Overview of Atopic Dermatitis in Different Ethnic Groups
Atopic dermatitis (AD) is a common chronic inflammatory skin disease with a high prevalence worldwide, including countries from Asia, Africa, and Latin America, and in different ethnic groups. In recent years, more attention has been placed on the heterogeneity of AD associated with multiple factors...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/7/2701 |
| _version_ | 1797607572678639616 |
|---|---|
| author | Andrea Chiricozzi Martina Maurelli Laura Calabrese Ketty Peris Giampiero Girolomoni |
| author_facet | Andrea Chiricozzi Martina Maurelli Laura Calabrese Ketty Peris Giampiero Girolomoni |
| author_sort | Andrea Chiricozzi |
| collection | DOAJ |
| description | Atopic dermatitis (AD) is a common chronic inflammatory skin disease with a high prevalence worldwide, including countries from Asia, Africa, and Latin America, and in different ethnic groups. In recent years, more attention has been placed on the heterogeneity of AD associated with multiple factors, including a patient’s ethnic background, resulting in an increasing body of clinical, genetic, epidemiologic, and immune-phenotypic evidence that delineates differences in AD among racial groups. Filaggrin (FLG) mutations, the strongest genetic risk factor for the development of AD, are detected in up to 50% of European and 27% of Asian AD patients, but very rarely in Africans. Th2 hyperactivation is a common attribute of all ethnic groups, though the Asian endotype of AD is also characterized by an increased Th17-mediated signal, whereas African Americans show a strong Th2/Th22 signature and an absence of Th1/Th17 skewing. In addition, the ethnic heterogeneity of AD may hold important therapeutic implications as a patient’s genetic predisposition may affect treatment response and, thereby, a tailored strategy that better targets the dominant immunologic pathways in each ethnic subgroup may be envisaged. Nevertheless, white patients with AD represent the largest ethnicity enrolled and tested in clinical trials and the most treated in a real-world setting, limiting investigations about safety and efficacy across different ethnicities. The purpose of this review is to describe the heterogeneity in the pathophysiology of AD across ethnicities and its potential therapeutic implications. |
| first_indexed | 2024-03-11T05:32:51Z |
| format | Article |
| id | doaj.art-6ff2b70293f64b71a99df4fc99a95a03 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:32:51Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6ff2b70293f64b71a99df4fc99a95a032023-11-17T17:00:44ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01127270110.3390/jcm12072701Overview of Atopic Dermatitis in Different Ethnic GroupsAndrea Chiricozzi0Martina Maurelli1Laura Calabrese2Ketty Peris3Giampiero Girolomoni4UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, ItalySection of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, ItalyUOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, ItalyUOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, ItalySection of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, ItalyAtopic dermatitis (AD) is a common chronic inflammatory skin disease with a high prevalence worldwide, including countries from Asia, Africa, and Latin America, and in different ethnic groups. In recent years, more attention has been placed on the heterogeneity of AD associated with multiple factors, including a patient’s ethnic background, resulting in an increasing body of clinical, genetic, epidemiologic, and immune-phenotypic evidence that delineates differences in AD among racial groups. Filaggrin (FLG) mutations, the strongest genetic risk factor for the development of AD, are detected in up to 50% of European and 27% of Asian AD patients, but very rarely in Africans. Th2 hyperactivation is a common attribute of all ethnic groups, though the Asian endotype of AD is also characterized by an increased Th17-mediated signal, whereas African Americans show a strong Th2/Th22 signature and an absence of Th1/Th17 skewing. In addition, the ethnic heterogeneity of AD may hold important therapeutic implications as a patient’s genetic predisposition may affect treatment response and, thereby, a tailored strategy that better targets the dominant immunologic pathways in each ethnic subgroup may be envisaged. Nevertheless, white patients with AD represent the largest ethnicity enrolled and tested in clinical trials and the most treated in a real-world setting, limiting investigations about safety and efficacy across different ethnicities. The purpose of this review is to describe the heterogeneity in the pathophysiology of AD across ethnicities and its potential therapeutic implications.https://www.mdpi.com/2077-0383/12/7/2701atopic eczemadermatitisallergyitchskin diseasetreatment |
| spellingShingle | Andrea Chiricozzi Martina Maurelli Laura Calabrese Ketty Peris Giampiero Girolomoni Overview of Atopic Dermatitis in Different Ethnic Groups Journal of Clinical Medicine atopic eczema dermatitis allergy itch skin disease treatment |
| title | Overview of Atopic Dermatitis in Different Ethnic Groups |
| title_full | Overview of Atopic Dermatitis in Different Ethnic Groups |
| title_fullStr | Overview of Atopic Dermatitis in Different Ethnic Groups |
| title_full_unstemmed | Overview of Atopic Dermatitis in Different Ethnic Groups |
| title_short | Overview of Atopic Dermatitis in Different Ethnic Groups |
| title_sort | overview of atopic dermatitis in different ethnic groups |
| topic | atopic eczema dermatitis allergy itch skin disease treatment |
| url | https://www.mdpi.com/2077-0383/12/7/2701 |
| work_keys_str_mv | AT andreachiricozzi overviewofatopicdermatitisindifferentethnicgroups AT martinamaurelli overviewofatopicdermatitisindifferentethnicgroups AT lauracalabrese overviewofatopicdermatitisindifferentethnicgroups AT kettyperis overviewofatopicdermatitisindifferentethnicgroups AT giampierogirolomoni overviewofatopicdermatitisindifferentethnicgroups |