Neuroimmune interactions in the skin

Neuroimmunologic aspects of skin inflammation involve several interacting systems. The modulating influence of autonomic and sensory nerves has been known for a long time. Neurokinines derived from these nerves have recently been shown to interact with antigen presentation in dermal Langerhans cells and other key functions of allergic skin disease. While some mechanisms of afferent function and local reflex are known, the nature of efferent effects (from brain to periphery) remains to be elucidated. New aspects include involvement of the brain-derived neurotrophic factor in addition to the autonomic nervous system in mental stress response and insight in the immunomodulation by proopiomelanocortins. Novel strategies for therapy and prevention of chronicity may also result from understanding the role of increased secretion of nerve growth factor in atopic eczema and psoriasis.