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.