Pediatric IMIDs in Dermatology: Immune Regulation, Biomarkers, and Targeted Therapeutic Advances

Pediatric immune-mediated inflammatory diseases (IMIDs) in dermatology constitute a clinically heterogeneous group, encompassing atopic dermatitis, psoriasis, vitiligo, alopecia areata, chronic urticaria, and connective-tissue-related dermatoses. These conditions significantly diminish the quality of life, place a long-term psychosocial burden on children and their families, and are often marked by relapsing or treatment-refractory courses. Their pathogenesis reflects a complex interplay among genetic susceptibility, epithelial barrier dysfunction, dysregulated immune circuits (such as Th1, Th2, Th17/IL-23, and type I interferon pathways), microbiome disturbances, and environmental triggers. Importantly, the pediatric immune system differs fundamentally from that of adults. Age-dependent immune maturation, distinct cytokine profiles, and specific microbiome-epithelium interactions lead to unique disease phenotypes, comorbidities, and therapeutic responses. Recent advancements in multi-omics technologies and single-cell immunology have facilitated the identification of novel endotypes and candidate biomarkers, which support disease stratification and precision medicine approaches. Nevertheless, the translation of these mechanistic understandings into pediatric-specific targeted therapies is still constrained by the paucity of pediatric clinical trials, developmental pharmacology limitations, and apprehensions regarding long-term safety. There is an urgent need to bridge this translational gap to achieve evidence-based, developmentally appropriate precision therapeutics for children with IMIDs.GoalThis Research Topic aims to comprehensively synthesize the current advancements in immunopathogenesis, biomarker discovery, and therapeutic development for pediatric immune-mediated inflammatory diseases (IMIDs) in dermatology, and to facilitate their translation into safe and effective treatments specifically customized for children. The collection endeavors to: (1) Elucidate age-dependent immune mechanisms and disease endotypes that characterize the heterogeneity of pediatric IMIDs; (2) Highlight validated biomarkers for diagnosis, risk stratification, and monitoring of therapeutic response; (3) Showcase emerging targeted and immune-modifying therapies with proven or potential applicability in pediatric care; and (4) Examine the methodological, ethical, and regulatory challenges inherent in pediatric clinical research. By integrating perspectives from clinicians, basic scientists, translational researchers, and industry partners, this Research Topic aims to offer a cohesive platform that expedites the development and implementation of personalized, developmentally informed therapeutic strategies for pediatric dermatologic IMIDs.Scope and Information for Authors This research topic welcomes original research articles, reviews, mini-reviews, case series, translational studies, and clinical trial reports on, but not limited to, the following themes:● Immunopathogenesis and mechanistic insights into pediatric immune-mediated inflammatory diseases (IMIDs), including T-cell and B-cell dysregulation, innate immune activation, epithelial barrier defects, microbiome interactions, and comparative studies differentiating pediatric-onset from adult-onset diseases.● Biomarker discovery and validation for pediatric immune-mediated inflammatory diseases (IMIDs), including diagnostic, prognostic, and predictive markers—such as molecular, cellular, imaging-based, or composite signatures—and their relevance to disease endotyping and risk stratification.● Targeted and immune - modulating therapies, including biologics, small - molecule inhibitors, JAK/STAT pathway blockers, cell - based treatments, and other emerging modalities, are supported by data from preclinical models or pediatric clinical cohorts.● Clinical trials, real-world evidence, and longitudinal cohort studies are used to assess the efficacy, safety, treatment optimization, and long-term outcomes of systemic or topical therapies in pediatric IMIDs.● Precision medicine and personalized treatment strategies encompass biomarker-guided therapy selection, prediction algorithms for treatment response or adverse events, and rational approaches to combination therapy or step-up/step-down management.● Integrative and complementary approaches, including evidence - based traditional medicine, dietary interventions, and lifestyle modification, and their potential role as adjunctive strategies to enhance outcomes in pediatric IMIDs.● Unmet clinical needs, methodological challenges, and future research directions in pediatric dermatologic immune-mediated inflammatory diseases (IMIDs), including perspectives on emerging technologies such as single-cell omics, spatial profiling, machine learning, and multidisciplinary care models. Topic editors: Ding Quan Yang, Bin ZHANG, Ming Li, YUAN XU, Liborija Lugović-Mihić Source: https://www.frontiersin.org/research-topics/76724/pediatric-imids-in-dermatology-immune-regulation-biomarkers-and-targeted-therapeutic-advances