Translational insights into interleukin-driven macrophage polarization as diagnostic biomarkers for atopic dermatitis—a narrative review

Atopic dermatitis (AD) is a chronic inflammatory skin disease driven by immune dysregulation and skin barrier impairment. As a core regulatory axis, interleukin-mediated macrophage polarization modulates the inflammatory cascade and barrier repair via NF-κB/STAT6/NLRP3 pathway crosstalk. This narrative review systematically summarizes the bidirectional regulatory mechanism of the interleukin-macrophage polarization axis in AD, clarifies the vicious cycle linking immune imbalance, inflammatory amplification and barrier damage, and updates targeted interventions including biological agents and natural products. We further analyze the translational challenges of this axis and propose future directions for precise stratified therapy. This review innovatively integrates the immune-barrier crosstalk mechanism and translational insights, providing a theoretical basis for pathogenesis-oriented precise treatment of refractory AD.