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Review
. 2023 May;151(5):1145-1154.
doi: 10.1016/j.jaci.2022.10.023. Epub 2022 Nov 22.

Novel insights into atopic dermatitis

Charles F Schuler 4th  1 , Allison C Billi  2 , Emanual Maverakis  3 , Lam C Tsoi  2 , Johann E Gudjonsson  4
Affiliations
Review

Novel insights into atopic dermatitis

Charles F Schuler 4th et al. J Allergy Clin Immunol. 2023 May.

Abstract

Recent research into the pathophysiology and treatment of atopic dermatitis (AD) has shown notable progress. An increasing number of aspects of the immune system are being implicated in AD, including the epithelial barrier, TH2 cytokines, and mast cells. Major advances in therapeutics were made in biologic cytokine and receptor antagonists and among Janus kinase inhibitors. We focus on these areas and address new insights into AD epidemiology, biomarkers, endotypes, prevention, and comorbidities. Going forward, we expect future mechanistic insights and therapeutic advances to broaden physicians' ability to diagnose and manage AD patients, and perhaps to find a cure for this chronic condition.

Keywords: Atopic dermatitis; Janus kinase inhibitors; T(H)2; epithelial barrier.

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Conflict of interest statement

The rest of the authors declare that they have no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.. Novel insights and additions to AD pathogenesis.
This figure highlights novel insights and additions to AD pathogenesis (shown in red), and environmental contribution (blue), and their relevance to key AD associated features including TH2 immune responses, epidermal inflammation and barrier function, mast cell activation, and pruritus. LTC4, leukotriene C4; MRGPRX2, Mas-related G protein-coupled receptor-X2; TARC, thymus and activation-regulated chemokine; TRPV3, transient receptor potential vanilloid subfamily V member 1; TSLP, thymic stromal lymphopoietin.
Figure 2.
Figure 2.. Novel therapeutic advances in AD.
Left panel, Intersection between therapeutic development and atopic dermatitis (AD) pathogenesis with therapeutic agents shown in red next to their biologic mechanisms of action. Right panel, Janus kinase (JAK) family members dimerize to mediate different cytokine responses. JAK inhibitors (JAKi) inhibit multiple aspects of AD pathogenesis through targeting of select JAK family members (right panel modified from Chovatiya et. al. (93)).
Figure 3.
Figure 3.. Novel Insights into AD Comorbidities.
Highlighted comorbidities associated with “Atopic March” or “Non-Atopic” aspects of AD pathogenesis. This includes association of AD disease severity with development of allergic rhinitis and association between AD and development of peanut allergy. Non-Atopic associated comorbidities include association between AD and all-cause mortality, AD associated vascular inflammation, influence of body mass index (BMI) with AD risk, and COVID-19.
See this image and copyright information in PMC

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