The Neuroimmune Axis in Atopic Dermatitis: From Pathogenic Mechanisms to Targeted Neuroimmunotherapy

Area of Science:

• Immunology
• Neuroscience
• Dermatology

Background:

• Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itch and eczematous lesions.
• A dysregulated neuroimmune axis, involving peripheral nerves, skin barrier, and central processing, is central to AD pathogenesis and heterogeneity.

Purpose of the Study:

• To review the neuroimmune mechanisms driving atopic dermatitis.
• To highlight multi-omics and systems biology approaches in understanding AD.
• To summarize neuroimmune biomarkers and targeted therapies for precision medicine.

Main Methods:

• Synthesis of current knowledge on neuroimmune mechanisms in AD.
• Review of multi-omics, systems biology, neuroimaging, and microbiome profiling studies.
• Analysis of established and emerging neuroimmune-targeted therapies.

Main Results:

• Cytokines (e.g., IL-31, IL-4/IL-13) and neuropeptides (e.g., substance P) create itch-scratch and inflammation loops.
• Multi-omics approaches reveal insights into the gut-skin-brain axis and neuroimmune interactions in AD.
• Key neuroimmune biomarkers (e.g., NGF, IL-31, microbial signatures) show potential for diagnosis and monitoring.

Conclusions:

• The neuroimmune axis is a critical framework for understanding AD pathogenesis.
• Biomarker-guided precision medicine and neuroimmunotherapy offer potential for stratified and durable treatment strategies.
• Further validation of biomarkers and addressing safety, accessibility, and implementation challenges are necessary.