Atopic dermatitis and the gut-skin axis: a review from dysbiosis to novel targeted therapeutic strategies.

Atopic dermatitis (AD) is a common, chronic, relapsing, inflammatory skin disorder with a complex pathogenesis involving genetic, immune, and environmental factors. Recent advances in the research on the gut-skin axis (GSA) have shed new light on the pathophysiology of AD, highlighting the critical role of gut microbiota dysbiosis in immune regulation and inflammatory responses. This review summarizes gut and skin microbial dysbiosis in AD and its impact on immune homeostasis, elaborates on molecular/cellular mechanisms by which gut-skin axis dysfunction drives AD inflammation, and focuses on targeted therapeutic strategies for gut-skin axis modulation. It outlines the latest research and clinical translation of interventions, including probiotics, prebiotics, postbiotics, dietary adjustments, fecal microbiota transplantation, and microbe/metabolite-targeted biologics, providing a theoretical basis for AD precision management and novel therapeutic development.