interleukin-4 production in severe atopic dermatitis. Ann Allergy Asthma Immunol 85: 227–232

    Article  PubMed  CAS  Google Scholar 

  18. Kao JS, Fluhr JW, Man MQ et al. (2003) Short-term glucocorticoid treatment compromises both permeability barrier homeostasis and stratum corneum integrity: inhibition of epidermal lipid synthesis accounts for functional abnormalities. J Invest Dermato 120(3): 456–464

    Article  CAS  Google Scholar 

  19. Katsuno M, Aihara M, Kojima M et al. (2003) Neuropeptides concentrations in the skin of a murine (NC/Nga mice) model of atopic dermatitis. J Dermatol Sci 33(1): 55–65

    Article  PubMed  CAS  Google Scholar 

  20. King RM, Wilson GV (1991) Use of a diary technique to investigate psychosomatic relations in atopic dermatitis. J Psychosom Res 35: 697–706

    Article  PubMed  CAS  Google Scholar 

  21. Kodama A, Horikawa T (1999) Effect of stress on atopic dermatitis: investigation in patients after the Great Hanshin Earthquake 104(1):173–176

  22. Lonne-Rahm S, Berg M, Mårin P, Nordlind K (2004) Atopic dermatitis, stinging, and effects of chronic stress: a pathocausal study. J Am Acad Dermatol 51(6): 899–905

    Article  PubMed  Google Scholar 

  23. Oren A, Ganz T, Liu L, Meerloo T (2003) In human epidermis, beta-defensin 2 is packaged in lamellar bodies. Exp Mol Pathol 74(2): 180–182

    Article  PubMed  CAS  Google Scholar 

  24. Pavlovic S, Daniltchenko M, Tobin DJ et al. (2008) Further exploring the brain-skin connection: stress worsens dermatitis via substance P-dependent neurogenic inflammation in mice journal of investigative dermatology. J Invest Dermatol 128: 434–446

    Article  PubMed  CAS  Google Scholar 

  25. Peters EM, Ericson ME, Hosoi J et al. (2006) Neuropeptide control mechanisms in cutaneous biology: physiological and clinical significance. J Invest Dermatol 126(9): 1937–1947

    Article  PubMed  CAS  Google Scholar 

  26. Peters EM, Raap U, Welker P et al. (2007) Neurotrophins act as neuroendocrine regulators of skin homeostasis in health and disease. Horm Metab Res 39(2): 110–124

    Article  PubMed  CAS  Google Scholar 

  27. Picardi A, Abeni D (2001) Stressful life events and skin diseases: disentangling evidence from myth. Psychother Psychosom 70(3): 118–136

    Article  PubMed  CAS  Google Scholar 

  28. Raap U, Goltz C, Deneka N et al. (2005) Brain-derived neurotrophic factor is increased in atopic dermatitis and modulates eosinophil functions compared with that seen in nonatopic subjects. J Allergy Clin Immunol 115(6): 1268–1275

    Article  PubMed  CAS  Google Scholar 

  29. Raap U, Kapp A (2005) Neuroimmunological findings in allergic skin diseases. Curr Opin Allergy Clin Immunol 5(5): 419–424

    Article  PubMed  CAS  Google Scholar 

  30. Salomon J, Baran E (2008) The role of selected neuropeptides in pathogenesis of atopic dermatitis. J Eur Acad Dermatol Venereol 22(2): 223–228

    PubMed  CAS  Google Scholar 

  31. Steinhoff M, Stander S, Seeliger S et al. (2003) Modern aspects of cutaneous neurogenic inflammation. Arch Dermatol 139: 1479–1488

    Article  PubMed  Google Scholar 

  32. Tarkowski E, Naver H, Wallin BG et al. (1996) Lateralization of cutaneous inflammatory responses in patients with unilateral paresis after poliomyelitis. J Neuroimmunol 67: 1–6

    PubMed  Google Scholar 

  33. Theoharides TC, Cochrane DE (2004) Critical role of mast cells in inflammatory diseases and the effect of acute stress. J Neuroimmunol 146: 1–12

    Article  PubMed  CAS  Google Scholar 

  34. Toyoda M, Nakamura M, Makino T et al. (2002) Nerve growth factor and substance P are useful plasma markers of disease activity in atopic dermatitis. Br J Dermatol 147(1): 71–79

    Article  PubMed  CAS  Google Scholar 

  35. Troilius A, Moeller H (1989) Unilateral eruption of endogenous eczema after hemiparesis. Acta Derm Venereol 69: 256–258

    PubMed  CAS  Google Scholar 

  36. Wallengren J, Sundler F (2004) Phototherapy reduces the number of epidermal and CGRP-positive dermal nerve fibres. Acta Derm Venereol 84(2): 111–115

    Article  PubMed  CAS  Google Scholar 

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Correspondence to U. Gieler.

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Mitschenko, A., Lwow, A., Kupfer, J. et al. Neurodermitis und Stress. Hautarzt 59, 314–318 (2008). https://doi.org/10.1007/s00105-008-1525-z

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