Atopic dermatitis: Pathophysiology, microbiota, and metabolome – A comprehensive review

• Published in: Microbiological research 2024-04, Vol.281, p.127595-127595, Article 127595
• Main Authors: Mohammad, Shahnawaz, Karim, Md. Rezaul, Iqbal, Safia, Lee, Jung Hyeok, Mathiyalagan, Ramya, Kim, Yeon Ju, Yang, Dong Uk, Yang, Deok Chun
• Format: Article
• Language: English
• Subjects: Atopic dermatitis; Child; Dermatitis, Atopic - etiology; Dermatitis, Atopic - pathology; Dermatitis, Atopic - therapy; Dysbiosis; Gut-skin microbial dysbiosis; Homeostasis; Humans; Inflammation; Metabolome; Metabolomics; Microbiota; Pathophysiology; Skin - microbiology
• ISSN: 0944-5013; 1618-0623
• DOI: 10.1016/j.micres.2023.127595

Atopic dermatitis (AD) is a prevalent inflammatory skin condition that commonly occurs in children. Genetics, environment, and defects in the skin barrier are only a few of the factors that influence how the disease develops. As human microbiota research has advanced, more scientific evidence has shown the critical involvement of the gut and skin bacteria in the pathogenesis of atopic dermatitis. Microbiome dysbiosis, defined by changed diversity and composition, as well as the development of pathobionts, has been identified as a potential cause for recurring episodes of atopic dermatitis. Gut dysbiosis causes "leaky gut syndrome" by disrupting the epithelial lining of the gut, which allows bacteria and other endotoxins to enter the bloodstream and cause inflammation. The same is true for the disruption of cutaneous homeostasis caused by skin dysbiosis, which enables bacteria and other pathogens to reach deeper skin layers or even systemic circulation, resulting in inflammation. Furthermore, it is now recognized that the gut and skin microbiota releases both beneficial and toxic metabolites. Here, this review covers a range of topics related to AD, including its pathophysiology, the microbiota-AD connection, commonly used treatments, and the significance of metabolomics in AD prevention, treatment, and management, recognizing its potential in providing valuable insights into the disease. •The skin inflammatory condition known as atopic dermatitis (AD), commonly presents in children with chronic, persistent, and itchy lesions.•Genetics, environment, immunological dysregulation, altered skin and gut microbiota, and other variables all play a role in the condition.•Emollients, anti-inflammatory therapies, and systemic immunosuppressants are often used for AD; but long-term use can cause severe side effects.•Precision medicine is important because of the highly diverse characteristics of atopic dermatitis.•The incorporation of microbiota-based therapies alongside conventional treatments may lead to better clinical outcomes.