Evie Huang1, Peck Y Ong2. 1. Division of General Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA, 90027, USA. 2. Division of Clinical Immunology and Allergy, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. MS #75, Los Angeles, CA, 90027, USA. pyong@chla.usc.edu.
Abstract
PURPOSE OF REVIEW: Severe atopic dermatitis (AD) in childhood leads to significant morbidity including psychosocial problems and infectious complications. There are only a few approved treatment options for these patients. These include topical corticosteroids and tacrolimus ointment, which are associated with potential side effects. RECENT FINDINGS: In order to find better and safer treatments, further understanding of AD mechanisms is needed. Primary skin barrier defects play an important role in the pathogenesis of AD. In addition, the suppression of skin barrier functions by Th2 inflammation also plays an important role in the persistence and recurrence of AD. Cytokines in the Th2 pathway, which includes IL-4, IL-13, TSLP, IL-25, IL-31, and IL-33, are potential therapeutic targets in AD. Other potential targets of AD are Janus kinase, phospholipase A2, aryl hydrocarbon receptor, and skin microbiota. A better understanding of the pathogenesis of AD will provide future direction for treatment.
PURPOSE OF REVIEW: Severe atopic dermatitis (AD) in childhood leads to significant morbidity including psychosocial problems and infectious complications. There are only a few approved treatment options for these patients. These include topical corticosteroids and tacrolimus ointment, which are associated with potential side effects. RECENT FINDINGS: In order to find better and safer treatments, further understanding of AD mechanisms is needed. Primary skin barrier defects play an important role in the pathogenesis of AD. In addition, the suppression of skin barrier functions by Th2 inflammation also plays an important role in the persistence and recurrence of AD. Cytokines in the Th2 pathway, which includes IL-4, IL-13, TSLP, IL-25, IL-31, and IL-33, are potential therapeutic targets in AD. Other potential targets of AD are Janus kinase, phospholipase A2, aryl hydrocarbon receptor, and skin microbiota. A better understanding of the pathogenesis of AD will provide future direction for treatment.
Entities:
Keywords:
Eczema; Microbiome; Pathogenesis; Pediatric; S. aureus; Therapy
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