Malik Kunal, Heitmiller Kerry D, Czarnowicki Tali
Department of Dermatology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA; Laboratory of Investigative Dermatology, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA; SUNY Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
University of Maryland School of Medicine, 655 West Baltimore South, Baltimore, MD 21201, USA.
Dermatol Clin. 2017 Jul;35(3):317-326. doi: 10.1016/j.det.2017.02.006. Epub 2017 May 6.
Atopic dermatitis (AD) is increasingly recognized as a complex, inflammatory skin disease involving interplay of multiple elements. This article notes key advances in understanding of immune dysregulation, skin barrier dysfunction, environmental, genetic, and microbial influences orchestrating disease pathogenesis, and the relevance of therapeutic interventions in each area. Accumulating evidence and the discovery of new T-cell subsets has matured AD as a multiple-cytokine-axes-driven disorder, evolved from the widely held belief of it being a biphasic Th1/Th2 disease. These new insights have led to active trials testing multiple, targeted therapeutics with better efficacy and safety-profiles.
特应性皮炎(AD)日益被认为是一种复杂的炎症性皮肤病,涉及多种因素的相互作用。本文指出了在理解免疫失调、皮肤屏障功能障碍、环境、遗传和微生物对疾病发病机制的影响以及各领域治疗干预的相关性方面取得的关键进展。越来越多的证据以及新T细胞亚群的发现,使AD从一种被广泛认为是双相Th1/Th2疾病,发展成为一种由多种细胞因子轴驱动的疾病。这些新见解促使人们积极开展试验,测试多种具有更好疗效和安全性的靶向疗法。