Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
Institute of Environmental Medicine, Helmholtz Zentrum München, Augsburg, Germany.
Allergy. 2021 Nov;76(11):3408-3421. doi: 10.1111/all.15058. Epub 2021 Sep 6.
Atopic eczema (AE) is an inflammatory skin disease with involvement of genetic, immunological and environmental factors. One hallmark of AE is a skin barrier disruption on multiple, highly interconnected levels: filaggrin mutations, increased skin pH and a microbiome dysbiosis towards Staphylococcus aureus overgrowth are observed in addition to an abnormal type 2 immune response. Extrinsic factors seem to play a major role in the development of AE. As AE is a first step in the atopic march, its prevention and appropriate treatment are essential. Although standard therapy remains topical treatment, powerful systemic treatment options emerged in the last years. However, thorough endotyping of the individual patients is still required for ideal precision medicine approaches in future. Therefore, novel microbial and immunological biomarkers were described recently for the prediction of disease development and treatment response. This review summarizes the current state of the art in AE research.
特应性皮炎（AE）是一种炎症性皮肤病，涉及遗传、免疫和环境因素。AE 的一个标志是多个高度相互关联的层面上的皮肤屏障破坏：除了异常的 2 型免疫反应外，还观察到丝聚蛋白突变、皮肤 pH 值升高和微生物组失调导致金黄色葡萄球菌过度生长。外在因素似乎在 AE 的发展中起主要作用。由于 AE 是特应性进行曲的第一步，因此预防和适当的治疗至关重要。尽管标准治疗仍然是局部治疗，但近年来出现了强大的系统治疗选择。然而，对于未来理想的精准医学方法，仍然需要对个体患者进行彻底的终末分型。因此，最近描述了新的微生物和免疫学生物标志物，用于预测疾病发展和治疗反应。这篇综述总结了 AE 研究的最新进展。
