Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press622110.36691/RJA6221ReviewsНаучные обзорыReview ArticleSkin microbiome and modern treatment options for complicated forms of atopic dermatitisОсобенности микробиома кожи и современные возможности лечения осложнённых форм атопического дерматитаhttps://orcid.org/0000-0003-0006-27732497-5608ChernushevichDaria D.ЧернушевичДарья Дмитриевна
Russian Federation
chernushevitchdasha@yandex.ruhttps://orcid.org/0000-0002-4609-25919567-1894ElisyutinaOlga G.ЕлисютинаОльга Гурьевна
Russian Federation

MD, Dr. Sci. (Med)

д.м.н.

el-olga@yandex.ruhttps://orcid.org/0000-0003-3358-50875012-7242FedenkoElena S.ФеденкоЕлена Сергеевна
Russian Federation

MD, Dr. Sci. (Med)

д.м.н.

efedks@gmail.comNational Research Center ― Institute of ImmunologyГосударственный научный центр «Институт иммунологии»Peoples’ Friendship University of RussiaРоссийский университет дружбы народов240320230604202320163732202202310032023Copyright ©; 2023, Pharmarus Print MediaCopyright ©; 2023, Фармарус Принт Медиа2023Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/6221

Currently, atopic dermatitis is considered a systemic multifactorial disease, and its development involves various factors, mainly genetic disorders, epidermal barrier impairment, microbiome changes, allergen sensitization, and nonspecific environmental factors.

The microbial skin barrier in patients with atopic dermatitis has its characteristics due to changes in the species composition of the microflora toward contamination by conditionally pathogenic microorganisms, which have a significant effect on the disease course, leading to secondary skin infection and exacerbations. Microbes and allergens percutaneously penetrate the disrupted epidermal barrier, leading to sensitization to various proteins, including bacterial and fungal proteins, characterizing the t2 immune response.

The treatment of atopic dermatitis aims at achieving long-term control over the disease through an integrated approach, including external and systemic therapy.

В настоящее время атопический дерматит рассматривается как системное многофакторное заболевание, в развитии которого принимает участие множество факторов, основными из которых являются генетические нарушения, дисфункция эпидермального барьера, изменения микробиома, сенсибилизация к аллергенам и влияние неспецифических факторов окружающей среды.

Микробный барьер кожи у больных атопическим дерматитом имеет свои особенности, обусловленные изменением видового состава микрофлоры в сторону контаминации условно-патогенными микроорганизмами, которые в свою очередь оказывают существенное влияние на течение заболевания, приводя к вторичному инфицированию кожных покровов и развитию обострений. Через нарушенный эпидермальный барьер происходит чрескожное проникновение микробов и аллергенов, сенсибилизация к различным белкам, в том числе к белкам бактерий и грибов, характеризующая Т2-иммунный ответ.

Лечение атопического дерматита направлено на достижение долгосрочного контроля над заболеванием и предусматривает комплексный подход, включающий наружную и системную терапию.

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