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Alteration of the skin by acne inflammation, infection, solar damage, illness, injury due to trauma, surgery, skin burns, accidents, or by chemical, dermabrasion or laser procedures employed for skin rejuvenation, creates a signal to the natural immune system and starts responses that may or may not be effective in a) avoiding an impending invasion from nearby microbes and b) in triggering the production of new healthy cells to replace those damaged. Dermal defense mechanisms by antimicrobial peptides Braff MH , Bardan A , Nizet V , Gallo RL . Department of Medicine, University of California San Diego, and VA San Diego Healthcare System, San Diego, California, USA. Anti-microbial peptides are mostly tiny cationic polypeptides that are grouped together due to their ability to impede the multiplication of microbes. As effectors of innate immunity, antimicrobial peptides quickly kill an ample spectrum of bacteria, fungi, and viruses. In addition, these peptides alter the local inflammatory response and start mechanisms of cellular and adaptive immunity. Cathelicidins and defensins comprise the most important families of antimicrobial peptides in the skin, although other cutaneous peptides, like proteinase inhibitors, chemokines, and neuropeptides also show antimicrobial activity. Together, these useful antimicrobial peptides play a crucial role in skin immune defense and disease pathogenesis. Antimicrobial Peptides in the Skin: Biological Relevance Antimicrobial peptides, which are synthesized in the dermis at sites of potential microbial entry, supply a soluble barrier that acts as an impediment to infection. In the case of infection or trauma, antimicrobial peptide expression in the dermis is upregulated due to increased synthesis by keratinocytes and deposition from degranulation of recruited neutrophils. Although antimicrobial peptides certainly demonstrate in vitro antimicrobial action, studies have revealed that many such peptides, including cathelicidins and defensins, are deactivated by normal salt concentrations (Goldman et al, 1997). In fact, a recent study has revealed that mammalian dermis contains a fundamental antimicrobial-enhancing factor that turns bacteria labile to cathelicidin in vitro, despite the presence of normal salt and serum (Dorschner et al, 2004). The in vivo relevance of antimicrobial peptides in the normal environment is highly accentuated by the laboratory animal models and human skin ailments. Biological immune defense function is highly improved by a soluble antimicrobial peptide barrier that is started when physical barriers fail to block microbial entry. The skin not only acts as a mechanical barrier against microorganisms, it also produces peptides which tend to display broad-spectrum antimicrobial activity. The skin also produces growth factors, inhibitors of tumors and proteins. Following skin injury or wounds, growth factors are secreted to promote the rejuvenation of tissue and to induce the synthesis of antimicrobial peptides. The growth factor work ceases after rejuvenation of the tissue, when the physical barrier defending against microbial infections is re-established.
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