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Atopic dermatitis endotypes and implications for targeted therapeutics.

Tali Czarnowicki1, Helen He2, James G Krueger3

  • 1Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.

The Journal of Allergy and Clinical Immunology
|January 8, 2019
PubMed
Summary

Atopic dermatitis (AD) presents diverse phenotypes and endotypes across patient groups. Personalized, precision medicine approaches are crucial for effective, tailored treatment of this complex skin condition.

Keywords:
African AmericanAsianAtopic dermatitisEuropean Americanendotypefilaggrinintrinsic and extrinsicphenotypeprecision medicinetargeted therapies

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Area of Science:

  • Immunology
  • Dermatology
  • Genetics

Background:

  • Atopic dermatitis (AD) is a complex skin condition with significant heterogeneity.
  • Current management often uses a "one-size-fits-all" approach, which is inadequate for diverse patient populations.

Purpose of the Study:

  • To highlight the importance of understanding AD heterogeneity for precision medicine.
  • To emphasize the need for endotype-driven therapeutic strategies.

Main Methods:

  • Review of recent research on atopic dermatitis phenotypes and endotypes.
  • Analysis of variability based on age, ethnicity, IgE levels, and filaggrin mutation status.

Main Results:

  • Atopic dermatitis exhibits distinct endotypes across different age groups, ethnicities, and genetic profiles (e.g., filaggrin mutations).
  • Patient subgroups include European American vs. Asian, children vs. adults, and IgE-high (extrinsic) vs. IgE-low (intrinsic) disease.

Conclusions:

  • The heterogeneity of atopic dermatitis necessitates a move away from generalized treatments.
  • Precision medicine, targeting specific endotypes, offers a path toward more effective prevention and treatment of AD.
  • Ongoing research into targeted therapies will further elucidate the role of specific pathways in disease perpetuation.