Abrocitinib versus dupilumab: impact on skin barrier function and proteomics in atopic dermatitis.

BACKGROUND The comparative impact of dupilumab and abrocitinib on skin barrier function and associated proteomics in atopic dermatitis (AD) remains not fully identified. OBJECTIVE To investigate the effects of dupilumab versus abrocitinib on skin barrier function and proteomic profiles in AD. METHODS In this study, 33 patients with moderate-to-severe AD were randomized into two groups: 16 received dupilumab and 17 received abrocitinib. Clinical outcomes and skin barrier parameters (transepidermal water loss [TEWL] and hydration) were assessed at baseline, 4 weeks, and 12 weeks. Skin tape strips were collected for four-dimensional data-independent acquisition-based proteomics. RESULTS Both therapies improved skin barrier function, with abrocitinib achieving superior reductions in TEWL in non-lesional skin (P = 0.0168). Proteomic analysis revealed differentially expressed proteins predominantly associated with ceramide metabolism, neurobiology, and keratinocyte biology in AD. Key potential biomarkers were identified: arginase 1 and proteasome subunit beta type-6 in lesional skin, alongside grancalcin and phospholipase D3 in non-lesional skin. Abrocitinib enhanced the expression of crucial barrier proteins, such as filaggrin-2 and loricrin, in lesional skin-an effect not observed with dupilumab. LIMITATIONS The cohort size is small. CONCLUSION While both abrocitinib and dupilumab effectively restore skin barrier function in AD, they exhibit distinct proteomic impacts.

• Publication year

  2025

• Venue

  Journal of American Academy of Dermatology

• Publication date

  2025-04-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.jaad.2025.04.027PMID 40246083
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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