Microbiome and pediatric atopic dermatitis

Powers, Claire E.; McShane, Diana B.; Gilligan, Peter H.; Burkhart, Craig N.; Morrell, Dean S.

doi:10.1111/1346-8138.13072

Cited by 65 publications

(75 citation statements)

References 55 publications

(54 reference statements)

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“…Barrier dysfunction, inflammation, and microbes contribute to the pathogenesis of AD, and the relationship between AD and microbes is well established . While few healthy individuals are colonized with Staphylococcus aureus , 70% of patients with AD are colonized at lesional sites .…”

Section: Discussionmentioning

confidence: 99%

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The infantile cutaneous microbiome: A review

Schoch

Monir

Satcher

et al. 2019

Pediatric Dermatology

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Recent focus on the neonatal intestinal microbiome has advanced our knowledge of the complex interplay between the intestinal barrier, the developing immune system, and commensal and pathogenic organisms. Despite the parallel role of the infant skin in serving as both a barrier and an interface for priming the immune system, large gaps exist in our understanding of the infantile cutaneous microbiome. The skin microbiome changes and matures throughout infancy, becoming more diverse and developing the site specificity known to exist in adults. Delivery method initially determines the composition of the cutaneous microbiome, though this impact appears transient. Cutaneous microbes play a critical role in immune system development, particularly during the neonatal period, and microbes and immune cells have closely intertwined, reciprocal effects. The unique structure of newborn skin influences cutaneous microbial colonization and the development of dermatologic pathology. The development of the infantile skin barrier and cutaneous microbiome contributes to future skin pathology. Atopic dermatitis flares and seborrheic dermatitis have been linked to dysbiosis, while erythema toxicum neonatorum is an immune response to the establishment of normal bacterial skin flora. Physicians who care for infants should be aware of the impact of the infantile skin microbiome and its role in the development of pathology. A better understanding of the origin and evolution of the skin microbiome will lead to more effective prevention and treatment of pediatric skin disease.

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Section: Discussionmentioning

confidence: 99%

“…While few healthy individuals are colonized with Staphylococcus aureus , 70% of patients with AD are colonized at lesional sites . During AD flares, cutaneous microbial diversity has been shown to decrease remarkably, with predominance of S epidermidis , S aureus , and Malassezia . These changes normalize after successful treatment .…”

Section: Discussionmentioning

confidence: 99%

The infantile cutaneous microbiome: A review

Schoch

Monir

Satcher

et al. 2019

Pediatric Dermatology

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“…As described earlier, AMPs are key to preventing S. aureus colonization [98–100, 116, 117]. The isolation of commensal strains that produce protective AMPs has been used to assess the effects of AMP replacement on S. aureus colonization.…”

Section: Discussionmentioning

confidence: 99%

“…Antimicrobial peptides (AMPs) play a key role in cutaneous immunity [25, 98–100] and are secreted by keratinocytes. AMPs can be constitutively active, while others are induced by infection to combat microbes.…”

Section: Control Of Staphylococcal Colonization Of Skin By Antimicrobmentioning

confidence: 99%

Staphylococcal Biofilms in Atopic Dermatitis

Gonzalez

Myers

Herr

et al. 2017

Curr Allergy Asthma Rep

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Purpose of Review Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is a major public health burden worldwide. AD lesions are often colonized by Staphylococcus aureus and Staphylococcus epidermidis. An important aspect of Staphylococcus spp. is their propensity to form biofilms, adhesive surface-attached colonies that become highly resistant to antibiotics and immune responses, and recent studies have found that clinical isolates colonizing AD skin are often biofilm-positive. Biofilm formation results in complex bacterial communities that have unique effects on keratinocytes and host immunity. This review will summarize recent studies exploring the role of staphyloccocal biofilms in atopic dermatitis and the implications for treatment. Recent Findings Recent studies suggest an important role for biofilms in the pathogenesis of numerous dermatologic diseases including AD. S. aureus biofilms have been found to colonize the eccrine ducts of AD skin, and these biofilms influence secretion of keratinocyte cytokines and trigger differentiation and apoptosis of keratinocytes. These activities may act to disrupt barrier function and promote disease pathogenesis as well as allergen sensitization. Summary Formation of biofilm is a successful strategy that protects the bacteria from environmental danger, antibiotics, and phagocytosis, enabling chronic persistence in the host. An increasing number of S. aureus skin isolates are resistant to conventional antibiotics, and staphylococcal biofilm communities are prevalent on the skin of individuals with AD. Staphylococcal colonization of the skin impacts skin barrier function and plays multiple important roles in AD pathogenesis.

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“…The skin barrier defect itself induces or interacts with immunological dysregulation, leading to cutaneous inflammation. Environmental factors, including microbiomes, are also involved in the pathogenesis of AD …”

Section: Introductionmentioning

confidence: 99%

Phenotypes of atopic dermatitis identified by cluster analysis in early childhood

Seo

Yoon

Jung

et al. 2018

The Journal of Dermatology

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Atopic dermatitis is a chronic, relapsing, inflammatory skin disease that usually appears in early childhood and develops into a heterogeneous disease during childhood. The clinical course and treatment for atopic dermatitis can differ according to its phenotype and/or endotype. This study aimed to identify clinical phenotypes of atopic dermatitis in early childhood. Data were obtained from 572 children under 3 years of age with atopic dermatitis. Cluster analysis applied to 11 variables, and we identified four clusters of atopic dermatitis. Children in cluster A (n = 141) had early‐onset atopic dermatitis with high blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to food allergens. Children in cluster B (n = 218) had early‐onset atopic dermatitis with low blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to both food and inhalant allergens. Children in cluster C (n = 53) had early‐onset atopic dermatitis with high C‐reactive protein levels and white blood cell counts. Children in cluster D (n = 160) had middle‐onset atopic dermatitis with high serum total immunoglobulin E and rates of sensitization to inhalant allergens. Cluster A had the highest Scoring for Atopic Dermatitis and transepidermal water loss values. Age at onset, age at diagnosis, white blood cell count, eosinophil count, C‐reactive protein and serum total immunoglobulin E level were the strongest predictors of cluster assignment. Analysis of these six variables alone resulted in correct classification of 95.5% of the subjects. These results support the heterogeneity of atopic dermatitis, even in early childhood.

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Microbiome and pediatric atopic dermatitis

Cited by 65 publications

References 55 publications

The infantile cutaneous microbiome: A review

The infantile cutaneous microbiome: A review

Staphylococcal Biofilms in Atopic Dermatitis

Phenotypes of atopic dermatitis identified by cluster analysis in early childhood

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