Our research focuses on understanding the determinants and long-term outcomes of chronic inflammatory disease. We use advanced analytic methods and an integrative approach to understand the dynamic relationship between inflammation in the skin and genetic, environmental, and sociocultural factors.

Our research focuses on three main themes:

Atopic dermatitis course and comorbidities - Our research challenges older paradigms which suggest that only children are affected by atopic dermatitis (aka eczema). We are working to identify patterns and predictors of disease activity into adulthood, understand differences in adult-onset eczema, and characterize the clinical and immunologic phenotype of eczema among older adults. We are also working to understand the associations between atopic dermatitis and multiple systemic conditions including cardiovascular disease, depression, and anxiety, and to identify possible causal and modifiable pathways.

The role of the skin barrier in inflammation and aging - Because the skin is one of the body’s largest organs, barrier decline may have important consequences for systemic health. We are studying how age-related changes in cutaneous physiology can lead to chronic inflammation and disturbances in sleep, cognition, and cardiovascular health. We are also examining the therapeutic potential of barrier repair with safe, low-cost, and widely available emollients.

Environmental and lifestyle drivers of immune-mediated disease – We are working to understand how exposure to natural spaces and dietary patterns can improve health. In particular, we are studying the impact of the environmental microbiome (i.e. microbial communities associated with soil, water, atmosphere, and the built environment) on immune-mediated diseases such as asthma, eczema, and allergies. We are also studying the impact of dietary salt on inflammatory skin diseases like eczema and psoriasis. This new area of investigation came about after collaborators revealed that most of the exchangeable sodium in the body is stored in the skin, but that high sodium concentrations trigger immune dysregulation, including Th2 and Th17 pathways involved in inflammatory skin disease. We are investigating population-level trends in sodium consumption and conducting observational and experimental trials to understand the impact of diet and skin barrier function on skin sodium storage.