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World Allergy Organ J. 2017 Aug 22;10(1):29. doi: 10.1186/s40413-017-0160-5. eCollection 2017.

The skin microbiome: impact of modern environments on skin ecology, barrier integrity, and systemic immune programming.

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School of Paediatrics and Child Health, University of Western Australia and Princess Margaret Hospital for Children, PO Box D184, Perth, WA 6001 Australia.
In-FLAME Global Network, of the World Universities Network (WUN), West New York, USA.
School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 Australia.
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
University of North Carolina School of Medicine, Chapel Hill, North Carolina USA.
Institute for Immunological Research, University of Cartagena, Cartagena, Colombia.
Division of Paediatric Allergy, University of Cape Town, Cape Town, South Africa.
Department of Pediatrics, University of Alberta, Edmonton, Canada.
Children's Hospital at Westmead, Sydney, Australia.
Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia.


Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.


Allergy; Antibiotics; Biodiversity; Caesarean section; Colonisation; Cytokines; DOHaD; Ecosystems; Inflammation; Microbiome; Microbiota; NCDs; Pregnancy; Prevention; Skin

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