University of Naples Federico II

The article proposes a framework for natural product drug discovery that translates evidence into auditable experimental actions through a four-tier architecture (source authentication, reproducible chemical fingerprinting, orthogonal prioritization, definitive characterization) with documented decision gates, and an 'evidence ladder' that separates molecular-identification confidence from chemical novelty, biological novelty and translational relevance, addressing three recurring gaps: incomplete integration of sample metadata, conflation of analytical detection with molecular novelty, and lack of explicit decision thresholds.

The article proposes a framework for natural product drug discovery that translates evidence into auditable experimental actions through a four-tier architecture (source authentication, reproducible chemical fingerprinting, orthogonal prioritization, definitive characterization) with documented decision gates, and an 'evidence ladder' that separates molecular-identification confidence from chemical novelty, biological novelty and translational relevance, addressing three recurring gaps: incomplete integration of sample metadata, conflation of analytical detection with molecular novelty, and lack of explicit decision thresholds.

This review summarizes the established clinical framework for atopic dermatitis (AD) diagnosis alongside emerging tools intended to complement it—circulating and skin-derived biomarkers, minimally invasive tape stripping, the skin microbiome, instrumental barrier assessment, noninvasive biofluids, advanced optical imaging (reflectance confocal microscopy, optical coherence tomography and line-field confocal OCT), and artificial-intelligence and digital tools, with attention to special populations—concluding that clinical diagnosis remains the reference standard, that the experienced clinician still outperforms any single test, and that these tools are promising adjuncts though few are standardized or prospectively validated.

This review summarizes the established clinical framework for atopic dermatitis (AD) diagnosis alongside emerging tools intended to complement it—circulating and skin-derived biomarkers, minimally invasive tape stripping, the skin microbiome, instrumental barrier assessment, noninvasive biofluids, advanced optical imaging (reflectance confocal microscopy, optical coherence tomography and line-field confocal OCT), and artificial-intelligence and digital tools, with attention to special populations—concluding that clinical diagnosis remains the reference standard, that the experienced clinician still outperforms any single test, and that these tools are promising adjuncts though few are standardized or prospectively validated.