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Atopic Dermatitis Learning Zone New

Expert opinion

Read time: 80 mins
Last updated:27th Jul 2021
Published:27th Jul 2021

Hear experts in the field of atopic dermatitis offer insight into clinician treatment decisions and how to support those living with the condition. They focus attention on key topics ranging from how the condition manifests to the cellular pathways involved and draw attention to ongoing research to ensure treatments are targeted and effective.

Moderate-to-severe atopic dermatitis pathophysiology

Watch Professor Seemal Desai (biography) draw on his experience to provide up-to-date knowledge as he talks about the pathophysiology of moderate-to-severe atopic dermatitis and associated treatment options.

What is the importance of epidermal hyperplasia in atopic dermatitis?


A combination of factors influences the development of epidermal hyperplasia in atopic dermatitis. Hear Professor Desai add insight into what is known of its pathogenesis. Further your understanding of the pathways involved in epidermal hyperplasia, knowledge which is key to providing targeted therapeutics and realising improvements for patients.

 

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Pruritis in atopic dermatitis

Professor Martin Steinhoff’s (biography) interest in atopic dermatitis is mainly around the pathophysiology and management of pruritis and understanding the neuroimmunology of the condition. Watch the videos below to hear him share expertise in these areas.

What is the burden of atopic dermatitis for patients?


Without getting into the skin of a patient with atopic dermatitis, can you truly understand the severity of pruritis? Professor Steinhoff emphasises the many ways in which the burden of itching can impact an individual’s life – from serious limitations on everyday activities to life-changing psychological impact. You may identify with what you’ve have encountered in your own clinical practice as you hear about patients describing pruritis as the symptom for which they require most urgent help.

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Emerging treatments in moderate-to-severe atopic dermatitis

Watch Professor Thomas Bieber (biography) talk about emerging treatments for moderate-to-severe atopic dermatitis.

What notable emerging topical and systemic agents are currently in the pipeline?


Will the battle between biologics and small molecules benefit patients? Expand your knowledge on the pipeline of biologics and JAK inhibitors that are currently in development for moderate-to-severe atopic dermatitis, including tralokinumab, lebrikizumab, upadacitinib, and abrocitinib.

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Unmet needs and treatment goals in atopic dermatitis

In this expert interview with Professor Michael Cork (biography) discover the impact of atopic dermatitis and the unmet needs that remain in treating this disease with topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI).

What impact can atopic dermatitis have on patients?

From interfering with work to negatively affecting sleep and mental health, see the profound impact on the lives of patients with atopic dermatitis.

What are the unmet needs in treating atopic dermatitis?

 

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PDE4 inhibition in atopic dermatitis

Explore how the phosphodiesterase-4 (PDE4) enzyme fits into the pathophysiology of atopic dermatitis with our expert Michael Cork, Professor of Dermatology at the University of Sheffield. Also learn about its potential as a therapeutic target and glimpse into the future with a look into upcoming clinical trials comparing PDE4 inhibitors to topical corticosteroids (TCS).

How is PDE4 involved in the pathophysiology of atopic dermatitis?

Professor Cork describes the central role of the PDE4 enzyme in regulating the release of a variety of inflammatory cytokines involved in the development of atopic dermatitis.


The pathophysiology of atopic dermatitis is complex and multifaceted, involving various elements such as skin barrier dysfunction, alterations to immune responses and environmental factors (Figure 1). Learn how elevated levels of PDE4 play a key role in the development of atopic dermatitis.

 

Expert op_AD_Fig1

Figure 1: cAMP is present at high levels within a variety of cells with PDE4 regulating its breakdown. However, it has been shown that patients with atopic dermatitis display elevated levels of PDE4 in circulating inflammatory cells, resulting in a reduction in cAMP and an increase in the production of a variety of proinflammatory cytokines such as IL-4, IL-5 and IL-17. Adapted from: Purushothaman et al. 20185. AC, Adenylyl cyclase; ATP, adenosine triphosphate; AMP, adenosine monophosphate; cAMP, cyclic adenosine monophosphate; IgE, immunoglobulin E; IL, interleukin; PDE4, phosphodiesterase-4.

 

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References

  1. Paller AS, Mcalister RO, Doyle JJ, Jackson A. Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr (Phila). 2002;41(5):323–332.
  2. Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, et al. Topical corticosteroid phobia in atopic dermatitis: A study of its nature, origins and frequency. Br J Dermatol. 2011;165(4):808–814.
  3. Lee JY, Her Y, Kim CW, Kim SS. Topical corticosteroid phobia among parents of children with atopic eczema in Korea. Ann Dermatol. 2015;27(5):499–506.
  4. Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatology Venereol. 2018;32(5):657–682.
  5. Purushothaman B, Arumugam P, Kulsi G, Song JM. Design, synthesis, and biological evaluation of novel catecholopyrimidine based PDE4 inhibitor for the treatment of atopic dermatitis. Eur J Med Chem. 2018;145:673–690.
  6. Oswald K. Atopic dermatitis: dupilumab and crisaborole could herald a new era in treatment. Pharm J. 2017;298(7898). doi:10.1211/pj.2017.20202337.
  7. Paller AS, Tom WL, Lebwohl MG, Blumenthal RL, Boguniewicz M, Call RS, et al. Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. J Am Acad Dermatol. 2016;75(3):494-503.e6.
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