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Dermatology
Immunology
Built from Dermatology, 5th Edition
What’s inside
7 sections · 143 slides
Introduction
The skin as an active immune organ
- Roadmap of this topic
- The skin as an immune organ
- Innate versus adaptive immunity
- Adaptive immunity: two response types
Innate Immune Response
Fast, non-specific first-line defence
- Cells of the cutaneous innate immune system
- The complement system
- Complement activation pathways
- What activated complement does
- The membrane-attack complex
- Complement links innate and adaptive immunity
- Pattern recognition and Toll-like receptors
- Where TLRs sit and what they detect
- Toll-like receptors and their signalling pathways
- How TLR signals reach the nucleus
- TLRs bridge innate and adaptive immunity
- Inflammasomes
- The NLRP3 inflammasome and periodic fever syndromes
- From inflammasome to disease
- The skin microbiota
- Antimicrobial peptides (AMPs)
- Skin-derived antimicrobial peptides
- AMPs in disease and after UV exposure
- AMPs also shape adaptive immunity
- Cytokines: the immune system's messengers
- Cytokines in innate versus adaptive responses
- Monocytes
- How macrophages recognise and destroy microbes
- Macrophages recruit more defenders
- Neutrophils
- Neutrophil ectosomes and extracellular traps
- Eosinophils
- Basophils and mast cells
- Mast cell degranulation
- Innate lymphoid cells (ILCs)
- ILCs in skin health and disease
- Natural killer (NK) cells
- Why tumours and viruses target MHC class I
Adaptive Immunity: Antigen Presentation
How the immune system shows T cells what to attack
- Adaptive immunity: specificity and memory
- Antigen-presenting cells of the skin
- Langerhans cells: discovery and origin
- Langerhans cells in the epidermis
- Birbeck granules and antigen capture
- Identifying Langerhans cells
- Phenotypic markers: resident LC vs migrating LC vs dermal DC
- Phenotypic markers: resident LC vs migrating LC vs dermal DC (continued)
- Dermal dendritic cell subtypes
- Dendritic cell subsets and their roles
- Plasmacytoid dendritic cells in disease
- Dendritic cell maturity shapes the T cell response
- Are Langerhans cells essential for sensitisation?
- The Langerhans cell paradigm
- From skin to lymph node: APC migration
- The mature antigen-presenting cell
- Two ways to present antigen to T cells
- MHC class I and class II antigen presentation to T cells
- MHC class I: presenting what is made inside the cell
- Endogenous antigen delivery to MHC class I
- MHC class II: presenting what comes from outside the cell
- Exogenous antigen delivery to MHC class II
- Cross-presentation
Adaptive Immunity: T Cells
Development, receptors, subsets and memory
- Where T cells come from
- Positive and negative selection
- Thymic selection as a two-step filter
- CD4 and CD8: helper versus cytotoxic T cells
- The T cell receptor (TCR)
- Generating T cell receptor diversity
- When receptor recombination fails
- T cell receptor signalling
- T cell receptor signal transduction
- From antigen binding to gene transcription
- Why one signal is not enough
- The two-signal model of T cell activation
- Costimulatory molecules and their ligands
- The B7-CD28 costimulatory family
- Immune checkpoints and cancer therapy
- Memory T cells
- Tissue-resident memory T cells (Trm) in skin
- Two major effector T cell types
- T helper cell differentiation
- Development of the different T helper subsets
- Th1 cells
- Th2 cells
- Th9 and Th22 cells
- Th17 cells
- Th17 cells and psoriasis therapy
- T follicular helper (Tfh) cells
- Cytotoxic T (Tc) cells
- Cytotoxic T cell subsets
- Discovery of regulatory T cells
- Natural versus induced regulatory T cells
- FoxP3: the master Treg gene
- Development and function of regulatory T cells
- How Tregs suppress immune responses
- Tregs living in skin
- Natural killer T (NKT) cells
- Gamma/delta T cells
- Dendritic epidermal T cells (DETCs)
- Mucosal-associated invariant T (MAIT) cells
- How naive T cells find their antigen
- How memory T cells home to the skin
- Chemokine receptors that fine-tune skin homing
Adaptive Immunity: B Cells and Antibodies
The humoral arm of the adaptive response
- B cells
- Immunoglobulin structure
- Immunoglobulin M (IgM)
- Immunoglobulin G (IgG)
- Immunoglobulin A (IgA)
- Immunoglobulin E (IgE)
- Immunoglobulin D (IgD)
- B cell activation without T cell help
- T cell-dependent B cell activation
- T cell-dependent B cell activation
- When CD40 signalling fails
- Follicular dendritic cells and germinal centres
Allergic Contact Hypersensitivity
A skin-specific model of adaptive immunity
- Why allergic contact hypersensitivity matters
- Haptens: how small chemicals become antigens
- Induction of contact hypersensitivity
- Sensitisation: from hapten to effector T cell
- What activates the antigen-presenting cell
- Effector versus regulatory balance in CHS
- Elicitation: the reaction on re-exposure
- Elicitation of contact hypersensitivity
- The elicitation timeline
Summary and References
Key takeaways from cutaneous immunology
- Key takeaways
- Innate versus adaptive immunity, revisited
- Where cutaneous immunology goes wrong
- References
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- Dermatology, 5th Edition (2-Volume Set)