介绍ICADA 2023犬特应性皮炎发病机制综述文章和更新定义 ...

王帆

Introduction to the ICADA 2023 canine atopic dermatitis pathogenesis review articles and updated definition

介绍ICADA 2023犬特应性皮炎发病机制综述文章和更新定义

翻译：王帆 

INTRODUCTION

介绍

The International Committee on Allergic Diseases of Animals (ICADA) considers recent literature to coordinate reviews of important advances in atopic and allergic diseases over time. These review articles and translations can be found on the website www.icada.org and include the following: feline atopic syndrome— pathogenesis, diagnosis and treatment ; canine atopic dermatitis—pathogenesis, diagnosis,research guidelines and treatments. The purpose of the following papers is to include new information since the last ICADA review papers pathogenesis of canine atopic dermatitis were published in 2015. These updated reviews were prepared by searching for articles and meeting abstracts from 2015 to 2022, and the manuscripts were submitted to the ICADA membership for review before submission to this journal.

国际动物过敏性疾病委员会(ICADA)将最近的文献，配合特应性皮炎和过敏性疾病随时间推移的重要进展的综述进行探讨。这些综述文章和译文可以在www.icada.org网站上找到，包括以下内容:猫特应性综合征——发病机制、诊断和治疗；犬特应性皮炎-发病机制、诊断、研究指南和治疗。以下论文的目的是包括自2015年发表的上一篇ICADA综述论文以来犬特应性皮炎发病机制的新信息。通过搜索2015—2022年的文章和会议摘要编写了这些更新的综述，并在投稿前将稿件提交给ICADA会员进行审阅。

 

ATOPIC DERMATITIS REDEFINED

特应性皮炎更新定义

As part of these updated reviews, there arose the need for an updated definition of canine atopic dermatitis (cAD). The last peer-reviewed definition was by Halliwell in 2006,stating that [canine] atopic dermatitis was ‘A genetically-predisposed inflammatory and pruritic allergic skin disease with characteristic clinical features. It is associated most commonly with immunoglobulin (Ig)E antibodies to environmental allergens’. ICADA has revised the definition based on the most recent knowledge of its pathogenesis. The 2023 ICADA definition of cAD is:

作为这些最新综述的一部分，有必要更新犬特应性皮炎(cAD)的定义。最后一个经过同行评议的定义是2006年的哈利威尔(Halliwell) ，他指出[犬]特应性皮炎是“一种具有典型临床特征的遗传易感性炎症和瘙痒性过敏性皮肤病，它最常与针对环境过敏原的免疫球蛋白(Ig)E抗体相关”。ICADA根据其发病机制的最新知识修订了定义。2023年ICADA对cAD的定义为:

 

 

Canine atopic dermatitis is a hereditary, typically pruritic and predominantly T-cell driven inflammatory skin disease involving interplay between skin barrier abnormalities, allergen sensitization and microbial dysbiosis

犬特应性皮炎是一种遗传性、典型的瘙痒性和主要由T细胞驱动的炎症性皮肤病，涉及皮肤屏障异常、过敏原致敏和微生物生态失调之间的相互作用。

 

This new definition is useful in that it includes our current broader understanding of the pathogenesis of this condition beyond allergy. This new definition highlights the multiple factors involved in this disease, which supports the recommendation that the management of canine atopic dermatitis must be multimodal (as seen in the former14 and soon-to-be updated Canine Atopic Dermatitis Practice Guidelines).

这个新的定义是有用的，因为它包括了我们目前对这种疾病的发病机制的在过敏症之上的更广泛的理解。这一新定义强调了该疾病涉及的多种因素，这支持了犬特应性皮炎的管理必须是多模式的建议(如以前的和即将更新的犬特应性皮炎实践指南中所见)。

 

UPDATES ON CANINE ATOPIC DERMATITIS

犬特应性皮炎最新进展

The following review papers on the pathogenesis of cAD are divided into topics that support this new definition. The three manuscripts in this collection include:

以下关于cAD发病机制的综述论文分为支持这一新定义的主题。本文集中的三份手稿包括:

• Update on the role of genetic factors, environmental factors and allergens in canine atopic dermatitis;

• Update on the role of skin barrier and structural changes to the skin, cutaneous microbiome and host defence peptides in canine atopic dermatitis; and

• Update on the role of cytokines and chemokines in canine atopic dermatitis.

•遗传因素、环境因素和过敏原在犬特应性皮炎中的作用的最新进展;
•在犬特应性皮炎中，皮肤屏障和皮肤结构变化、皮肤微生物组和宿主防御肽的作用的最新进展;和
•细胞因子和趋化因子在犬特应性皮炎中的作用的最新进展。

 

The first paper includes multiple studies showing the importance of environmental factors in the development of atopy, including lifestyle, diet and parasite exposure. Although atopy is unquestionably a hereditary condition and large atopy prevalence studies continue to show strong breed predispositions, unfortunately no consistent genetic markers have yet been found. The next paper reviews skin barrier measurement (which continues to be difficult and controversial), as well as updates on ceramides, filaggrins and other skin proteins, and interesting studies on the cutaneous microbiome and dysbiosis, and cutaneous host defence peptides. Most new knowledge on the pathogenesis of cAD is in the last paper, which examines the role of cytokines and chemokines. However, many studies are conflicting. Several consistently show upregulation of many T-helper (Th) cell cytokines that is not restricted to certain groups (such as only Th2 cytokines, for example). There also is a consistently strong central role for interleukin (IL)-31 in pruritus, in line with successful therapies targeting this cytokine for relief of clinical signs of AD.

第一篇论文包括多项研究，显示了环境因素在特应性体质形成中的重要性，包括生活方式、饮食和寄生虫暴露。尽管特应性体皮炎毫无疑问是一种遗传性疾病，而且大规模的特应性皮炎患病率研究继续显示出很强的品种易感性，但不幸的是，还没有发现一致的遗传标记。下一篇文章综述了皮肤屏障的测量(这仍然是困难和有争议的)，以及关于神经酰胺、丝聚蛋白和其他皮肤蛋白质的最新进展，以及关于皮肤微生物组和生态失调和皮肤宿主防御肽的有趣研究。关于cAD发病机制的大部分新知识在最后一篇论文中，其中探讨了细胞因子和趋化因子的作用。然而，许多研究结果相互矛盾。一些研究一致显示许多不局限于特定群体的辅助性T (Th)细胞因子上调(例如仅Th2细胞因子)。此外，白细胞介素(IL)-31在瘙痒中也起着始终强大的核心作用，这与针对该细胞因子缓解AD临床症状的成功疗法一致。

 

Certain topics were not included in the updated pathogenesis papers (e.g. the role of eosinophils, basophils, IgE and dendritic cells) because there is a lack of new information in these areas in dogs.

某些主题没有包括在最新的发病机制论文中(例如，嗜酸性粒细胞、嗜碱性粒细胞、IgE和树突状细胞的作用)，因为在犬的这些领域缺乏新的信息。

 

In conclusion, these articles summarise the most important studies on cAD since 2015. Our knowledge of the pathogenesis and the definition of cAD will continue to evolve over the years. Hopefully these review papers will be useful to help direct future research endeavours to better understand the multifactorial complexity of cAD.

综上所述，这些文章总结了2015年以来cAD领域最重要的研究。多年来，我们对cAD发病机制和定义的了解将继续发展。希望这些综述论文将有助于指导未来的研究工作，以更好地理解cAD的多因素复杂性。

王帆

2023年ICADA对cAD的定义为:

Canine atopic dermatitis is a hereditary, typically pruritic and predominantly T-cell driven inflammatory skin disease involving interplay between skin barrier abnormalities, allergen sensitization and microbial dysbiosis
犬特应性皮炎是一种遗传性、典型的瘙痒性和主要由T细胞驱动的炎症性皮肤病，涉及皮肤屏障异常、过敏原致敏和微生物生态失调之间的相互作用。