Neuro-immune Crosstalk in Atopic Dermatitis: A Multiaxial Regulatory Network and Novel Therapeutic Perspectives.

Atopic dermatitis (AD) is a chronic inflammatory disorder driven by complex neuro‑immune interactions beyond classical immune dysregulation. Previous reviews have largely focused on local peripheral neuro‑immune circuits mediating itch and inflammation, but they have not provided an integrative framework connecting peripheral, systemic, and psychological axes. Here, we propose a “multi‑axial neuro‑immune regulatory network” unifying cutaneous, central, and gut–brain–skin pathways to explain the systemic and psychosomatic nature of AD. We highlight neuroplastic remodeling, psycho-neuro-immunologic mechanisms, and therapeutic innovations that target these intertwined axes. This conceptual framework extends beyond prior literature by positioning AD as a dynamic neuro‑immune disorder rather than a purely epithelial or allergic disease.