Atopic eczema treatment now and in the future:Targeting the skin barrier and key immune mechanisms in human skin

• 作者: David C Bell Sara J Brown
• 来源期刊: 世界皮肤病学杂志
• 学科: 医学
• 关键词: ATOPIC ECZEMA Novel TREATMENT FILAGGRIN Skin BARRIER Immune DYSFUNCTION
• 年，卷（期）: 2017,（3）
• 页码范围: 42-51
• 页数: 10页
• 分类号: R

摘要

The skin facilitates a number of key roles but its functioning can be impaired by disease.Atopic eczema is a chronic inflammatory disease where the skin barrier has become leaky,and inflammation occurs.It affects up to 20%of children and 3%of adults worldwide,manifesting as red itchy patches of skin with varying severity.This review aims to investigate the leaky skin barrier and immune mechanisms from the perspective of potential novel treatments.The complexity of atopic eczema as a disease is what makes it difficult to treat.Genome-wide association studies have highlighted possible genetic variations associated with atopic eczema,however in some cases,individuals develop the disease without these genetic risk factors.Loss of function mutations in the filaggrin gene are one of these associations and this is plausible due to its key role in barrier function.The Th2 immune response is the link with regards to the immune mechanisms as atopic inflammation often occurs through increased levels of interleukin(IL)-4 and IL-13.Eczematous inflammation also creates susceptibility to colonisation and damage by bacteria such as Staphylococcus aureus.Potential novel treatments are becoming ever more specific,offering the hope of fewer side effects and better disease control.The best new treatments highlighted in this review target the immune response with human beta defensin 2,phosphodiesterase-4 inhibitors and monoclonal antibodies all showing promise.