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Skin Barrier Dysfunction and Immune Dysregulation

AD is the result of immune dysregulation and skin-barrier dysfunction, leading to chronic inflammation.1,2

Inflammation in AD Skin Is Driven by an Outside-In/Inside-Out Process

  • Immune dysregulation involves the activation of type 2 T-helper (Th2) cells and subsequent inflammatory signaling2
  • Skin-barrier dysfunction results in inflammatory signaling due to antigen penetration of AD skin2
  • Resulting chronic inflammation further contributes to both skin-barrier dysfunction and immune dysregulation2
Graphic created by representing chronic inflammation in patients with skin-barrier dysfunction vs immune dysregulation.

Th2 cytokines are the key drivers of inflammation in AD for non-lesional, acute lesional, and chronic lesional skin.3

  1. Boguniewicz M, Leung DY. Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev. 2011;242(1):233-246.
  2. Guttman-Yassky E, Waldman A, Ahluwalia J, Ong PY, Eichenfield LF. Atopic dermatitis: pathogenesis. Semin Cutan Med Surg. 2017;36(3):100-103.
  3. Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;4(1):1-20.