Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
J Dermatol. 2017 Dec;44(12):1341-1348. doi: 10.1111/1346-8138.14031. Epub 2017 Sep 19.
Evidence has emerged about the relationship between atopic dermatitis (AD) and autoimmune diseases, but the underlying mechanism of this association is complex and still unclear. Recent epidemiological data from the published work suggest a positive correlation. The aim of this review is to analyze the frequency of co-occurrence of AD and autoimmune diseases. Our systematic review included 22 articles from PubMed describing the reciprocal association between AD and autoimmune diseases. Although not all the studies achieved statistically significant results, patients suffering from autoimmune diseases involving skin and intestinal mucosa, such as vitiligo, alopecia areata, celiac disease and inflammatory bowel diseases, showed a higher risk to have AD as comorbidity. In contrast, patients with rheumatological autoimmune disorders did not show a significant correlation with AD. By analyzing the occurrence of autoimmune disorders in patients with AD, we confirmed a positive correlation between AD and autoimmune diseases involving skin and intestinal mucosa, but also with systemic lupus erythematosus, while the association between AD and type 1 diabetes, autoimmune thyroiditis and rheumatoid arthritis showed conflicting results. Further investigations are need to explain the mechanism underlying the observed comorbidity between AD and autoimmune diseases and to develop targeted prevention strategies and treatment.
已经有证据表明特应性皮炎(AD)与自身免疫性疾病之间存在关联,但这种关联的潜在机制很复杂,目前仍不清楚。最近发表的流行病学数据表明两者呈正相关。本综述的目的是分析 AD 与自身免疫性疾病同时发生的频率。我们的系统综述包括了 22 篇来自 PubMed 的文章,这些文章描述了 AD 与自身免疫性疾病之间的相互关联。尽管并非所有研究都得出了统计学上显著的结果,但患有自身免疫性疾病且涉及皮肤和肠道黏膜的患者,如白癜风、斑秃、乳糜泻和炎症性肠病,其 AD 作为合并症的风险更高。相比之下,患有风湿性自身免疫性疾病的患者与 AD 之间没有显著相关性。通过分析 AD 患者自身免疫性疾病的发生情况,我们证实了 AD 与涉及皮肤和肠道黏膜的自身免疫性疾病之间存在正相关,也与系统性红斑狼疮相关,但 AD 与 1 型糖尿病、自身免疫性甲状腺炎和类风湿关节炎之间的关联则存在相互矛盾的结果。需要进一步的研究来解释观察到的 AD 与自身免疫性疾病之间的合并症的潜在机制,并制定有针对性的预防策略和治疗方法。