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J Allergy Clin Immunol. 2019 Jan;143(1):26-35. doi: 10.1016/j.jaci.2018.11.015. Epub 2018 Nov 23.

The microbiome in patients with atopic dermatitis.

Author information

1
Dermatology and Infectious Disease, Northwestern University Feinberg School of Medicine and the Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Ill. Electronic address: apaller@northwestern.edu.
2
Dermatology Branch, National Institute of Arthritis and Musculoskletal and Skin Diseases, Bethesda, Md.
3
Dermatology and Infectious Disease, Northwestern University Feinberg School of Medicine and the Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Ill.
4
Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.
5
Department of Dermatology, University of California, San Francisco, Calif.
6
Dermatology, University of California, San Diego, Calif.
7
Dermatology, University of Muenster, Munster, Germany.
8
Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, National Children's Research Centre and Trinity College, Dublin, Ireland. Electronic address: irvinea@tcd.ie.

Erratum in

Abstract

As an interface with the environment, the skin is a complex ecosystem colonized by many microorganisms that coexist in an established balance. The cutaneous microbiome inhibits colonization with pathogens, such as Staphylococcus aureus, and is a crucial component for function of the epidermal barrier. Moreover, crosstalk between commensals and the immune system is now recognized because microorganisms can modulate both innate and adaptive immune responses. Host-commensal interactions also have an effect on the developing immune system in infants and, subsequently, the occurrence of diseases, such as asthma and atopic dermatitis (AD). Later in life, the cutaneous microbiome contributes to the development and course of skin disease. Accordingly, in patients with AD, a decrease in microbiome diversity correlates with disease severity and increased colonization with pathogenic bacteria, such as S aureus. Early clinical studies suggest that topical application of commensal organisms (eg, Staphylococcus hominis or Roseomonas mucosa) reduces AD severity, which supports an important role for commensals in decreasing S aureus colonization in patients with AD. Advancing knowledge of the cutaneous microbiome and its function in modulating the course of skin disorders, such as AD, might result in novel therapeutic strategies.

KEYWORDS:

Atopic dermatitis; Staphylococcus aureus; biotherapy; commensal; host-microbiome interaction; immune regulation; microbiome

PMID:
30476499
DOI:
10.1016/j.jaci.2018.11.015
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