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Subtypes of atopic dermatitis: From phenotype to endotype

Allergology International, 2022-01, Vol.71 (1), p.14-24 [Peer Reviewed Journal]

2021 Japanese Society of Allergology ;Copyright © 2021 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved. ;ISSN: 1323-8930 ;EISSN: 1440-1592 ;DOI: 10.1016/j.alit.2021.07.003 ;PMID: 34344611

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  • Title:
    Subtypes of atopic dermatitis: From phenotype to endotype
  • Author: Tokura, Yoshiki ; Hayano, Satoshi
  • Subjects: Adult ; Asians ; Atopic dermatitis ; Blacks ; Child, Preschool ; Dermatitis, Atopic - classification ; Dermatitis, Atopic - genetics ; Dermatitis, Atopic - therapy ; Endotype ; Humans ; Intrinsic type ; Mutation ; Phenotype ; Skin - immunology ; Subtype ; Whites
  • Is Part Of: Allergology International, 2022-01, Vol.71 (1), p.14-24
  • Description: Atopic dermatitis (AD) is a heterogenous disorder and can be classified into different types. Stratification of subtypes may enable personalized medicine approaches. AD can be categorized into the IgE-high, extrinsic subtype and the IgE-normal, intrinsic subtype. While extrinsic AD is the major subtype possessing skin barrier impairment (high incidence of filaggrin mutations), intrinsic AD occupies about 20% of AD with female dominance and preserved barrier. Extrinsic AD exhibits protein allergy and food allergy, but intrinsic AD shows metal allergy possibly in association with suprabasin deficiency. In particular, accumulated knowledge of food allergy has more clearly characterized extrinsic AD. European American (EA) and Asian AD subtypes have been also proposed. Asian patients with AD are characterized by a unique blended immune dysregulation and barrier feature phenotype between EA patients with AD and those with psoriasis. In another ethnic study, filaggrin loss-of-function mutations are not prevalent in African American patients with AD, and Th1/Th17 attenuation and Th2/Th22 skewing were seen in these patients. Recent endotype classification provides new insights for AD and other allergic disorders. Endotype is defined as the molecular mechanisms underlying the visible features/phenotype. Endotype repertoire harbors activation of type 2 cytokines, type 1 cytokines, and IL-17/IL-22, impairment of epidermal barrier, and abnormalities of intercellular lipids. Classification of endotype has been attempted with serum markers. These lines of evidence indicate a need for personalized or precision medicine appropriate for each subtype of AD.
  • Publisher: England: Elsevier B.V
  • Language: English;Japanese
  • Identifier: ISSN: 1323-8930
    EISSN: 1440-1592
    DOI: 10.1016/j.alit.2021.07.003
    PMID: 34344611
  • Source: Freely Accessible Japanese Titles (ERDB Project)
    Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    DOAJ Directory of Open Access Journals
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