Mast-Cell Driven Dermal White Adipose Tissue Remodeling Amplifies Inflammation and Fibrosis in Atopic Dermatitis

This study investigates the role of dermal white adipose tissue (dWAT) in atopic dermatitis (AD) using a mouse model. It reveals that dWAT undergoes lipolysis and fibrosis alongside mast-cell (MC) accumulation. Adipocytes lose lipids and transform into inflammatory preadipocytes, secreting chemokines that recruit MCs, creating a self-amplifying inflammatory-fibrotic loop. Neutralizing these chemokines or depleting MCs disrupts this loop. Human AD skin shows similar adipocyte changes, suggesting a new pathway where adipocytes convert to fibroblasts, promoting MC recruitment and fibrosis. This offers a potential therapeutic target to block adipocyte dedifferentiation and its signals to reduce inflammation and fibrosis in AD.