Vestnik dermatologii i venerologiiVestnik dermatologii i venerologiiВестник дерматологии и венерологии0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov1696310.25208/vdv16963REVIEWSОБЗОР ЛИТЕРАТУРЫENDOTYPES OF ATOPIC DERMATITIS: CURRENT UNDERSTANDING AND PERSPECTIVESЭНДОТИПЫ АТОПИЧЕСКОГО ДЕРМАТИТА: СОВРЕМЕННОЕ ПОНИМАНИЕ И ПЕРСПЕКТИВЫhttps://orcid.org/0000-0002-7689-83506938-4768DrozhdinaMariannaДрождинаМарианна Борисовна
Russian Federation

Professor, PhD, MD, Professor of the department od dermatovenereology and cosmetology of Kirov state medical University

Доцент, доктор медицинских наук, доцент кафедры дерматовенерологии и косметологии Кировского ГМУ

drozhdina@yandex.ruhttps://orcid.org/0000-0001-7610-6061236692410006807-7137SokolovskiyEvgeny V.СоколовскийЕвгений Владиславович
Russian Federation

Professor, MD, PhD

Head, Department of Dermatovenereology

Доктор медицинских наук

Профессор

Зав. кафедрой дерматовенерологии с клиникой

s40@mail.ruhttps://orcid.org/0009-0008-8241-09064614-1812SuslovaElena ViktorovnaСусловаЕлена Викторовна
Russian Federation

Кандидат медицинских наук

Заведующая отделением косметологии

врач-дерматовенеролог

ev780464@gmail.comFSBEI HE Kirov SMU MOH RussiaФГБОУ ВО Кировский ГМУ Минздрава РоссииFederal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare, St. Petersburg, RussiaФГБОУ ВО ПСПБГМУ им. И.П. Павлова Минздрава России, Санкт-ПетербургLLC "Medica"ООО "Медика"2905202610221202202613052026Copyright ©; , Drozhdina M., Sokolovskiy E.V., Suslova E.V.Copyright ©; , Дрождина М.Б., Соколовский Е.В., Суслова Е.В.Drozhdina M., Sokolovskiy E.V., Suslova E.V.Дрождина М.Б., Соколовский Е.В., Суслова Е.В.https://creativecommons.org/licenses/by-nc/4.0https://vestnikdv.ru/jour/article/view/16963

Atopic dermatitis (AD) is currently a heterogeneous disease with diverse immunological endotypes. Modern methods of high-resolution molecular analysis have made it possible to identify the key endotypes of the disease: Th2/ILC 2-dominant, Th22-associated, Th17/Th1-mixed and late onset with low IgE levels. This review provides a detailed analysis of the pathogenetic mechanisms of each endotype, the main cellular mechanisms and their direct effect on the epidermal barrier and neuroimmune interactions. The main attention is paid to substantiating the choice of targeted biological therapy and small molecules depending on the dominant pathway. Options for dividing patients into groups using serum biomarkers (TARC/CCL17, IL-22, IL-17) and a transcriptomic profile of the skin are considered. Endotype-based personalization of therapy may become a new approach in patients with severe and resistant AD.

Атопический дерматит (АД) в настоящее время является гетерогенным заболеванием с многообразными иммунологическими эндотипами. Современные методы высокоразрешающего молекулярного анализа позволили идентифицировать ключевые эндотипы заболевания: Th2/ILC2-доминантный, Th22-ассоциированный, Th17/Th1-смешанный и поздний дебют с низким уровнем IgE. В данном обзоре представлен детальный анализ патогенетических механизмов каждого эндотипа, основные клеточные механизмы и их прямое влияние на эпидермальный барьер и нейроиммунные взаимодействия. Основное внимание уделено обоснованию выбора таргетной биологической терапии и малых молекул в зависимости от доминирующего пути. Рассмотрены варианты разделения пациентов на группы с использованием сывороточных биомаркеров (TARC/CCL17, IL-22, IL-17) и транскриптомного профиля кожи. Персонализация терапии с учетом эндотипа может стать новым подходом у пациентов с тяжелым и резистентным течением АД.

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