Abstract：
Atopic dermatitis (AD) or eczema is a chronic inflammatory skin disease characterized by dry, itchy, and inflamed skin. We review emerging concepts and clinical evidence addressing the pathogenesis and prevention of AD. We examine several interventions ranging from skin barrier enhancement strategies to probiotics, prebiotics, and synbiotics; and conversely, from antimicrobial exposure to vitamin D and omega fatty acid supplementation; breastfeeding and hydrolyzed formula; and house dust mite avoidance and immunotherapy. We appraise the available evidence base within the context of the Grades of Recommendation, Assessment, Development, and Evaluation approach. We also contextualize our findings in relation to concepts relating AD and individual-patient allergic life trajectories versus a linear concept of the atopic march and provide insights into future knowledge gaps and clinical trial design considerations that must be addressed in forthcoming research. Finally, we provide implementation considerations to detect population-level differences in AD risk. Major international efforts are required to provide definitive evidence regarding what works and what does not for preventing AD.
摘要：
特应性皮炎（AD）或湿疹是一种慢性炎症性皮肤病，发痒,皮肤发炎.我们回顾了有关特应性皮炎发病机理和预防的新兴概念和临床证据。我们回顾了几种干预措施，包括皮肤屏障增强策略；益生菌，益生元,和合生元，反过来,抗菌暴露；维生素D和欧米茄脂肪酸补充；母乳喂养和水解配方；避免室内尘螨和免疫疗法。我们在GRADE方法的背景下评估可用的证据基础。我们还将我们的发现与特应性皮炎和个体患者过敏性生命轨迹相关的概念与特应性行军的线性概念联系起来，并提供对未来知识差距和临床试验设计考虑的见解，这些考虑必须在未来的研究中解决。最后,我们提供了实施考虑因素来检测AD风险的人群水平差异.需要作出重大的国际努力，提供关于什么是有效的明确证据，什么没有，预防AD。
