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特应性皮炎的演变概念

Evolving Concepts in Atopic Dermatitis.

作者信息

Sidbury Robert, Khorsand Kate

机构信息

Department of Pediatrics, Division of Dermatology, Seattle Childrens Hospital, University of Washington School of Medicine, OC 9.835, Seattle Childrens Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.

出版信息

Curr Allergy Asthma Rep. 2017 Jul;17(7):42. doi: 10.1007/s11882-017-0710-5.

Abstract

PURPOSE OF REVIEW

Tremendous advances have been made in the field of atopic dermatitis in the past 5 years. We will explore developments in burden of disease, co-morbidities, pathogenesis, prevention, and management.

RECENT FINDINGS

The tremendous burden moderate to severe atopic dermatitis (AD) places on families from a medical, psychosocial, and financial perspective has been characterized. Epidemiologic studies have identified intriguing new associations beyond the well-characterized "atopic march" of food allergies, asthma, and hay fever. Studies of primary prevention have gained traction including the remarkable impacts of early emollient therapy. Basic advances have simultaneously elucidated the nature of atopic inflammation, setting the stage for an explosion of new potential therapeutic targets. After a fallow period of nearly 15 years without a substantial therapeutic advance, this year has already seen two new FDA-approved treatments for AD. AD has a tremendous impact on quality of life with an underappreciated burden of disease; there are important newly described co-morbidities including ADHD and anemia; new insights into etio-pathogenesis have paved the way for novel topical therapies like crisaborole, and new systemic interventions like dupilumab.

摘要

综述目的

在过去5年中,特应性皮炎领域取得了巨大进展。我们将探讨疾病负担、共病、发病机制、预防和管理方面的进展。

最新发现

从中度至重度特应性皮炎(AD)给家庭带来的医疗、心理社会和经济负担已得到描述。流行病学研究已经确定了除了已充分描述的食物过敏、哮喘和花粉热的“特应性进程”之外的有趣新关联。一级预防研究受到关注,包括早期润肤剂治疗的显著影响。基础研究进展同时阐明了特应性炎症的本质,为大量新的潜在治疗靶点的出现奠定了基础。在经历了近15年没有重大治疗进展的停滞期后,今年已经有两种新的经美国食品药品监督管理局(FDA)批准的AD治疗方法。AD对生活质量有巨大影响,且疾病负担未得到充分认识;有新描述的重要共病,包括注意力缺陷多动障碍(ADHD)和贫血;对病因发病机制的新见解为克立硼罗等新型局部治疗方法以及度普利尤单抗等新型全身干预措施铺平了道路。

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