Skin Microbiome Compositional Changes in Atopic Dermatitis Accompany Dead Sea Climatotherapy

Brandwein, Michael; Fuks, Garold; Israel, Avigail; Sabbah, Farid; Hodak, Emmilia; Szitenberg, Amir; Harari, Marco; Steinberg, Doron; Bentwich, Zvi; Shental, Noam; Meshner, Shiri

doi:10.1111/php.13119

Cited by 21 publications

(31 citation statements)

References 39 publications

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“…The community composition was similar on AD LS and NLS, despite clinically differences between the two sample sites. No signi cant association was found with neither AD disease severity (SCORAD), nor carriage of loss-of-function FLG mutations, as previously reported for the bacterial community on AD skin [5,19]. The present study con rms, that the eukaryotic microbial richness is signi cantly greater on AD skin compared to healthy control skin [8,9].…”

Section: Discussionsupporting

confidence: 69%

Identification of Cutaneous Fungi and Mites in Adult Atopic Dermatitis: Analysis by Targeted 18S rRNA Amplicon Sequencing

Edslev

Andersen

Ingham

et al. 2020

Preprint

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Background: Atopic dermatitis (AD) patients have a changed skin bacterial community, with high abundance of Staphylococcus aureus associated with flairs, highlighting that microbial organisms may be important for disease exacerbation. Despite strong evidence of association between bacterial skin colonization and AD, very limited knowledge regarding the eukaryotic microbial community, including fungi and ectoparasites, in AD exists. In this study, we compared the skin and nasal eukaryotic microbial community between adult AD patients (n=55) and non-AD healthy controls (n=45) using targeted 18S rRNA amplicon sequencing. Analysis was based on the presence or absence of eukaryotic microorganisms. Results: The cutaneous composition of the eukaryotic microbial community and the alpha-diversity differed significantly between AD patients and non-AD individuals, with increased species richness on AD skin. Alpha-diversity and beta-diversity were similar on lesional and non-lesional skin of patients. The ectoparasite Demodex folliculorum and the yeast Geotrichum candidum were significantly more prevalent on the skin of AD patients. The prevalence of D. folliculorum on lesional skin was greater among patients recently treated with topical corticosteroid. Malassezia was one of the most frequently detected genera at all sites, with M. globosa and M. restricta being the most prevalent. M. restricta was overrepresented in the anterior nares of AD patients as compared to the non-AD control population. Conclusion: Significant differences in the eukaryotic microbial communities were found between AD patients and non-AD individuals, with the most striking finding being the significantly overrepresentation of D. folliculorum on AD skin. Whether D. folliculorum can contribute to skin inflammation in AD needs further investigation.

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Section: Discussionsupporting

confidence: 69%

Identification of Cutaneous Fungi and Mites in Adult Atopic Dermatitis: Analysis by Targeted 18S rRNA Amplicon Sequencing

Edslev

Andersen

Ingham

et al. 2020

Preprint

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“…These findings indicate that AD pathogenesis has an impact on the overall skin microbiota, comprising staphylococcal species, independent of the presence of eczema. The presence of a universal bacterial community within AD skin sites has also previously been suggested [ 8 , 11 ], and Brandwein et al found that increasing AD severity, rather than the presence or absence of lesions, was most important regarding changes in bacterial community within AD skin compared to healthy skin [ 11 ]. The present study of species-level characterization of Staphylococcus further supports this theory.…”

Section: Discussionmentioning

confidence: 90%

“…Yet, reduced alpha diversity may not be universal, but depend on S. aureus skin colonization [ 4 , 6 ] and the microenvironmental skin conditions, such as moisture and sebum content [ 7 , 8 ]. Some studies have found that alpha diversity is significantly reduced on lesional compared to non-lesional skin [ 9 , 10 ] whereas other have found no difference in alpha diversity between the two skin sites [ 5 , 11 ]. These contradictory results may suggest a continuous transition between lesional and non-lesional skin within AD patients.…”

Section: Introductionmentioning

confidence: 99%

Staphylococcal Communities on Skin Are Associated with Atopic Dermatitis and Disease Severity

et al. 2021

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The skin microbiota of atopic dermatitis (AD) patients is characterized by increased Staphylococcus aureus colonization, which exacerbates disease symptoms and has been linked to reduced bacterial diversity. Skin bacterial communities in AD patients have mostly been described at family and genus levels, while species-level characterization has been limited. In this study, we investigated the role of the bacteria belonging to the Staphylococcus genus using targeted sequencing of the tuf gene with genus-specific primers. We compared staphylococcal communities on lesional and non-lesional skin of AD patients, as well as AD patients with healthy controls, and determined the absolute abundance of bacteria present at each site. We observed that the staphylococcal community, bacterial alpha diversity, and bacterial densities were similar on lesional and non-lesional skin, whereas AD severity was associated with significant changes in staphylococcal composition. Increased S. aureus, Staphylococcus capitis, and Staphylococcus lugdunensis abundances were correlated with increased severity. Conversely, Staphylococcus hominis abundance was negatively correlated with severity. Furthermore, S. hominis relative abundance was reduced on AD skin compared to healthy skin. In conclusion, various staphylococcal species appear to be important for skin health.

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“…Importantly, the AD group consisted of infants who not necessarily had developed AD or had active disease at the sampling time-points, which very well can influence the results. S. aureus was not identified in any of the skin samples (36), despite the fact that S. aureus is frequently detected on antecubital and popliteal fossa skin regions in older children and adults with AD (8,10). Although this could indicate that S. aureus colonization at the antecubital and popliteal fossa is not an essential marker for AD during disease development in the first year of life, culture-based analysis has indicated the opposite (37).…”

Section: Box 2 Diversity and Taxonomy Analysismentioning

confidence: 99%

“…Furthermore, patients with AD have an increased burden of Staphylococcus aureus skin colonization, which is associated with disease severity and exacerbation (4)(5)(6)(7)(8). Within recent years, where it has become possible to examine complete microbial communities using advanced DNA sequencing technologies, it is evident that cutaneous S. aureus is associated with decreased bacterial diversity on AD skin (8)(9)(10)(11)(12)(13). The aim of this review is to provide an overview of the recent literature on the skin microbiome as well as microbe-host interactions in AD.…”

mentioning

confidence: 99%

Skin Microbiome in Atopic Dermatitis

Edslev

Agner²,

Andersen³

2020

Acta Derm Venereol

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This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Acta Derm Venereol 2020; 100: adv00164 Centenary theme section: ATOPIC DERMATITIS SIGNIFICANCE Atopic dermatitis is a common skin disease characterized by dry and itchy skin with eczema flares. The disease is associated with changes in the skin microbiota, which constitutes all microorganisms present on the skin surface. The greatest difference is due to increased abundance of Staphylococcus aureus, a bacterium that can cause skin infections and probably contributes to aggravation of the disease. This review aims to provide an overview of recently published literature regarding changes in the skin microflora in atopic dermatitis and its association with disease severity and exacerbation. Atopic dermatitis is a common inflammatory skin disease with a complex pathogenesis that includes imbalanced immune system signalling, impaired skin barrier and enhanced Staphylococcus aureus skin colonization. The skin bacterial communities are characterized by increasing abundance of S. aureus, leading to reduced diversity compared with the bacterial communities on healthy skin, and increasing disease severity. In contrast, fungal communities are richer and more diverse on the skin of patients with atopic dermatitis, although distribution of the most common species is similar in patients and controls. Filaggrin deficiency in atopic dermatitis skin might be related to the enhanced skin colonization by S. aureus. In addition, S. aureus expressing variant virulence factors have been shown to elicit atopic dermatitis-like phenotypes in mice, indicating that specific S. aureus strains can induce flare-ups. This review aims to provide an overview of the recent literature on the skin microbiome in atopic dermatitis.

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Skin Microbiome Compositional Changes in Atopic Dermatitis Accompany Dead Sea Climatotherapy

Cited by 21 publications

References 39 publications

Identification of Cutaneous Fungi and Mites in Adult Atopic Dermatitis: Analysis by Targeted 18S rRNA Amplicon Sequencing

Identification of Cutaneous Fungi and Mites in Adult Atopic Dermatitis: Analysis by Targeted 18S rRNA Amplicon Sequencing

Staphylococcal Communities on Skin Are Associated with Atopic Dermatitis and Disease Severity

Skin Microbiome in Atopic Dermatitis

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