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Filaggrin in atopic dermatitis
Abstract
The recent identification of loss-of-function mutations in the structural protein filaggrin as a widely replicated major risk factor for eczema sheds new light on disease mechanisms in eczema, a disease that had heretofore largely been considered to have a primarily immunologic etiopathogenesis. The filaggrin gene (FLG) mutation findings are consistent with a recently proposed unifying hypothesis that offers a mechanistic understanding of eczema pathogenesis synthesizing a heritable epithelial barrier defect and resultant diminished epidermal defense mechanisms to allergens and microbes, followed by polarized T(H)2 lymphocyte responses with resultant chronic inflammation, including autoimmune mechanisms. Although compelling evidence from genetic studies on FLG implicates perturbed barrier function as a key player in the pathogenesis of eczema in many patients, much is still unknown about the sequence of biologic, physicochemical, and aberrant regulatory events that constitute the transition from an inherited barrier defect to clinical manifestations of inflammatory eczematous lesions and susceptibility to related atopic disorders. The exact contribution of FLG to the wider atopic story, factors modifying FLG expression, and the role of other barrier proteins remain to be delineated. In this review we highlight recent advances in our understanding of the FLG genetics in the cause of eczema and related complex diseases.
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“Furthermore, the incidence and the prevalence of AD in Asian countries, such as China and Korea, where there are high-PM2.5 areas, are similar to those of European ancestry despite FLG mutations being more uncommon in Chinese and Korean ancestry (20, 67, 73, 74).”
From Particulate matter causes skin barrier dysfunction. (2021) · cites this paper as [74]
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Huang, H., Tao, K., Qin, Z., Guo, L., Fitzgerald, C., Fernández, J. R., & Pérez, E. (2024) · Archives of Microbiology & Immunology · doi:10.26502/ami.936500165 · Cited by 1
Nutrition and Disease: Atopic Dermatitis
Lim, J. J., Liu, M. H., & Chew, F. T. (2025) · Springer eBooks · doi:10.1007/978-3-031-32047-7_67-1 · Cited by 1
Skin microbiocenosis in children with atopic dermatitis
Zaynullina, O. N., Печкуров, Д. В., & Khismatullina, Z. R. (2017) · Kazan medical journal · doi:10.17750/kmj2017-597 · Cited by 1
Dermatite atopique de l’enfant, un traitement strictement symptomatique
Appay, M. (2020) · Actualités Pharmaceutiques · doi:10.1016/s0515-3700(20)30265-2 · Cited by 1
Severity assessment of atopic dermatitis in children
Yanchevskaya, E. Y., Башкина, О. А., & Макрем, Б. М. (2016) · Russian Journal of Skin and Venereal Diseases · doi:10.18821/1560-9588-2016-19-6-334-339 · Cited by 1
Сидоренко, О. А., Opruzhenkova, E. P., Grebennikov, V. A., Анисимова, Л. А., & Гребенникова, С. В. (2020) · Russian Journal of Clinical Dermatology and Venereology · doi:10.17116/klinderma202019051678 · Cited by 1
Prediction of Skin Irritation by Noninvasive Bioengineering Methods
Tupker, R. A. (2019) · Springer eBooks · doi:10.1007/978-3-319-68617-2_103 · Cited by 1
Immunology of Atopic Dermatitis
Byrne, A. M., & Leung, D. Y. M. (2011) · Harper's Textbook of Pediatric Dermatology · doi:10.1002/9781444345384.ch24 · Cited by 1
Skin Barrier Dysfunction in Atopic Dermatitis
Cork, M. J., Moustafa, M., Danby, S. G., Vasilopoulos, Y., Ahnini, R. T., Ward, S. J., Hadgraft, J., Lane, M. E., Guy, R. H., & MacGowan, A. (2009) · Basic and clinical dermatology · doi:10.3109/9781420070958.013 · Cited by 1
Management of Atopic Dermatitis
Boguniewicz, M., & Leung, D. Y. M. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4377-0271-2.00054-7 · Cited by 1
Metadata
- Authors
- O'Regan, G. M., Sandilands, A., McLean, W. H. I., & Irvine, A. D.
- Affiliations
- University of Dundee (GB)
- Trinity College Dublin (IE)
- Corresponding author
- Irvine, Alan D.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 122
- Issue
- 4
- Pages
- 689-693
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W4296927509
- Cited by
- 350
- References
- 25
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 13 · 2023: 14 · 2022: 20 · 2021: 20 · 2020: 29 · 2019: 22 · 2018: 9 · 2017: 15 · 2016: 14 · 2015: 11 · 2014: 17 · 2013: 23 · 2012: 25
- FWCI
- 37.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Skin and Cellular Biology Research
- Keywords
- filaggrin, FLG gene, atopic dermatitis, loss-of-function mutations, epithelial barrier function, chronic inflammation, autoimmune mechanisms, atopic diseases, genetic susceptibility
- MeSH terms
- Filaggrin Proteins, Animals, Chronic Disease, Dermatitis, Atopic, Eczema, Flagellin, Humans, Inflammation, Mutation, Autoimmunity, Th2 Cells
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