title: Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go?
abstract: Atopic dermatitis (AD) is a paradigmatic chronic inflammatory skin disease characterized by a complex pathophysiology and a wide spectrum of the clinical phenotype. Despite this high degree of heterogeneity, AD is still considered a single disease and usually treated according to the "one-size-fits-all" approach. Thus more tailored prevention and therapeutic strategies are still lacking. As for other disciplines, such as oncology or rheumatology, we have to approach AD in a more differentiated way (ie, to dissect and stratify the complex clinical phenotype into more homogeneous subgroups based on the endophenotype [panel of biomarkers]) with the aim to refine the management of this condition. Because we are now entering the era of personalized medicine, a systems biology approach merging the numerous clinical phenotypes with robust (ie, relevant and validated) biomarkers will be needed to best exploit their potential significance for the future molecular taxonomy of AD. This approach will not only allow an optimized prevention and treatment with the available drugs but also hopefully help assign newly developed medicinal products to those patients who will have the best benefit/risk ratio.
authors.affiliation: Department of Dermatology and Allergy, University of Bonn, Bonn, Germany; Christine Kühne-Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland. Electronic address: thomas.bieber@ukb.uni-bonn.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bieber
authors.affiliation: Unit of Dermatology, Livorno Hospital, Livomo, Italy; Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Angelo M
authors.initials: AM
authors.lastname: D'Erme
authors.affiliation: Christine Kühne-Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland; Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland.
authors.forename: Cezmi A
authors.initials: CA
authors.lastname: Akdis
authors.affiliation: Christine Kühne-Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland; Institute for Environmental Medicine, Technische Universität München and Helmholtzzentrum München, Munich, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Traidl-Hoffmann
authors.affiliation: Christine Kühne-Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, and the University of Zurich, Zurich, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Lauener
authors.affiliation: Christine Kühne-Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Schäppi
authors.affiliation: Christine Kühne-Center for Allergy Research and Education (CK-CARE) Davos-Augsburg-Bonn-St Gallen-Zürich, St Gallen, Switzerland; Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid-Grendelmeier
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000378:metabolism; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D019468:Disease Management; D058068:Endophenotypes; D006801:Humans; D010641:Phenotype; D057285:Precision Medicine; D018570:Risk Assessment; D049490:Systems Biology
chemical_list: D015415:Biomarkers
keywords: Atopic dermatitis; biomarkers; clinical phenotype; endophenotype; precision medicine; stratified medicine