How Do Classical Subtypes Correspond to Endotypes in Atopic Dermatitis?

Area of Science:

• Dermatology
• Immunology
• Genetics

Background:

• Atopic dermatitis (AD) is a complex skin condition with diverse patient presentations.
• Traditional AD classification relies on phenotypic characteristics, which may not fully capture underlying disease mechanisms.
• The heterogeneity of AD necessitates more precise methods for patient stratification.

Purpose of the Study:

• To review the concept of atopic dermatitis endotyping.
• To explore various stratification approaches, including cytokine profiles, barrier function, and biomarkers.
• To discuss the correlation between classical AD subtypes and emerging endotypes.

Main Methods:

• Literature review of recent findings on AD mechanisms and endotyping.
• Analysis of different endotype classification systems (cytokine-based, biomarker-based).
• Comparison of classical AD subtypes (extrinsic/intrinsic, racial, age-based) with proposed endotypes.

Main Results:

• Endotyping offers a more accurate patient characterization than phenotyping.
• Cytokine-based endotypes (Type 2, Type 1, Type 3 high) are particularly useful.
• Biomarker-based endotyping is emerging for individualized treatment strategies.

Conclusions:

• AD endotyping is crucial for developing personalized therapeutic choices.
• Aligning classical subtypes with endotypes will aid clinical understanding and application.
• Further research is needed to integrate endotyping into daily clinical practice for AD management.