Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.
Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
J Allergy Clin Immunol. 2019 Jan;143(1):1-11. doi: 10.1016/j.jaci.2018.10.032.
Recent research advancements indicate that atopic dermatitis (AD) is a complex disease characterized by different subtypes/phenotypes based on age, disease chronicity, ethnicity, filaggrin and IgE status, and underlying molecular mechanisms/endotypes. This heterogeneity advocates against the traditional "one-size-fits-all" therapeutic approaches still used to manage AD. Precision medicine approaches, striving for targeted, tailored, endotype-driven disease prevention and treatment, rely on detailed definitions of the disease's variability across different phenotypes. Studies have shown that AD harbors different endotypes across different age groups and ethnicities and according to IgE levels and filaggrin mutation status. These include European American versus Asian patients, children versus adults, intrinsic versus extrinsic (IgE status) disease, and patients with and without filaggrin mutations. Therapies targeting different cytokine axes and other mechanisms involved in disease pathogenesis, which are currently being tested for patients with AD across the disease spectrum, will expand our ability to dissect the relative contribution of each of these pathways to disease perpetuation.
最近的研究进展表明，特应性皮炎（AD）是一种复杂的疾病，根据年龄、疾病的慢性程度、种族、丝聚蛋白和 IgE 状态以及潜在的分子机制/表型，可分为不同的亚型/表型。这种异质性反对了传统的“一刀切”的治疗方法，这些方法仍被用于管理 AD。精准医学方法旨在针对特定的、量身定制的、基于表型的疾病预防和治疗，这依赖于对不同表型的疾病变异性的详细定义。研究表明，AD 在不同年龄组和种族中存在不同的表型，根据 IgE 水平和丝聚蛋白突变状态的不同而有所不同。这些包括欧洲裔美国人和亚洲人、儿童和成年人、内在性（IgE 状态）疾病和有丝聚蛋白突变和无丝聚蛋白突变的患者。目前正在针对 AD 患者进行针对不同细胞因子轴和疾病发病机制中涉及的其他机制的治疗，这些治疗将扩大我们分析这些途径对疾病持续存在的相对贡献的能力。
