Exploring the link between mind and skin: understanding the neurocutaneous axis in atopic dermatitis (360G-Wellcome-317617_Z_24_Z)

Atopic dermatitis (AD) is a significant health burden, resulting in chronic inflammation and itching of the skin. AD has the highest prevalence in children and is often accompanied by various comorbidities such as food and respiratory allergies, sleep disorders and neuropsychiatric conditions (e.g. anxiety and depression), which can have long-term consequences, thus further increasing the health burden of AD. The combination of chronic cutaneous inflammation and pruritus aggravate scratching behaviour which further damages and worsens inflammation of the skin. Moreover, this itching-scratching cycle also leads to significant sleep disturbance. Poor sleep quality during early childhood could severely alter neurodevelopment, increasing the risk of neurological conditions seen in AD sufferers, such as attention deficit hyperactivity disorder. Additionally, chronic skin inflammation in the patients could lead to systemic and even neuroinflammation which has been implicated in sleep disturbances and altered neurodevelopment. In this study, we aim to delineate the multi-directional relationships between inflammation, sleep, brain structure, functional connectivity and cognitive functions in AD patients. This will be achieved by employing advanced computational analysis methods, including machine learning. In the future, novel treatment approaches can be designed to target these new mechanisms to reduce the long-term health impact on these patients.