BARRIER BREAKDOWN ACROSS SPECIES: TRANSLATIONAL LESSONS FROM ANIMAL MODELS TO ADVANCED ATOPIC DERMATITIS CARE: A REVIEW

Atopic dermatitis (AD) is a chronic inflammatory skin disorder with rising global prevalence, affecting both children and adults. It is marked by intense pruritus, xerosis, erythematous lesions, and skin barrier dysfunction, often leading to recurrent infections and impaired quality of life. The pathophysiology of AD is multifactorial, involving genetic predisposition, immune dysregulation, environmental triggers, and microbial imbalances, with Th2-driven inflammation as the key pathway. This review provides an overview of AD epidemiology, mechanisms, diagnostic criteria, and therapeutic strategies, while highlighting emerging treatments and future directions. A systematic analysis of recent literature shows that AD affects 2.1%–4.9% of adults globally, with higher prevalence among females and younger populations. Skin barrier impairment, dominant Th2 immune responses, and microbial dysbiosis are major drivers. Diagnostic tools such as SCORAD, EASI, and IGA are widely used, though disease assessment still varies. Conventional management relies on topical corticosteroids, calcineurin inhibitors, and systemic agents. Biologic therapies, particularly dupilumab, have transformed moderate-to-severe AD care, yet accessibility remains limited. Recently, novel approaches—including JAK inhibitors, microbiome-based therapies, gene therapy, and neuroimmune modulators—have shown promise in advancing personalized medicine. Despite significant therapeutic progress, AD remains a heterogeneous disease requiring a multifaceted, patient-centred approach. Long-term management challenges persist, particularly in tailoring treatments, ensuring safety, and addressing socioeconomic disparities. Future research should prioritize biomarker-guided therapy, identification of environmental triggers, and development of novel targeted strategies to improve disease control, patient outcomes, and overall quality of life.