1. ¹Department of Internal Medicine, Psychosomatics, Biomedical Research Center, Universitätsmedizin-Charité, Campus Virchow Klinikum, Berlin, Germany
2. ²Department of Dermatology, University of Minnesota Academic Health Center, Minneapolis Minnesota, USA
3. ³Shiseido Life Science Research Center, Yokohama, Japan
4. ⁴Division of Dermatology and Cutaneous Sciences, Michigan State University, East Lansing, Michigan, USA
5. ⁵University of Colorado Health Sciences Center, Denver, Colorado USA
6. ⁶Department of Dermatology, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany
7. ⁷Department of Dermatology, Ludwig Boltzmann Institute for Cell Biology and Immunobiology of the Skin, University of Münster, Münster, Germany

Correspondence: Dr Eva M.J. Peters, University-Medicine Charité, Campus Virchow Clinics, Biomedical Research Center (BMFZ), Room Nr. 2.0549, Augustenburger Platz 1, 13353 Berlin, Germany. E-mail: frl_peters@yahoo.com

Received 2 September 2005; Revised 10 January 2006; Accepted 27 January 2006.

Abstract

The skin as a barrier and immune organ is exposed to omnipresent environmental challenges such as irradiation or chemical and biologic hazards. Neuropeptides released from cutaneous nerves or skin and immune cells in response to noxious stimuli are mandatory for a fine-tuned regulation of cutaneous immune responses and tissue maintenance and repair. They initialize host immune responses, but are equally important for counter regulation of proinflammatory events. Interaction of the nervous and immune systems occurs both locally – at the level of neurogenic inflammation and immunocyte activation – and centrally – by controlling inflammatory pathways such as mononuclear activation or lymphocyte cytokine secretion. Consequently, a deregulated neurogenic immune control results in disease manifestation and frequently accompanies chronic development of cutaneous disorders. The current understanding, therapeutic options, and open questions of the role that neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide/pituitary adenylate cyclase-activating polypeptide, neuropeptide Y, or others play in these events are discussed. Progress in this field will likely result in novel therapies for the management of diseases characterized by deregulated inflammation, tissue remodeling, angiogenesis, and neoplasm.