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Frédéric Berard

Publications and source records attributed to Frédéric Berard.

4 recordsLinked to original sources

[Epidemiology and pathophysiology of eczemas].

Pathophysiological characteristics of these two types of eczema, both involve antigen specific effector T lymphocytes and down-regulatory CD4+ T cells (Treg). These cells are responsible for the cutaneous inflammatory response through the production of inflammatory cytokines and the destruction of keratinocytes by apoptosis. The main difference between these two types of disease is the nature of the environmental antigen. Indeed, protein allergens are involved in cases of atopic dermatitis whereas non protein chemicals (calles haptens) are responsible for allergic contact dermatitis. The skin lesions of eczema follow the activation of antigen specific T lymphocytes within the skin, leading to the production of inflammatory cytokines and to the destruction of keratinocytes by apoptosis. CD4+ Treg cells are endowed with down-regulatory and tolerogenic functions since they limit the skin inflammation in patients and prevent sensitization and induction of eczema in normal individuals. Eczema should therefore be considered as inflammatory dermatoses caused by the loss of immune tolerance to environmental antigens. Different strategies capable of restoring immune tolerance could avoid eczema outbursts and/or induce prolonged remissions of the disease.

Eczema↗

Allergen penetration through the skin.

The skin is directly in contact with environmental molecules which are present in the air or directly in contact with the epidermis. Despite the assumption that it has a barrier role which could prevent the penetration of molecules, the skin is permeable to all substances from the low molecular weight xenobiotics to the high molecular weight proteins. Only the degree of permeability varies depending on the physiological state of the skin and the chemical properties of molecules. Recent insights into the pathophysiology of allergic skin diseases have shown that allergen penetration is not the major factor in explaining why some patients become allergic while others maintain an immunological tolerance to the penetrating molecules. Indeed, the functional properties of some allergenic molecules able to induce activation of innate immunity appear to be far more important in the development of allergy than their ability to penetrate the skin easily.

Allergens↗

The role of CD4+ and CD8+ T cells in contact hypersensitivity and allergic contact dermatitis.

Allergic contact dermatitis (ACD) and contact hypersensitivity (CHS) are delayed-type hypersensitivity reactions which are mediated by hapten specific T cells. During the sensitisation phases, both CD4+ and CD8+ T cell precursors are activated in the draining lymph nodes by presentation of haptenated peptides by skin dendritic cells. Subsequent hapten skin painting induces the recruitment of T cells at the site of challenge which induces inflammatory signals and apoptosis of epidermal cells, leading to the development of a skin inflammatory infiltrate and of clinical symptoms. There have been major controversies on the respective roles of CD4+ and CD8+ T cells in the development of the CHS inflammatory reaction. Experimental studies from the last 10 years have demonstrated that, in normal CHS responses to strong haptens, CD8+ type 1 T cells are effector cells of CHS while CD4+ T cells are endowed with down-regulatory functions. The latter may correspond to the recently described CD4+ CD25+ regulatory T cell population. However, in some instances, especially those where there is a deficient CD8 T cell pool, CD4+ T cells can be effector cells of CHS. Ongoing studies will have to confirm that the pathophysiology of human ACD is similar to the mouse CHS and that the CHS response to weak haptens, the most frequently involved in human ACD, is similar to that reported for strong haptens.

CD4-Positive T-Lymphocytes↗

Allergic contact dermatitis.

Contact dermatitis is an inflammatory skin condition induced by exposure to an environmental agent. Eczema and dermatitis are used synonymously to denote a polymorphous pattern of skin inflammation characterized at least in its acute phase by erythema, vesiculation and pruritus. Substances responsible for contact dermatitis after single or multiple exposures are non protein chemicals, i.e. haptens, that induce skin inflammation through activation of innate skin immunity (irritant contact dermatitis) or both innate and acquired specific immunity (allergic contact dermatitis). The present review will focus on allergic contact dermatitis, a delayed-type hypersensitivity reaction, which is mediated by hapten-specific T cells. Recent advances in the pathophysiology of ACD have shown that the occurrence of ACD, as well as its magnitude and duration, is controlled by the opposite functions of CD8 effector T cells and CD4 regulatory T cells. From these studies ACD can be considered as a breakdown of cutaneous immune tolerance to haptens.

Dermatitis, Allergic Contact↗