Significant Changes in the Skin Microbiome in Patients with Chronic Plaque Psoriasis after Treatment with Narrowband Ultraviolet B

Assarsson, Malin; Duvetorp, Albert; Dienus, Olaf; Söderman, Jan; Seifert, Oliver

doi:10.2340/00015555-2859

Cited by 56 publications

(50 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may facilitate early colonization with pathogenic bacteria ( Staphylococcus aureus ), favouring T helper (Th)2/Th17 as is postulated in atopic dermatitis. Environmental factors, including ultraviolet ( UV ) radiation may also directly influence the cutaneous microbiome and consequently T‐cell responses . Antimicrobial peptides ( AMP s), Toll‐like receptors ( TLR s) and peptidoglycan recognition proteins ( PGRP s) can also modulate bacterial colonization and function .…”

Section: Discussionmentioning

confidence: 99%

“…Environmental factors, including ultraviolet (UV) radiation may also directly influence the cutaneous microbiome and consequently T-cell responses. 30,31,65 Antimicrobial peptides (AMPs), Toll-like receptors (TLRs) and peptidoglycan recognition proteins (PGRPs) can also modulate bacterial colonization and function. 50 In terms of psoriasis, modulation of the cutaneous microbiome may be possible via (1) UV radiation, (2) anti-interleukin (IL)-17/23 systemic therapy, 66 (3) microbial regulation of angiogenesis, 67 (4) translocation or modulation of gut bacteria, [68][69][70][71][72] (5) modulation of hormone production, 73 (6) altered AMP/ TLR expression and/or direct application of protective bacterial strains.…”

Section: Discussionmentioning

confidence: 99%

“…A subset of patients underwent repeat swabbing during treatment. Exclusion criteria included use of antibiotics (systemic and/or topical) in the 6 months prior to the study and solarium use (healthy controls) or ultraviolet radiation therapy (patients with psoriasis) in the 4 weeks prior to the study, given the effects of ultraviolet radiation on the microbiome . Healthy controls with a first‐degree relative diagnosed with psoriasis were also excluded from participation.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis

et al. 2019

View full text Add to dashboard Cite

Summary Background The treatment of psoriasis has been revolutionized by the development of biologic therapies. However, the pathogenesis of psoriasis, in particular the role of the cutaneous microbiome, remains incompletely understood. Moreover, skin microbiome studies have relied heavily on 16S rRNA sequencing data in the absence of bacterial culture. Objectives To characterize and compare the cutaneous microbiome in 20 healthy controls and 23 patients with psoriasis using metagenomic analyses and to determine changes in the microbiome during treatment. Methods Swabs from lesional and nonlesional skin from patients with psoriasis, and from controls matched for site and skin microenvironment, were analysed using both 16S rRNA sequencing and traditional culture combined with mass spectrometry (MALDI‐TOF) in a prospective study. Results Psoriasis was associated with an increased abundance of Firmicutes and a corresponding reduction in Actinobacteria, most marked in lesional skin, and at least partially reversed during systemic treatment. Shifts in bacterial community composition in lesional sites were reflected in similar changes in culturable bacteria, although changes in the microbiota over repeated swabbing were detectable only with sequencing. The composition of the microbial communities varied by skin site and microenvironment. Prevotella and Staphylococcus were significantly associated with lesional skin, and Anaerococcus and Propionibacterium with nonlesional skin. There were no significant differences in the amount of bacteria cultured from the skin of healthy controls and patients with psoriasis. Conclusions Shifts in the cutaneous microbiome in psoriasis, particularly during treatment, may shed new light on the pathogenesis of the disease and may be clinically exploited to predict treatment response. What's already known about this topic? Alterations in the composition of the cutaneous microbiome have been described in psoriasis, although methodological differences in study design prevent direct comparison of results. To date, most cutaneous microbiome studies have focused on 16S rRNA sequencing data, including both living and dead bacteria. What does this study add? This prospective observational study confirms that changes in the composition of the cutaneous microbiome, detected by 16S rRNA sequencing, are consistent with those identified by bacterial culture and mass spectrometry. The changes in the microbiome during antipsoriasis therapy should be further investigated to determine whether these represent potential novel biomarkers of treatment response. What is the translational message? Characterization of cutaneous microbiota may ultimately move into the clinic to help facilitate treatment selection, not only by optimizing currently available treatments, but also by identifying new therapeutic targets.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Previous studies have indicated that, in patients with psoriasis, the serum levels of 25-hydroxyvitamin D increase in response to NB-UVB treatment, and there is a correlation between this increase and the number of therapy sessions [23]. Moreover, changes in the skin microflora following UVB treatment may be related to treatment response [24]. These findings thus indicate that the effectiveness and safety of phototherapy on psoriasis may depend on a complex interaction of immunological and metabolic mechanisms.…”

Section: Background and Rationalementioning

confidence: 90%

Our Choice: study protocol for a randomized controlled trial for optimal implementation of psoriasis treatment by the integration of Chinese and western medicine

Sun

Zhou

Wei

et al. 2020

Trials

View full text Add to dashboard Cite

Background: Plaque psoriasis is a refractory inflammatory skin disease. The common therapies used to treat plaque psoriasis in traditional Chinese medicine (TCM) and western medicine (WM) have distinct characteristics and advantages. Although a combination of TCM and WM therapies, adjusted to the clinical situation, is widely used, there are no systematic studies on the hierarchical selection of this treatment combination based on the severity of skin lesions. We therefore designed a randomized clinical trial to focus on the sequence of internal and external treatments of TCM in patients with mild-to-moderate plaque psoriasis and to optimize the integration of Chinese and western medicine for the treatment of patients with severe plaque psoriasis, thereby achieving high-level clinical evidence and establish treatment norms for the integrated use of Chinese and western medicines. Methods: In this proposed multicenter, single-blinded, randomized controlled trial, 108 patients with mild-tomoderate plaque psoriasis will be randomly assigned to two groups in a 1:1 ratio to receive either internal or external TCM treatment, and 270 patients with severe plaque psoriasis will be randomly assigned to three groups in a 1:1:1 ratio to receive treatment with TCM or WM, or TCM + WM. All enrolled patients will receive 8 weeks of treatment. Follow-up assessments will be done 8 weeks after the treatment. The primary outcome of this study is the evaluation of efficacy and relapse rate, based on the Psoriasis Area and Severity Index, and the secondary outcome measures include determination of the affected body surface area, physician's global assessment, pruritus scores (determined using a visual analog scale), TCM symptom score, Dermatology Life Quality Index, patientreported quality of life score and incidence of serious adverse events.

show abstract

“…Successful therapies for psoriasis, such as balneotherapy and narrow-band ultraviolet B radiation, have been associated with alterations in the skin microbiota. 53 Studies of strategies to alter gut microbiomes of patients with psoriasis are underway. These include a randomized, placebocontrolled trial of FMT into the small intestine of patients with psoriatic arthritis or active peripheral disease that has not responded to methotrexate.…”

Section: Inflammatory Disorders Outside the Gastrointestinal Tract Psmentioning

confidence: 99%

Fecal Microbial Transplantation for Diseases Beyond Recurrent Clostridium Difficile Infection

D’Haens¹,

Jobin

2019

Gastroenterology

View full text Add to dashboard Cite

As microbiome research has moved from associative to mechanistic studies, the activities of specific microbes and their products have been investigated in the development of inflammatory bowel diseases, cancer, metabolic syndrome, and neuropsychiatric disorders. Findings from microbiome research have already been applied to the clinic, such as in fecal microbiota transplantation for treatment of recurrent Clostridium difficile infection. We review the evidence for associations between alterations in the intestinal microbiome and gastrointestinal diseases and findings from clinical trials of fecal microbiota transplantation. We discuss opportunities for treatment of other diseases with fecal microbiota transplantation, based on findings from small clinical and preclinical studies.

show abstract

Significant Changes in the Skin Microbiome in Patients with Chronic Plaque Psoriasis after Treatment with Narrowband Ultraviolet B

Cited by 56 publications

References 54 publications

Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis

Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis

Our Choice: study protocol for a randomized controlled trial for optimal implementation of psoriasis treatment by the integration of Chinese and western medicine

Fecal Microbial Transplantation for Diseases Beyond Recurrent Clostridium Difficile Infection

Contact Info

Product

Resources

About