New Era of Therapeutics in Atopic Dermatitis

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  • Nakahara Takeshi
    Department of Dermatology, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • アトピー性皮膚炎治療の新時代 : 病態解明の進歩と新規治療薬の開発
  • アトピーセイ ヒフエン チリョウ ノ シン ジダイ : ビョウタイ カイメイ ノ シンポ ト シンキ チリョウヤク ノ カイハツ

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Description

Atopic dermatitis is a common, chronic inflammatory skin disease that is characterized by skin barrier dysfunction, inflammation and intense itch. Although the exact mechanisms behind its pathogenesis remain unclear, it is evident that the complex interplay among barrier dysfunction, inflammation and itch are critical in its development, progression and chronicity. Barrier-disrupted skin produces thymic stromal lymphopoietin and interleukin (IL)-33 ; these in turn promote skin inflammation characterized by type 2 immune deviation. This inflammation then downregulates the expression of filaggrin in keratinocytes and exacerbates epidermal barrier dysfunction. Furthermore, various itch mediators/pruritogens produced during this inflammatory process can act directly on sensory nerves and cause itch. Based on this understanding of the pathophysiology, many new drugs are being developed, and a new era of treatment is underway. Specifically, anti-IL-4 receptor antibody, anti-IL-31 receptor antibody, and JAK inhibitors are already available for use in clinical practice. Still, however, how to select the optimal drug remains a major challenge. In this review, we summarize the basics and recent advances in our understanding of the pathophysiology of atopic dermatitis, including our recent research findings. In addition, the status of development of new drugs is also outlined.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 113 (3), 45-52, 2022-09-25

    Fukuoka Medical Association

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