Hui-Beckman Jessica W, Goleva Elena, Berdyshev Evgeny, Leung Donald Y M
Department of Pediatrics, National Jewish Health, Denver, Colo.
Department of Medicine, National Jewish Health, Denver, Colo.
J Allergy Clin Immunol. 2023 Jan;151(1):26-28. doi: 10.1016/j.jaci.2022.07.021. Epub 2022 Aug 30.
Atopic dermatitis (AD) and food allergy (FA) are strongly associated, with one-third of children with AD developing concomitant FA. Epithelial barrier dysfunction is important in both conditions. Genetic factors, such as filaggrin mutations and IL-4 receptor alpha chain polymorphisms, are linked to increased risk. In addition, several environmental exposures lead to reduced filaggrin and contribute to skin barrier dysfunction. Staphylococcus aureus colonization appears to contribute to AD and FA, as well as activating the type 2 immune response. Comprehensive multiomic studies using skin tape stripping have identified distinct atopic endotypes with unique characteristics of the stratum corneum lipids, proteins, S aureus abundance, and type 2 cytokine expression. Our new understanding of AD and FA presents an area of opportunity to move toward improved diagnosis and prevention of atopy.
特应性皮炎（AD）与食物过敏（FA）密切相关，三分之一的AD患儿会同时发生FA。上皮屏障功能障碍在这两种疾病中都很重要。遗传因素，如丝聚合蛋白突变和白细胞介素-4受体α链多态性，与患病风险增加有关。此外，多种环境暴露会导致丝聚合蛋白减少，并导致皮肤屏障功能障碍。金黄色葡萄球菌定植似乎与AD和FA有关，还会激活2型免疫反应。使用皮肤胶带剥离法进行的综合多组学研究已经确定了不同的特应性内型，它们具有角质层脂质、蛋白质、金黄色葡萄球菌丰度和2型细胞因子表达的独特特征。我们对AD和FA的新认识为改善特应性疾病的诊断和预防提供了一个机会领域。
