Beyond the Skin: Exploring the Gut-Skin Axis and Metabolic Pathways in Atopic Dermatitis Pathogenesis

Atopic dermatitis (AD), is a chronic, recurrent inflammatory skin condition characterized by eczema-like lesions, itching, and dryness. It often coexists with other atopic comorbidities, including food allergies (FA), allergic rhinitis (AR), and allergic asthma (AA). The pathogenesis of AD is complex and multifactorial, involving immune dysregulation, epidermal barrier disruption, and dysbiosis of intestinal and skin microbiota. Recent research has increasingly focused on the gut-skin axis, highlighting the role of intestinal microbiota and their metabolic products in regulating skin immunity and barrier function. Dietary changes and metabolic pathway modulation are emerging as promising therapeutic strategies. This article reviews recent advancements in AD research across three dimensions: gut microbiota, metabolomics, and comorbidities, while exploring potential therapeutic approaches to regulate gut microbiota and target metabolic pathways.