Reversal of BCAA-driven inflammatory senescence by traditional herbal oil prevents atopic dermatitis relapse

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease for which effective strategies for achieving sustained remission are lacking. Here, we investigated the efficacy and mechanisms of Liuweirunfu (LWRF) Oil, a traditional Chinese herbal formulation, in preventing AD relapse.

A randomized, controlled clinical trial demonstrated that topical LWRF Oil significantly reduced relapse rates and improved clinical outcomes in AD patients during remission (Chictr.org.cn registration number: ChiCTR2400084762). Metabolomic analysis revealed that LWRF Oil restored the skin metabolome by modulating branched-chain amino acid (BCAA) metabolism. Mechanistically, LWRF Oil reversed inflammatory senescence in a murine AD model by selectively enhancing BCAT1-mediated BCAA catabolism, leading to reduced expression of the senescence marker P21. Furthermore, LWRF Oil modulated Th2 cell responses, dampening their infiltration and activation in the skin.

Our findings indicate that LWRF Oil prevents AD relapse by restoring the skin metabolome, reversing BCAA-driven inflammatory senescence, and modulating Th2 cell responses, suggesting it is a safe and effective approach for long-term AD management.