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

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 a...

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Vydáno v:	Journal of allergy and clinical immunology Ročník 139; číslo 4; s. S65 - S76
Hlavní autoři:	Brunner, Patrick M., Guttman-Yassky, Emma, Leung, Donald Y.M.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Elsevier Inc 01.04.2017 Elsevier Limited
Témata:	Accreditation Allergies Allergy and Immunology Animals Anti-Inflammatory Agents - therapeutic use Atopic dermatitis Chronic illnesses Copyright Cytokines Cytokines - metabolism Dermatitis Dermatitis, Atopic - immunology Dermatitis, Atopic - therapy Eczema Health education Human subjects Humans immune Immune response Immunology Inflammation keratinocyte Keratinocytes - physiology Kinases Light therapy Molecular Targeted Therapy Pathogenesis Pharmaceutical industry Psoriasis Skin Skin diseases skin immune map Studies targeted therapy Th17 Cells - immunology Th2 Cells - immunology T helper cell FLG targeted therapy immune AD AMP TSLP OX40L PDE T helper cell EASI Atopic dermatitis keratinocyte JAK eczema CRTH2 skin immune map Prostaglandin DP2 receptor Eczema Area and Severity Index Filaggrin OX40 ligand Thymic stromal lymphopoietin Janus kinase Antimicrobial peptide Phosphodiesterase
ISSN:	0091-6749, 1097-6825, 1097-6825
On-line přístup:	Získat plný text
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Popis
Shrnutí:	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.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	0091-6749 1097-6825 1097-6825
DOI:	10.1016/j.jaci.2017.01.011