Transcript
Raj Chovatiya, ...: For years, there was an existential debate in the atopic dermatitis world. Is AD an inside out or an outside in disease? Meaning that, was it primarily barrier dysfunction that drove the inflammation and immune dysregulation we saw in this disease? Or was it the inflammation and immune dysregulation that drove the barrier dysfunction? We used to debate this in the conference setting and the literature, [00:00:30] and what we found out is that it's probably all true to an extent and everybody is right.
And so when thinking about that outside in modality, this is where we think about certain acquired deficits in the skin barrier, whether it's related to the external environment, irritants, toxins, or innate intrinsic acquired barrier dysfunction that might be related to polygenic traits one carries, filaggrin's a great example, can oftentimes make your skin barrier that much leakier. Water comes out, various types of toxins, allergens, irritants, [00:01:00] bacteria creep their way in, activate the immune system, and thus starts the cycle of atopic dermatitis. So in that way, you can think about barrier dysfunction being a driver of disease. And it's another reason why a primary strategy across atopic dermatitis and guidelines all around the world is centered around good moisturization, good bathing, and trigger avoidance, all of which are designed to help repair the barrier.
