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Abrocitinib versus dupilumab: Impact on skin barrier function and proteomics in atopic dermatitis
Jui-Wen Chang1, Xiaobao Huang2, Wenjing Jiang1
1Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Background:
The comparative impact of dupilumab and abrocitinib on skin barrier function and associated proteomics in atopic dermatitis (AD) remains not fully identified.
Objective:
To investigate the effects of dupilumab versus abrocitinib on skin barrier function and proteomic profiles in AD.
Methods:
In this study, 33 patients with moderate-to-severe AD were randomized into 2 groups: 16 received dupilumab and 17 received abrocitinib. Clinical outcomes and skin barrier parameters (transepidermal water loss and hydration) were assessed at baseline, 4 weeks, and 12 weeks. Skin tape strips were collected for four-dimensional data-independent acquisition-based proteomics.
Results:
Both therapies improved skin barrier function, with abrocitinib achieving superior reductions in transepidermal water loss in nonlesional skin (P = .0168). Proteomic analysis revealed differentially expressed proteins predominantly associated with ceramide metabolism, neurobiology, and keratinocyte biology in AD. Key potential biomarkers were identified: arginase 1 and proteasome subunit beta type-6 in lesional skin, alongside grancalcin and phospholipase D3 in nonlesional skin. Abrocitinib enhanced the expression of crucial barrier proteins, such as filaggrin-2 and loricrin, in lesional skin-an effect not observed with dupilumab.
Limitations:
The cohort size is small.
Conclusion:
While both abrocitinib and dupilumab effectively restore skin barrier function in AD, they exhibit distinct proteomic impacts.
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