Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
J Allergy Clin Immunol. 2021 Apr;147(4):1174-1190.e1. doi: 10.1016/j.jaci.2021.01.013. Epub 2021 Jan 28.
Atopic dermatitis (AD) is a common yet complex skin disease, posing a therapeutic challenge with increasingly recognized different phenotypes among variable patient populations. Because therapeutic response may vary on the basis of heterogeneous clinical and molecular phenotypes, a shift toward precision medicine approaches may improve AD management. Herein, we will consider biomarkers as potential instruments in the toolbox of precision medicine in AD and will review the process of biomarker development and validation, the opinion of AD experts on the use of biomarkers, types of biomarkers, encompassing biomarkers that may improve AD diagnosis, biomarkers reflecting disease severity, and those potentially predicting AD development, concomitant atopic diseases, or therapeutic response, and current practice of biomarkers in AD. We found that chemokine C-C motif ligand 17/thymus and activation-regulated chemokine, a chemoattractant of T2 cells, has currently the greatest evidence for robust correlation with AD clinical severity, at both baseline and during therapy, by using the recommendations, assessment, development, and evaluation approach. Although the potential of biomarkers in AD is yet to be fully elucidated, due to the complexity of the disease, a comprehensive approach taking into account both clinical and reliable, AD-specific biomarker evaluations would further facilitate AD research and improve patient management.
特应性皮炎（AD）是一种常见但复杂的皮肤疾病，由于在不同的患者群体中存在越来越被认识到的不同表型，因此具有治疗挑战性。由于治疗反应可能基于异质的临床和分子表型而有所不同，因此向精准医学方法的转变可能会改善 AD 的管理。在此，我们将考虑生物标志物作为 AD 精准医学工具包中的潜在工具，并将回顾生物标志物的开发和验证过程、AD 专家对生物标志物使用的看法、生物标志物的类型，包括可能改善 AD 诊断的生物标志物、反映疾病严重程度的生物标志物以及可能预测 AD 发展、伴随的特应性疾病或治疗反应的生物标志物，以及当前 AD 中生物标志物的应用。我们发现，趋化因子 C-C 基序配体 17/胸腺激活调节趋化因子是 T2 细胞的趋化因子，目前通过使用建议、评估、开发和评估方法，具有与 AD 临床严重程度在基线和治疗期间均具有强相关性的最大证据。尽管由于疾病的复杂性，AD 中生物标志物的潜力尚未得到充分阐明，但采用综合方法，同时考虑临床和可靠的 AD 特异性生物标志物评估，将进一步促进 AD 研究并改善患者管理。
