Atopic Dermatitis - Current Research

Researchers supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and other institutes of the National Institutes of Health are gaining a better understanding of what causes atopic dermatitis and how it can be managed, treated, and, ultimately, prevented. Some promising avenues of research are described below.

Genetics: Although atopic dermatitis runs in families, the role of genetics (inheritance) remains unclear. It does appear that more than one gene is involved in the disease.

Research has helped shed light on the way atopic dermatitis is inherited. Studies show that children are at increased risk for developing the disorder if there is a family history of other atopic disease, such as hay fever or asthma. The risk is significantly higher if both parents have an atopic disease. In addition, studies of identical twins, who have the same genes, show that in an estimated 80 to 90 percent of cases, atopic disease appears in both twins. Fraternal (nonidentical) twins, who have only some genes in common, are no more likely than two other people in the general population to both have an atopic disease. These findings suggest that genes play an important role in determining who gets the disease.

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Biochemical Abnormalities: Scientists suspect that changes in the skin's protective barrier make people with atopic dermatitis more sensitive to irritants. Such people have lower levels of fatty acids (substances that provide moisture and elasticity) in their skin, which causes dryness and reduces the skin's ability to control inflammation.

Other research points to a possible defect in a type of white blood cell called a monocyte. In people with atopic dermatitis, monocytes appear to play a role in the decreased production of an immune system hormone called interferon gamma (IFN-γ), which helps regulate allergic reactions. This defect may cause exaggerated immune and inflammatory responses in the blood and tissues of people with atopic dermatitis.

Faulty Regulation of Immunoglobulin E (IgE): As already described in the section on diagnosis, IgE is a type of antibody that controls the immune system's allergic response. An antibody is a special protein produced by the immune system that recognizes and helps fight and destroy viruses, bacteria, and other foreign substances that invade the body. Normally, IgE is present in very small amounts, but levels are high in 80 to 90 percent of people with atopic dermatitis.

Controlling Atopic Dermatitis

• Prevent scratching or rubbing whenever possible.
• Protect skin from excessive moisture, irritants, and rough clothing.
• Maintain a cool, stable temperature and consistent humidity levels.