Atopic Dermatitis Itch: Scratching for an Explanation

Advancements in artificial intelligence for atopic dermatitis: diagnosis, treatment, and patient management

Atopic dermatitis (AD) is a common and complex skin disease that significantly affects the quality of life of patients. The latest advances in artificial intelligence (AI) technology have introduced new methods for diagnosing, treating, and managing AD. AI has various innovative applications in the diagnosis and treatment of atopic dermatitis, with particular emphasis on its significant benefits in medical diagnosis, treatment monitoring, and patient care. AI algorithms, especially those that use deep learning techniques, demonstrate strong performance in recognizing skin images and effectively distinguishing different types of skin lesions, including common AD manifestations. In addition, artificial intelligence has also shown promise in creating personalized treatment plans, simplifying drug development processes, and managing clinical trials. Despite challenges in data privacy and model transparency, the potential of artificial intelligence in advancing AD care is enormous, bringing the future to precision medicine and improving patient outcomes. This manuscript provides a comprehensive review of the application of AI in the process of AD disease for the first time, aiming to play a key role in the advancement of AI in skin health care and further enhance the clinical diagnosis and treatment of AD.

Electroacupuncture exerts antipruritic and anti-inflammatory effects on atopic dermatitis by activating CB2 receptor

BACKGROUND

The therapeutic benefits of electroacupuncture (EA) for atopic dermatitis (AD) are recognized, yet the underlying mechanisms remain elusive. Given the side effects associated with clinical CB2 receptor (CB2R) agonists used in AD treatment, our study seeks to elucidate EA's role in modulating CB2R in lesional skin and its impact on antipruritic and anti-inflammatory responses using an AD mouse model.

METHODS

The AD model was induced with MC903, and EA was applied to'Qu chi'(LI11) and'He gu'(LI4) acupoints, corresponding to the neck dermatome. Mice were assessed for scratching behavior and scoring atopic dermatitis score every other day. Immunohistochemistry and immunofluorescence evaluated epidermal thickness, inflammatory cell infiltration, and CB2R expression. Meanwhile, RT-qPCR detected the expression of inflammatory factors, their receptors, and cannabinoid metabolizing enzymes. The study used both wild-type and CB2R knockout (CB2R-/-) mice to clarify CB2R's role in EA's treatment of AD.

RESULTS

EA treatment effectively mitigated chronic itching and AD-like symptoms, especially the proliferation of mast cells and CD4+ T cells. Additionally, EA treatment was found to reduce the expression of IL4, IL13, and IL31 in the skin lesions, as well as the expression of their receptors IL4R and IL31R in the dorsal root ganglia of the neck, contributing to its anti-inflammatory action. Moreover, EA augmented the expression of CB2R and regulated endocannabinoid metabolic enzymes. Furthermore, using CB2R-/- mice, it was found that the antipruritic and anti-inflammatory effects of EA were impaired. EA inhibited ERK phosphorylation in lesional skin, which was also reversed in CB2R-/- mice.

CONCLUSION

EA exerts therapeutic effects on persistent itch and skin inflammation in AD mice by activating CB2R, thereby inhibiting mast cell and CD4+ T cell proliferation and the expression of associated inflammatory factors, as well as downstream ERK phosphorylation.

Stratum corneum pH and ceramides: Key regulators and biomarkers of skin barrier function in atopic dermatitis

The skin, as the outermost layer of the body, serves as a crucial protective barrier against environmental insults while maintaining homeostasis. Atopic dermatitis (AD), a chronic inflammatory skin disorder characterized by recurrent eczema and type 2 inflammation, affects a significant global population. The pathophysiology of AD is closely linked to skin barrier dysfunction, which contributes to increased permeability, immune dysregulation, and microbial imbalances. Historically, skin barrier research has centered on the stratum corneum (SC) and intercellular lipids within the epidermis, primarily conceptualized through the "brick-and-mortar" model. However, recent advancements have revealed a more intricate interplay among various barrier components. Two key determinants of skin barrier-SC pH and SC ceramides-have gained substantial attention. Elevated SC pH leads to enhanced serine protease activity, impaired lipid metabolism, and microbiome dysbiosis, all of which exacerbate barrier dysfunction and inflammation in AD. Concurrently, alterations in SC ceramide profiles and structures compromise skin barrier function. Emerging evidence underscores the potential of SC pH and ceramides as biomarkers for disease progression and as therapeutic targets for barrier restoration. Advances in lipid analyses and non-invasive pH assessment offer promising prospects for personalized dermatologic interventions. This review explores the complex interactions of SC pH and ceramides in AD pathogenesis, discussing their implications for predicting disease flares, guiding treatment strategies, and identifying novel drug targets. A deeper understanding of these mechanisms could pave the way for next-generation therapeutic approaches in AD and other skin barrier-related disorders.

Prim-O-glucosylcimifugin mitigates atopic dermatitis by inhibiting Th2 differentiation through LCK phosphorylation modulation

OBJECTIVE

To assess the safety and topical efficacy of prim-O-glucosylcimifugin (POG) and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis (AD).

METHODS

The effects of POG on human keratinocyte cell viability and its anti-inflammatory properties were evaluated using cell counting kit-8 assay and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Subsequently, the impact of POG on the differentiation of cluster of differentiation (CD) 4+ T cell subsets, including T-helper type (Th) 1, Th2, Th17, and regulatory T (Treg), was examined through in vitro experiments. Network pharmacology analysis was used to elucidate POG's therapeutic mechanisms. Furthermore, the therapeutic potential of topically applied POG was further evaluated in a calcipotriol-induced mouse model of AD. The protein and transcript levels of inflammatory markers, including cytokines, lymphocyte-specific protein tyrosine kinase (Lck) mRNA, and LCK phosphorylation (p-LCK), were quantified using immunohistochemistry, RT-qPCR, and Western blot analysis.

RESULTS

POG was able to suppress cell proliferation and downregulate the transcription of interleukin 4 (Il4) and Il13 mRNA. In vitro experiments indicated that POG significantly inhibited the differentiation of Th2 cells, whereas it exerted negligible influence on the differentiation of Th1, Th17 and Treg cells. Network pharmacology identified LCK as a key therapeutic target of POG. Moreover, the topical application of POG effectively alleviated skin lesions in the calcipotriol-induced AD mouse models without causing pathological changes in the liver, kidney or spleen tissues. POG significantly reduced the levels of Il4, Il5, Il13, and thymic stromal lymphopoietin (Tslp) mRNA in the AD mice. Concurrently, POG enhanced the expression of p-LCK protein and Lck mRNA.

CONCLUSION

Our research revealed that POG inhibits Th2 cell differentiation by promoting p-LCK protein expression and hence effectively alleviates AD-related skin inflammation. Please cite this article as: Zhao H, Ma X, Wang H, Ding XJ, Kuai L, Song JK, Zhang Z, Yang D, Gao CJ, Li B, Zhou M. Prim-O-glucosylcimifugin mitigates atopic dermatitis by inhibiting Th2 differentiation through LCK phosphorylation modulation. J Integr Med. 2025; Epub ahead of print.

Epidermal Mechanical Scratching-Induced ROS Exacerbates the Itch-Scratch Cycle through TRPA1 Activation on Mast Cells in Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by the itch-scratch cycle. Itching, induced by irritants or allergens that stimulate pruriceptive neurons, triggers uncontrollable mechanical scratching, leading to epidermal barrier disruption, immune response activation, inflammatory mediator release, and further stimulation of pruritus conduction. Although oxidative stress and immune cells can exacerbate this cycle, the correlation between mechanical scratching, epidermal oxidative stress, and dermal mast cell activation in AD remains unclear. In this study, by examining clinical specimens of AD, establishing a 3-dimensional coculture system of HaCaT and LAD2 cells, and utilizing a mechanical scratching mouse model of AD, we found that ROS produced by mechanically stimulated HaCaT can activate TRPA1 on mast cells presenting tryptase. Implementing a free radical scavenger and TRPA1 inhibitor can inhibit mast cell activation and type II inflammatory response, thereby alleviating itching and skin lesions in AD. These results indicate that active oxygen scavenging combined with TRPA1 inhibition can inhibit the itch-scratch cycle, which may present a potential approach for treatment of AD.

Microneedles as transdermal drug delivery system for enhancing skin disease treatment

Microneedles (MNs) serve as a revolutionary paradigm in transdermal drug delivery, heralding a viable resolution to the formidable barriers presented by the cutaneous interface. This review examines MNs as an advanced approach to enhancing dermatological pathology management. It explores the complex dermis structure and highlights the limitations of traditional transdermal methods, emphasizing MNs' advantage in bypassing the stratum corneum to deliver drugs directly to the subdermal matrix. The discourse outlines the diverse typologies of MNs, including solid, coated, hollow, hydrogel, and dissolvable versions. Each type is characterized by its unique applications and benefits. The treatise details the deployment of MNs in the alleviation of cutaneous cancers, the administration of inflammatory dermatoses such as psoriasis and atopic dermatitis, and their utility in wound management. Additionally, the paper contemplates the prospects of MNs within the realm of aesthetic dermatology and the burgeoning market traction of cosmetic MN formulations. The review summarizes the scientific and commercial challenges to the clinical adoption of MN therapeutics, including dosage calibration, pharmacodynamics, biocompatibility, patient compliance, sterilization, mass production, and regulatory oversight. It emphasizes the need for ongoing research, innovation, and regulatory harmonization to overcome these obstacles and fully realize MNs' potential in treating skin diseases and improving patient welfare.

Updated insights into the molecular pathogenesis of canine atopic dermatitis

Atopic dermatitis (AD) is a common and chronic inflammatory skin disease with frequent relapses. The genomics revolution has greatly contributed and revolutionised our knowledge of human AD; understanding the molecular skin fingerprint of AD and associated pathogenic immune pathways has led to preclinical assessments of several novel treatments. Initial studies using microarray analysis to analyse transcriptome (gene expression) changes provided relevant insight on the inflammatory and structural changes occurring at the time of acute or chronic AD skin lesions, or after immunomodulating treatments with drugs ciclosporin and dupilumab, a monoclonal antibody anti-IL4 receptor. The studies revealed that human AD is characterised by the activation of multiple cytokine pathways (predominance of T helper cell [Th]2 with some activation of Th1, Th17 and Th22) as well as dysregulated expression of barrier components in the skin. There are several reports on the expression of different single molecular targets (e.g. interleukin [IL]-13, CCL17 and periostin) in spontaneous canine AD (cAD). However, significant studies of the transcriptome have been limited to a single microarray study analysing chronic AD skin lesions in dogs. While revealing a large number of genes differentially expressed in cAD skin, the small sample size (n = 13 dogs) and the lack of changes in key epidermal barrier and inflammatory cytokine genes in the microarrays have inhibited discussion towards specific immunological changes. This review summarises the current literature regarding the molecular mechanisms of spontaneous cAD, including the recent data regarding RNA sequencing, and compares some pathogenic aspects to the previously published data from human AD.