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Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? - 19/04/17

Doi : 10.1016/j.jaci.2017.01.008 
Thomas Bieber, MD, PhD, MDRA a, b, , Angelo M. D'Erme, MD c, d, Cezmi A. Akdis, MD b, e, Claudia Traidl-Hoffmann, MD b, f, Roger Lauener, MD b, g, Georg Schäppi, PhD b, Peter Schmid-Grendelmeier, MD b, h
a Department of Dermatology and Allergy, University of Bonn, Bonn, Germany 
b Christine Kühne–Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland 
c Unit of Dermatology, Livorno Hospital, Livomo, Italy 
d Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy 
e Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland 
f Institute for Environmental Medicine, Technische Universität München and Helmholtzzentrum München, Munich, Germany 
g Children's Hospital of Eastern Switzerland, St Gallen, and the University of Zurich, Zurich, Switzerland 
h Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland 

Corresponding author: Thomas Bieber, MD, PhD, MDRA, Department of Dermatology and Allergy, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.Department of Dermatology and AllergyUniversity of BonnSigmund-Freud-Strasse 25Bonn53105Germany

Abstract

Atopic dermatitis (AD) is a paradigmatic chronic inflammatory skin disease characterized by a complex pathophysiology and a wide spectrum of the clinical phenotype. Despite this high degree of heterogeneity, AD is still considered a single disease and usually treated according to the “one-size-fits-all” approach. Thus more tailored prevention and therapeutic strategies are still lacking. As for other disciplines, such as oncology or rheumatology, we have to approach AD in a more differentiated way (ie, to dissect and stratify the complex clinical phenotype into more homogeneous subgroups based on the endophenotype [panel of biomarkers]) with the aim to refine the management of this condition. Because we are now entering the era of personalized medicine, a systems biology approach merging the numerous clinical phenotypes with robust (ie, relevant and validated) biomarkers will be needed to best exploit their potential significance for the future molecular taxonomy of AD. This approach will not only allow an optimized prevention and treatment with the available drugs but also hopefully help assign newly developed medicinal products to those patients who will have the best benefit/risk ratio.

Le texte complet de cet article est disponible en PDF.

Key words : Atopic dermatitis, clinical phenotype, endophenotype, biomarkers, stratified medicine, precision medicine

Abbreviation used : AD


Plan


 Disclosure of potential conflict of interest: T. Bieber serves on the board for Sanofi/Regeneron, serves as a consultant for Sanofi/Regeneron, receives payments for lectures from Sanofi/Regeneron, and receives payment for educational presentation from Sanofi/Regeneron. A. M. D'Erme serves as a consultant for La Roche Posay. C. A. Akdis serves as a consultant form Actellion, Aventis, Stallergenes, Allergopharma, and Circacia; is an employee of the Swiss Institute of Allergy and Asthma Research, University of Zurich; receives grant support from Novartis, PREDICTA: European Commission's Seventh Framework Programme, the Swiss National Science Foundation Research, MeDALL: European Commission's Seventh Framework Programme, and the Christine Kühne–Center for Allergy Research (CK-CARE). C. Traidl-Hoffmann receives grants support from the CK-CARE Center of Allergy Research and Education. R. Lauener receives grant support and travel support from the Kühne Foundation; serves as a consultant for AstraZeneca; and receives support from Meda, Menarini, Nestlé, Vifor, and ALK-Abelló. P. Schmid-Grendelmeier serves as a consultant for Sanofi AG. The rest of the authors declare that they have no relevant conflicts of interest.


© 2017  American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 139 - N° 4S

P. S58-S64 - avril 2017 Retour au numéro
Article précédent Article précédent
  • Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines
  • Lawrence F. Eichenfield, Jusleen Ahluwalia, Andrea Waldman, Jenna Borok, Jeremy Udkoff, Mark Boguniewicz
| Article suivant Article suivant
  • The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies
  • Patrick M. Brunner, Emma Guttman-Yassky, Donald Y.M. Leung

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