Novel approach to pathogenetic therapy of atopic dermatitis: efficacy of filaggrinol-containing emollient-plus according to the dynamics of filaggrin and clinical indices



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Abstract

Background: Atopic dermatitis (AD) is a multifactorial genetically determined inflammatory skin disease. Mutations in the filaggrin gene (FLG), a key epidermal barrier protein, represent the most significant genetic risk factor for AD. Filaggrin deficiency leads to impaired skin barrier function, TEWL, and enhanced allergen penetration. Current research is focused on developing strategies to correct filaggrin levels. Emollients-plus are a promising pathogenetic approach to restore the epidermal barrier.  
Aim: To evaluate the efficacy of the emollient-plus “Admera” containing filaggrinol in increasing filaggrin levels and improving clinical manifestations in patients with AD.  
Materials and methods: The study included 60 patients with AD, divided into the main group (n=45), using filaggrinol-containing emollient-plus “Admera”, and the control group (n=15), using standard moisturizing therapy. The dynamics of clinical indices (vIGA-AD, EASI, POEM, ELMAN, DLQY, SKINDEX) and filaggrin expression in the skin before and after therapy were evaluated. 
Results: The main group showed a statistically significant increase in the level of filaggrin (p=0.024) and a significant improvement in all clinical and quality of life indicators (p<0.05). Positive trends were observed in the control group, but improvement on a number of scales did not reach statistical significance. Absolute intergroup differences in the level of filaggrin after treatment were not statistically significant, however, the intragroup dynamics in the main group confirms the pathogenetic efficacy of filaggrinol-containing emollient-plus with regard to filaggrin recovery.  
Conclusion: Filagrinol-containing emollient-plus “Admera” increases filaggrin levels and meaningfully improves clinical symptoms and quality of life in AD patients. The results confirm that “Admera” is pathogenetically sound, effective, safe and well tolerated as a basic therapy for AD.

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About the authors

Elena S. Snarskaya

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: snarskaya-dok@mail.ru
ORCID iD: 0000-0002-7968-7663
SPIN-code: 3785-7859

MD, Dr. Sci. (Medicine), Professor

Russian Federation, 4/1 Bolshaya Pirogovskaya street, 119991 Moscow

Anna V. Bratkovskaya

Faculty of Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Author for correspondence.
Email: annabratk24@gmail.com
ORCID iD: 0000-0002-7284-9113

PhD student

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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