Cytokines and Epidermal Lipid Abnormalities in Atopic Dermatitis: A Systematic Review

Abstract

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease and presents a major public health problem worldwide. It is characterized by a recurrent and/or chronic course of inflammatory skin lesions with intense pruritus. Its pathophysiologic features include barrier dysfunction, aberrant immune cell infiltration, and alterations in the microbiome that are associated with genetic and environmental factors. There is a complex crosstalk between these components, which is primarily mediated by cytokines. Epidermal barrier dysfunction is the hallmark of AD and is caused by the disruption of proteins and lipids responsible for establishing the skin barrier. To better define the role of cytokines in stratum corneum lipid abnormalities related to AD, we conducted a systematic review of biomedical literature in PubMed from its inception to 5 September 2023. Consistent with the dominant TH2 skewness seen in AD, type 2 cytokines were featured prominently as possessing a central role in epidermal lipid alterations in AD skin. The cytokines associated with TH1 and TH17 were also identified to affect barrier lipids. Considering the broad cytokine dysregulation observed in AD pathophysiology, understanding the role of each of these in lipid abnormalities and barrier dysfunction will help in developing therapeutics to best achieve barrier homeostasis in AD patients.

Role of Ubiquitin-conjugating enzyme E2 (UBE2) in two immune-mediated inflammatory skin diseases: a mendelian randomization analysis

“…Likewise, AD affects up to 20% of the world population [ 4 ]. Both of them are characterized by pruritus and xerosis [ 3 , 5 ]. These skin manifestations severely affect the quality of life because of these skin manifestations.…”

Cholesterol Nanofiber Patches with Sustainable Oil Delivery Eliminate Inflammation in Atopic Skin

“…Importantly, cholesterol makes SC lipid bilayer more flexible, improving skin homeostasis and resulting in faster skin recovery . The relationship between cholesterol and atopic dermatitis still remains unclear, yet formulations containing cholesterol effectively treat atopic skin restoring skin barrier and reducing TEWL . An equimolar mixture of cholesterol, ceramides, and fatty acids applied topically on the skin accelerates skin repair .…”

“… 14 The relationship between cholesterol and atopic dermatitis still remains unclear, yet formulations containing cholesterol effectively treat atopic skin restoring skin barrier and reducing TEWL. 15 An equimolar mixture of cholesterol, ceramides, and fatty acids applied topically on the skin accelerates skin repair. 16 Cholesterol has been used only as a constituent of creams for atopic dermatitis applied topically to the skin.…”