Immunologic, microbial, and epithelial interactions in atopic dermatitis

Abstract

Objective: To provide an overview of studies contributing to the understanding of immunologic, microbial, and epithelial interactions in atopic dermatitis.

Data sources: PubMed literature review (2000-2017) and meeting abstracts from recent international dermatology conferences.

Study selections: Articles discussing primarily human disease.

Results: Clinical studies showed that atopic dermatitis is a type 2 immune-centered disease with a systemic inflammatory component but with heterogeneous treatment responses. This suggests that other factors are likely involved in shaping the skin disease phenotype, including microbial dysbiosis and epidermal barrier dysfunction.

Conclusion: Recent clinical investigation has significantly expanded our knowledge on disease pathogenesis in atopic dermatitis, and current and future clinical trials will most likely further help to elucidate this complex, heterogeneous skin disease.

Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1.. “The roof is on fire” –

Immune cell subsets mediating local as well as potentially systemic inflammation.

Figure 2.. Potential “driver” cytokines in AD.

Immune mediators that have been shown to contribute to AD skin inflammation (IL-4, IL-13, IL-31, IL-12/IL-23), and that are potentially involved in shaping the disease phenotype, that are currently being investigated in clinical trials (IL-22, IL-17).