Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press159610.36691/RJA1596ReviewsНаучные обзорыReview ArticlePhenotypes of atopic dermatitisФенотипы атопического дерматитаhttps://orcid.org/0000-0001-5999-70852399-5783MacharadzeDali S.МачарадзеДали Шотаевна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д-р мед. наук, профессор

dalim_a@mail.ruPeoples’ Friendship University of RussiaРоссийский университет дружбы народов имени Патриса Лумумбы20092023181020232033543650201202308092023Copyright ©; 2023, Pharmarus Print MediaCopyright ©; 2023, Фармарус Принт Медиа2023Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1596

This review summarizes the current understanding of the phenotypes (clinical manifestations) of atopic dermatitis based on morphological and some laboratory diagnostic tools (total IgE level, sensitization status, filaggrin mutations). The author gives a chronology of the study of atopic dermatitis phenotypes, including the use of modern statistical methods (clusters). Recent studies have described unique phenotypes in patients with atopic dermatitis colonized by Staphylococcus aureus; in patients with atopic dermatitis and food allergies; in patients with herpes eczema, including a history of herpes infection. At the same time, it is quite obvious that phenotypes are determined by molecular mechanisms (endotype), which are associated with the age of patients, the severity of the disease, persistence, etc. Recently, publications have appeared that confirmed the features of the course of the disease in different ethnic groups (European-American and Asian phenotypes), including immunopathogenetic differences characteristic of different races of people.

Together, studies on the endo- and phenotypes of atopic dermatitis will help to better identify the most optimal approach to personalized treatment of these patients. Ultimately, such studies are important for developing a classification of atopic dermatitis phenotypes.

В обзоре обобщены современные представления о фенотипах (клинических проявлениях) атопического дерматита на основании морфологических и некоторых лабораторно-диагностических инструментов (уровень общего IgE, статус сенсибилизации, мутации филаггрина). Автор приводит хронологию по изучению фенотипов атопического дерматита, в том числе с использованием современных статистических методов (кластеры). По результатам последних исследований описаны уникальные фенотипы атопического дерматита при колонизации Staphylococcus aureus, наличии пищевой аллергии или осложнении герпесной инфекцией. В то же время совершенно очевидно, что фенотипы определяются молекулярными механизмами (эндотипом), которые связаны с возрастом больных, степенью тяжести заболевания, персистенцией и т.п. В последнее время появились публикации, которые подтвердили особенности течения заболевания в разных этнических группах (европейско-американский и азиатский фенотипы), включая иммунопатогенетические различия, характерные для разных рас людей.

В совокупности исследования по эндо- и фенотипам атопического дерматита помогут выбрать наиболее оптимальный подход к персонализированному лечению таких пациентов. В конечном счёте, такие исследования важны для разработки классификации фенотипов атопического дерматита.

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