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Impact of Air Pollution on Atopic Dermatitis: A Comprehensive Review

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Abstract

Air pollution is associated with multiple health problems worldwide, contributing to increased morbidity and mortality. Atopic dermatitis (AD) is a common allergic disease, and increasing evidence has revealed a role of air pollution in the development of atopic dermatitis. Air pollutants are derived from several sources, including harmful gases such as nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), as well as particulate matter (PM) of various sizes, and bioaerosols. Possible mechanisms linking air pollution to atopic dermatitis include damage to the skin barrier through oxidative stress, increased water loss, physicochemical injury, and an effect on skin microflora. Furthermore, oxidative stress triggers immune dysregulation, leading to enhanced sensitization to allergens. There have been multiple studies focusing on the association between various types of air pollutants and atopic dermatitis. Since there are many confounders in the current research, such as climate, synergistic effects of mixed pollutants, and diversity of study population, it is not surprising that inconsistencies exist between different studies regarding AD and air pollution. Still, it is generally accepted that air pollution is a risk factor for AD. Future studies should focus on how air pollution leads to AD as well as effective intervention measures.

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Acknowledgements

The figures are created with BioRender.com.

Funding

This work was supported by the Beijing Natural Science Foundation [grant number 7191008], the National Natural Science Foundation of China [grant number 81971515], and CAMS Innovation Fund for Medical Sciences [grant number 2020-I2M-C&T-B-001].

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Author notes

  1. Zhouxian Pan, Yimin Dai, and Nicole Akar-Ghibril contributed equally to this work.

Authors and Affiliations

  1. Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Zhouxian Pan, Lishan Zhang, Yibo Hou, Xueyi Wen, Rui Tang & Jin-Lyu Sun

  2. Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Zhouxian Pan, Lishan Zhang, Yibo Hou, Xueyi Wen, Rui Tang & Jin-Lyu Sun

  3. Eight-Year Clinical Medicine System, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Yimin Dai

  4. Division of Immunology, Allergy and Rheumatology, Joe DiMaggio Children’s Hospital, Memorial Healthcare System, Hollywood, FL, 33021, USA

    Nicole Akar-Ghibril, Jessica Simpson & Christopher Chang

  5. Department of Allergy, Beijing Electric Power Hospital of State Grid Company of China, Electric Power Teaching Hospital of Capital Medical University, Beijing, 100073, China

    Huali Ren

  6. Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, 95616, USA

    Christopher Chang

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Pan, Z., Dai, Y., Akar-Ghibril, N. et al. Impact of Air Pollution on Atopic Dermatitis: A Comprehensive Review. Clinic Rev Allerg Immunol 65, 121–135 (2023). https://doi.org/10.1007/s12016-022-08957-7

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