Cited by 266Dermatology and Skin DiseasesContact Dermatitis and AllergiesAdvancements in Transdermal Drug Delivery

Multifactorial skin barrier deficiency and atopic dermatitis: Essential topics to prevent the atopic march

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Egawa, Gyohei, Kabashima, Kenji·2016·Journal of Allergy and Clinical Immunology

Abstract

Atopic dermatitis (AD) is the most common inflammatory skin disease in the industrialized world and has multiple causes. Over the past decade, data from both experimental models and patients have highlighted the primary pathogenic role of skin barrier deficiency in patients with AD. Increased access of environmental agents into the skin results in chronic inflammation and contributes to the systemic "atopic (allergic) march." In addition, persistent skin inflammation further attenuates skin barrier function, resulting in a positive feedback loop between the skin epithelium and the immune system that drives pathology. Understanding the mechanisms of skin barrier maintenance is essential for improving management of AD and limiting downstream atopic manifestations. In this article we review the latest developments in our understanding of the pathomechanisms of skin barrier deficiency, with a particular focus on the formation of the stratum corneum, the outermost layer of the skin, which contributes significantly to skin barrier function.

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Integrity signals

Registry

Crossref · 10.1016/j.jaci.2016.06.002

Cites

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  • The pathogenesis of atopic dermatitis appears to result from a complex interaction between defects in skin barrier function, immune dysregulation, and environmental and infectious agents.

    “The pathogenesis of AD is not completely understood, however, the disorder appears to result from the complex interaction between defects in skin barrier function, immune dysregulation, and environmental and infectious agents [4, 5, 10].”

    From Atopic dermatitis (2018) · cites this paper as [4]

    The Abstract and ‘Immunologic Modulation of Skin Integrity’ describe interactions among skin-barrier defects, environmental antigens, and immune dysregulation in AD pathogenesis. ‘Tight Junctions in AD Pathogenesis’ describes viral infections as complications of AD, not as agents contributing to its pathogenesis, so that part of the claim is not supported. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • Atopic dermatitis is a primary skin barrier defect that facilitates the development of other atopic conditions.

    “Current evidence suggests that AD is a primary skin barrier defect that facilitates the development of other atopic conditions [4, 5].”

    From Atopic dermatitis (2018) · cites this paper as [4]

  • Skin inflammation decreases FLG and LOR expression and disrupts epidermal barrier function; barrier dysfunction augments skin inflammation.

    “Skin inflammation decreases FLG and LOR expression and disrupts epidermal barrier function; moreover, in the opposite direction, barrier dysfunction augments skin inflammation [12,13,26].”

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Authors
Egawa, G., & Kabashima, K.
Affiliations
  • Kyoto University (JP)
  • Agency for Science, Technology and Research (SG)
Corresponding author
  • Egawa, Gyohei
  • Kabashima, Kenji
Venue
Journal of Allergy and Clinical Immunology
Publisher
Elsevier BV
Published
2016-08
Volume
138
Issue
2
Pages
350-358.e1
ISSN
0091-6749 (ISSN-L)
OpenAlex
W2474553364
Cited by
265
References
112
Citations by year
2026: 20 · 2025: 23 · 2024: 27 · 2023: 27 · 2022: 28 · 2021: 41 · 2020: 29 · 2019: 11 · 2018: 30 · 2017: 26 · 2016: 3
FWCI
3.34
Type
journal article
Language
en
Open access
Locations
  • Journal of Allergy and Clinical Immunology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Ministry of Education, Culture, Sports, Science and Technology
Topics
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advancements in Transdermal Drug Delivery
Keywords
atopic dermatitis, atopic march, stratum corneum formation, skin barrier function, skin inflammation, environmental allergens, chronic inflammation
MeSH terms
Filaggrin Proteins, Animals, Dermatitis, Atopic, Desmosomes, Epidermis, Humans, Hypersensitivity, Intermediate Filament Proteins, Skin, Tight Junctions, Disease Management, Lipid Metabolism, Immunomodulation

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