The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:139

Review

Brunner, Patrick M.¹  Guttman-Yassky, Emma^2,3  Leung, Donald Y. M.⁴ 

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

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

[3] Icahn Sch Med Mt Sinai, Lab Inflammatory Skin Dis, New York, NY 10029 USA

[4] Natl Jewish Hlth, Dept Pediat, Denver, CO USA

关键词: Atopic dermatitis;    eczema;    keratinocyte;    immune;    T helper cell;    skin immune map;    targeted therapy;   

DOI  :  10.1016/j.jaci.2017.01.011

来源: Elsevier

【 摘 要 】

Atopic dermatitis (AD), the most common chronic inflammatory skin disease, is driven by both terminal keratinocyte differentiation defects and strong type 2 immune responses. In contrast to chronic plaque-type psoriasis, AD is now understood to be a much more heterogeneous disease, with additional activation of TH22, TH17/IL-23, and TH1 cytokine pathways depending on the subtype of the disease. In this review we discuss our current understanding of the AD immune map in both patients with early-onset and those with chronic disease. Clinical studies with broad and targeted therapeutics have helped to elucidate the contribution of various immune axes to the disease phenotype. Importantly, immune activation extends well beyond lesional AD because nonlesional skin and the blood component harbor AD-specific inflammatory changes. For this reason, future therapeutics will need to focus on a systemic treatment approach, especially in patients with moderate-to-severe disease.

【 授权许可】

Free