Emerging Roles of Adipose Tissue in the Pathogenesis of Psoriasis and Atopic Dermatitis in Obesity

Zhuolin Guo; Yichun Yang; Yanhang Liao; Yulin Shi; Ling-Juan Zhang

doi:10.1016/j.xjidi.2021.100064

Emerging Roles of Adipose Tissue in the Pathogenesis of Psoriasis and Atopic Dermatitis in Obesity

JID Innov. 2021 Oct 13;2(1):100064. doi: 10.1016/j.xjidi.2021.100064. eCollection 2022 Jan.

Authors

Zhuolin Guo^{1

2

3}, Yichun Yang⁴, Yanhang Liao⁴, Yulin Shi^{1

2

3}, Ling-Juan Zhang^{1

4}

Affiliations

¹ Department of Dermatology, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji University School of Medicine, Shanghai, China.
² Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
³ Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China.
⁴ State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.

Abstract

Obesity is a growing epidemic worldwide, and it is also considered a major environmental factor contributing to the pathogenesis of inflammatory skin diseases, including psoriasis (PSO) and atopic dermatitis (AD). Moreover, obesity worsens the course and impairs the treatment response of these inflammatory skin diseases. Emerging evidence highlights that hypertrophied adipocytes and infiltrated immune cells secrete a variety of molecules, including fatty acids and adipokines, such as leptin, adiponectin, and a panel of cytokines/chemokines that modulate our immune system. In this review, we describe how adipose hypertrophy leads to a chronic low-grade inflammatory state in obesity and how obesity-related inflammatory factors are involved in the pathogenesis of PSO and/or AD. Finally, we discuss the potential role of antimicrobial peptides, mechanical stress and impairment of epidermal barrier function mediated by fast expansion, and dermal fat in modulating skin inflammation. Together, this review summarizes the current literature on how obesity is associated with the pathogenesis of PSO and AD, highlighting the potentially important but overlooked immunomodulatory role of adipose tissue in the skin.

Keywords: AD, atopic dermatitis; AMP, antimicrobial peptide; AT, adipose tissue; BAT, brown adipose tissue; BMI, body mass index; CI, confidence interval; DC, dendritic cell; DIO, diet-induced obesity; FFA, free fatty acid; HFD, high-fat diet; KC, keratinocyte; OA, oleic acid; PA, palmitic acid; PSO, psoriasis; SCORAD, SCORing Atopic Dermatitis; TC, total cholesterol; TEWL, transepidermal water loss; TG, triglyceride; TLR, toll-like receptor; Th, T helper; WAT, white adipose tissue; dFB, dermal fibroblast; dWAT, dermal white adipose tissue; sWAT, subcutaneous white adipose tissue.

Publication types

Review