Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Curr Opin Allergy Clin Immunol. 2022 Jun 1;22(3):153-159. doi: 10.1097/ACI.0000000000000820. Epub 2022 Feb 11.
Endotypes are clinically relevant phenotypes that can be explained by molecular mechanisms, and are defined to predict the development, progression, prognosis and responses to treatment on the individual level. This review summarizes atopic dermatitis phenotypes, endotypes and their potential application for personalized medicine.
Atopic dermatitis can be classified into several phenotypes according to disease courses that likely have common pathophysiology. The genotype is important to define endotypes, but the value of genotype alone remains somewhat limited in most atopic dermatitis patients. Recent studies have demonstrated that atopic dermatitis phenotypes according to ethnicity or age can be classified into endotypes based on the dominant immunologic markers, that is TH1/TH2/TH17/TH22 cells. Newly developed biologic agents targeting specific cytokines show therapeutic potential in a personalized medicine approach.
Cytokine-based endotypes in different age groups or ethnic groups have contributed to expanding our understanding of atopic dermatitis. Recent biologics or small molecules can be used for more personalized treatment of atopic dermatitis. Further research using integrated multiomic analysis is needed to define a more detailed classification of endotypes and provide endotype-driven targeted therapies for personalized medicine.
表型是可以用分子机制解释的临床相关表型，其定义是为了预测个体水平的发病、进展、预后和治疗反应。这篇综述总结了特应性皮炎的表型、内型及其在个体化医学中的潜在应用。
根据可能具有共同病理生理学的疾病过程，特应性皮炎可以分为几种表型。基因型对于定义内型很重要，但在大多数特应性皮炎患者中，仅基因型的价值仍然有些有限。最近的研究表明，根据种族或年龄的特应性皮炎表型可以根据优势免疫标志物（即 TH1/TH2/TH17/TH22 细胞）分为内型。针对特定细胞因子的新型生物制剂在个体化医学方法中显示出治疗潜力。
不同年龄组或种族的基于细胞因子的内型有助于扩大我们对特应性皮炎的认识。最近的生物制剂或小分子可用于更个性化的特应性皮炎治疗。需要使用整合的多组学分析进行进一步研究，以定义更详细的内型分类，并为个体化医学提供内型驱动的靶向治疗。
