Dessì Angelica, Di Maria Camilla, Pintus Roberta, Fanos Vassilios, Bosco Alice
Department of Surgical Sciences, University of Cagliari and Neonatal Intensive Care Unit, AOU Cagliari, Cagliari, Italy.
Curr Pediatr Rev. 2024;20(4):510-524. doi: 10.2174/1573396320666230411093122.
To date, the complex picture of atopic dermatitis (AD) has not yet been fully clarified, despite the important prevalence of this disease in the pediatric population (20%) and the possibility of persistence into adulthood, with important implications for the quality of life of those affected, as well as significant social and financial costs. The most recent scientific evidence suggests a new interpretation of AD, highlighting the important role of the environment, particularly that of nutrition in the early stages of development. In fact, the new indications seem to point out the harmful effect of elimination diets, except in rare cases, the uselessness of chrono-insertions during complementary feeding and some benefits, albeit weak, of breastfeeding in those at greater risk. In this context, metabolomics and lipidomics can be necessary for a more in-depth knowledge of the complex metabolic network underlying this pathology. In fact, an alteration of the metabolic contents in children with AD has been highlighted, especially in correlation to the intestinal microbiota. While preliminary lipidomic studies showed the usefulness of a more in-depth knowledge of the alterations of the skin barrier to improve the development of baby skin care products. Therefore, investigating the response of different allergic phenotypes could be useful for better patient management and understanding, thus providing an early intervention on dysbiosis necessary to regulate the immune response from the earliest stages of development.
迄今为止,尽管特应性皮炎(AD)在儿科人群中的患病率很高(20%),且有可能持续到成年,对患者的生活质量产生重要影响,并带来巨大的社会和经济成本,但这种疾病的复杂情况尚未完全阐明。最新的科学证据对AD提出了新的解释,强调了环境的重要作用,尤其是营养在发育早期的作用。事实上,新的迹象似乎表明,除了极少数情况外,排除饮食具有有害影响,辅食添加期间按时间顺序添加并无用处,而母乳喂养对高危人群虽有一些微弱益处。在这种情况下,代谢组学和脂质组学对于更深入了解这种病理背后的复杂代谢网络可能是必要的。事实上,已经发现AD患儿的代谢成分发生了改变,尤其是与肠道微生物群相关的改变。而初步的脂质组学研究表明,更深入了解皮肤屏障的改变有助于开发婴儿护肤品。因此,研究不同过敏表型的反应可能有助于更好地管理和理解患者,从而在发育的最早阶段对调节免疫反应所需的生态失调进行早期干预。