Association of Disease Severity With Skin Microbiome and Filaggrin Gene Mutations in Adult Atopic Dermatitis

Abstract

IMPORTANCE Skin microbiome correlates with disease severity for lesional and nonlesional skin, indicating a global influence of atopic dermatitis (AD). A relation between skin microbiome and filaggrin gene (FLG) mutations proposes a possible association between skin microbiome and host genetics. OBJECTIVES To assess skin and nasal microbiome diversity and composition in patients with AD and compare with healthy controls, and to investigate the microbiome in relation to disease severity and FLG mutations in patients with AD. DESIGN, SETTING, AND PARTICIPANTS An observational case-control study of 45 adult healthy controls and 56 adult patients with AD was carried out from January 2015 to June 2015 in a tertiary referral center,

Skin Microbiome Compositional Changes in Atopic Dermatitis Accompany Dead Sea Climatotherapy

“…Over the past few years, a plethora of microbiome studies have been published elucidating different aspects of the skin microbiome in AD. The microbiome of pediatric AD skin is different than that of adult AD skin , yet microbial community diversity has been anticorrelated with disease state in pediatric patients , and subsequently in adult AD skin . Our cohort, consisting of both pediatric and adult AD patients, exhibited the same traits (Fig.…”

The influence of treatment in alpine and moderate maritime climate on the composition of the skin microbiome in patients with difficult to treat atopic dermatitis

“…The SA‐EASI score decreased from a median of 39.0 (IQR 18.7‐59.3) to 2.6 (IQR 0.3‐6.2) and 40.8 (IQR 22.2‐52.8) to 12.0 (IQR 3.6‐22.1) after six‐week treatment in alpine climate and moderate maritime climate, respectively . Literature shows a positive correlation between the abundance of Staphylococcus , in particular S aureus , and disease severity in patients with AD . A decrease in disease severity also leads to higher bacterial diversity .…”

“…While the skin barrier and the immune system were the most important factors in AD aetiology, the role of the skin microbiome recently gained more attention due to development of new molecular methods . The skin microbiome is in constant interaction with the skin barrier and immune system, reinforcing the process of inflammation . The skin in AD is characterized by an overgrowth of Staphylococcus aureus and analysis of the skin microbiome in different disease states of AD showed a correlation between the abundance of S aureus and disease severity, with a higher load during disease flares .…”

Identification of a unique Staphylococcus aureus ribosomal signature in severe atopic dermatitis

“…Its prevalence on the skin increases with disease severity when examined using both culture‐dependent and culture‐independent methods . Microbiome studies, targeting the gene encoding bacterial 16S ribosomal RNA (rRNA), have shown that microbial diversity is inversely correlated with disease stage in both adults and children, and also with the overall proportion of Staphylococcus species in children . This trend is reversed with treatment …”