About this Research Topic
Atopic Dermatitis (AD) has become an important health problem due to its increased prevalence in recent years, as well as the fact that adolescent and adult-onset cases are more common than previously thought. The pathogenesis of AD is complex and includes genetic, immune and environmental factors that lead to chronic inflammation. The elucidation of AD pathogenesis in recent years (determination of T helper subgroups including Th17, Th22, Th9 and the JAK-STAT pathway) has led to the development of systemic treatments (biological agents targeting IL-4 and IL-13 and small molecules JAK inhibitors) and topical treatments (phosphodiesterase 4 and JAK/STAT inhibitors). On the other hand, it is much more important to know the risk factors and to prevent the development of AD. However, prevention studies of the disease have been few and slow.
Due to the complex pathogenesis and multifactorial nature of the disease, its treatment and control are still difficult. The fact that adult-onset cases have different phenotypic and clinical features, and are accompanied by different risk factors and comorbidities, makes the disease even more complicated. Differentiating adult-onset cases from cutaneous T-cell lymphoma, as well as the necessary lifelong follow-up for potential lymphoma development, is also of importance. In the treatment and management of the disease, age of onset, genotypic, phenotypic characteristics and risk factors should be considered. Here, strategies for the prevention of the disease in the light of the risk factors of the disease, as well as new and future targeting treatments with new developments in pathogenesis will be discussed.
Themes of Interest:
1. Pathogenesis
• Immune Dysregulation (Innate/Adaptive Immune System, TH2, TH1, TH9, TH22, TH17, Regulatory T cells)
• Skin Barrier Dysfunction (Filaggrin, Lipids, Tight Junctions, Skin pH)
• Skin Microbiome
• Genetics
• Itch-Inflammation (Neuroimmunologic Mechanisms)
• Phenotype and Endotypes in Childhood and Adulthood
2. Environmental Risk Factors
• Maternal Exposures During Pregnancy
• Irritants, Allergens and Pruritogens
• Hygiene Hypothesis
• Climate (Temperature, Humidity, UV Radiation, Latitude, Precipitation)
• Air Pollutants (Outdoor Pollutants, Indoor Pollutants)
• Tobacco Smoke Exposure
• Urban Versus Rural Setting
• Diet, Physical Exercise and Obesity
• Breastfeeding and Time of Weaning
3. Prevention
• Infant Feeding
• Modulating the Gut Flora (Probiotics and Prebiotics)
• Dietary Supplementation
• Preventing a Skin Barrier Breakdown
4. Treatment
• Conventional Treatments (Topical Corticosteroids, Calcineurin Inhibitors, Phototherapy and Systemic Immunosuppressants)
• New Agents
• Topical agents (Phosphodiesterase 4 (PDE4) Inhibitors, Topical Janus Kinase Inhibitors, Therapeutic Aryl Hydrocarbon Receptor modulating agents, Antimicrobial Agents: AMP and Topically Applied Commensal Organisms)
• Systemic Agents
• Dupilumab
• IL-13 and IL-31 Inhibitors
• Targeting Other Cytokines and Receptors: OX40, TSLP, IL-33, IL-36, IL-5, and the Th17/IL-22 pathway
• Oral Small Molecule Inhibitors
Disclosure: Dr. Andac Salman served as a medical advisor and/or participated in educational activities for Novartis, Sanofi, Pfizer and Eli Lilly.
Due to the complex pathogenesis and multifactorial nature of the disease, its treatment and control are still difficult. The fact that adult-onset cases have different phenotypic and clinical features, and are accompanied by different risk factors and comorbidities, makes the disease even more complicated. Differentiating adult-onset cases from cutaneous T-cell lymphoma, as well as the necessary lifelong follow-up for potential lymphoma development, is also of importance. In the treatment and management of the disease, age of onset, genotypic, phenotypic characteristics and risk factors should be considered. Here, strategies for the prevention of the disease in the light of the risk factors of the disease, as well as new and future targeting treatments with new developments in pathogenesis will be discussed.
Themes of Interest:
1. Pathogenesis
• Immune Dysregulation (Innate/Adaptive Immune System, TH2, TH1, TH9, TH22, TH17, Regulatory T cells)
• Skin Barrier Dysfunction (Filaggrin, Lipids, Tight Junctions, Skin pH)
• Skin Microbiome
• Genetics
• Itch-Inflammation (Neuroimmunologic Mechanisms)
• Phenotype and Endotypes in Childhood and Adulthood
2. Environmental Risk Factors
• Maternal Exposures During Pregnancy
• Irritants, Allergens and Pruritogens
• Hygiene Hypothesis
• Climate (Temperature, Humidity, UV Radiation, Latitude, Precipitation)
• Air Pollutants (Outdoor Pollutants, Indoor Pollutants)
• Tobacco Smoke Exposure
• Urban Versus Rural Setting
• Diet, Physical Exercise and Obesity
• Breastfeeding and Time of Weaning
3. Prevention
• Infant Feeding
• Modulating the Gut Flora (Probiotics and Prebiotics)
• Dietary Supplementation
• Preventing a Skin Barrier Breakdown
4. Treatment
• Conventional Treatments (Topical Corticosteroids, Calcineurin Inhibitors, Phototherapy and Systemic Immunosuppressants)
• New Agents
• Topical agents (Phosphodiesterase 4 (PDE4) Inhibitors, Topical Janus Kinase Inhibitors, Therapeutic Aryl Hydrocarbon Receptor modulating agents, Antimicrobial Agents: AMP and Topically Applied Commensal Organisms)
• Systemic Agents
• Dupilumab
• IL-13 and IL-31 Inhibitors
• Targeting Other Cytokines and Receptors: OX40, TSLP, IL-33, IL-36, IL-5, and the Th17/IL-22 pathway
• Oral Small Molecule Inhibitors
Disclosure: Dr. Andac Salman served as a medical advisor and/or participated in educational activities for Novartis, Sanofi, Pfizer and Eli Lilly.
Keywords: Dermatitis, Pathogenesis, Prevention, Risk Factors, Treatment
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