Division of Immunology, Allergy & Rheumatology, Department of Internal Medicine.
Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Curr Opin Allergy Clin Immunol. 2023 Oct 1;23(5):383-389. doi: 10.1097/ACI.0000000000000931. Epub 2023 Jul 28.
Atopic dermatitis (AD) and ocular allergy aka allergic eye disease (AED) are two common conditions that often coexist in patients. However, molecular connections between these two conditions are incompletely understood. While common etiologic components including Th2 immune signaling have been suggested for AD and AED, the mechanism how current Th2-targetd therapies (dupilumab, tralokinumab) for AD can augment conjunctivitis is not well understood.
Differentially regulated genes and pathways relevant for AD disease manifestation are known. In contrast, similar information is not yet available for AED, which could be largely addressed by emerging noninvasive ocular sampling techniques. Emerging evidence indicated a reduction in goblet cell number and mucin production in a subpopulation of AD patients with AD leading to adverse ocular outcomes, while other potential mechanisms could also be involved. Involvement of particular barrier function protein(s) in AED needs further investigation.
Modern cytokine-targeted therapies for AD showed elevated risk for developing conjunctivitis. Recently developed noninvasive sampling techniques should be leveraged to identify AD endotypes associated with AED and with dupilumab-associated ocular outcomes.
特应性皮炎（AD）和过敏性眼病（AED）是两种常见的疾病，常同时存在于患者身上。然而，这两种疾病之间的分子联系尚未完全阐明。虽然已经提出 AD 和 AED 的常见病因成分，包括 Th2 免疫信号，但目前针对 AD 的 Th2 靶向治疗（度普利尤单抗、特利鲁单抗）如何增强结膜炎的机制尚不清楚。
已知与 AD 疾病表现相关的差异调节基因和途径。相比之下，AED 尚没有类似的信息，这在很大程度上可以通过新兴的非侵入性眼部采样技术来解决。新出现的证据表明，AD 患者的一部分人群中杯状细胞数量和粘蛋白产生减少，导致不良的眼部结局，而其他潜在的机制也可能涉及其中。AED 中特定屏障功能蛋白的参与需要进一步研究。
AD 的现代细胞因子靶向治疗显示出发生结膜炎的风险增加。应利用最近开发的非侵入性采样技术来确定与 AED 和与度普利尤单抗相关的眼部结局相关的 AD 表型。
