Pathogenesis and therapies of atopic dermatitis

Abstract

Atopic dermatitis (AD) is a chronic skin disorder characterized by pruritus and recurrent eczematous lesions that are accompanied by T-helper (Th) 2-dominated inflammation. Etiology of AD is not yet completely understood, but it is multifactorial. The pathogenesis of AD is driven by three major pathological factors, namely, disruption of the skin barrier, an altered Th2 cell response and pruritus (itching).

To improve skin barrier functions, daily use of moisturizer products are required to increase moisture content in the stratum corneum, which further leads to the prevention of allergen invasion and relapse of dermatitis, as well as suppression of itching by recovering and maintaining skin barrier functions. Topical anti-inflammatory ointment such as topical corticosteroid and tacrolimus is essential to improve the dermatitis in AD. Dupilumab, which is a monoclonal antibody against interleukin (IL) -4 receptor α and inhibits down-stream signaling induced by IL-4 and IL-13, shows tremendous effectiveness on moderate to severe AD.