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Atopic Dermatitis in the Precision Medicine Era: Immunological Mechanisms, Biomarkers,...
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Atopic Dermatitis in the Precision Medicine Era: Immunological Mechanisms, Biomarkers, and Therapeutic Innovations

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 28 February 2027 | Viewed by 1009

Editor

Prof. Dr. Mihail Virgil Boldeanu

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Guest Editor
Department of Immunology-Laboratory of Immunology, Universitatea de Medicina si Farmacie din Craiova, Craova, Romania
Interests: immunity; endocrine; chronic diseases; inflammatory bowel diesel; diabetes melitus; preeclampsia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Atopic dermatitis (AD) is one of the most prevalent chronic inflammatory skin diseases, characterized by complex interactions between genetic predisposition, epidermal barrier dysfunction, immune dysregulation, and environmental factors. Despite significant therapeutic advances in recent years, including biologics and small-molecule inhibitors, significant heterogeneity persists in disease manifestations, treatment responses, and long-term outcomes.

The molecular understanding of AD continues to evolve rapidly, supported by progress in immunology, multi-omics profiling, neuroimmune research, and microbiome science. These breakthroughs are enabling the development of precision medicine strategies, the identification of new biomarkers, the stratification of clinical phenotypes, and the unveiling of novel therapeutic targets.

This Special Issue aims to gather high-quality contributions focused on the latest progress in atopic dermatitis research, spanning fundamental mechanisms, translational science, and clinical innovation. Submissions exploring immunopathology, skin barrier biology, neuroimmune signaling, microbiome interactions, therapeutic targets, biomarkers, and personalized treatment approaches are particularly encouraged. Studies on pediatric vs. adult AD, disease endotypes, and predictors of therapeutic response are also welcome.

We invite research articles and review papers that advance the understanding and management of atopic dermatitis.

Prof. Dr. Mihail Virgil Boldeanu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • atopic dermatitis
  • immunopathology
  • skin barrier biology
  • neuroimmune signaling
  • microbiome interactions
  • therapeutic targets
  • biomarkers
  • personalized treatment approaches

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Published Papers (2 papers)

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20 pages, 721 KB  
Article
Evaluation of Selected Laboratory Parameters as Predictive Biomarkers of Clinical Response to Dupilumab Therapy in Patients with Atopic Dermatitis
by Katarzyna Waligóra-Dziwak, Piotr Jerzy Skrzypczak and Dorota Jenerowicz
Biomedicines 2026, 14(8), 1767; https://doi.org/10.3390/biomedicines14081767 - 6 Aug 2026
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Abstract
Background: Clinical response to dupilumab in patients with atopic dermatitis is variable, and no established laboratory biomarkers currently enable reliable identification of patients likely to achieve a predictable response prior to treatment initiation or early during therapy. Methods: This prospective, real-world study conducted [...] Read more.
Background: Clinical response to dupilumab in patients with atopic dermatitis is variable, and no established laboratory biomarkers currently enable reliable identification of patients likely to achieve a predictable response prior to treatment initiation or early during therapy. Methods: This prospective, real-world study conducted in a Polish population evaluated the discriminative capacity of selected laboratory biomarkers for predicting short- and long-term clinical response to dupilumab in patients with atopic dermatitis. Results: Lactate dehydrogenase (LDH) was the most consistently informative continuous baseline biomarker (area under the receiver operating characteristic curve [AUC] for at least 75% improvement in the Eczema Area and Severity Index [EASI-75] at week 16: 0.60; EASI-90 at week 16: 0.63; EASI-75 at week 40: 0.66; EASI < 7 at week 40: 0.64). The systemic inflammatory response index (SIRI) was the second most stable baseline predictor (AUC = 0.63 and 0.64 for EASI-75 and EASI < 7 at week 40, respectively) and demonstrated the highest overall discriminative performance among week 16 biomarkers. Conclusions: LDH and SIRI appear to be the most promising candidates for further evaluation in larger cohorts owing to their cross-outcome and cross-time consistency rather than a single dominant AUC value. The predictive potential of individual biomarkers, while detectable, remained below the threshold of clinical utility for every biomarker–outcome combination examined. Composite multi-biomarker models may be required to achieve clinically meaningful predictive accuracy. Full article
(This article belongs to the Special Issue Atopic Dermatitis in the Precision Medicine Era: Immunological Mechanisms, Biomarkers, and Therapeutic Innovations)
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Review

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25 pages, 3776 KB  
Review
Gut Microbiome Dysbiosis in Atopic Dermatitis: Pathogenic Mechanisms, Gut–Skin Axis Disruption, and Emerging Microbiota-Targeted Therapies
by Lidia Boldeanu, Alice Elena Ghenea, Marius Bogdan Novac, Virgilios Galatis, Rodica Pădureanu, Mohamed-Zakaria Assani, Vlad Pădureanu, George G. Mitroi, Ancuța-Ramona Boicea Camen and Mihail Virgil Boldeanu
Biomedicines 2026, 14(8), 1711; https://doi.org/10.3390/biomedicines14081711 - 30 Jul 2026
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Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by epidermal barrier dysfunction, immune dysregulation, and marked clinical heterogeneity. Growing evidence implicates the gut microbiome in AD-related pathways through microbial metabolites, intestinal barrier function, and systemic immune signaling. This narrative review synthesizes [...] Read more.
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by epidermal barrier dysfunction, immune dysregulation, and marked clinical heterogeneity. Growing evidence implicates the gut microbiome in AD-related pathways through microbial metabolites, intestinal barrier function, and systemic immune signaling. This narrative review synthesizes current evidence on gut microbial alterations in AD, with particular attention to short-chain fatty acids, tryptophan-derived aryl hydrocarbon receptor ligands, intestinal permeability, gut–skin microbiome interactions, and microbiota-targeted interventions. Human studies have reported associations between AD and altered abundance of selected microbial taxa, metabolite profiles, and markers of intestinal barrier dysfunction, whereas animal and in vitro studies provide complementary mechanistic evidence. However, findings remain heterogeneous across age groups, disease phenotypes, geographic populations, analytical platforms, and treatment exposures, and causality is incompletely established. Probiotic and synbiotic interventions have shown strain-specific and context-dependent effects, while postbiotics, fecal microbiota transplantation, washed microbiota transplantation, and metabolite-directed approaches remain investigational. AI-assisted multi-omics methods may improve biological stratification and hypothesis generation, but current applications are limited by small sample sizes, cohort heterogeneity, overfitting, insufficient external validation, and limited clinical implementation. Current evidence therefore supports the gut microbiome as a mechanistically plausible contributor, potential biomarker, and therapeutic target in AD while underscoring the need for longitudinal, phenotype-aware, and externally validated studies before routine clinical translation. Full article
(This article belongs to the Special Issue Atopic Dermatitis in the Precision Medicine Era: Immunological Mechanisms, Biomarkers, and Therapeutic Innovations)
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