Immune processes in the context of cutaneous and systemic
diseases in the SAT
Moving into the discussion of immune processes, the skin acts as a
physical barrier, orchestrating a complex interplay of structural and
cellular elements. Resident and migrating immune cells protect against
pathogens. The cutaneous immune system can also trigger pathologic
responses, leading to allergies, autoimmunity, and autoinflammatory
conditions (29-31). However, the role of SAT in the cutaneous immune
system and its impact under homeostatic and pathogenic conditions has
been poorly characterized.
Evidence suggests that SAT’s reservoir of immune and stromal cells may
direct metabolic and immunologic processes
(29-31). SAT-mediated pathologic
responses can manifest within SAT, the overlying dermis or epidermis, or
extracutaneous sites throughout the body (Fig 2). Examples include SAT’s
involvement in (i) cutaneous wound
healing (27, 32, 33), (ii) induction of a protective immune responses
(34), (iii) modulation of immunologic and metabolic processes, (iv)
regulation of cutaneous inflammatory diseases, (v) promotion of
neoplastic processes, and (vi) and influence on the phenotype of various
genodermatoses (35, 36) (Fig 2). However, much of this evidence is
derived from animal studies, necessitating further investigations to
understand SAT-mediated pathologies in humans and its communication with
superficial skin layers.