From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine
Atopic dermatitis (AD) affects up to 20% of children and is considered the starting point of the atopic march with the development of food allergy, asthma, and allergic rhinitis. The heterogeneous phenotype reflects distinct and/or overlapping pathogenetic mechanisms with varying degrees of epiderma...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/6/893 |
| _version_ | 1797485585706778624 |
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| author | Laura Maintz Thomas Bieber Helen D. Simpson Anne-Laure Demessant-Flavigny |
| author_facet | Laura Maintz Thomas Bieber Helen D. Simpson Anne-Laure Demessant-Flavigny |
| author_sort | Laura Maintz |
| collection | DOAJ |
| description | Atopic dermatitis (AD) affects up to 20% of children and is considered the starting point of the atopic march with the development of food allergy, asthma, and allergic rhinitis. The heterogeneous phenotype reflects distinct and/or overlapping pathogenetic mechanisms with varying degrees of epidermal barrier disruption, activation of different T cell subsets and dysbiosis of the skin microbiome. Here, we review current evidence suggesting a systemic impact of the cutaneous inflammation in AD together with a higher risk of asthma and other comorbidities, especially in severe and persistent AD. Thus, early therapy of AD to restore the impaired skin barrier, modified microbiome, and target type 2 inflammation, depending on the (endo)phenotype, in a tailored approach is crucial. We discuss what we can learn from the comorbidities and the implications for preventive and therapeutic interventions from precision dermocosmetics to precision medicine. The stratification of AD patients into biomarker-based endotypes for a precision medicine approach offers opportunities for better long-term control of AD with the potential to reduce the systemic impact of a chronic skin inflammation and even prevent or modify the course, not only of AD, but possibly also the comorbidities, depending on the patient’s age and disease stage. |
| first_indexed | 2024-03-09T23:20:55Z |
| format | Article |
| id | doaj.art-daea6d608d914232ad4b37362434153d |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T23:20:55Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-daea6d608d914232ad4b37362434153d2023-11-23T17:27:11ZengMDPI AGJournal of Personalized Medicine2075-44262022-05-0112689310.3390/jpm12060893From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and MedicineLaura Maintz0Thomas Bieber1Helen D. Simpson2Anne-Laure Demessant-Flavigny3Department of Dermatology and Allergy, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Dermatology and Allergy, University Hospital Bonn, 53127 Bonn, GermanyMy Word Medical Writing, 13260 Cassis, FranceLa Roche-Posay International, 92300 Levallois-Perret, FranceAtopic dermatitis (AD) affects up to 20% of children and is considered the starting point of the atopic march with the development of food allergy, asthma, and allergic rhinitis. The heterogeneous phenotype reflects distinct and/or overlapping pathogenetic mechanisms with varying degrees of epidermal barrier disruption, activation of different T cell subsets and dysbiosis of the skin microbiome. Here, we review current evidence suggesting a systemic impact of the cutaneous inflammation in AD together with a higher risk of asthma and other comorbidities, especially in severe and persistent AD. Thus, early therapy of AD to restore the impaired skin barrier, modified microbiome, and target type 2 inflammation, depending on the (endo)phenotype, in a tailored approach is crucial. We discuss what we can learn from the comorbidities and the implications for preventive and therapeutic interventions from precision dermocosmetics to precision medicine. The stratification of AD patients into biomarker-based endotypes for a precision medicine approach offers opportunities for better long-term control of AD with the potential to reduce the systemic impact of a chronic skin inflammation and even prevent or modify the course, not only of AD, but possibly also the comorbidities, depending on the patient’s age and disease stage.https://www.mdpi.com/2075-4426/12/6/893asthmaatopic dermatitisatopic marchbiologic therapiescomorbiditiesdermocosmetics |
| spellingShingle | Laura Maintz Thomas Bieber Helen D. Simpson Anne-Laure Demessant-Flavigny From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine Journal of Personalized Medicine asthma atopic dermatitis atopic march biologic therapies comorbidities dermocosmetics |
| title | From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine |
| title_full | From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine |
| title_fullStr | From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine |
| title_full_unstemmed | From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine |
| title_short | From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine |
| title_sort | from skin barrier dysfunction to systemic impact of atopic dermatitis implications for a precision approach in dermocosmetics and medicine |
| topic | asthma atopic dermatitis atopic march biologic therapies comorbidities dermocosmetics |
| url | https://www.mdpi.com/2075-4426/12/6/893 |
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