Decade of Atopic Dermatitis Research Highlights Advances and Gaps in Treatment and Prevention
Dermatology Times highlighted significant research in atopic dermatitis (AD) over the past decade. Researchers Peter Arkwright and Jennifer Koplin reviewed 14,406 peer-reviewed publications on AD from the last 10 years, accounting for 46% of all AD-related articles since 1948. The research predominantly focused on treatment, with biologics comprising 33% of all publications. Prevention strategies, such as the use of moisturizers, probiotics, and breastfeeding, were also extensively studied, although findings have been mixed. While early studies suggested moisturizers might prevent AD, larger trials found no significant benefit. Similarly, research on probiotics and breastfeeding showed varied results, highlighting the need for more consistent and robust studies.
Staphylococcus Aureus Protease Drives Atopic Dermatitis Itch
Research has revealed that the pathogenesis of atopic dermatitis (AD) involves complex interactions between the host’s genetic factors, immune system, and microbiome. Notably, the overgrowth of Staphylococcus aureus on the skin of patients with AD plays a significant role in worsening the disease. The bacteria’s V8 protease activates protease-activated receptor 1 on sensory nerves, triggering itch and perpetuating the cycle of skin damage and inflammation.
New Guidelines for Managing Atopic Dermatitis With Topical Therapies
Updated evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These updated guidelines provide evidence-based recommendations for managing AD in adults using a variety of topical treatments. A multidisciplinary workgroup conducted a systematic review and used the GRADE approach to assess the certainty of evidence and to formulate and grade recommendations.
Study Links Atopic Dermatitis Itch to Bacteria, Not Inflammation, Suggesting New Treatment Pathways
Research revealed that the itching experienced by patients with atopic dermatitis may not be due to inflammation but instead caused by the bacterium Staphylococcus aureus and its impact on nerve cells. This novel finding challenges the common assumption that inflammation is the primary cause of itch in these patients. The study used a mouse model to test various bacteria and found that S. aureus caused itch, leading to an itch-scratch cycle, skin damage, and alloknesis, a hypersensitive response to gentle stimuli. The researchers discovered that the serine protease V8 from S. aureus triggers itch by activating the protein PAR1 on skin neurons, proposing that inhibiting V8-PAR1 signaling could be a new treatment strategy for itch.
The Pathogenesis of Atopic Dermatitis: Key Roles of Cytokines and Therapeutic Targets
The pathogenesis of atopic dermatitis (AD) is influenced by immune dysregulation, barrier dysfunction, and pruritus. Various immune cells, including Th2 cells, type 2 innate lymphoid cells (ILC2s), and basophils, produce Th2 cytokines (IL-4, IL-5, IL-13, IL-31) in lesional skin. Alarmins like TSLP, IL-25, and IL-33, from keratinocytes, amplify type 2 inflammation. In chronic AD, Th22 and Th17 cells further suppress filaggrin expression, worsening barrier function. Treatments like dupilumab (IL-4/IL-13 inhibitor) and nemolizumab (IL-31RA inhibitor) show efficacy in moderate-to-severe AD.
Study Reveals Gender Disparities in Atopic Dermatitis Symptoms and Impact on Quality of Life
A study involving 1,011 adolescent and adult patients from Germany and Switzerland highlighted significant gender differences in patients with atopic dermatitis (AD). Researchers discovered that while male patients exhibited more severe objective symptoms of AD, such as higher scores on the SCORing Atopic Dermatitis test and greater affected body surface area, female patients reported more severe subjective symptoms and equal impairments in quality of life. This discrepancy between objective and subjective measures of AD severity raises questions about sex-associated differences in the condition, which are currently not well understood.
The Role of Gut Microbiota in Atopic Dermatitis
Researchers of recent studies have highlighted the vital role of gut microbiota in the onset of atopic dermatitis (AD). Research underscores the influence of maternal diet and health on fetal development, with microbes in the vaginal tract interacting with the fetus, impacting prenatal growth. Notably, the Stool Microbiome and Allergic ReacTion (SMART) study in China identified delivery mode, feeding method, and intrapartum antibiotic use as significant influencers on the early-life gut microbiome, preceding AD development. Dysbiosis in the gut, particularly in infancy, has been consistently linked to AD, with certain bacterial species associated with increased risk, while short-chain fatty acids show protective effects.
Dermavant Seeks FDA Approval for Tapinarof Cream in Treating Young Patients With Atopic Dermatitis
Dermavant Sciences has submitted a supplemental new drug application to the FDA for VTMA (tapinarof) cream 1%, a treatment for atopic dermatitis (AD) in patients aged 2 years and older. VTMA cream, an aryl hydrocarbon receptor agonist, is already approved for treating adults with plaque psoriasis. This application is significant due to the growing prevalence of atopic dermatitis, particularly among children, and the need for new, long-term treatment options.
Atopic Dermatitis Treatment: Rapid Itch Relief With Emerging Therapies
Casey Butrus, PharmD, and Michael Cameron, MD, FAAD, discuss the effectiveness of various therapies for atopic dermatitis (AD). Topical ruxolitinib and oral JAK inhibitors, they note, provide rapid itch relief within days, while systemic therapies like dupilumab also offer fast relief. In contrast, older treatments, such as topical steroids, may have a slower onset of action since they don’t directly target specific itch pathways like newer medications.
Dermatology Pipeline Review: JAK Inhibitors and Skin Condition Treatments
This article provides an overview of the dermatology pipeline, reviewing medications for alopecia areata, atopic dermatitis, and plaque psoriasis, with a focus on JAK inhibitors for alopecia areata. Recent atopic dermatitis approvals include abrocitinib, upadacitinib, dupilumab, and tralokinumab, with lebrikizumab in phase 3 research. Promising plaque psoriasis treatments include deucravacitinib, bimekizumab, and various other options, including gene therapy.
