Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
Lower Saxony Institute of Occupational Dermatology, University of Göttingen, Göttingen, Germany.
J Dtsch Dermatol Ges. 2023 Apr;21(4):349-353. doi: 10.1111/ddg.15050. Epub 2023 Mar 24.
Atopic dermatitis (AD) is a chronic inflammatory skin disease for which many new insights have been gained in recent years through a better understanding of pathophysiology, concomitant diseases and therapeutics in particular. In this review, new and practice-relevant results from current research are presented. Many studies have been performed on the diagnosis of AD and on different subtypes, yet no diagnostic biomarker or clinical predictor of treatment response has been established. For topical treatment, some agents such as Janus kinase (JAK) inhibitors are in advanced stages of clinical trials or already approved in some countries, which will be available in Europe for the treatment of certain eczema subtypes in the foreseeable future. Current systemic therapies in Europe include two antibodies for inhibition of the interleukin (IL)-4/13 signaling cascades and three oral JAK inhibitors with somewhat different efficacy and safety profiles. Among the antibody therapies for AD already advanced in development, promising new targets include blockade of IL-31, of neurokinin-1 receptor on sensory neurons, and inhibition of the OX40/OX40L axis for cutaneous dendritic cell and T lymphocyte interaction. Primary prevention and modulation of sequential disease progression as well as effects on concomitant diseases by early therapeutic intervention will be important questions in future research on AD.
特应性皮炎（AD）是一种慢性炎症性皮肤病，近年来通过对发病机制、伴随疾病和治疗方法的深入了解，有了许多新的认识。本文综述了当前研究中的新的和与实践相关的结果。AD 的诊断和不同亚型有许多研究，但尚未建立诊断生物标志物或治疗反应的临床预测因子。在局部治疗方面，一些药物如 Janus 激酶（JAK）抑制剂已经处于临床试验的后期阶段，或在某些国家已经获得批准，在可预见的未来，它们将在欧洲用于治疗某些特定的湿疹亚型。目前欧洲的系统性治疗方法包括两种用于抑制白细胞介素（IL）-4/13 信号通路的抗体，以及三种具有不同疗效和安全性特征的口服 JAK 抑制剂。在AD 开发中已经取得进展的抗体治疗中，有前景的新靶点包括阻断 IL-31、感觉神经元上的神经激肽-1 受体，以及抑制 OX40/OX40L 轴以调节皮肤树突状细胞和 T 淋巴细胞的相互作用。在 AD 的未来研究中，初级预防和调节疾病的序贯进展以及早期治疗干预对伴随疾病的影响将是重要的问题。
