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Basics and recent advances in the pathophysiology of atopic dermatitis
Author(s) -
Nakahara Takeshi,
KidoNakahara Makiko,
Tsuji Gaku,
Furue Masutaka
Publication year - 2021
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.15664
Subject(s) - thymic stromal lymphopoietin , filaggrin , atopic dermatitis , inflammation , immunology , medicine , pathogenesis , skin barrier , pathophysiology , immune system , allergic inflammation , dermatology , pathology
Atopic dermatitis is a common, chronic inflammatory skin disease that is characterized by skin barrier dysfunction, inflammation and intense itch. Although the exact mechanisms behind its pathogenesis remain unclear, it is evident that the complex interplay among barrier dysfunction, inflammation and itch are critical in its development, progression and chronicity. Abnormalities in filaggrin, intercellular lipids and tight junctions induce barrier‐disrupted skin, which produces thymic stromal lymphopoietin, interleukin (IL)‐25 and IL‐33; these in turn promote skin inflammation characterized by type 2 immune deviation. This inflammation then downregulates the expression of filaggrin in keratinocytes and exacerbates epidermal barrier dysfunction. Furthermore, various itch mediators/pruritogens produced during this inflammatory process can act directly on sensory nerves and cause itch. In this review, we summarize the basics and recent advances in our understanding of the pathophysiology of atopic dermatitis focusing on three aspects: barrier dysfunction, skin inflammation and itch.