St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK.
Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK.
Allergy. 2024 Jan;79(1):26-36. doi: 10.1111/all.15818. Epub 2023 Jul 19.
Atopic dermatitis (AD) is a chronic, pruritic and inflammatory, dry skin condition with many known comorbidities. These include airway disease, food allergies, atopic eye disease and autoimmune conditions. Furthermore, there is often significant sleep disturbance as well as increased psychological distress and mental health problems. Severe AD therefore often has a significant impact on the quality of life of both patients and their families. In this review we discuss recent findings on the putative links between AD, its association with itch, sleep disturbance and neuropsychiatric morbidity, including the role of inflammation in these conditions. Itch was thought to predominantly drive sleep disruption in AD. We now understand changes in sleep influence immune cell distribution and the associated inflammatory cytokines, which suggests a bidirectional relationship between AD and sleep. We also increasingly recognize inflammation as a key driver in psychological symptoms and disorders. The link between cutaneous, systemic and possible brain inflammation could at least in part be driven by the sleep deprivation and itch-driven neuronal proliferation seen in AD.
特应性皮炎（AD）是一种慢性、瘙痒性和炎症性的干燥皮肤疾病，有许多已知的合并症。这些合并症包括气道疾病、食物过敏、特应性眼病和自身免疫性疾病。此外，通常还存在明显的睡眠障碍，以及增加的心理困扰和心理健康问题。因此，严重的 AD 通常会对患者及其家人的生活质量产生重大影响。在这篇综述中，我们讨论了 AD 与其与瘙痒、睡眠障碍和神经精神发病率的关联的最新发现，包括炎症在这些疾病中的作用。人们认为瘙痒主要是导致 AD 睡眠中断的原因。我们现在了解到睡眠的变化会影响免疫细胞的分布和相关的炎症细胞因子，这表明 AD 和睡眠之间存在双向关系。我们也越来越认识到炎症是心理症状和障碍的一个关键驱动因素。皮肤、全身和可能的大脑炎症之间的联系至少部分可能是由 AD 中所见的睡眠剥夺和瘙痒驱动的神经元增殖所驱动的。
