Atopic dermatitis (AD) is a chronic type-2 inflammatory skin disease characterized by eczema and epithelial barrier dysfunction. Along with the type-2 cytokines IL-4 and IL-13, IL-22 contributes to AD pathogenesis. To date, most skin studies rely on reconstructed keratinocytes, which do not represent the real skin response.
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The Epithelial Barrier Theory is a comprehensive explanation for the global, epidemic-level rise in chronic health conditions over the past 65 years. The theory, postulated by Akdis, proposes that exposure to toxic substances introduced by industrialization and modern lifestyle changes disrupts the epithelial barrier of the skin, upper and lower airways, and gut mucosa and causes microbial dysbiosis triggering an inflammatory immune response that can initiate or aggravate many chronic inflammatory diseases.