From itchy skin to wheezing: Potential biomarkers and targeted drugs for atopic dermatitis and asthma in children

Atopic dermatitis (AD) and allergic asthma (AA) are interconnected allergic diseases that frequently co-occur in early childhood, representing a critical sequence in the "atopic march". The rising global prevalence of these conditions, driven by environmental factors and epigenetic changes, underscores an urgent clinical need to understand their shared pathogenesis and disrupt disease progression. Evidence implicates multifaceted mechanisms in AD-to-AA progression, including skin barrier dysfunction, type 2 inflammation, microbiome dysbiosis, and systemic immune priming. These pathways not only elucidate the disease continuum but also offer actionable biomarkers for early prediction and targeted interventions. This review synthesizes the epidemiology, mechanistic insights, and translational implications of AD-to-AA progression, advocating for a paradigm shift toward early-risk stratification and precision medicine. By bridging mechanistic discoveries with clinical practice, we aim to guide optimized management and primary prevention, ultimately reducing the global allergy burden.