“New and advanced treatments for atopic dermatitis (AD) are moving beyond just managing symptoms. For some patients, these therapies can modify the disease itself, potentially leading to long-term remission (“deep remission”) even after stopping medication. This new treatment goal is called “disease modification.” The aim is to fundamentally change the course of AD and its related health conditions, offering transformative and lasting relief. However, optimal measurement of deep remission remains a key challenge for clinicians, researchers, regulators, and ultimately the payers. Our recent publication in Allergy discussing the Atopic Dermatitis Disease Activity Index (ADDAI), a composite tool to help determine if a treatment has successfully achieved true disease modification, helping doctors and patients know if the right treatment approach has been found. (link to publication).
New insights into the spatial organization of inflammation in atopic dermatitis
In our study published in Allergy, we investigated how immune cells and their interactions are spatially organized in the skin of patients with atopic dermatitis. Using spatial transcriptomics combined with single-cell RNA sequencing data, imaging mass cytometry and multiplex immunofluorescence, we identified conserved immune niches at the dermal-epidermal junction.
These niches are characterized by the close spatial association of CD4+ T cells and mature migratory dendritic cells (mmDCs) and show signatures of local T cell activation and Type 2 cytokine signaling. They are embedded within a broader inflammatory microenvironment involving fibroblasts and keratinocytes and display transcriptional features resembling tertiary lymphoid structures.
Our findings suggest that specialized immune niches within the skin may sustain local T cell activation and thereby contribute to chronic inflammation and disease relapse in atopic dermatitis. The mmDC – T cell interaction therefore represents an interesting potential target for future therapeutic strategies aimed at achieving more durable disease control.
Read the manuscript: https://onlinelibrary.wiley.com/doi/10.1111/all.70513



