Resumo
Objetivo: Analisar, sob perspectiva neuroimune, os principais mecanismos fisiopatológicos da dermatite atópica, enfatizando a integração entre disfunção da barreira epidérmica, inflamação crônica mediada por eixos imunes do tipo Th2 e vias neurogênicas do prurido, além de discutir o papel regulatório do endocanabinoidoma e os fundamentos mecanísticos da modulação por canabidiol. Revisão bibliográfica: A dermatite atópica resulta da interação entre disfunção da barreira cutânea, hiper-reatividade imunológica e alterações neuroimunes que perpetuam o prurido crônico. Citocinas como IL‑4, IL‑13 e IL‑31 comprometem a barreira epidérmica e intensificam a inflamação, enquanto mediadores neurogênicos ampliam a sensibilização periférica e central. O endocanabinoidoma configura um eixo regulatório composto por mediadores lipídicos, enzimas metabólicas e múltiplos receptores canônicos e não canônicos, incluindo TRP, PPARγ e GPR55 que participa da modulação da inflamação, diferenciação epidérmica e sinalização pruritogênica. O canabidiol regula indiretamente o endocanabinoidoma por mecanismos como modulação alostérica negativa do CB1, interação funcional com CB2 e inibição parcial da FAAH, repercutindo positivamente nos processos inflamatórios e neuroimunes envolvidos na doença. Considerações finais: O endocanabinoidoma consolida-se como eixo conceitual relevante para compreender a integração entre inflamação, barreira epidérmica e prurido. O canabidiol demonstra potencial modulador promissor, embora ainda limitado por lacunas científicas que requerem investigação adicional rigorosa.
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