Atopic dermatitis endotypes and implications for targeted therapeutics

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:143

Review

Czarnowicki, Tali^1,2,3  He, Helen^1,2  Krueger, James G.³  Guttman-Yassky, Emma^1,2,3 

[1] Icahn Sch Med Mt Sinai, Dept Dermatol, New York, NY 10029 USA

[2] Icahn Sch Med Mt Sinai, Inst Immunol, New York, NY 10029 USA

[3] Rockefeller Univ, Lab Invest Dermatol, 1230 York Ave, New York, NY 10021 USA

关键词: Atopic dermatitis;    phenotype;    endotype;    precision medicine;    targeted therapies;    European American;    Asian;    African American;    filaggrin;    intrinsic and extrinsic;   

DOI  :  10.1016/j.jaci.2018.10.032

来源: Elsevier

【 摘 要 】

Recent research advancements indicate that atopic dermatitis (AD) is a complex disease characterized by different subtypes/phenotypes based on age, disease chronicity, ethnicity, filaggrin and IgE status, and underlying molecular mechanisms/endotypes. This heterogeneity advocates against the traditional one-size-fits-all therapeutic approaches still used to manage AD. Precision medicine approaches, striving for targeted, tailored, endotype-driven disease prevention and treatment, rely on detailed definitions of the disease's variability across different phenotypes. Studies have shown that AD harbors different endotypes across different age groups and ethnicities and according to IgE levels and filaggrin mutation status. These include European American versus Asian patients, children versus adults, intrinsic versus extrinsic (IgE status) disease, and patients with and without filaggrin mutations. Therapies targeting different cytokine axes and other mechanisms involved in disease pathogenesis, which are currently being tested for patients with AD across the disease spectrum, will expand our ability to dissect the relative contribution of each of these pathways to disease perpetuation.

【 授权许可】

Free