Modern concepts of pathogenesis and therapy of atopic dermatitis in children


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Abstract

The article provides an overview of new data on the mechanisms of formation and approaches to the treatment of atopic dermatitis (AD) in children. Recent research indicates that the prevention of the formation of AD can be achieved through early intervention to ensure the safety and effectiveness of the skin barrier. In children with debut of AD, it is necessary to provide therapy that will effectively control both local and systemic effects of immune activation. Early optimal therapeutic intervention can improve long-term results of AD treatment, and reduce systemic sensitization to allergens which leads to the formation of comorbid allergic respiratory diseases and gastrointestinal diseases.

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About the authors

I. I Balabolkin

FSAI “Scientific Center of Children's Health" of RMH

V. A Bulgakova

FSAI “Scientific Center of Children's Health" of RMH

Email: irvilbulgak@mail.ru
MD, a pediatrician of the highest qualification category, with an additional specialization in Allergology and Immunology, Clinical Pharmacology; Chief Researcher

T. I Eliseeva

FSOEI “Institute of Russian Federal Security Service “

References

  1. Gauthier M., Ray A., Wenzel S.E. Evolving Concepts of Asthma. Am. J. Respir. Crit. Care Med. 2015;192(6):660-68.
  2. Simpson E.L., Chalmers J.R., Hanifin J.M., Thomas K.S., Cork M.J., McLean W.H.I., et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J. Allergy Clin. Immunol. 2014;134(4):818-23.
  3. Irvine A.D., McLean W.H., Leung D.Y. Filaggrin mutations associated with skin and allergic diseases. N. Engl. J. Med. 2011;365(14):
  4. Cole C., Kroboth K., Schurch N.J., Sandilands A., Sherstnev A., O'Regan G.M., Watson R.M., McLean W.H., Barton G.J., Irvine A.D., Brown S.J. Filaggrin-stratified transcriptomic analysis of pediatric skin identifies mechanistic pathways in patients with atopic dermatitis. J. Allergy Clin. Immunol. 2014;134(1):82-91.
  5. Мутации в гене филаггрина и атопический дерматит. Клиническая дерматология и венерология. 2014;3:58-62.
  6. Balabolkin I.I., Larkova I.A., Bulgakova V.A., Pinelis V.G., Gusar V.A., Janin I.S. Mutations in the gene filaggrin in patients with atopic dermatitis as a risk factor for the severity of the disease. Allergy. 2016;71(S102):300-1.
  7. Brauweiler A.M., Bin L., Kim B.E., Oyoshi M.K., Geha R.S., Goleva E., Leung D.Y. Filaggrin-dependent secretion of sphingomyelinase protects against staphylococcal alpha-toxin-induced keratinocyte death. J. Allergy Clin. Immunol. 2013;131:421-27.
  8. O'Regan G.M., Sandilands A., McLean W.H., et al. Filaggrin in atopic dermatitis. J. Allergy Clin. !mmunol. 2009;124:2-6.
  9. Ong P.Y., Ohtake T., Brandt C., Strickland I., Boguniewicz M., Ganz T., Gallo R.L., Leung D.Y. Endogenous antimicrobial peptides and skin infections in atopic dermatitis. N. Engl. J. Med. 2002;347(15):1151-60.
  10. Howell M.D., Wollenberg A., Gallo R.L., Flaig M., Streib J.E., Wong C., Pavicic T., Boguniewicz M., Leung D.Y. Cathelicidin deficiency predisposes to eczema herpeticum. J. Allergy. Clin. Immunol. 2006;117(4):836-41.
  11. Schlievert P.M., Strandberg K.L., Lin Y.C., Peterson M.L., Leung D.Y. Secreted Virulence Factor Comparison Between Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus, and its Relevance to Atopic Dermatitis. J. Allergy Clin. Immunol. 2010;125(1):39-49.
  12. Czarnowicki T., Krueger J.G., Guttman-Yassky E. Skin barrier and immune dysregulation in atopic dermatitis: an evolving story with important clinical implications. J. Allergy Clin. Immunol. Pract. 2014;2(4):371-79.
  13. Novak N. An update on the role of human dendritic cells in patients with atopic dermatitis. J. Allergy Clin. !mmunol. 2012;129:879-86.
  14. Gittler J.K., Krueger J.G., Guttman-Yassky E. Atopic dermatitis results in intrinsic barrier and immune abnormalities: implications for contact dermatitis. J. Allergy Clin. !mmunol. 2013;131:300-13.
  15. Werfel T. The role of leukocytes, keratinocytes, and allergen-specific !gE in the development of atopic dermatitis. J. !nvest. Dermatol. 2009;129:1878-91.
  16. Kaesler S., Volz T., Skabytska Y.Ю et al. Tolllike receptor 2 ligands promote chronic atopic dermatitis through !L-4-mediated suppression of !L-10. J. Allergy Clin. Immunol. 2014; 134:92-99.
  17. Eichenfield L.F., Tom W.L., Chamlin S.L., et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J. Am. Acad. Dermatol. 2014;70:338-51.
  18. Garmhausen D., Hagemann T., Bieber T., Dimitriou I., Fimmers R., Diepgen T., Novak N. Characterization of different courses of atopic dermatitis in adolescent and adult patients. Allergy. 2013;68:498-506.
  19. Tang T.S., Bieber T., Williams H. Does «autoreactivity» play a role in atopic dermatitis? J. Allergy Clin. Immunol. 2012;129:1209-15.
  20. Novak N., Simon D. Atopic dermatitis - from new pathophysiologic insights to individualized therapy. Allergy. 2011;66:830-39.
  21. Клиническая аллергология детского возраста с неотложными состояниями / Под ред. И.И Балаболкина., В.А. Булгаковой М., 2011. 264 с.
  22. Harskamp C.T., Armstrong A.W. Immunology of atopic dermatitis: novel insights into mechanisms and immunomodulatory therapies. Semin. Cutan. Med. Surg. 2013;32:132-39.
  23. Oldhoff J.M., Darsow U. Werfel T., Bihari I.C., Katzer K., Laifaoui J., Plötz S, Kapp A., Knol E.F., Bruijnzeel-Koomen C.A., Ring J., de Bruin-Weller M.S. No effect of anti-interleukin-5 therapy (mepolizumab) on the atopy patch test in atopic dermatitis patients. !nt. Arch. Allergy !mmunol. 2006;141:290-94.
  24. Sheinkopf L.E., Rafi A.W., Do L.T., Katz R.M., Klaustermeyer W.B. Efficacy of омализумаб in the treatment of atopic dermatitis: a pilot study. Allergy Asthma. Proc. 2008;29:530-37.
  25. Heil P.M., Maurer D., Klein B., Hultsch T., Stingl G. Omalizumab therapy in atopic dermatitis: depletion of !gE does not improve the clinical course - a randomized, placebo-controlled and double blind pilot study. J. Dtsch. Dermatol. Ges. 2010;8:990-98.
  26. Simon D., Hösli S., Kostylina G., Yawalkar N., Simon H.U. Anti-CD20 (rituximab) treatment improves atopic eczema. J. Allergy Clin. Immunol. 2008;121:122-28.
  27. Weisenseel P. Reich K. Paradoxical skin reactions under therapy with TNF-alpha antagonists. Z. Rheumatol. 2013;72(5):423-28.
  28. Puya R., Alvarez-Lopez M., Velez A., Casas Asuncion E., Moreno J.C. Treatment of severe refractory adult atopic dermatitis with ustekinumab. Int. J. Dermatol. 2012; 51:115-16.
  29. Navarini A.A., French I.E., Hofbauer G.F Interrupting IL-6-receptor signaling improves atopic dermatitis but associates with bacterial superinfection. J. Allergy Clin. Immunol. 2011;128:1128-30.
  30. Beck L.A., Thaci D., Hamilton J.D., Graham N.M., Bieber T., Rocklin R., Ming J.E., Ren H., Kao R., Simpson E., Ardeleanu M., Weinstein S.P., Pirozzi G., Guttman-YasskyE., Suárez-FariñasM., Hager M.D., Stahl N., Yancopoulos G.D., Radin A.R. Dupilumab treatment in adults with moderate-to-severe atopic dermatitis. N. Engl. J. Med. 2014;371:130-39.
  31. Rozenblit M., Suarez-Farinas M., Shemer A., Khattri S., Gilleaudeau P., Sullivan-Whalen M., Zheng X., Xu H., Cardinale I., Krueger J.G., Guttman-Yassky E. Residual genomic profile after cyclosporine treatment may offer insights into atopic dermatitis reoccurrence. J. Allergy Clin. Immunol. 2014;134(4):955-57.
  32. Wilson S.R., The L., Batia L.M., Beattie K., Katibah G.E., McClain S.P, Pellegrino M., Estandian D.M., Bautista D.M. The epithelial cell-derived atopic dermatitis cytokine TSLP activates neurons to induce itch. Cell. 2013;155:285-95.
  33. Wang W.L., Li H.Y., Zhang M.S., Gao P.S., He S.H., Zheng T., Zhu Z., Zhou L.F. Thymic stromal lymphopoietin: a promising therapeutic target for allergic diseases. Int. Arch. Allergy Immunol. 2013;160:18-26.
  34. Schmitt J., Langan S., Deckert S., Svensson A., von Kobyletzki L., Thomas K., Spuls P. Assessment of clinical signs of atopic dermatitis: a systematic review and recommendation. J. Allergy Clin. Immunol 2013;132:1337-47.

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