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特应性皮炎的多样性与免疫靶点的选择。

Diversity of atopic dermatitis and selection of immune targets.

机构信息

Icahn School of Medicine at Mount Sinai Medical Center, New York, New York; University of Puerto Rico School of Medicine, San Juan, Puerto Rico.

Icahn School of Medicine at Mount Sinai Medical Center, New York, New York; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Ann Allergy Asthma Immunol. 2024 Feb;132(2):177-186. doi: 10.1016/j.anai.2023.11.020. Epub 2023 Nov 24.

Abstract

Atopic dermatitis (AD) is a heterogeneous immune-mediated skin disorder affecting people of all ages and ethnicities. Despite the development of targeted therapeutics such as biologics and Janus kinase inhibitors, attaining complete clinical efficacy remains difficult. This therapeutic challenge may be attributed to the complex pathogenesis of AD. Although the T2 axis has been extensively studied, recent advancements have started to reveal the involvement of additional immune pathways including T1, T17, and T22. Understanding the interplay of these immune axes may contribute to a more personalized therapeutic approach based on patients' molecular profile, with the prospect of improving clinical outcome. This review will discuss studies exploring the molecular profile of AD in both skin and blood across age, ethnicity/race, disease chronicity, IgE levels, filaggrin mutation status, and AD association with other atopic conditions. Moreover, it will explore the potential of personalized treatment strategies based on a patient's distinct immune signature.

摘要

特应性皮炎(AD)是一种异质性免疫介导的皮肤疾病,影响所有年龄段和种族的人群。尽管已经开发了生物制剂和 Janus 激酶抑制剂等靶向治疗药物,但仍难以达到完全的临床疗效。这种治疗挑战可能归因于 AD 的复杂发病机制。尽管 T2 轴已被广泛研究,但最近的进展开始揭示其他免疫途径的参与,包括 T1、T17 和 T22。了解这些免疫轴的相互作用可能有助于根据患者的分子特征制定更个性化的治疗方法,有望改善临床结果。本综述将讨论在皮肤和血液中研究 AD 的分子特征的研究,包括年龄、种族/民族、疾病慢性、IgE 水平、丝聚蛋白突变状态以及 AD 与其他特应性疾病的关联。此外,它还将探讨基于患者独特免疫特征的个性化治疗策略的潜力。

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