Pathophysiology of AD
The complex pathophysiology of AD involves not only the visible signs and symptoms on the skin, but also the underlying, persistent inflammation that drives the symptoms.1-4
The AD Disease Process
- The causes of the abnormal skin barrier observed in AD are complex and are driven by a combination of genetic, environmental, and immunologic factors; these factors likely account for the heterogeneity of AD5
- An ongoing debilitating itch-scratch cycle that involves allergens, an altering of skin microbiome, skin barrier defects in non-lesional skin, and inflammation in lesional skin1-3, 5
- The pathophysiology underlying the inflammatory response in AD arises from an exceedingly complex cytokine-mediated intercellular communication network6
Atopic dermatitis is a result of immune dysregulation and skin barrier dysfunction.7,8
- Jakasa I, Verberk MM, Esposito M, Bos JD, Kezic S. Altered penetration of polyethylene glycols into uninvolved skin of atopic dermatitis patients. J Invest Dermatol. 2007;127(1):129-134.
- May RD, Fung M. Strategies targeting the IL-4/IL-13 axes in disease. Cytokine. 2015;75(1):89-116.
- Williams MR, Gallo RL. The role of the skin microbiome in atopic dermatitis. Curr Allergy Asthma Rep. 2015;15(65):1-10.
- Weidinger S, Novak N. Atopic dermatitis. Lancet 2016; 387(10023): 1109–22.
- Leung DY, Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol. 2014;134(4):769-779.
- Nygaard U, Vestergaard C, Deleuran M. Emerging treatment options in atopic dermatitis: systemic therapies. Dermatology. 2017;233(5):344-357.
- Boguniewicz M, Leung DY. Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev. 2011;242(1):233-246.
- Guttman-Yassky E, Waldman A, Ahluwalia J, Ong PY, Eichenfield LF. Atopic dermatitis : pathogenesis. Semin Cutan Med Surg. 2017;36(3):100-103.