Department of Morphological Sciences, Adelson School of Medicine, Ariel University, Ariel 4077625, Israel.
Department of Anatomy and Anthropology, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv 6927846, Israel.
Cells. 2024 Nov 18;13(22):1899. doi: 10.3390/cells13221899.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with multifactorial and unclear pathogenesis. Its development is characterized by two key elements: epigenetic dysregulation of molecular pathways involved in AD pathogenesis and disrupted skin and gut microbiota (dysbiosis) that jointly trigger and maintain chronic inflammation, a core AD characteristic. Current data suggest that failed inflammation resolution is the main pathogenic mechanism underlying AD development. Inflammation resolution is provided by specialized pro-resolving mediators (SPMs) derived from dietary polyunsaturated fatty acids acting through cognate receptors. SPM levels are reduced in AD patients. Administration of SPMs or their stable, small-molecule mimetics and receptor agonists, as well as supplementation with probiotics/prebiotics, demonstrate beneficial effects in AD animal models. Epidrugs, compounds capable of restoring disrupted epigenetic mechanisms associated with the disease, improve impaired skin barrier function in AD models. Based on these findings, we propose a novel, multilevel AD treatment strategy aimed at resolving chronic inflammation by application of SPM mimetics and receptor agonists, probiotics/prebiotics, and epi-drugs. This approach can be used in conjunction with current AD therapy, resulting in AD alleviation.
特应性皮炎(AD)是一种慢性炎症性皮肤病,其发病机制具有多因素且不明确的特点。其发展的特征是两个关键因素:涉及 AD 发病机制的分子途径的表观遗传失调,以及共同引发和维持慢性炎症的皮肤和肠道微生物群(失调)。目前的数据表明,炎症反应的失败是 AD 发展的主要发病机制。炎症反应的解决是由饮食中的多不饱和脂肪酸衍生的专门的促解决介质(SPM)提供的,这些 SPM 通过同源受体发挥作用。AD 患者的 SPM 水平降低。在 AD 动物模型中,给予 SPM 或其稳定的小分子模拟物和受体激动剂,以及补充益生菌/益生元,都显示出有益的效果。表皮药物,能够恢复与疾病相关的破坏的表观遗传机制的化合物,改善 AD 模型中的受损皮肤屏障功能。基于这些发现,我们提出了一种新的、多层次的 AD 治疗策略,旨在通过应用 SPM 模拟物和受体激动剂、益生菌/益生元和表皮药物来解决慢性炎症。这种方法可以与目前的 AD 治疗联合使用,从而减轻 AD。
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